But you know what? I still raced. We finished twenty-first at Daytona. And except for my meeting with Rick, I must have done a pretty nice job of acting normal. I had a pre-race media session that lasted a half-hour, and you know how many concussion questions I got? Zero. Same for the post-race. The Big One happened on just past the halfway point of the night, and I got jostled around a little but managed to snake my way through the pileup without suffering a big lick. As bad as I already felt, I can’t imagine what I would have been like if I’d suffered another big hit that night.
We were full bore toward the next weekend’s race at the bumpy Kentucky Speedway, but that whole week I felt terrible. When we made a visit to the Nationwide Children’s Hospital in Columbus, Ohio, it exposed a trigger that has continued to varying degrees ever since. This might sound odd coming from a guy who has spent his whole life in crowds, whether it was following my dad around as a kid or making my living in front of thousands every day, but I’ve never felt comfortable when I’m surrounded. That’s particularly true when it’s a really overstimulating environment, like a big event, and even worse when the focus is on me. You’d think I’d be used to that by now, but I’m not.
Now, that kind of situation didn’t merely make me nervous or anxious. It taxed my mind to the point that it set off my symptoms so badly that I felt like I needed to grab ahold of something to stay upright. The thought that other people might see that and realize I was struggling only made it worse.
Still feel wobbly. It gets worse in populated areas or when I’m being fed a lot of information. Went to Children’s Hospital and felt very dizzy going through the appearance. I feel worse wearing sunglasses than without. No sinus pain or headache.
Turning around quick or any quick movement makes me lightheaded for a second.
Saturday, July 9, 2016
Kentucky Speedway
The next weekend, I had another new at-track symptom. We were in the garage after a practice session, and I looked up at the scoring pylon to see where everyone had run. The numbers on that pylon were fuzzy, out of focus. I asked my PR rep if it looked fuzzy to her. She said no.
At track for practice. Have some moments walking around that get me dizzy. Head feels weird, some sinus discomfort possibly. Blurry vision at 50 or more feet. Eyes feel sore and irritated a little bit.
Felt off balance all weekend. Worse on Friday and Saturday and through the next week.
We finished thirteenth at Kentucky, marking two consecutive races without any additional hits, and now I was nearly a month removed from my last crash, the one at Michigan. But that didn’t stop my symptoms from hanging around. Now, they never seemed to take a break. It was seven days a week, and they were getting worse. When I read this now, it kind of feels like all those other notes, starting in April 2014, were leading up to this one.
Dealt with more and more nauseous feelings. Mentally felt sharp. But standing balance was bad and head felt like it was hit with a bat. Just felt in a constant state of daze.
Went to doctor on Tues and Wed. Ruled out everything like allergy or inner ear.
Docs think it’s a brain injury.
While the rest of the NASCAR world was preparing to travel to the New Hampshire Motor Speedway for the season’s nineteenth race, Amy and I were back at Dr. Jerry Petty’s office. We ended up there because I had finally done what I should have done much earlier, at the very least two weeks earlier at Daytona. On Tuesday morning, when I woke up, stood up, and could barely walk straight, I called Rick and I finally confessed to him how bad I’d been feeling. What I proposed was that we should see how I felt by week’s end, but to have Alex Bowman ready to jump into my car, just in case.
Rick was not happy with me. He said he wasn’t mad at me because he was my boss. He was mad at me because he was my friend and he didn’t want me to suffer. What Rick says now is that he realized something wasn’t right with me when I blew up on him in his motorcoach at Daytona, but he didn’t realize how bad it really was. Not until I called him with this news.
He told me that I had been stupid to be out there racing while I felt like this, and that, no, he wasn’t going to call any substitute drivers yet.
Then he told me to stop screwing around and go see Dr. Petty.
I remember I drove to Dr. Petty’s office in Charlotte, and when I got out of the car I had to walk really carefully across the parking lot, hanging on to the rail and the front door. That’s how jacked-up my balance was. What started as a small symptom had now grown to the point that any movement that included rotation of my head and eyes, like walking around a corner or up a set of stairs, would trigger a total imbalance, like I was going to fall down.
