For most adults, spring and summer thunderstorms bring the annoyance of driving in a downpour.

But others dread this time of year for migraines triggered by the environment.

What are migraines?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, describes migraines as episodic disorders that cause severe, throbbing headaches, usually on one side of the brain.

The list of triggers is, unfortunately, long.

“Emotional stress can trigger migraines. Moving, changing jobs, other stressful life situations,” Dr. Ogun says. “A change in sleeping habits can trigger a migraine. Skipping a meal. Your diet: wine, aged cheese, coffee withdrawal and foods high in nitrates.”

Other common triggers include hormones, bright lights, loud sounds and changes in altitude. A propensity for frequent headaches can also run in the family, Dr. Ogun says.

You can prepare

Dr. Ogun says not much is known about weather-induced migraines. But most medical professionals agree there is some evidence for migraines caused by changes in barometric pressure.

How can you prepare?

“Up and move,” Dr. Ogun says, tongue firmly planted in cheek.

More realistically, watch the weather forecast. If there’s a chance for a lot of dust or smoke in the air (think areas like California or Arizona), plan to limit time outside.

Stock up on medication after talking with your health care provider. Dr. Ogun says over-the-counter medicine like ibuprofen will help with pain and can even be taken ahead of when you know a migraine is coming.

“They could have a headache diary where they write down what causes their headaches, where the pain is located, how long does it last, symptoms and what treatment helps,” Dr. Ogun adds.

If your migraines are more frequent, feel different, or come with other symptoms like confusion, neck rigidity, weakness in the arms or legs, fever or chills, see a doctor right away. Some of those symptoms may be signs of a heart attack or stroke.

Any head trauma, like a sports injury or a car crash, should also be checked on by a doctor.

Interview clips

Previous coverage

One big headache
June is national migraine and headache awareness month
A good calendar may be able to help you fight headaches
Three steps to help with severe or frequent headaches
When should you see a specialist for your headaches?
Weather changes can be a pain for migraine sufferers

When Gordon Ramsay raises his voice, it’s usually about an undercooked dish.

But in 2024, the celebrity chef was calling for help after a scary bicycle accident.

“It really shook me,” says the avid cyclist in a June 15, 2024, Instagram post. “Honestly, I’m lucky to be here.”

Ramsay says he didn’t suffer any major injuries, but he’s bruised and on the mend. And he’s again joining health care professionals in stressing the importance of wearing a helmet and biking within your means.

“I don’t care how short the journey is,” Ramsay says.

Biking accidents in the emergency department

Kurt Bloomstrand, MD, an emergency medicine physician who sees patients at OSF HealthCare, has treated people who have fallen off a moving object. It could be a bicycle, scooter or motorcycle. Sometimes it’s a child who’s learning their way. Or it could be an adult who didn’t hit the brakes in time.

“A lot of times what happens is they fall off the bike, put their arm out to protect themselves and injure their arm,” Dr. Bloomstrand says.

“But most importantly, we also see head injuries. We know that people who get in a bike accident have better outcomes if they’re wearing a helmet. People that are not have a higher risk of head injuries and traumatic brain injuries,” he adds.

Those head injuries are not something to take lightly, Dr. Bloomstrand says. Traumatic brain injuries can result in lifelong complications or death.

“When we see people in the emergency department who have suffered from a bicycle accident, we’re going to do a rapid trauma assessment,” Dr. Bloomstrand explains. “We’re going to pay special attention to the head. We’re going to make sure there are no signs of skull fracture or neurological abnormality. Depending on the severity of the injury, we may do a CAT scan [also called a CT scan] to make sure there’s no internal injury like bleeding on the brain. Those internal injuries are life-threatening emergencies that need to be addressed quickly.”

Advice

Check these off your list the next time you get on a bicycle or something similar:

• People of all ages should wear a helmet while biking. Young kids who are learning to ride should also wear knee elbow pads.
   
• Long shirts and pants and closed toe shoes (not sandals) are better than bare skin if you fall and skid on pavement (commonly called “road rash”).
   
• Be alert when riding. Don’t ride while tired or under the influence of alcohol or drugs. If you’re listening to music, consider having one ear free so you can hear your surroundings.
   
• Don’t ride above your means. Choose a speed and terrain that fits your skills.
   
• Keep your bike in good condition and configured to match your height. Your feet should touch the ground when seated. This should be true for all ages. A child should not “grow into” a bike. 
  
  At night, a headlight, reflectors, flag and a horn help you to be seen and heard. Bright-colored clothing also helps your visibility at night.
   
• Look closely before crossing an intersection, and obey all traffic laws. This typically includes riding on the right side of the road. Use universal hand signals: left arm straight for a left turn, left arm bent up for a right turn and left arm bent down for a stop. Make eye contact with the driver of a vehicle before passing in front of them.
   
