Serious risks are associated with continuing game play immediately after incurring a concussion, yet 91探花 researchers found that many young female soccer players do just that.

Dr. John O鈥橩ane, 91探花professor of orthopedics and sports medicine, and Dr. Melissa Schiff, professor of epidemiology and director of education at the Harborview Injury Prevention and Research Center, had parents make weekly online reports about any concussion symptoms their daughters experienced. They determined that a majority of players stayed on the field after experiencing concussion symptoms, and half never sought medical care.

The findings are reported Jan. 20 in. The study was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

鈥淯nlike a sprained ankle, concussion symptoms like a headache or dizziness often don鈥檛 physically prevent an athlete from continuing play, even though they鈥檙e putting themselves at risk by doing so,鈥� O鈥橩ane said.

Part of the problem may be that many concussed players don鈥檛 recognize symptoms. Concentration problems, headache, and dizziness were the most commonly reported symptoms in the study. More obvious symptoms, such as loss of consciousness, were least common.

Playing through concussion makes people more vulnerable to getting hit again, and having longer and more severe symptoms. A second blow can cause a rare condition known as second-impact syndrome, which can result in severe injury or death. Second-impact syndrome typically occurs in people under 20, O鈥橩ane said.

He and Schiff found a higher rate of concussion among middle school soccer players than has been reported among high school and college soccer players.

鈥淵oung athletes who get a concussion tend to underreport or minimize it because they don鈥檛 want to be taken out of play,鈥� Schiff said. 鈥淯nless they tell their coach about it, coaches often aren鈥檛 aware of what happened.鈥�

Luckily for Kristina Serres, a high school soccer player, her coach noticed she was feeling disoriented after back-to-back impacts and took her off the field immediately.

鈥淚 felt dizzy and disoriented, and was wobbling around,鈥� Serres said. 鈥淢y mom said I was slurring my words and would stop in the middle of what I was saying.鈥�

The next day, she went to the 91探花Medicine Sports Medicine Center, where O鈥橩ane diagnosed a concussion and prescribed rest.

Serres had experienced two types of head blows common in soccer: a collision with another player and redirecting the ball with her head. Schiff and O鈥橩ane found that, among study participants, more than half received concussions from contact with another player, and 30 percent occurred when players headed the ball.

Findings are mixed about whether heading causes concussion. The researchers speculated that heading may pose a greater risk to the middle school players due to factors related to their development, such as less neck strength and less mature brains, and poorer heading technique.

鈥淚t may be beneficial to teach proper heading techniques to younger players, and there may be situations where those players shouldn鈥檛 head the ball,鈥� O鈥橩ane said.

Schiff and O鈥橩ane emphasized the crucial role education plays in preventing concussed players like Serres from returning to the game and reinjuring themselves.

鈥淲e need more education for children, as well as parents and coaches, about what a concussion is and what the consequences can be if it isn鈥檛 taken seriously,鈥� Schiff said.

Note to reporters: A copy of the JAMA Pediatrics paper is available to the news media at

Note to readers: The citation for the scientific paper is: JAMA Pediatr. 2014; doi: 10.1001/jamapediatrics.2013.4518.

Last weekend, 14-year-old Samantha spent yet another day in a hospital, but this visit was different. This time she got to be the nurse, rather than the patient.

Samantha experienced the world of a nurse in a neonatal intensive care unit (NICU) at the 91探花Medical Center 鈥� her dream career, said mother Mary.

Hospital stays characterize Samantha鈥檚 long-winded battle with a heart condition. She has undergone countless surgeries and recovered from two strokes that impaired her speech and motor abilities. Samantha is drawn to nursing, she said, because of all the nurses who have helped make her hospital visits easier and more comforting.

When assistant nurse manager Lori Chudnofsky heard about Samantha鈥檚 wish, she was motivated to make it reality. She and other NICU nurses prepared for a week before Samantha鈥檚 visit.