With that in mind, Dr. Petty took me upstairs and put me through a set of tests designed to identify inner-ear issues that racers can develop, like vertigo and what we’ve always called rocks in your ears. The goal of those tests was to try to re-create the conditions that caused my imbalance, but they couldn’t do it. We did another MRI, and I took another ImPACT test. Dr. Petty looked over all the results and knew instantly what the cause was. The scans were fine, and my new ImPACT results lined up very nicely with my last baseline test in 2014, except for one aspect. My visual memory was lagging.
“Dale, you’ve suffered another concussion. You aren’t racing this weekend.” He called Rick and told him the same thing.
The notes that I took over that weekend only further emphasize how irresponsible it would have been for me to have tried to drive my car at the next race at New Hampshire Motor Speedway. On Friday, while Alex Bowman was qualifying the No. 88 in the twenty-sixth starting position, this was me:
Woke up Friday morning feeling really drunk. Worse than before. Kinda clearing up a little as I get moving but balance is worse than it’s been. Got in car at lunch with L.W. and felt very very dizzy and nauseous as I’ve ever been.
Close to puking. Seems to be getting worse. Cleared up back to original symptoms an hour later and was steady the rest of the day.
On Saturday, while Alex ran twenty-second fastest in the final “Happy Hour” practice session:
Saturday woke up much like Thursday. No improvement. Slept very late. Had a moment laying down when the room spun perfectly counterclockwise 45 degrees. That was new. It was over as quick as it happened. Balance issues very similar as the past few days as of 1 pm. When I get up I get very wobbly and nauseous. Only feel better laying or sitting. Head feels like it’s super heavy when I don’t lean it on something. Went to the hospital for a CT scan. Got really wobbly and drunk feeling by all the stimulation of the people and hallways and activity. But my emotion was fun, not anxious.
On Sunday, while Alex finished twentieth in the race, the final car on the lead lap:
Sunday. Woke up early real wobbly. Even laying down, movement made me feel drunk. This day feels pretty bad, like Friday. 11 AM I feel terrible. Severe imbalance. Disoriented. Nausea, real close to vomiting. Felt much better later in the evening around 5. So much better. Way tolerable. When I went to get ready for bed at 9 I felt worse. Climbing stairs and walking 100 or more feet really made me drunk and nauseous. I laid in bed and felt better.
You know, it’s strange when I think about it now, but when Dr. Petty broke the news to me that I would have to sit out New Hampshire, it wasn’t the devastating moment that it had been in 2012, the previous time he’d told me that I had to get out of my racecar. I think part of it is that I was actually a little relieved that we had a diagnosis. It was out in the open now. I didn’t have to keep on being so sneaky about it. But I also think that the news was manageable because I believed that I was probably just going to miss one race. I’d sit out New Hampshire, get some rest, do some exercises, and be back for the Brickyard 400 at Indianapolis Motor Speedway the following weekend. That’s pretty much how it had gone down in 2012, right?
Tuesday, July 19, 2016
Pittsburgh, Pennsylvania
Like in 2012, we were headed back to Pittsburgh.
Today we get up early and go to see Micky. I felt exactly the same this morning as most other mornings. No nausea getting ready. I sense my balance giving me problems when I’m up and walking but I’m less aware of it. I’m either getting used to it or it is slightly improved.
It’s so hard to measure because my vision hasn’t changed, but my eyes have a hard time locking onto a moving object. My eyeballs and my inability to operate them properly is frustrating . . . When the plane would turn to ascend or descend it would trip my head out.
When I walked into the UPMC Sports Medicine Concussion Program offices, I was surprised to be back. Dr. Micky Collins, however, says he wasn’t super surprised to see me again. He had nailed me and my personality in 2012. I was a worrier. I was prone to anxiety. I internalized a lot of what and how I felt, just as I was internalizing the details of my illness, shared only in my private notes. I tell people all the time that my 2012 accidents had made me feel more susceptible to future injuries, and Micky believed that too.
