How many concussions are safe?

What exactly is a concussion?  It is the mildest form of brain injury and does not always involve loss of consciousness although it often does.  It usually occurs following a traumatic blow to the head, face, or neck although any impact that transfers to the forces to the head can cause a concussion.  A concussion can occur without any symptoms although the most common signs are headache, dizziness, and lack of awareness of surroundings.  A study also reports the following signs associated with concussion.

• Vacant stare (befuddled facial expression)
• Delayed verbal expression (slower to answer questions or follow instructions)
• Inability to focus attention (easily distracted and unable to follow through with normal activities)
• Disorientation (walking in the wrong direction, unaware of time, date, place)
• Slurred or incoherent speech (making disjointed or incomprehensible statements)
• Gross observable incoordination (stumbling, inability to walk tandem/straight line)
• Emotionality out of proportion to circumstances (appearing distraught, crying for no apparent reason)
• Memory deficits (exhibited by patient repeatedly asking the same question that has already been answered or inability to memorize and return three of three words and three of three objects for five minutes)
• Any period of loss of consciousness (coma, unresponsiveness to stimuli)

How many concussions are safe?  The short answer is the fewer the better with none being optimal  The importance of the brain cannot be overstated and should be protected from injury.  The long answer is well... long.  The lack of data and research makes clinicians hesitant to state a number.  Some sport teams have set limits but mostly out of fear of a lawsuit than from research.  It is difficult to compare concussions because no two are alike.  Complete recovery from a concussion is important to avoid cumulative injury from repeated concussions.  Current guidelines focus of symptom resolution before allowing athletes to return to play

Upstate New York: Aging Adults and Migration of the Young

As we grow older lots of things change.  Our hair falls out or turns gray as our bodies age.  Small everyday tasks leave us sore and aching.  More and more health problems surface and soon our list of medications is longer than a grocery list.  As communities age the need for healthcare, assisted living, and infrastructure increases.  This in turn places a burden on the tax base.  This is a normal turn of events; however, when the tax base begins to shrink questions and concerns are raised.
 
Upstate New York saw an enormous migration of young adults leaving New York in search of greener pastures.  According to "Flight of the Young Adults is Causing Alarm Upstate" an article published in the New York Times there was a 25% reduction statewide in adults age 24-35 between 1990 and 2004.  In the more rural counties the migration was even more pronounced.  The graph below shows census data comparing the median age of New York compared to the US.  Notice the median age of Upstate New York in particular.

For more information see the Graying of the Empire State

What does the future hold?  The smaller tax base has already strained local communities and school districts, but the news isn't all bad.  A little financial stress always helps to bring about creative ways to save money.  Communities are forced to cut out wasteful spending and to reprioritize to focus on the necessities.

Otsego County has been part of this drama with the pending sale of the Otsego Manor, and adult home operated since 1827.  Due to escalating costs and budget cuts the County is selling the home to the highest bidder.   For the latest news on the bidding see this recent article from The Daily Star.