鈥淲e really appreciate their creativity and willingness to make it work,鈥� said Angela Geiss, regional co-director for Make-A-Wish Washington. 鈥淭his was the first time I鈥檇 ever seen a child have a wish like that, and the nurses did an excellent job making Samantha feel welcomed and loved.鈥�

On her special day, Samantha was taught how to hold and change a baby, and listen to its heart. She took a class that involved activities like journaling and play therapy designed to support siblings of an infant in the NICU.

One highlight for Samantha was bottle-feeding Scarlett, the two-month-old daughter of NICU nurse Britany Sembower. The new mother also showed Samantha how to read the baby鈥檚 vital signs on a computer.

No detail was neglected in making Samantha鈥檚 experience as realistic as possible. She received an ID badge, scrubs and a stethoscope. A welcome sign greeted her at the entrance to the unit and 鈥淩N: Samantha!鈥� was written on the whiteboard in baby Scarlett鈥檚 temporary patient room. The nursing staff even made a potluck lunch because, as Chudnofsky said, 鈥渘urses love potlucks.鈥�

Mary, Samantha鈥檚 aunt Margaret and little sister Juistine tagged along for the day. Their presence made the experience richer for Samantha, and echoed the hospital鈥檚 commitment to patient- and family-centered care, Chudnofsky said.

Samantha鈥檚 visit wasn鈥檛 just a dream come true; it also provided inspiration for the nursing staff.

鈥淥f all the things Samantha could ask for, she wanted to be a nurse. For us nurses, that meant so much,鈥� Chudnofsky said. 鈥淓very work day is just a normal day to us, but actually we鈥檙e living a wish. Samantha鈥檚 presence reminded us how important our jobs are.鈥�

* Samantha鈥檚 last name has been withheld to protect her and her family鈥檚 privacy.

See KING 5鈥檚 coverage of Samantha鈥檚 story:

Sarah Lien was 24 when she was diagnosed with breast cancer, yet she was not unprepared for the news.

She had spent six years going from doctor to doctor to ask about being tested for cancer. They all told her she was too young to worry about it.

Lien suspected otherwise. Ever since she learned that her mother, 91探花School of Nursing alumna Barbara Hawkins, was first diagnosed with breast cancer at age 37, Lien wondered what her own chances were for getting cancer at a young age.

She found out in March 2010, after feeling a lump in her right breast during a self-exam. She received her first mammogram the next day, and shortly after was diagnosed with stage 3 breast cancer.

Lien learned at the that she has the BRCA2 breast cancer gene, inherited from her father鈥檚 side of the family. (Her mother and sister subsequently tested negative for the gene.) Several doctors she saw recommended a mastectomy, but were focused only on eradicating the cancer.

鈥淒octors told me that I couldn’t worry about my fertility or appearance, that I should only be concerned with longevity of life, but as a newly married woman who wants four children, I was concerned about those things,鈥� Lien said. 鈥淚 felt that no one knew what to do with a woman in her 20s asking about cancer.鈥�

She became the patient of Dr. Kristine Calhoun, a surgeon and breast specialist, and Dr. David Mathes, a plastic surgeon At 91探花Medical Center and the . 聽Calhoun is a 91探花associate professor of surgery in the Division of General Surgery, and Mathes is a 91探花associate professor of surgery, Division of Plastic Surgery.

After discussing treatment options with them at the SCCA , Lien opted for bilateral mastectomies, which is the removal of both breasts.

鈥淭he bilateral mastectomies made sense based on Sarah鈥檚 family history of breast cancer,鈥� Calhoun said. 鈥淚 supported her decision, and was struck by her desire to maintain her fertility. She was very, very upfront about her desire to have children. She wanted to do everything possible to beat her cancer so she could achieve that goal.鈥�

Mathes likewise listened to Lien鈥檚 concerns about how her body would look after surgery. He told her he would do his best to rebuild her breasts the way she wanted.

