{"id":17855,"date":"2019-12-20T12:40:30","date_gmt":"2019-12-20T19:40:30","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=17855"},"modified":"2021-10-12T12:52:23","modified_gmt":"2021-10-12T18:52:23","slug":"traumatic-brain-injury-kept-bodybuilder-offstage-but-not-for-long","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/traumatic-brain-injury-kept-bodybuilder-offstage-but-not-for-long\/","title":{"rendered":"Traumatic brain injury kept bodybuilder offstage \u2013 but not for long"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>She played basketball, soccer and volleyball in high school. She has done rock climbing; she has gone skydiving. These days, Cassandra Witt, 31, is a personal trainer and professional bodybuilder. She is, to summarize, young, coordinated, and wicked-strong. Which makes the adage, \u201cIf it can happen to her, it can happen to anyone,\u201d all the more apt.<\/p>\n<figure id=\"attachment_17858\" aria-describedby=\"caption-attachment-17858\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-17858 size-large\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08094243\/Cassandra-lead-photo-sized-e1578073835907.webp\" alt=\"Cassandra Witt works out in a Westminster gym after recovering from a traumatic brain injury.\" width=\"640\" height=\"375\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08094243\/Cassandra-lead-photo-sized-e1578073835907.webp 640w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08094243\/Cassandra-lead-photo-sized-e1578073835907-300x176.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08094243\/Cassandra-lead-photo-sized-e1578073835907-150x88.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08094243\/Cassandra-lead-photo-sized-e1578073835907-200x117.webp 200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-17858\" class=\"wp-caption-text\">Cassandra Witt works out at TRU FIT Athletic Club. She has made an incredible recovery from a traumatic brain injury that forced her to suspend all her training. Photos by Cyrus McCrimmon for UCHealth Today.<\/figcaption><\/figure>\n<p>What happened to Witt? It was November 2017. She and husband Trent were winding down for the night in their Thornton apartment. She was putting on pajama bottoms. She had on the sort of socks that turn a hardwood floor into something like black ice. Her feet got tangled in the pajama legs somehow. And down she went, backwards. Bam.<\/p>\n<p>Trent rushed into the room, Witt learned later. She learned this later because she had cracked the back of her head with such force that she went dark. She came to with her husband leaning over her, asking if she was OK.<\/p>\n<p>She was not OK.<\/p>\n<p>\u201cI\u2019ve done so many extreme things in my life, and I get taken out by a hardwood floor and some socks,\u201d Witt said later.<\/p>\n<p><iframe loading=\"lazy\" title=\"I Did | UCHealth\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/X7aKfTzxwCA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2><strong>A traumatic brain\u00a0<\/strong><b>injury<\/b><\/h2>\n<p>She felt dizzy and nauseous. It was as if the apartment had become a funhouse tilt room. Trent suggested they go to an ER. She declined, figuring she\u2019d sleep it off. He agreed to watch and wait, but if things didn\u2019t improve, he would take her anyway.<\/p>\n<figure id=\"attachment_17857\" aria-describedby=\"caption-attachment-17857\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-17857\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized.webp\" alt=\"Cassandra Witt works out in a gym\" width=\"640\" height=\"361\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized-300x169.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized-1024x578.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized-768x433.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized-150x85.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08093934\/Cassandra-face-working-hard-sized-200x113.webp 200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-17857\" class=\"wp-caption-text\">Cassandra Witt works out at TRU FIT Athletic Club in Westminster, She has made an incredible recovery from a traumatic brain injury in November that forced her to suspend all her training.<\/figcaption><\/figure>\n<p>She slept late into the next morning. She was dizzy when she woke up. And now she had a splitting headache. Trent took her to the\u00a0<a href=\"https:\/\/www.uchealth.org\/locations\/emergency-room-thornton-120th\/\">UCHealth Emergency Room<\/a>\u00a0at Colorado Boulevard and 120<sup>th<\/sup>\u00a0Avenue in Thornton. The emergency physician ordered CT and MRI scans, some of which Witt slept through, \u201cwhich tells you how out of it I was,\u201d she said. The physician asked why she had waited to come in. With a\u00a0traumatic brain injury\u00a0(TBI) in particular, it\u2019s always better safe than sorry. The doctor in Westminster, concerned with what he saw, transferred her to\u00a0<a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-university-of-colorado-hospital-uch\/\">UCHealth University of Colorado Hospital<\/a>\u00a0on the Anschutz Medical Campus. Neurosurgeon\u00a0<a href=\"https:\/\/www.uchealth.org\/provider\/steven-ojemann-md-neurological-surgery\/\">Dr. Steven Ojemann<\/a>\u00a0led the care team there. The care started with more scans. The scans found a hairline skull fracture, a brain bleed and, in a vein toward the right side of the back of her head, a blood clot (technically, a\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3858762\/\">sinus thrombosis<\/a>).