Concussion Patient Story: Shane O'Donnell
An unexpected hit during training was the beginning of a concussion journey for All-Ireland winning hurler and Clare forward Shane O’Donnell. A scientist, with a PhD in microbiology, Shane had just started a new job in 2021 but could not focus at work due to intense pressure in his head along with confusion and nausea. The turning point came when he was referred to the UPMC Concussion Network where his doctor charted a path to recovery. Watch the video interview below with "Off the Ball's" Ger Gilroy to learn more about Shane’s concussion journey and road to wellness.
Recorded 9 Sept. 2022 as part of the academic conference: "Concussion in Sport - A National Conversation," hosted by the UCD School of Medicine in partnership with UPMC. Learn more about the conference and webinar "Concussion in Sport - A National Conversation."
Ger Gilroy: Our next guest has a terrifying, but ultimately uplifting, I hope, story about going through a very severe concussion. Shane O'Donnell, for those of you who are unfamiliar, is a hurler and a scientist. And so as somebody who would deeply understand the science of the concussion, can you talk to us... Maybe this is a stupid question, but can you talk to us about your injury? Do you remember anything about it?
Shane O'Donnell: No, not really, to be honest. And it's probably stitched together, some memories of what people have told me happened, more than my actual memory of it. Basically, long story short, it was in just a pretty innocuous challenge in hurling training, got pinned with my arms to my side with somebody tackling from behind and made contact with the ground, basically. Just got tripped up in her feet and had no protection. So went down and don't think I lost consciousness, maybe for a couple of seconds, depending on who I asked after. But was brought off the pitch and brought to hospital, all of that, but I didn't feel like it was that severe at the time or people around didn't think it was that bad.
Ger Gilroy: So, immediately there's a sense that it's bad enough to have to go to hospital, but you're thinking, "I'll be grand in a couple of days."
Shane O'Donnell: Well, I wasn't thinking much, I don't think, but the people around me thought that it was not that big a deal. I think one of the big things was a couple people come up to me asking like, "Okay, where's your car keys? Where's your gear?", and I was able to provide logical answers. So they seemed to think that that was a sign that things weren't that bad, but it deteriorated going later in the (summer).
Ger Gilroy: So this is summer 2021?
Shane O'Donnell: Yeah.
Ger Gilroy: Okay.
Shane O'Donnell: This is last year.
Ger Gilroy: How long is it then before you're actually back feeling well, from that point to the bit where you're like; here you are again.
Shane O'Donnell: Where I am now? Well, it was 10 weeks, I'd say, until I got back on the pitch. But the psychological side of it, I would say took the guts of 12 months to get through. But I got given the all clear 10 weeks later to go back on the pitch.
Ger Gilroy: Okay. You did it again though, after that.
Shane O'Donnell: Did it again. In hindsight, possibly, it wasn't an actual concussion, but it was just the whole fear around the whole thing that I just was so afraid that I would go back into that experience, that I think I maybe just brought it upon myself thinking that the symptoms, they were possibly just normal sensations, were the symptoms that I had experienced before.
Ger Gilroy: Okay. So to go back then, in the immediate aftermath, what are your symptoms? How do you feel? What are the physical manifestations of the concussion?
Shane O'Donnell: So the immediate aftermath was just that confusion that's hand in hand with concussion, that people would expect really; not being able to think or process any thoughts or really give answers to anything. It was actually very interesting to see in the discussion there with the Maddocks questions, I hadn't seen a formalized of what those questions looked like. When I went to the hospital, the doctor asked me what my name was, what date... Or what my date of birth was and where I'd come from, and being able to provide those answers I think someone could do in their sleep. And I was downed in full training gear, so I made a stab at the fact that I'd come from training and he seemed to think that that was a good answer and told me to go on my way and that I was fine. So I think it was only after my parents pleaded with him to ask some more questions that he actually revealed that there was a bit more going on.
Ger Gilroy: Okay, so that's the hospital. And then over the next few days, apart from the confusion, what begins to make you think that something more serious is happening here?
Shane O'Donnell: So the couple of days after, nothing really. To be honest, I actually felt quite well. So I stayed overnight in hospital just for (observation). And they cleared me the next morning saying that a mild concussion, but that I'd be okay basically. The next couple of days were fine, to be honest. I was quite active and had a weekend and was out and about really, nothing of note. A couple of bouts of being very fearful when I thought of the actual impact and breaking down this moment, but maybe that should have been a red flag at the time, but I thought it was fine and it was really only when I tried to go back to work that Monday, Tuesday, Wednesday, the next week, that things really started to come down around my ears.
Ger Gilroy: Okay. And when you say come down around your ears, what does that mean? Because I think these symptoms manifest for different people and that's one of the things we've learned is that every case is really different. So for you, you just started a new job I think?
