Concussion: movies vs. reality

Our hero sinks back into the shadows, waiting for the night watchman to make his regular rounds. He doesn’t have to wait long. He swings with the butt of his pistol and renders the guard unconscious with a blow to the head. “Sweet dreams,” he says. “You’re gonna wake up with a wicked headache.”

Stop the video. For decades, good guys and bad guys (and girls, too) have been knocked out with a bop on the head, a sock to the chin or a quick karate chop. The movies’ all time knockout champ has to be super spy James Bond, who usually comes into consciousness bound and gagged for the next cliffhanger. The hapless detective on The Rockford Files was knocked out pretty much every episode of the TV show’s six-season run.   

We asked Dr. Kenneth Podell, a neuropsychologist and co-director of the Houston Methodist Concussion Center: Is it really possible to smack someone in the head and render them unconscious?

The short answer is yes, it is indeed possible, but the complications come after. “If you hit somebody hard enough with an object to cause unconsciousness, you could also be hitting them hard enough to break the skull,” Podell says. “It depends on the weapon … one with a large surface area (like a frying pan) dissipates the shock over a larger area, while a smaller weapon focuses the force and can easily fracture a skull.”

It doesn't take a big blow to result in a concussion that carries many long-term health effects Click To Tweet

Podell has seen many cases of people suffering long-term effects from concussion after receiving a blow much less violent than those usually depicted in movies. A person coming out of an unconscious episode, waking up as if from a nap, does not happen most of the time. “There’s a kernel of truth there but a blow substantial enough to cause unconsciousness is also very, very dangerous,” he says.

Let’s speed up the video a bit and check out this part: two combatants grapple fiercely in hand-to-hand combat, and the battle is at a deadlock. Suddenly, one uses an explosive head butt to stun his opponent and gain the upper hand.

“Again, this has a bit of truth to it as well … the front, top part of the skull is the thickest part and can theoretically be used as a weapon,” Podell explains. “But remember that’s also the other guy’s thick skull, so the butt-er needs to select a weak point on the butt-ee, like the bridge of the nose or the side of the head.”

Podell cautions that any kind of head injury has the potential to be very serious and have long-term complications. Concussion can cause dizziness, shaky balance, confusion, headaches and memory loss that can linger for weeks or even months. If you suspect you or someone you know may have had a concussion, please immediately seek medical care. 

Like many other physicians, Podell regularly sees things in movies that don’t really line up with real life. He tries to check his expertise at the door, he says, and suspends disbelief to enjoy the fantasy on screen.

My Fitbit is keeping me healthy

I’ve always been generally active, but I just ran to run. That’s good, don’t get me wrong, but I’ve found that when I have a goal in mind, I can push myself to run better, faster, longer.

The Fitbit craze is sweeping across Houston Methodist. All employees were given the opportunity to buy a discounted Fitbit and wow, have we jumped on it! It’s wonderful to see a community of people come together to proactively work towards being more active and also attempt to “beat our CEOs.” Amazingly, Houston Methodist employees are averaging nearly 8,200 steps a day.

Through this challenge I have been able to think more about the little stuff. How parking my car farther away from the office and walking a little more here and there can really add up. Here are a couple of other things I’ve learned from our Fitbit challenge:

Make it a challenge

My office has turned into an obstacle course. Do you have a multilevel building? Great! I work on the second level so I put my lunch on the third level and I use the bathroom on the first floor. When I go to grab my lunch or need to relieve myself, I take a little jog up and down the stairs. It’s a simple move that will really helps, especially, if you’re prone to a couple cups of green tea and have a small bladder, like myself.

Fitness trackers can make exercise more fun and help track progress toward health goals Click To Tweet

It takes the vagueness out of activity

The great thing about Fitbit is the little progress dots. You set a goal, you know where you are in reaching that goal, you know what you need to do and there’s an awesome light show when you reach your goal! Talk about accomplishment!

Make a game of it

You’ve probably heard of TV show drinking games where every time someone says a certain word, you have to drink. Take that concept and fit-i-nize it. For example: every time my phone rings, I stand up for the entire call.

Question yourself

Can you walk there? Then do it! Texas is a very car-centric state but we often drive 2 blocks to get somewhere when we could’ve easily walked. I understand Texas heat, believe me, but just take the time to ask yourself—can I walk there?