So here we were, face-to-face once again. We chatted about those four years since our last visit, and we did an inventory. It was scary. I counted up ten incidents that I believed may have resulted in concussions. Ten. There had been five crashes this year alone.
As we had our conversation, we also had an audience. In 2012 it had only been me, Amy, and Dr. Petty in the room. Now the three of us were joined by Kelley; her husband, L.W.; and Mike Davis. My initial consultation with Micky was with that whole group sitting there with us, watching and listening.
The audience aside, the setting and the situation were like déjà vu, like 2012 all over again. But what I couldn’t tell was how much more refined the processes had become for Micky and his staff in the four years since I’d been there. Remember when I told you about all those people lined up in his office during my first visit? The UPMC clinic sees 20,000 cases per year. That means they’d had 80,000 patient visits between my first appointment and this one. Think about how much information had been gathered over that time. In racing, we are constantly discovering new ways to make racecars go faster, using the tiniest changes to the most obscure pieces and parts of the car, stuff we would have never even thought to look at just a few years ago. That’s how fast the technology of racing moves. Well, the technology of brain science moves even faster. You can read a book or an article now—and I’ve read most of them—that was written just a few years ago, and so much of it already feels dated. Just like trying to run a 2012 model racecar in a 2016 race.
Micky immediately recognized that my symptoms were more severe than 2012. Then, it had all been sort of a general fog with only flashes of anxiety, balance, and vision issues. Now, all of that more intense stuff was around all the time. So were my irritable mood swings, nausea, and sensitivity to busy, overwhelming environments. Back in his office I was reminded of his explanation from four years earlier, about the six different types of concussions—cognitive/fatigue, ocular, migraine, cervical, anxiety/mood, and vestibular. There were posters all over the UPMC building explaining those six types and listing the symptoms of each.
It all sounded like what was happening to me. All of it. Had I suffered all six types? Micky reminded me of another lesson he’d taught me in 2012, that the brain’s regions and systems didn’t exist in separated compartments. They are all interconnected through constant communication. So when there is an injury to one area, it’s going to affect the others. It’s really not unlike the geometry of a racecar. If we make a chassis adjustment to the right front corner, then that also affects the left rear, the corner connected to it diagonally. Likewise, if one of those corners is damaged and the car is no longer in balance, then that’s going to create wear and tear throughout other areas of the car when they are working to compensate for the corner that’s no longer keeping up.
Micky explained to me that, like 2012, my primary issues were rooted in my vestibular system, the sensory system that controls our sense of balance and spatial orientation, and uses those to coordinate our movements. That’s tied to our eyes. For me, it also tugged on my emotional systems. Why? Because when the vestibular and ocular systems are not working at 100 percent, it leads to increased analysis, anxiety, and worry, especially for a person with my personality.
The term Micky uses is rumination. I ruminate. A lot. He realized that in 2012 too. That’s why he wasn’t so surprised to see me back in the building all those years later.
As Micky sent me off to the gym to be evaluated by the physical therapy team, there was plenty of ruminating going on among the large group who’d made the trip to Pittsburgh with me. While I was being pushed on exercise machines and in front of computer screens to figure out where my new mental and physical limits were, Dr. Petty was in constant contact with Hendrick Motorsports, who was wanting to know as soon as possible what my status was going to be for the Brickyard 400. Meanwhile, Kelley was running our businesses from the lobby of UPMC, all just as anxious to know if the guy whose name was on the building would be racing five days from now. On the other ends of their phone lines were our sponsors.
Don’t misunderstand here. No one was calling and screaming, “What’s up with Dale? We have to know!” But there are so many parts and pieces and people and scheduling connected to every race weekend, and it’s all dependent upon me being there to participate. Some poor sales guy, he’s been working for months to do a big deal, and his closing move might be that the CEO gets to chat with me at the Brickyard, but now I might not be there—that guy needs a heads-up. The race team is about to load up our racecar for the weekend, and they need to know what driver is going to be in that car when they hit the track for practice on Friday.