Shane O'Donnell: Yeah, I'd started a job that Monday. That was my first day I was going back and I just couldn't... So at first day, I went back and I was trying to do things and realizing that there was something off, by lunchtime of the first day. I was trying to minimize the amount of work I doing, trying to minimize the screen time and got through the day, was okay. The next day was worse, started to get a pressure in my head, started to feel nauseous, was really trying to minimize screen time, thinking that I'll just get through a couple days of this and then Wednesday, woke up and it was just catastrophic. I just couldn't process any thoughts. I couldn't hold a thought in my head. I was 8 or 9 or 10 in nausea. I had this pressure in my head that I just couldn't... It was just a very severe pressure in my head and they were the main symptoms that I had for, really for, weeks then, at that stage.
Ger Gilroy: The diagram earlier on had the different circles and one of them has migraine and another one is anxiety. And of course the more anxious you get, the more your head hurts, the more anxious you get and the more anxious you get, the more your head's going to hurt. So it begins to feed off each other.
Shane O'Donnell: Yeah. And I actually wasn't experiencing pain really, so much as just this pressure, which was even more concerning actually. And it really wasn't. I just thought that; okay, this is part of it. I'll get to the worst, the bottom of this and then I'll start to improve slowly, day by day. And so I wasn't starting off. I didn't start off being anxious or worried about it really. I just thought that; okay, this is scary, but it's just a process I have to go through. The scariest part of it was that I would get better a day or two and then I would be more active because of that, and then the next day I'd wake up and I'd be worse than ever and this cycle would happen. I'd do a day or two of starting to feel better, then I'd have a particularly active day, by active day I mean I might go outside or play with the dog or something. And then the next day after that it would crash again. So that's when the fear really started to kick in that I don't know what's going on, I don't know how to resolve this and I don't know what's causing this cycle.
Ger Gilroy: And who were you talking to at this point? Or where is the medical advice that you're getting? Are you on your own?
Shane O'Donnell: Yeah, so there's medical advice coming in. We had physios and a doctor that was linked with our squad, but not necessarily intimately in contact with us, so had discussed with him and after going to the hospital, they had given this that it's a mild concussion and you just have to rest for two weeks and you'll be fine, basically. My brother then and his wife are also doctors. They're GPs and trainers for different programs, but they also gave me the same advice, that; just rest for a couple of weeks and you'll start to come out of it. Then two weeks comes and goes, and three weeks comes and goes, and they would turn up at the house and say things like, "Oh, you're not feeling better." And it's like, at some point I just had to stop answering that question and just take a couple of deep breaths and just try to just put that out of my mind, because the thought of them being worried or not even worried, them not understanding what was going on, put me in a more precarious and scary position.
Ger Gilroy: So at that stage, what are you thinking?
Shane O'Donnell: Well, when I could formulate a proper thought, I was afraid. I was really scared of what was happening and I just didn't know where to go really. So, I had any GP or any medic that I talked to was emphasizing this rest and that you'll get to the bottom of it and you'll come out of it basically. But I didn't seem to be reaching the bottom and every day I thought I went to the bottom, two days later, three days later, I would return to that point.
Ger Gilroy: And this seems endless for you, like you're stuck in a loop where you feel like there's progress, but then that actually has a negative impact. And again, so, are you thinking; am I going to be able to function in my new job? Am I going to be able to play sport again?
Shane O'Donnell: Yeah, the job was a major concern. Obviously, I just started, and I had to tell them that I wasn't going to be in work for a while and an unknown amount of time. Each week, the new week would come, and I would have to tell them; no, I can't do this week either. That was a major (issue). I was worried about that. The sports side of it, I'd basically given up on sport at that stage. That year, maybe even ever playing hurling again, it was really at the back of my mind. I wasn't overly concerned if I never picked up a hurley again, but I was able to function in work and function normally, I would've taken that. I would've bitten someone's hand off for that at the time.
Ger Gilroy: Yeah, I think that's what Rod was talking about earlier on. It's like return to real life is just as important, if not more important, than return to sport. But maybe we use return to sport as a shorthand for return to real life. But at some point along the way, something happens. There's a turning point here in this story. What's the turning point for you?
Shane O'Donnell: So the turning point was basically, it was, (and this is why it was great to hear all the discussion this morning), was joining Dr. Enda Devitt with the UPMC, meeting him. I was referred by Dr. Liam Glynn, who joined later in the process as our new medic with the Clare team. But it was actually a funny, maybe funny looking back on it, that the first contact with Dr. Enda Devitt's receptionist, when we rang to get an appointment, I was sent that impact report and told to do this online, on my computer, had been told for four weeks by every person that seemed to know what they're talking about, do not look at the computer and don't look at the screen. So I ended up refusing the impact report and saying; no, I'm not going to turn up, because don't you know I can't look at a screen? Joe, I can't do that. So after I rang the second time, then realizing that; okay, I'm not getting better this three or four days later, I'd do anything basically. Rang again, also had this apprehension and I think Dr. Devitt actually then rang me personally and said, "Just do the impact assessment, you'll be fine. Come in to see me. It'll be okay." Basically, so I think that was actually the first step in starting to get better.