鈥淗onestly, I just wanted to look great in a bikini, and I wanted to feel comfortable with my body,鈥� Lien said. 鈥淚鈥檓 extremely happy with the results.鈥�

Lien remained optimistic throughout her experience. She said that she modeled her mother鈥檚 approach to overcoming the disease.

Their cancer journeys are interwoven. Hawkins was diagnosed with breast cancer again in 2008, and for a third time in 2010, after which she chose to have a double mastectomy. Last October, Hawkins was diagnosed with stage 4 bone disease.

Mother and daughter have taken turns supporting each other through diagnosis, radiation, chemotherapy, surgery, and recovery. When Hawkins went through radiation, Lien had a card waiting for her at the hospital five days a week for six weeks, the duration of her treatment.

鈥淭here is a special bond between Sarah and me because we have gone through cancer together,鈥� Hawkins said. 鈥淲e know what each other is thinking and feeling.鈥�

Hawkins is receiving bone-strengthening treatment and takes oral chemotherapy, yet still works full-time as a critical-care nurse. Lien is in remission and pregnant with her first child, a girl whose middle name will be Elizabeth, after both her and Hawkins鈥� middle name. Her due date is Nov. 20, Hawkins鈥� birthday.

鈥淐ancer affected every part of my life and my mother鈥檚 life, but blessings came out of our cancer journey: new friends, support from so many people, and my relationship with my mom has grown,鈥� Lien said. 鈥淐ancer has devastated our lives, but the struggles are well worth the blessings and knowledge that resulted. I wouldn鈥檛 wish cancer on anybody, but I鈥檓 happy with how it turned out. There is life after cancer.鈥�

Lien and Hawkins and the story of their family journey with breast cancer is scheduled for tonight, Friday, Oct. 18. In Seattle, the newscast appears at 6 p.m. on KING TV, channel 5, and is expected to be rebroadcast on KING-5 News.

The Exchange is part of the Affordable Care Act signed into law March 23, 2010, by President Obama. Under the new law, many previously uninsured people now qualify for health insurance. Medicaid also has expanded to accommodate more people. Coverage will begin Jan. 1 nationwide.

91探花Medicine created a plan for guiding patients at Harborview Medical Center, the 91探花 Medical Center, 91探花Neighborhood Clinics, Northwest Hospital and Valley Medical Center in signing up for health insurance. Financial counselors, social workers and other staff at each hospital are trained to help patients from all backgrounds learn what coverage they鈥檙e eligible for, work through the registration, and choose the plan that is best for them.

The Washington Healthplanfinder website was down, but that didn鈥檛 deter 91探花Medicine staff from helping enroll patients. Staff at Harborview helped patients begin enrollment over the phone. Harborview also has multiple mobile stations patients can visit. Also, staff from various departments are prepared to answer any questions patients have about expanded Medicaid or the Exchange.

鈥淚t鈥檚 helpful to have someone navigate you through the process,鈥� said Elise Chayet, Harborview’s associate administrator of planning. 鈥淓ven our security staff at Harborview are trained to help point people who have questions in the right direction.鈥�

鈥淲e are very committed to helping our patients enroll. Over 200 patients have already been scheduled for appointments with our navigators,鈥� said Debra Gussin, associate administrator of ambulatory and allied care services at Harborview.

The fact that the Healthplanfinder website was down didn鈥檛 keep patients from stopping by to enroll. Soavarin Jirasetpatana drove to Seattle from La Conner, Wash., to sign up for insurance on the day she became eligible.

Jirasetpatana said she first came to Harborview for surgery, and then for diabetes care.

鈥淚 always come to Harborview because I like the doctors here,鈥� Jirasetpatana said through her Thai interpreter. She came prepared with a bag full of documents she thought she might need. 聽Jodell Reed, a patient services specialist with Harborview Financial Counseling, guided Jirasetpatana through the process.

Rebecca Parker, a social worker at the Harborview Madison Clinic, spent months preparing to help patients navigate enrollment. The Madison Clinic provides medical care and social services for people living with HIV/AIDS. Many patients at the clinic now have access to health insurance for the first time, Parker said.

