Q: What are the signs of a concussion?

Jeffrey Later, Trauma Care Program Manager, Maui Health: A concussion is a type of traumatic brain injury that affects brain function. Effects are usually temporary, but can include headaches, problems with concentration, speech slurring, memory loss, balance issues, lack of coordination, dizziness, nausea and vomiting, and confusion.

Concussions are caused by a blow to the head, with falls as the most common cause of a concussion. Concussions are also common in certain contact sports, such as football or soccer. Most people usually recover fully after a concussion, but a medical evaluation is highly recommended.

At Maui Memorial Medical Center, some of the most common trauma-related injuries we see in our Emergency Department are from “standing height falls” which unfortunately occur often with our kupuna. In addition to a concussion, many of these falls result in other serious traumatic injuries. Fortunately, the MMMC Trauma Team is trained and ready to care for the victims of traumatic brain injuries, including concussions.

Starting June 1, the trauma program at MMMC will be expanding its services to include a dedicated trauma surgery group that will be available 24/7. This is part of Maui Health’s path to becoming an American College of Surgeons Verified Level II Trauma Center. As the only acute care hospital on Maui, it is vital that Maui Health provides the highest level of trauma care for our residents and visitors. In addition to traumatic brain injuries, the MMMC Trauma Team treats many visitor-related injuries, such as spinal cord trauma from water activities. To assist in providing more awareness of these types of injuries, community education efforts will also be expanding to include fall prevention tips, spinal cord injury facts and prevention methods, and Stop the Bleed classes to reduce the number of fatalities caused by blood loss.

Maui Health is committed to caring for victims of concussions, and for providing continuous education on how to prevent traumatic injuries. If you or someone you care about have any symptoms of a concussion, prompt treatment is essential. Call your family physician as soon as possible, and if your symptoms get worse at any point, seek emergency care at the MMMC Emergency Department.

Q: Is it safe to get the Johnson & Johnson vaccine?

Chrissy Miller, Employee Health Manager, Maui Health: The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have once again recommended use of the Johnson & Johnson COVID-19 vaccine after a temporary pause. This means that an investigation found that the vaccine’s benefits outweigh any potential risks.

You should know that doctors and scientists continuously monitor and study reports of any side effects from all of the COVID-19 vaccines. To date, more than 8 million people have received the Johnson & Johnson vaccine with fewer than 30 reports of people who experienced an extremely rare but potentially serious blood clot condition called thrombosis with thrombocytopenia syndrome (TTS). This rare side effect occurred a week to two weeks after receiving the Johnson & Johnson vaccine and all were women under age 60.

The risk of developing this problem is small. For women ages 18-49 — the group considered most at risk — the chances of having this happen are around seven in 1 million. For women over 50 and all men, the chances are closer to zero.

The bottom line is that the risks of the Johnson & Johnson COVID-19 vaccine are low. The slightly increased risk of TTS for women 50 and younger remains extremely rare. However, the risks associated with contracting COVID-19, including the potential for long-haul symptoms, are much higher. And, remember, the Johnson & Johnson vaccine is only one of the three FDA emergency use authorization-approved vaccines for COVID-19. Pfizer and Moderna are a two-dose alternative that have not produced the TTS side effect and is a viable option if there are TTS concerns.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.