• One person should ride a bike at a time, and keep both hands on the handlebars. Put items like books in a backpack or basket. Don’t try to carry items and ride.
   
• If you or someone you’re with suffers a bike injury, call 9-1-1 immediately.

Interview clips

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Miami Dolphins quarterback Tua Tagovailoa recently suffered his third confirmed concussion in 25 months – just another reminder that football and other contact sports pose the threat of a traumatic brain injury.  Research indicates it’s important to accurately and immediately diagnose a concussion because the consequences of misdiagnosis or faulty management can lead to major disability or death.

Illinois State University senior Cyerra Hibbert knows about concussions. She’s had multiple ones while playing soccer in high school and at ISU, the most recent just a month ago. Hibbert is one of the first athletes to test a new FlightPath concussion app. The lead app developer is *Adam Cross, MD, a pediatric hospitalist and clinical informaticist for OSF HealthCare and director of the OSF Children’s Innovation Lab at Jump Simulation & Education Center in Peoria, Illinois. He is working with co-lead Inki Kim, of the Health Care Engineering Systems Center at the Grainger College of Engineering at the University of Illinois Urbana-Champaign.

The concussion assessment app is a grant-funded project through Jump ARCHES, a research collaborative that partners teams of clinicians and engineers working together to improve patient outcomes and reduce health care costs. The FlightPath app is being tested at Illinois State, Illinois Wesleyan and Bradley Universities as part of a clinical trial and research coalition.  Hibbert used the FlightPath app after receiving instructions from her athletic trainer six days after she received a blow to the head during a game.

Hibbert was able to finish the test. It only takes about two minutes to collect more than a million data points as a person tries to catch a hummingbird within a 3D space on a screen.

“After a while it did bring a little confusion or if I wasn’t aware of where the bird flew on or off the screen, that did trick a little bit of my memory and concentration skills, so I do think it’s definitely approachable," Hibbert explains. “It’s definitely doable. I think just based on your outcome will determine where you are in your concussion level.”

Dr. Cross says the single biggest risk factor for prolonged time to recovery is delayed diagnosis, so FlightPath is his answer with its ability to diagnose a concussion within minutes. His research team has done some internal testing.

“Regarding how well it detects differences in impairments with people – how well they can determine if someone is functioning, acting appropriately, or if there's if there's something else going on. The challenge has been really doing that with individuals that have true concussion,” says Dr. Cross.

Athletes with a suspected concussion are challenged by FlightPath to walk in their environment while trying to keep a hummingbird in a bubble on the screen.

“The players themselves are trying out this app while concussed after having been consented earlier on in the year so that we can get data around how they perform with this app while concussed versus not concussed, and comparing that to the normal, typical present-day evaluation techniques that the trainers perform.”

Dr. Cross stresses, right now, the clinical trial does not involve trainers using the app to help make decisions. He says the research is not that far along and data collection needs to happen first. But, Karan Rai, MD, a sports medicine physician with OSF HealthCare who also serves as the team doctor for ISU Athletics, says eventually, the data from FlightPath could help beyond diagnosis.

“It in turn can help us with making prognoses, coming up with recovery timelines, implementing certain vestibular therapy. Other than diagnostic purposes, we can extrapolate that data to help us come up with a better treatment plan as well.”

Takes the pressure off
Both Hibbert and Dr. Rai are excited to be part of what they consider ground-breaking research that has the potential for helping athletes in the future. Hibbert, who plans to go into medical sales, says it’s helpful to have an objective tool for an evaluation. She thinks it takes the pressure off athletes.

“Because as athletes, we’re always eager to be on the field or play the game and to have that mindset to be better and get back on your feet as quickly as you can. I think this app will allow you to really settle and to really take your time with your symptoms.”

The clinical trial is looking at whether FlightPath can do as good or better as traditional methods in diagnosing a concussion.  So far, Dr. Rai says nearly 15 athletes who have suffered a concussion have completed a FlightPath assessment and it’s been performing well.

“Results are early so far but in our sample size we found some associations at least where FlightPath has shown some abnormalities similar to what other examinations have found as well, whether that’s the SCAT test or the ImPACT test.”

There are other concussion applications commercially available, but Dr. Cross suggests none are as robust as FlightPath.

“There aren't any, as far as I've seen, that use this mixed reality approach to gather the kinds of data that we're gathering. This is very rich data in a very short time in our app. One of the things that makes it so unique and sets it apart is that we get so much data about so many different manifestations of concussion in such a short time.”

Testing is expected to take at least two years. After testing, the app will be submitted to the FDA for clinical approval.