鈥淧eople now have increased access, which also means increased choices,鈥� Parker said. 鈥淲e can鈥檛 wait to help people sign up.鈥�

The 91探花Medicine web site has more info on for expanded Medicaid or one of the health exchange insurance plans.

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, published Sept. 16 in , found that participants experienced improved cognitive function and a decrease in perceived cognitive impairments, and also reported a higher quality of life. The study is one of few to examine the effects of cognitive rehabilitation on cancer survivors.

Cherrier and her research team held cognitive rehabilitation sessions for 28 people during a seven-week period. The sessions were held in a group setting.

鈥淭here鈥檚 a sense of connectedness that patients get with other patients who are struggling with a similar problem,鈥� Cherrier said. 鈥淭hey also get a chance to practice the skills we teach them while they鈥檙e in the group each week.鈥�

Cognitive rehabilitation is a therapy involving memory aids and skill-based tasks to improve memory and attention 鈥� similar to techniques used to treat patients with traumatic brain injury.

Chemotherapy and some anti-cancer medications 鈥� such as tamoxifen, which prevents the growth of breast cancer cells 鈥� have been associated with memory and attention problems informally referred to as 鈥渃hemo brain.鈥� Many cancer survivors are hesitant to take more medications after treatment, Cherrier said, and would rather find a different way to address any memory and attention problems.

Cognitive impairment is the second-most reported problem among cancer survivors, yet little research has been conducted to find effective treatments. Past studies have explored using medication to treat cognitive impairment in cancer survivors, but most have not demonstrated that drugs can treat these issues effectively.

The results of the recent study reflect emerging understanding of brain plasticity, the brain鈥檚 ability to recover from damage, Cherrier said.

鈥淧eople used to believe that you鈥檙e born with a certain number of brain cells which can鈥檛 be replaced after you reach a certain age,鈥� Cherrier said. 鈥淚n fact, what we鈥檙e finding is that you can make a difference in terms of your cognitive functioning. The brain is very plastic: You can significantly boost and improve your cognitive abilities.鈥�

The next phase of the research involves taking functional magnetic resonance imaging scans of cancer survivors鈥� brains to see which areas of the brain are activated during cognitive rehabilitation. Cherrier said she hopes to conduct a larger study of the therapy鈥檚 efficacy in the future.

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Those interested in participating in this research may call 206-667-7930 for more information.

This week the newest 91探花Medicine Sports Medicine Center opened its doors to the community.

The clinic, housed at the south end of Husky Stadium, relocated from its old spot next to Edmundson Pavillion. The move-out took only three days, but the project began in late 2010.

The new location 鈥� and spacious 30,000 square foot facility 鈥� makes coming to appointments and treatment sessions more convenient for patients, because their doctors, surgeons, physical therapists, radiologists, and other sports medicine specialists are now gathered underneath the same roof.

鈥淚鈥檓 extremely excited to work with this amazing group of physicians,鈥� said Dr. Mark Harrast, medical director of the new center.聽 鈥淥ur new location enables us to provide an even higher level of care using a collaborative, team-based approach.鈥� Harrast is a 91探花clinical associate professor of rehabilitation medicine and of orthopedics and sports medicine.

The new facility offers the same treatment and care options as the other three 91探花Medicine sports medicine clinics, as well as special services, including an expanded Physical Therapy Clinic and Sports Cardiology and Running Medicine programs. The center is home to a brand-new Sports Performance Center where injured athletes can undergo rehabilitation and healthy athletes can work on 鈥減rehab鈥� strategies to prevent sports injury and improve performance.

One of the features of the Exercise Performance Center is an anti-gravity treadmill. The treadmill works by decreasing an athlete鈥檚 body weight during running, tthereby taking pressure off the legs. Small cameras at the base of the treadmill allow runners to see their own stride on a large television screen as they run. The treadmill is used for rehabilitation after injury, as well as for training

Other therapies featured are platelet-rich plasma treatment for chronic tendon injuries, and musculoskeletal ultrasound for diagnosing muscle and tendon injuries, as well as treating these injuries with ultrasound-guided injections.