Ger Gilroy: And immediately then you start the treatment. Is that what happens? The diagnosis has to happen first?
Shane O'Donnell: Yeah. So the diagnosis I guess, or more accurate diagnosis of what's actually going on, and also a huge part of it was just informing me as to what was going on, telling me, one, that this is normal, two, that it's going to be okay. And then three, explaining what was explained this morning, to all the different parts of a concussion, what I was experiencing. And yeah.
Ger Gilroy: Yeah. You're a scientist. I don't know if everybody knows. Shane's a PhD and so you have a rational, logical mind and yet in the midst of this, you can't control your mind, because it's not behaving the way you think it's going to behave. That's where the terror comes in, I suspect.
Shane O'Donnell: Yeah, definitely. It's everything you've had for the last twenty, or however many, years is just not working the way it used to. And yeah, there's huge fear about it, but the relief, I think, outpouring of relief when I met Dr. Devitt and just being able to, for him to explain what's actually going on and chart a path to recovery, that was definitely the pivotal point and took a lot of the fear away.
Ger Gilroy: And obviously it's not a magic wand, so you need to work and you need to rehab. But as the work and the rehab begins, I guess you begin to see some progress?
Shane O'Donnell: Yeah. And there was a lot of talk about exposure and exposure obviously is a huge part of it. So even though physically I felt maybe worse after doing the things that were causing the symptoms, knowing that, excuse me, that was helping. I viewed the whole thing through a different lens altogether and it actually made it, even though I was feeling worse, I felt better about it, if that makes sense.
Ger Gilroy: So previously, you would've gone and played with the dog and then what would've seemed like a setback, would've prevented you from doing that again, but actually the right thing to do was to go back and do it again the next day in a small amount and manage the amount according to a pathway to recovery.
Shane O'Donnell: Yeah, yeah, exactly. A managed amount. I think I was given basically indication that if my symptoms are going above three or four or at that kind of level out of ten, that maybe pull it back a small bit. But anything to that level, you do want to be pushing yourself to not have a massive setback where you feel like you're back at square one, but also to be pushing the boundaries a small bit to make sure you're progressing.
Ger Gilroy: You have, as I said, a scientific background, a curious mind. You have family members who are involved in the medical profession. So it wasn't for the want of trying that you weren't being able to access the (medical care). And we talked about elite sports people get better medical care than the general population. That's all true in your case and even in that case, it still took finding somebody who knew exactly what they were talking about. So that's why stuff like today is important, that's why telling your story is important and that's why this is not a job of work that's going to happen or that's going to be an end point. It's kind of like painting the Golden Gate Bridge. It's going to be telling people about concussion forever.
Shane O'Donnell: Yeah, absolutely. And I think there was mention of a public health campaign or something like that, and a lot of the focus of the discussion in the panel was about how that would impact GPs and getting that information to GPs, and is that the best way to get that information to the medics? But I think there's also a responsibility to get that information into the wider sphere of just your layperson out there, so they can understand that if they hit their head, it's not the end of the world. And Dr. Collins mentioning that it's not an accumulative effect, that emphatically if you treat it the first time, the second time isn't (as tragic).
Ger Gilroy: That's really interesting, because you did have a second concussion or you're not sure if it was a concussion in retrospect, but what was that process about 10 weeks after your original injury and after you start getting the treatment, you're back to play.
Shane O'Donnell: Yeah. So 10 weeks after I got the initial, I went back and maybe a couple weeks later, I had a pretty innocuous bang, but something that was definitely an impact to the head. I just got a hurley to the helmet, basically. And in hindsight, I don't think it was actually a concussion or a concussive blow, but just it drove this whole, another cycle of being afraid that this was happening again. And the power of the mind was insane, that I had all the symptoms coming back again. But honestly in hindsight, I don't think I actually experienced, and I discussed this with Dr. Devitt as well, and he mentioned that; no, I don't think you actually had that concussion, but I was fully convinced at the time that I had.
Ger Gilroy: That's bad, isn't it?
Shane O'Donnell: Yeah, yeah.
Ger Gilroy: And maybe one of the aspects of this that needs to be further researched as well is what the traumatic impact, and I don't mean in the medical terms, but the psychological, traumatic and the PTSD that you might have had.
