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New clinic in Pine concentrates on concussions

| Wednesday, May 1, 2013, 9:01 p.m.
Deborah Deasy | Pine Creek Journal
Helena Pingree, a physical therapist, shows how to administer a concussion test as she performs a series of tests to Vanessa Fazio, a neuropsychologist.
Deborah Deasy | Pine Creek Journal
Kelly Flanigan, 21, of Peters Township, wears some specialized equipment to allow Helena Pingree to administer an eye test to check for double vision.

People commonly think of a concussion as a blow to the head.

A “shaking of the brain” more accurately describes the injury, according to neuropsychologist Vanessa Fazio of the University of Pittsburgh Medical Center.

“There's a chemical change that disrupts how the brain is handling blood flow,” she said

In response, a person might experience dizziness, fatigue, memory loss, sleep problems, increased anxiety and sadness.

Fazio sees concussion victims of all ages with such problems at a new UPMC clinic in Pine, which opened in late February.

The brain might not be slammed against the skull, but “it's the movement — with a lot of force and velocity — that causes a disruption in the chemical processes of the brain,” said Fazio.

“Typically, the symptoms do go away, but it does require some management.

“Certain things can exacerbate symptoms, such as increased physical and cognitive activity,” Fazio said. “So early management is the key to helping the symptoms go away.”

If a person's headaches, sensitivity to light or other symptoms fail to subside, Fazio might refer a person to a physician for medication.

The new concussion clinic — located in Suite 202 of the Children's Pine Center at 11279 Perry Highway — is part of the UPMC Sports Medicine Concussion Program, based on the South Side of Pittsburgh. The program operates additional satellite offices in Monroeville, Bethel Park and Oakland.

Medical Director Mickey Collins, a consultant to the Pittsburgh Steelers and Pittsburgh Penguins, oversees the program, launched in 2000.

“We really try to service whoever needs us,” said Fazio, 36, of Indiana Township, who primarily sees children, adolescents and college athletes and works with fellow neuropsychologist Nathan Kegel.

Fazio and Kegel both have doctorates and work for the University of Pittsburgh Department Of Orthopedic Surgery.

Both may refer some concussion victims for physical therapy — such as gaze-stabilizing exercises to treat vision problems — with Helena Pingree of the UPMC Centers for Rehab Services.

Pingree, 38, of Economy, Beaver County, offer such therapy for concussion victims at the Pine clinic and the UPMC Centers for Rehab Services office in Northtowne Square on Route 8 in Richland.

“I see elderly people who have fallen and hit their head,” Pingree said. “It can happen to anyone of any age.”

Primary-care physicians and athletic trainers generally refer people to the clinic, but anyone can call for an appointment.

A first visit generally includes an interview to gather information about a person's injury, medical history and symptoms, followed by a 25-minute test — administered at a computer — to measure a person's cognitive functions, such as verbal memory, visual memory, reaction time and ability to concentrate.

First-timers also undergo tests to assess their balance and coordination.

“A concussion is a neuro-metabolic injury that affects a variety of functions,” Fazio said.

“Often, it will produce physical symptoms, such as headaches or dizziness. It can also produce cognitive symptoms, such as memory problems, or slowed processing ... It also can produce emotional symptoms, where someone can become more irritable, more anxious.”

Depending on test results, Fazio might recommend that a young person do schoolwork at home or get extra time to complete exams at school. Fazio also might recommend that young people cease playing a certain sport through which they might experience a second concussion.

“With physical activity, we try to balance a little activity with not over exerting the person,” Fazio said. “We're really trying to keep the heart rate low during this time.”

Fazio said patients generally recover from a concussion within a month.

“It does take a while to get back to normal,” Fazio said. “The average recovery time seems to be three to four weeks, in uncomplicated cases.”

Deborah Deasy is a staff writer for Trib Total Media. She can be reached at 724-772-6369 or

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