The specialists at the new center treat anyone with a passion for activity, from recreation enthusiasts to college athletes like the 91探花Huskies and professionals like the Seattle鈥檚 Seahawks and Mariners.

鈥淓ven though our physicians treat high-performing athletes, we are also here for the weekend warrior and the general public,鈥� said Harrast. 鈥淎nyone with activity-related pain, be it from hiking, gardening, golf, or running a marathon, is welcome to see us.鈥�

Other 91探花Medicine sports medicine care locations include Harborview Medical Center, the 91探花Medical Center at Roosevelt, and the Eastside Specialty Center in Bellevue.

The Sports Medicine Center at Husky Stadium is holding an open house for the general public from 1-3 p.m., Saturday, Oct. 19. Parking will be free. Come to the South Entrance of Husky Stadium and proceed up to the first floor.

As the weather gets warmer, Harborview Medical Center reports a significant increase in the number of children needing treatment because they fell from an open window. Each year between 3,000 and 5,000 children in the United States, most of them toddlers, will experience a window fall.

Dr. Brian Johnston, chief of pediatrics at Harborview and a researcher with Harborview鈥檚 Injury Prevention and Research Center, said the hospital receives about 50 pediatric window fall patients annually. About one-fourth of these children experience a serious head injury or permanent disability as a result of the fall.

Most window falls are caused by children falling against a window screen. Screens are not designed to support a child鈥檚 weight, and when the child makes contact with the screen, the screen pops out. Many people are unaware that window falls present a serious risk for children, or they blame the accident on lack of parental supervision.

鈥淧eople always want to blame the parents,鈥� Johnston said, 鈥渂ut the truth is most of the parents were observing appropriate supervision at the time of the accident. They may not realize that screens won鈥檛 support their child鈥檚 weight, or the child may approach the window too quickly for the parents to react in time.”

To reduce the risk of window falls, Johnston recommends these easy safety tips:

• Do not open windows more than four inches.
• Place a guard or stop in the window.
• Move furniture and boxes away from windows to discourage children from climbing on them to reach an open window.

Beginning May 1, Airlift Northwest will station a Turbo Commander aircraft in Juneau to allow the medical transport service to reach more people living in outlying rural communities in Southeast Alaska.

Airlift has served Southeast Alaska for over 30 years transporting critically ill or injured patients to specialty care in Anchorage or Seattle, and will continue this service. Airlift currently operates a Learjet, which has limitations landing in smaller communities due to shorter airport runways.

The Turbo Commander is better suited to land on shorter runways allowing improved access to the smaller community airports based in Gustavas, Haines, Hoonah, Kake, Prince of Wales Island and Skagway.

鈥淎irlift Northwest is dedicated to saving lives by providing pre-hospital emergency treatment on the ground and in the air,鈥� said Chris Martin, executive director. 鈥淚n response to requests for improved access to medical transport from providers in Southeast Alaska, we are pleased to offer this new service.鈥�

鈥淭he turboprop will allow us to access patients who, in the past, have had to make their way to an area where we could get them in the Learjet. Now we won鈥檛 see that delay,鈥� said Dr. Richard Utarnachitt, medical director for Airlift.

Patient care will be provided by two critical care nurses with current certifications in advanced skills for cardiac life support, pediatric life support, neonatal resuscitation and trauma care.

Airlift Northwest, an entity of 91探花Medicine, provides medical transport to critically ill and injured adults and children throughout the Pacific Northwest and beyond. It operates six bases in Washington and Alaska.

Airlift also announced recently that it will permanently base a Turbo Commander aircraft in Yakima to provide communities in Central Washington with improved access to urgent medical transport. Communities served by the Yakima-based crew include Wenatchee, Ellensburg, Omak, Moses Lake, the Tri-Cities, Sunnyside, Toppenish and other Central Washington locations.