Diagnosis: Head Trauma, Skateboard Accident
Many skateboarders never wear helmets. It’s a common sight. They just don’t see the need. But Alex Hargis wasn’t like that. He recognized the benefits of wearing a helmet and was good about it — most of the time.
Then there was that one day in September 2013. While waiting for his family to get ready to go out, Alex decided to go for a short ride. No one knows whether he forgot his helmet or simply decided not to wear it. Alex doesn’t remember. But a few minutes into his ride, he fell backward off his skateboard and cracked his skull on the pavement. He instantly lost consciousness and started having seizures.
His parents called 911, and he was taken to Rady Children’s Hospital-San Diego.
Alex was in the pediatric intensive care unit (PICU) when doctors were determining the severity of his brain injury. The news was not good.
“His coma score was a three when he came in, and that’s about as low as you can get,” says Bradley Peterson, M.D., senior consultant at the Ernest Hahn Critical Care Center at Rady Children’s and the Center’s former medical director. “Three” indicated severe brain injury. “This would have been a different story if he’d been wearing a helmet,” Dr. Peterson adds.
For Alex to stay alive with a chance of normal brain function, his blood pressure, blood oxygen and intracranial pressure needed to be controlled. High intracranial pressure can slow blood flow, reduce oxygen levels and damage more brain cells.
“If we do all these things right, minute after minute, day after day, the patient has a good chance,” says Dr. Peterson, also an associate clinical professor at UC San Diego.
To prevent further brain damage, Alex was placed in a medically induced coma. He was given several medications to control his intracranial pressure and aid his brain’s recovery.
Meanwhile, his mother, Paige, took a leave of absence from her job to be with her son. His father, David, a physicist, focused on Alex’s brain pressure and other measurements.
“I was terrified,” says Paige. “I just had to stay in the moment, be with him and focus on right now. The staff was incredible.”
Two weeks passed. Alex’s parents decorated the room with cards from well-wishers. Kids from school rallied for Alex’s recovery. The Instagram hashtags were #wearyourhelmet and #prayforalex. In the PICU room, sad talk was prohibited.
“We weren’t allowed to cry in there or be negative at all,” says David. “If anyone got negative, we kicked them out.”
The PICU team took Alex off his coma medications. But an MRI showed he had diffuse axonal injury, which meant widespread damage to his brain.
“We didn’t know what was going to happen,” Paige says. “Even if he recovered, he could have had a completely different personality.”
After several weeks, Alex was moved from the PICU to inpatient rehabilitation. On his third day, he began to wake up and continued showing signs of healing. Best of all, his personality was intact.
Rehabilitation was slow. Alex had to relearn how to walk, talk and even use the bathroom.
For four hours daily, he worked with the inpatient rehabilitation team on basic tasks such as speaking normally, moving his fingers, eating, drinking and putting on shoes. He also battled a painful foot condition called complex regional pain syndrome that made it hard to walk. But he was determined.
“Every day I had a personal goal,” says Alex. “I figured the harder you push yourself, the faster you’ll achieve it.”
He also had memory problems, but slowly his brain rewired, giving him access to old knowledge and memories.
“A concussion or traumatic brain injury is a permanent injury, but the brain recovers by regrowing neural networks,” says Andrew Skalsky, M.D., who was Alex’s doctor and is chief of the Rehabilitation Medicine Division at Rady Children’s and an assistant professor of pediatrics at UC San Diego.
Alex, now 14, spent 61 days in the Hospital. He still has balance problems, can’t play contact sports and needs 24-hour adult supervision.
But he is lucky to be alive and wants to pay it forward. He has spoken about helmet safety at schools and founded the Alex Hargis Helmet Safety Foundation, which is working to provide helmets for kids who can’t afford them.
“I just don’t want anyone to ever have to go through what I did,” says Alex. “People need to wear a helmet when they ride. Always.”
For thousands of kids seriously injured in skateboard, bike or scooter accidents, a helmet could have lessened their injuries or saved their lives. But wearing a helmet is more than just common sense—it’s the law.
In California, anyone under age 18 riding a bike, skateboard, scooter or inline skates is required to wear a helmet. Equally important, the helmet must be properly fitted and fastened. For instance, a detached chin strap does no good at all, as the helmet often flies off during a crash.
“The helmet should fit snugly but be comfortable and sit low on the child’s forehead,” says Mary Beth Moran, injury prevention manager at the Center for Healthier Communities at Rady Children’s Hospital-San Diego. “It shouldn’t move more than an inch in any direction, and the child should not be able to pull it off when the strap is in place. When the strap is fastened, the child should be able to open his or her mouth fully and the helmet will nod slightly.”
Choosing the right helmet is key. Look for a helmet with a label saying it meets the U.S. Consumer Product Safety Commission (CPSC) safety standard. This ensures that the helmet provides “excellent head protection” and that the chin strap is strong enough to keep the helmet in place during a fall or collision, according to the National Highway Traffic Safety Administration.
Helmets can be purchased at Rady Children’s Safety Store.
For more information, visit the Sporting Goods page of the Safety Store on the Rady Children’s website: rchsd.org/health safety/safetystore- at-rady-childrens/sporting-goods/. Helmet safety videos can also be viewed on the Rady Children’s website: rchsd. org/programs-services/center-for-healthiercommunities/ injury-prevention/safetyvideos/.
Originally published in U-T San Diego, October 2014