Sentara Concussion Clinic grows rapidly

Laura Melgoza never saw it coming. A driver ran a red light and T-boned her SUV, colliding with the driver’s door. A curtain airbag whacked her on the side of her head. She didn’t lose consciousness, but after the hard collision, she was rattled. She already had a sharp headache, and the effects of the accident would be profound.

“I had a hard time processing what happened and answering questions,” she recalled about the first few minutes after the impact. An ambulance crew took her to Sentara Virginia Beach General Hospital’s trauma center. A computerized tomography scan, also called a CT scan, revealed no bleeding on the brain. She was back home in a few hours with a concussion, but her experience was just beginning.

“I started having intense headaches, dizziness and nausea,” she said about the classic symptoms of concussion. Three days later, her primary care physician referred Melgoza to the new Sentara Concussion Clinic program, which serves the Hampton Roads area of eastern Virginia. It was cathartic.

“The first day in therapy, I kind of broke down,” Melgoza said. “I manage a lot of stress in my job, and I have lived with multiple sclerosis for 27 years. The concussion just amplified my symptoms as daily tasks became more difficult.”

The effects of the concussion, and therapy that challenged balance and vision, were hard to tolerate at first. But twice-a-week sessions brought improvement in her symptoms. Nausea medication prior to therapy helped settle her stomach.

“I could not lie flat without vertigo,” she said. “Now I can lie flat without my head spinning. The exercises are helping my eyes and brain work together.”

Helping Melgoza recover through therapy

There are tiny crystals in the inner ear that help control balance. When a head trauma knocks them out of position, it can cause dizziness, light-headedness, and nausea. Therapy helps the crystals move slowly back into the proper position.

At 7:30 on a Tuesday morning, Physical Therapist Christina Guevara worked with Melgoza at the Sentara Therapy Center - Healthy Way. She took Melgoza’s head in her hands and laid her down quickly on a pillow, then gently turned her head to look at the floor.

“That wasn’t so bad,” Melgoza observed. “I couldn’t do this before without getting dizzy.”

Other exercises included walking on a padded bar on the floor, like a tight rope, while tossing a basketball in the air and catching it. She did the same thing stepping sideways. She played a form of whack-a-mole in her stocking feet, walking back and forth among small flashing lights on the floor, and touching them with her toes to change direction quickly, restore coordination, and get her brain to respond to visual cues.

“The team has been great,” Melgoza said of her Sentara providers.

A quickly growing program

“Concussions happen every day, to all kinds of people, and symptoms can appear immediately or develop later,” said Julie Nathaniel, manager of rehabilitation services for Sentara Therapy Centers in Virginia Beach. “Many people dismiss mild signs at first, and only seek help when dizziness, headaches, vomiting, or morning fatigue interfere with daily life.”

Patients may be referred to the Sentara Concussion Clinic by primary care providers, urgent care centers, emergency departments, or other healthcare professionals. Patients also have the option to self-refer by contacting the program directly.

Referral volume demonstrates a clear need. The program launched in January with 10 patient referrals. That number grew to 62 in February, and 58 in March. As providers in the community learn about the program, more are directing patients to early intervention, rather than letting them endure weeks of symptoms before seeking care.

Initial screenings are done by Sentara athletic trainers over the phone. They do a quick safety check to rule out any acute warning signs, then a detailed review of symptoms. The trainer uses the assessment to determine the next steps in care.

“Physical or speech therapists get involved depending on the assessment,” Nathaniel said. “They set up a treatment plan around the patient’s needs, and they can work with them in-person or through telehealth visits.”

1 in 4 Americans suffers a concussion

The American Brain Foundation estimates that one-in-four Americans suffer a concussion during their lives, or up to 3.6 million annually. These include sports and recreation injuries, vehicle crashes, and slip-and-fall incidents with head trauma. Concussions account for more than half of ER visits for kids between five and 18.

“Remember that a concussion is a mild traumatic brain injury, and proper care is important,” said Alexander Grunsfeld, M.D., medical director for Sentara Neurosciences and the Sentara Concussion Clinic. “Optimal recovery depends on early intervention, and a gradual return to normal activity, guided by the symptoms and clinical support.”

For the Sentara therapy team, the goal is helping patients to overcome the symptoms of concussion quickly and safely.

“We’re here to get you back into life,” Nathaniel said.