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John: Concussion

The Challenge: A Fall From His Horse

John was enjoying a horseback ride on a ranch just north of Dallas, Texas, in November 2020 when, suddenly, his horse caught its hoof on something and took a tumble.

“I was wearing a helmet, but when I fell, I hit my chin really hard, which was unprotected,” says John. “I never lost consciousness, but I knew I had gotten a concussion right away.”

John is no stranger to concussions, previously having sustained three others, all from sports – high school football, college lacrosse, and a recreational game of squash.

This time around, his symptoms included:

  • Vision impairment
  • Fatigue

John’s Path to UPMC for Concussion Treatment

Upon sustaining his concussion, a friend of John’s mentioned she had heard good things about a doctor in Pittsburgh named Micky Collins. Already having made appointments with doctors in Dallas, however, John wanted to see those through and stay with his family in Dallas during his recovery.

After a month of consultations with doctors who advised him to sit, wait, and avoid stimuli like bright light and loud noise in order to heal, John still wasn’t getting better.

Unhappy with this advice, John took it upon himself to research and learn about his concussion. Eventually, he reached out to one of his family members who is an orthopaedic surgeon to see if they had any recommendations of a concussion doctor that could help him recover.

“I told him that I was willing to go anywhere in the country to see someone that he recommended, and the doctor he suggested was Dr. Collins,” says John. “Upon hearing this, I knew it couldn’t be a coincidence – out of the all the possible options, the same doctor was recommended to me twice.”

"Dr. Collins did his best to listen, understand my particular circumstances and personality type, and prescribe what would be best for me and my recovery. For that, I am deeply grateful." — John

The Solution: Telemedicine and Remote Treatment

Given the distance between Texas and Pennsylvania in the midst of the COVID-19 pandemic, John set up a telemedicine appointment with Michael “Micky” Collins, PhD, at the UPMC Sports Medicine Concussion Program. After just one meeting, John felt that he understood his concussion better than ever before.

He learned that he had sustained a vestibular concussion, a diagnosis he had not received from his prior consultations and visits with other doctors. A vestibular concussion impairs the balance center of the brain, causing trouble with balance, motion, and vision.

“Dr. Collins was so knowledgeable and really explained my concussion diagnosis to me,” says John. “Before meeting with him, I had no idea that there were six different types of concussions, let alone which type I had sustained.”

Unlike John’s previous doctors, Dr. Collins told him that rest and reduced stimuli was the exact opposite of what he needed. While a short rest period is sometimes helpful, research and patient outcomes show it takes more than that. An active treatment approach — one that forces the brain to readapt to stimuli — is key to making a full recovery.

“He informed me that anxiety and depression can often be associated with vestibular concussions and sitting in a dark room doing nothing can just exacerbate those side effects and create more problems,” says John. “Instead, he wanted me to get out of the house, throw myself back into work and exercise, and not really think about my concussion. He wanted me to go out and get back to life.”

The Results: Resuming His Active Lifestyle

After only two telemedicine appointments with Dr. Collins, John was back to his routine and feeling like himself again, without ever having to travel to Pittsburgh. While each patient’s experience is individualized and tailored to their specific goals, John was fortunate in that the guidance provided in only two check-ins helped him recover. Some concussion treatments may take longer or require partial in-person care.

“My experience with Dr. Collins was great, even though I have never met him in person,” says John. “Telemedicine allowed me to see a top-notch doctor like him from the comfort of my home, and I was able to avoid having to pay for travel, lodging, and other expenses. Plus, my prescribed treatment didn’t even feel like a treatment regimen – Dr. Collins encouraged me to get back to living my life.”

John is appreciative of the UPMC Sports Medicine Concussion Program and Dr. Collins’ expertise, which helped him get back on track.

“I only saw Dr. Collins twice, and at the first visit I felt that the level of care that I got was above what I was receiving from other providers in person,” says John. “Dr. Collins did his best to listen, understand my particular circumstances and personality type, and prescribe what would be best for me and my recovery. For that, I am deeply grateful.”