<\/p>\n<p>Big, risky clots can be removed using a minimally-invasive procedure involving a catheter. Ojemann determined that Witt\u2019s clot was of a nature that a blood thinner \u2013 warfarin \u2013 would do the trick. She stayed at UCH for two weeks as Ojemann and colleagues found the right dosage (her metabolism, amped up by her bodybuilding, made this a challenge). She would have to take it for another two-and-a-half months when she went home, too, plus twice-daily shots of another blood thinner, enoxaparin (trade name Lovenox).<\/p>\n<h2><strong>Risks with blood thinners<\/strong><\/h2>\n<p>The shots weren\u2019t a problem for Witt. The big deal was that she was under strict orders to avoid strenuous physical activity as a result of her traumatic brain injury. That meant no working out. It fell to UCHealth neurosurgeon <a href=\"https:\/\/www.uchealth.org\/provider\/christopher-roark-md-ms\/\">Dr. Christopher Roark<\/a>, who took over for the inpatient team when Witt transitioned to outpatient care, to stress the importance of compliance.<\/p>\n<figure id=\"attachment_17863\" aria-describedby=\"caption-attachment-17863\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-17863 size-large\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized.webp\" alt=\"Cassandra Witt works out on pull-uobars\" width=\"640\" height=\"435\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized-300x204.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized-1024x696.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized-768x522.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized-150x102.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08095106\/Cassandra-with-bars-from-the-back-sized-200x136.webp 200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-17863\" class=\"wp-caption-text\">Cassandra Witt works on bars at a Westmister gym.<\/figcaption><\/figure>\n<p>\u201cThe hardest thing with her, quite honestly, was convincing her that the best thing for her body was to take it easy, because she\u2019s not wired that way,\u201d Roark said. \u201cWe had to convince her that, hey, for three months while you\u2019re on blood thinners, you\u2019ve got to take it easy. And if you do that, a year from now, this all will be just an unpleasant memory.\u201d<\/p>\n<p>The risks of working out included that of falling again, which could trigger another brain bleed, this one made worse by the blood thinners. Also, it\u2019s easy to get dehydrated during workouts of the sort Witt put herself through, which can slow blood flow and make a blood clot worse. Going back to bodybuilding too soon risked not being able to go back to bodybuilding at all.<\/p>\n<p>\u201cThey put the fear of god in me,\u201d Witt said.<\/p>\n<p>The day she got out of the hospital, she was back at the gym \u2013 but coaching, not training.<\/p>\n<p>\u201cIt almost made it worse because I had to watch everyone else working out,\u201d she said.<\/p>\n<p>She had, prior to the traumatic brain injury, been building toward her first competition (Witt had only started lifting weights two years earlier, the goal at the time having been to look good in a wedding dress). An Instagram group of friends posting about their training in preparation for it became so hard to read that she \u201cgot off Instagram and Facebook,\u201d she said.<\/p>\n<h2><strong>Back, bigger after brain injury<\/strong><\/h2>\n<p>At the same time, she recognized that she was still recovering. When she went to fill her Lovenox prescription after leaving UCH, she couldn\u2019t remember her phone number. She\u2019d had it since high school.<\/p>\n<p>\u201cIt was a slap in the face: this really happened,\u201d she said.<\/p>\n<figure id=\"attachment_17879\" aria-describedby=\"caption-attachment-17879\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-17879 size-large\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08103139\/Cassandra-working-with-ropes-sized-e1578073869729.webp\" alt=\"Cassandra Witt works with ropes in the gym\" width=\"640\" height=\"398\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08103139\/Cassandra-working-with-ropes-sized-e1578073869729.webp 640w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08103139\/Cassandra-working-with-ropes-sized-e1578073869729-300x187.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08103139\/Cassandra-working-with-ropes-sized-e1578073869729-150x93.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/08\/08103139\/Cassandra-working-with-ropes-sized-e1578073869729-200x124.webp 200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-17879\" class=\"wp-caption-text\">Cassandra Witt works with ropes at a local gym.<\/figcaption><\/figure>\n<div class=\"su-callout-box col-xs-6 col-sm-6 right\" style=\"background-color:#dce4e7; color:#2e3b44;\">\n<h2><strong>What is a traumatic brain injury?