Shane O'Donnell: Yeah, my girlfriend's actually a psychologist, a clinical psychologist, and she had said that I was presenting as someone who had a mild PTSD presentation after the entire event. She thought that I had treated this as a traumatic in both senses, physical and psychological. And I do think that's how I was processing it in my mind as well. If I would think about it, and even to this day, if I think about it or if I hear people talk about it, I have a very hyper aware of what it was like, and it's very kind of vivid experience that is evoked.
Ger Gilroy: So it's visceral. And when you think about it, that makes sense, particularly at the elite level where your athletic identity is such a large part of your full identity. Maybe in GA, you're a bit fortunate, because you have to have an exterior life and you're not a professional athlete, but I think it's definitely something that needs to be thought about is when this happens to you again or when you are talking about it, that you're revisiting it in a very deep and meaningful way.
Shane O'Donnell: Yeah, and maybe to reflect on that, that I think if I had, as all the discussion this morning about seeing someone within seven days that can get you on that path, I really don't think it would've been embedded in my mind as a traumatic event in that case. I think it was really the fear and uncertainty, and really not understanding what was going on. That was the part that I was so scared about, and that's the part that is the traumatic side of it. Hitting your head against the ground in and of itself is not particularly traumatic. It happens all the time, really, but it's how you react to it and all the things that come after. That's the part that I struggled with.
Ger Gilroy: And so the second time something happened, whether or not it was or wasn't, you did then seek treatment straight away and you recovered?
Shane O'Donnell: Yeah, yeah, basically. And that was what prompted the conversation with Dr. Devitt, that; okay, maybe this isn't actually a concussion, but at least I was equipped with the tools and the knowledge of how you would treat that. And I essentially just got over it, yeah.
Ger Gilroy: And so the start of this season, you went back hurling and hurled the whole year, and were there any incidents where in the middle of the year, you're like, "Ooh, that might be something."
Shane O'Donnell: If it had happened last summer, after I'd come out of it, yes, definitely. But no. Now, once I got over a few weeks and maybe a month of training and got settled back in, I took a couple of hits, but none of them where I was like; okay, that's an issue. I just assessed them objectively, in a mindset that I would've been in prior to last year maybe, and just thought; no, that's fine, basically. And was able to maybe just rationally think through; am I experience anything? And be able to say no and move on, basically.
Ger Gilroy: One of the big learnings that we all reach at some point in life is that we don't know what we don't know. And maybe in GA, because there have been high profile incidents, [inaudible 00:17:48] in the Ireland final gets concussed, but continues on. Was Declan O'Sullivan concussed in the game against the Dubs? He probably was, stayed on. And because those conversations happen and they flame up and then they disappear, we think that it has become something that everybody is familiar with. But I'd say your journey shows that it isn't something that is still widely known or talked about?
Shane O'Donnell: Yeah. Everyone knows what concussion is, but do they really know what concussion is or what it actually entails? And I definitely don't think they do. I think the media as well portray this view. And that's why I think that conversation on the cumulative effect of concussion is so important. If you talk to anybody, when they talk about Sexton playing rugby after a number of concussions, they'll think; why is he doing that? Why are they letting him out there? But it's only when you realize that; yeah, if you treat them one at a time, as they come, then he can go out and if he gets another one, we'll treat that one as well. But the media would lead you to believe, and this is just the general consensus out there, that if you have two or three or four, then really regardless of how you're treated, you should be considering stopping playing sport.
Ger Gilroy: It's a fair point. As I said, we've been covering the story for years, but certainly there are voices who come on, who we amplify, who say things like that. And it makes sense to you, when you don't know. And I think that was the logical journey that I was talking about earlier on with Micky Collins, is that immediately, you're like, "Oh, well, of course. You're piling damage on damage." But actually, no, that's not what the story is. You're actually... It's a new injury and because we've trained you to recover from it, you can actually recover from it quicker.
Shane O'Donnell: Yeah, absolutely. And then I think that even just getting that information out there via the media would reduce that fear and actually make the severity of any concussion, in some way, it would lessen it.
Ger Gilroy: And the public information campaign is definitely something. You're okay talking about it now? I'd say obviously it took you a while?
Shane O'Donnell: Yeah, I'm okay talking about it now. I still get a bit emotional about it. And even when Dr. Collins mentioned emphatically that; yeah, it's not accumulative. This is treatable. I still even get a bit emotionally hearing those things, because I remember that day going into Dr. Devitt and he said those things, and I just completely, just an outpouring of relief and tears and everything. I think if we get that information out there, and I play an extremely small part in that, but if anything I can do to help, I think is worthwhile.
Ger Gilroy: So, you're going to continue hurling?
Shane O'Donnell: Yeah. Well, as long as my legs last, they're the bigger issue than my head now.
Ger Gilroy: Good luck. It is an incredible story.