You vs. your goal

Every day you should try to meet, or even beat, your goal! As I get closer to finishing my goal, I find that I start walking more and more. If it’s bedtime and I’m 100 steps away, I will pace around the kitchen, walk around while brushing my teeth or do anything else to get those last 100 steps in.

Just buying a Fitibit won’t help you lose weight or become more active. You will still have to work at your goals, but a Fitbit—or any pedometer—might help to challenge you in a new way. 

The limitations of body mass index (BMI)

 166608586A few days ago a friend on Facebook reposted a cartoon of a woman declaring that according to the BMI chart, she was too short. For those who aren’t familiar, Body Mass Index, or BMI, is a simple measurement tool used to calculate height-to-weight ratio.

Some people argue that BMI is too simple a measurement. Is BMI still useful for someone concerned about their weight?

“It can be helpful as one factor to consider in determining chronic disease risk in the general population,” explained Chelsea VanDusen, a clinical dietitian at Houston Methodist Hospital.

She explained that other factors such as age, gender, past medical history, family history and lifestyle factors including diet, smoking and physical activity levels all play a part in helping to determine risk and must all be considered in order to have an accurate picture.

The limitation of BMI as Chelsea explained it is that it’s intended as a “measure of fatness” but doesn’t actually take body fat percentage into account. “It’s therefore skewed in individuals who are highly muscular or those who have muscle wasting,” she said.

BMI doesn’t take body fat percentage into account, making it a skewed metric Click To Tweet

For example, a bodybuilder – whose weight may be higher than normal due to increased muscle mass – may appear obese according to his BMI number. In comparison, an elderly person’s BMI number may appear in the healthy range (<27) even though they’ve had significant muscle loss.

166596238“In fact, elderly people may have increased mortality risk with a BMI of less than 22, whereas that is considered in the ‘healthy range’ for younger adults,” Chelsea said.

Another limitation of BMI is the fact that it does not differ between men and women even though men tend to have larger frames in addition to a more muscular build. So even though a man and a woman may have the same BMI, the woman would likely have a higher percentage of body fat than the male.

BMI also doesn’t take fat distribution into account.  For example, a person’s waist circumference can be used to determine their amount of visceral fat, which is located around vital internal organs and is often associated with increased levels of inflammation and chronic disease risk.

Why do people continue to use BMI as a measurement to determine how healthy someone is?

“While other measures of body fat including waist measurement, skin-fold measurements and bioelectrical impedance are useful, they tend to be more expensive, intrusive and/or difficult to standardize due to human error,” Chelsea explained.  “Therefore, BMI continues to be widely used.”

Regardless of your BMI number, remember – it’s only one piece of the puzzle. And unless you’re planning on growing a few more inches, the best way to reduce it is by eating better and getting some exercise

Want to see what your BMI is? Try the calculator below:

Why running is so important to me

I have been running since I can remember. I was on a track team by the time I was in 3rd grade and since then, I have been running regularly, both competitively and for leisure. Running is one thing that never leaves my life for an extended period of time. During busy weeks at work or home, I may not run as often, but I will always continue to run.

I want to share a few of the reasons why running is so important to me. The physical health benefits are obvious, but I wanted to include a few other benefits of running.

It’s a family affair

Ever since I was young, I remember coming to the kitchen for breakfast and seeing my dad coming home from his morning run. To me, he looked refreshed, instead of tired, and happier when he was running. When my wife and I were dating, running was an opportunity for us to talk and spend time together.

Today, it continues to be a great opportunity for me to be outside with my kids, especially since I can exercise and spend time with my kids. My daughter regularly asks to go with me. Sure I go a bit slower since her short legs can’t keep up, but it allows me to set an example to her, just as my father was a good example for me.

It’s simple

Unlike other forms of exercise, there is no need to purchase an expensive gym membership, any sort of equipment, or join a sports team. All you need are clothes and a pair of running shoes.

I like the simplicity of running. There's no need to purchase an expensive gym membership or any sort of… Click To Tweet

All the fancy running gear that people try to sell you like heart rate monitors and GPS watches can be useful tools, but I try not to let the gadgets get in the way of what I truly love, which is keeping my feet moving.

You’re outside

There is something refreshing about being outside, whether I am in the middle of a city, or out in a rural area. All the stresses and cares of daily life seem to fade away when I am running through the woods, just putting one foot in front of the other.

No matter how busy my day gets, I always try to make time for a run. There are hundreds of reasons to run, but for me the sociality, simplicity and just being outside are what keeps the passion for running alive.