<\/strong><\/h2>\n<p>A traumatic brain injury is caused by a bump, blow or jolt to the head that disrupts normal brain function. The severity of extent of brain tissue damage can range from mild to severe. Consequences of a brain injury can affect all aspects of a person\u2019s life including, physical, mental and emotional health.<\/p>\n<h2><strong>Leading causes of TBI<\/strong><\/h2>\n<ul>\n<li>Vehicular crashes<\/li>\n<li>Falls<\/li>\n<li>Violence<\/li>\n<\/ul>\n<h2><strong>Symptoms of a TBI<\/strong><\/h2>\n<p>Mild: Fatigue, headaches, visual problems, memory loss\/amnesia, poor attention\/concentration, sleep disturbances, dizziness\/loss of balance, irritability, depression, nausea\/vomiting, sensitivity to light and sound, mood changes, confusion and slowness of thought.<\/p>\n<p>Moderate to severe: Agitation, poor attention, difficulty concentrating, distractibility, poor memory, slowness of thought, confusion, impulsiveness, perseveration, little or no awareness of inappropriate behaviors, difficulty starting tasks, limited problem solving, poor time management, deficits with reading, spelling and writing. Difficulty understanding or producing speech correctly, slurred speech, swallowing deficits, changes in vision, ringing in ears or changes in hearing, seizures, pain, sleep disturbances, uncontrolled bowel and bladder function and personality changes.<\/p>\n<\/div>\n<p>She noticed a change in her temperament \u2013 in particular, that she had become \u201cshorter-fused\u201d when it came to little things that might not have made her angry before. But she gradually got better, and a February 2018 MRI scan showed the clot to have dissolved. She could work out again, Roark told her.<\/p>\n<p>She had lost a lot of strength. She was doing shoulder presses with 30-pound dumbbells before the traumatic brain injury in December. Now she struggled with half that weight. But working out six days a week, she was back to the status quo within six weeks. She wasn\u2019t stopping there: she made her competition debut at the July 2018 National Physique Committee Colorado State Championships at the Buell Theater in Denver.<\/p>\n<p>What a debut it was. Of the three events in which she competed, she placed second in two and fourth in the third.<\/p>\n<p>\u201cIt was the most fun I\u2019ve had in a very long time,\u201d she said.<\/p>\n<h2><strong>TBI advice<\/strong><\/h2>\n<p>More than a year later, Witt is a successful independent personal trainer and nutrition coach while helping run a nutritional supplement company in Westminster on the side. She hasn\u2019t competed since \u2013 but there\u2019s a reason for that.<\/p>\n<p>During that July 2018 competition, she went onstage in the \u201cFigure\u201d class, which requires muscle mass and definition, but not the bulk, muscle striation and popping veins of the next class up \u2013 called \u201cPhysique.\u201d The five-foot-four-inch Witt weighed 125 pounds on the Buell stage; when she competes again next summer, she\u2019ll be at about 140 pounds and equally lean (she\u2019s shooting for a body fat percentage of about 11%, she says). She figures she\u2019ll be shoulder pressing 60-pound dumbbells by the time she flexes for the Physique judges.<\/p>\n<p>For those who <a id=\"\" href=\"\/diseases-conditions\/concussion-management\/\">bang their heads<\/a> \u2013 in pajama-related incidents and otherwise \u2013 Witt has two pieces of advice. First, <a href=\"https:\/\/www.uchealth.org\/services\/neurology\/concussion-management\/\">get to an emergency room<\/a>.<\/p>\n<p>And second, have faith, because things, as she put it, \u201cfind a way of turning out the way they\u2019re supposed to.\u201d The experience also made her mentally stronger and more determined, which she credits for doing so well her first time on the stage and powering through the long hours and pain involved in building an even more formidable physique ever since.<\/p>\n<p>\u201cGive yourself time to heal, and don\u2019t get frustrated,\u201d she said. \u201cYou\u2019ll heal with time. You\u2019ll recover.\u201d<\/p>\n<p><iframe loading=\"lazy\" title=\"I Did - Director&#039;s Cut | UCHealth\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/_ud9KmwXHNc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>She played basketball, soccer and volleyball in high school. She has done rock climbing; she has gone skydiving. These days, Cassandra Witt, 31, is a personal trainer and professional bodybuilder. She is, to summarize, young, coordinated, and wicked-strong. Which makes the adage, \u201cIf it can happen to her, it can happen to anyone,\u201d all the [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":17858,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[570,3418,184,4624,2487,2488],"class_list":["post-17855","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-brain","tag-concussions-and-head-injuries","tag-neurology","tag-neurosciences-outcomes","tag-tbi","tag-traumatic-brain-injury"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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