Here is a video demonstrating how the app works.

*Dr. Adam Cross also holds these positions:
Assistant Professor, University of Illinois College of Medicine Peoria, Division of Pediatric Hospital Medicine
Adjunct Professor, University of Illinois at Urbana-Champaign, Health Care Engineering Systems Center (HCESC)
Clinical Research Informatician, OSF HealthCare | Jump Trading Simulation & Education Center (JTSEC) 

Dr. Adam Cross, ISU soccer player Cyerra Hibbert and Dr. Karan Rai

B-roll of ISU soccer player Cyerra Hibbert on soccer field

B-roll of FlightPath app demonstration

A January grocery trip for Charlotte Davis turned out to be life-altering.

The Shipman, Illinois, woman was loading food into the back of her van when she says the hydraulics failed, and the back door slammed into her head.

While she didn’t lose consciousness or have any visible signs of trauma, Davis doesn’t mince words: “It hurt really bad.”

Davis says she put up with worsening headaches, garbled speech and weakened memory as long as she could.

“I tried to drive one day. I hit a flower pot, drove through the ditch, missed my turn, forgot where I was going three times,” Davis says. “My eight year old granddaughter told her mom, ‘Please don't let Mawmaw drive anymore. She's scaring me.’”

When a CAT Scan found no brain bleed, Davis wound up at the OSF HealthCare rehabilitation office in Alton, Illinois. She was skeptical at first but now considers herself a prime example of why you shouldn’t just shake off a head injury – whether it’s in a football game or just around the house. Otherwise, serious issues like the brain disease chronic traumatic encephalopathy (CTE) may follow.  CTE is often seen in football players. In July 2022, officials announced the late NFL player Demaryius Thomas had CTE.

Physical therapist Kelly Bogowith cared for Davis at the Alton office.

“All concussions are a form of at least mild traumatic brain injury,” Bogowith says. “So it’s important to make sure that you get assessed and also ensure that you're not playing sports later that same day. A provider can give you education on how long you should be sitting out from sports and other physical activities, as well. And that might even include work.”

“Sometimes with concussions, we may not have symptoms for hours or even weeks afterwards. So it's important to get checked out by your physician, urgent care, emergency department, or athletic trainer, depending on your setting,” Bogowith adds. “But it's not something to shake off. And it can be especially important, too, to not have a second concussion because that can be very dangerous and even deadly.”

Every patient recovering from a head knock receives a specially-tailored plan, Bogowith says. The roadmap could include different types of therapy, like physical or speech language. It will always include at-home activities – stretches for physical therapy or puzzles for speech language therapy, for example. And the OSF HealthCare team encourages you to ask questions along the way.

Davis’ plan started with massages and stretches to relieve tension. She progressed to walking, then running on a treadmill.

“I beat that treadmill,” Davis says, beaming.

She beat the non-physical aspects, too. Davis’ memory and speech improved to the point that when she met with speech language pathologist Ashley Brim at the Alton location, it was a one-and-done.

“[Speech therapy] can range within working on targeting problem solving skills,” Brim explains. “So, either really basic problem solving all the way up to reading paragraphs of information. And trying to figure out information that, most of the time, people don't think about. We can just read it and figure it out. But when you have a concussion, and that is impacting you, it makes it 10 times more difficult.”

“We work on a lot of memory tasks,” Brim continues. “Exercises for working on memorizing word lists, figuring out different ways to help the patient memorize things better. So they associate the word to something else and then they use those associations to be able to remember what has been said to them and chain it all together.”

What people in Bogowith and Brim’s roles don’t want to see: people relying solely on pills to get through pain. That can lead to addiction and side effects. Therapy is somewhat the opposite, Brim notes. It gives the patient ownership of their recovery.

Davis agrees with that assessment and says her determination to see therapy through to the end has paid off in multiple ways. Most notably, she can handle playing with her eight grandkids.

“I want people to know that it's important,” Davis says. “I understand that it's a pain. It's not always convenient. There are always other things people want to do. But if your doctor says to do therapy, I 100% will tell you: go to therapy. You don't know how bad you need it until you actually go.”

For more information on types of rehabilitation, visit the OSF HealthCare website or talk to your primary care provider. OSF HealthCare also offers neurological services.

Interview Clips - Charlotte Davis

Interview Clips - Kelly Bogowith

Interview Clips - Ashley Brim

Previous Coverage

OSF Innovation preparing to test concussion diagnosis gaming app

Concussions Hit Student Athletes as Fall Sports Get Underway

Preventing concussion in young athletes 

Concussion: More than Just Getting Your Bell Rung

Myths about concussions increase the risk of harmful effects

Taking a Team Approach to Concussion Rehab

Heading Up Health Study on High School Heads