What is Talk and Die Syndrome?

It wil be on the cover of dozens of magazines over the next few weeks, with the loss of the beautiful, talented Natasha Richardson. Yet, it wasn't talked about as much when Sam Kinison died over a decade ago. He seemed to be handling a head-on collision fairly well, was talking to his brother, then the talk became confused, and then he died. Mrs. Neeson even told the ski instructor jokes about her mistake and fall, and apparently shoo'd away the idea of seeing a hotel doctor until she started to feel head pain. By then, the swelling in her brain had done more damage than could be repaired.

Our brains have no nerve endings to feel pain. When we get headaches, it's not the brain that is aching, it's the tissues around it, the muscles, the sinus cavities, and even the skullcap. The skull is constructed to provide a protective layer of bone around our brains, and there is also small space between the brain and the skull allowing for minor swellings in case of injury. But, when the swelling is too much, the tissue around the skull responds with pain. Some people have brain trauma that is so severe they don't realize it until something catastrophic happens. Brain injuries are often diagnosed well past the time when people can have full recovery.

In the last few years the show Mystery Diagnosis on Discovery Health, has featured several illnesses that people have survived that could have had dire consequences. One woman had brain fluids leaking from part of her skull. She tasted strange metallic flavors, but no doctor could find the issues she was having. Her head hurt especially when she was subject to pressure changes, like in airplanes or hiking. Any one of these flights could have killed her. It was her persistence to seek help that finally got her an answer, and required her undergoing multiple surgeries to patch this leak.

In another tale, a man had water in his ear, and would experience dizziness. After several years of issues, he found out that part of his brain had swelled so much it was leaking into other parts of his head. A young girl had an accident during her teen years, and only a decade or more later was given the news that her illness was due to a pituitary injury. Yet, sudden trauma can confuse us because our brains feel no pain. And, we are unable to tell people that we are experiencing brain injuries if we have no symptoms. People may notice us slurring our speech, or even responding slowly, yet we assume we are fine. In fact, we may be experiencing stroke.

There is a reason why ambulances are called to any car accident. If a person has hit her head on an airbag, a steering wheel, or even the back of her car seat, she may have some trauma that will not show up for days. EMT's are trained to ask specific questions, and to look into a victim's pupils to see the responses. If there is the slightest chance there is brain trauma, the victim will be taken to a hospital and given a CATscan, MRI, or even a test that measures epilepsy or sleep responses. They're not trying to bilk you, they're trying to ensure no injuries are hidden. Many people lose their lives weeks, months, or even years after an accident simply because they refused to go to a hospital.

There were no less than 20 emails to me in the hours that Natasha Richardson went into the hospital. No one was asking about gossip and silliness- they wanted to know how common it is to die from an accident as minor as a ski slope fall. I don't have numbers and stats on that, and I am sure the magazines and news wire services are going to do a substantial amount of reporting. I do know the under-reported incidents are very high since hospitals are no longer required to do autopsies after deaths. I also know that in the last thirty years, more men have died from brain related injuries simply because they do not go to the doctors as often as women do.

Talk and Die Syndrome is a common issue with brain trauma. The victim may have bumped his head on a shelf, or had something fall on him at work. For the next few hours he will appear to be fairly normal, but when he gets home from work, his wife will notice that he seems to be daydreaming, or that he seems to mispronounce words. Some people will have emotional changes, and seem to have mood swings. Then they start to feel, in some instances, but not all, that they have a headache, or are nauseous. They'll lie down- or take a pain med, which hides symptoms further. Aspirin, the blood thinner and pain reducer may end up making it worse. Because it thins the blood, more flows into the skull cavity. The swelling and blood have nowhere to go, and the pain intensifies. This is usually when a doctor or ambulance is called, and by this time, unless drastic measures are taken to relieve brain pressure, it may be too late.

Being a self-advocate is REQUIRED of anyone experiencing any form of injury. If you feel you are probably over-reacting when it comes to a head injury, there is no such thing. You could be saving your life. You could be saving yourself from years of disability. If you fall and feel the impact from your spine to your head, you should see a doctor before dismissing the possibility that you have harmed yourself. The doctor is happy to say "Oh, you're probably fine" and send you on your way. It's up to us to insist we get care for injuries. It's better to have a medical file that has a clear test, than a mortuary file that lists a preventable cause of death.

Was Ms. Richardson's death preventable? Possibly, but it's not clear how fast the injury happened to her, how much injury she may have suffered in the past, or if her trauma was the result of this one incident or of years of incidents. For some people,it can be a matter of minutes from the impact to their demise, and for others, it may take several incidents over several years. Talk and Die Syndrome can kill someone within moments, even if the patient seems fine and normal for hours. The damage that is fatal is done and nothing can change it.

So, today's questions- What can you do to protect yourself from head trauma? Were you in any accidents and refused medical care? How important is it for a doctor to take tests even if the signs are pointing to "normal" after an injury?