So I understood the concern. And I like to think they were also worried about, you know, me.
While everyone paced the floor of Micky’s office, I rode an exercise bike and did rounds on an elliptical machine. I also did what they call dynamic exercises: thirty rounds of deep squats, lunges, and medicine ball rotations, where I would catch a heavy ball, turn to one side or the other, and toss it to a target behind me. I also did functional testing, speed-stepping up and down on a one-step frame, forward/backward jogging, and a jump/turn/toss. After every exercise, measurements were taken, looking to see what symptoms, if anything, had been triggered and how bad they became. What they found was that when dealing with straight horizontal lines—anything that moved horizontally and kept my eyes focused straight ahead—I was okay. But anything that moved off that line, that went vertical and took my eyes into different directions, that’s when my mind struggled to keep up.
Looking at Micky’s notes from this appointment, it says that on the bike I showed no symptoms, but the elliptical triggered both dizziness and headaches. Squats and lunges? Nothing. But the twisting and turning of those medicine ball rotations registered a six out of ten on the dizziness scale. The speed step drill—quick movements up and down on a little one-step platform—that was the worst. That scored an eight on dizziness and a five on nausea.
After a couple of hours in the gym, Amy and I rejoined the group. Micky came in with the new data in hand. That data didn’t tell him that I was concussed; he’d known that as soon as he’d seen me. What it did was put the focus on my specific issues, giving us a target to hit and allowing his staff to design a rehabilitation plan aimed at that target. They call it exertion therapy, using exercises to take me right up into my symptom triggers, and then using those same exercises to retrain my mind, eyes, and body how to work together to handle those situations. If an exercise made me feel bad, then I would take that home with me and do it until it no longer made me sick. If an exercise didn’t cause any issues, it went off the list.
This time around, my homework included exertion exercises—squats, lunges, “wood chop” catches and tosses of the medicine ball, time on the stationary bike and elliptical machine, and those dang speed step-ups. There was also a list of four finer tasks. There was a backward ball toss, where someone would have to stand b
ehind me as I threw a ball over my shoulder to them, then I would rotate and catch it on the other side, and repeat. I did a “standing static” that on paper looks like nothing—standing on a soft cushion, feet together, and closing my eyes for twenty seconds. All I was supposed to do was stand there. But when I closed my eyes, I would lose my balance and pitch one way or the other. It was the same for my “gait” test, which is basically the same test a police officer gives someone when they’ve been pulled over for a DUI check. You walk heel-to-toe along a straight line, twenty steps, with your eyes closed. I couldn’t even come close. I’d get to the third step and just veer off to the left to the point that I’d have to catch myself.
Micky was very matter-of-fact about my condition. He reiterated the importance of keeping my anxiety level low, toning down those ruminations, and prescribed me a low dose of Klonopin, an anti-anxiety medication, with the hope that it would help me focus on my rehab tasks and not the reason for them.
What he said to me next also helped. It was the same promise he made in 2012: “Dale, we can fix this. This is treatable.”
Then, taking the temperature of the room, he reminded me of what the real issue was here. It wasn’t the Brickyard 400 or sponsors or schedules. The only schedule that mattered now was the one I had in my hand, the one that listed my daily exercises. He knew I was worried about all of that other stuff, the racing stuff. I was ruminating again. “I don’t care about any of that,” he told me. “All I care about is making you better and giving you the tools to repair this. Right now, that’s what you need to care about too.”
Micky told me that he would see me again in two weeks. Everyone in the room looked at their calendars, and they knew what that meant. I would be out of the car not just for Indianapolis but the following weekend at Pocono Raceway too.
Dr. Petty dialed Rick Hendrick. All he said was, “He ain’t racing.”
CHAPTER 7
Racing to the Finish Page 10
