Sports have always been a big part of Cassidy Nicholls' life, but now the former competitive athlete can barely watch a hockey game without feeling sick.
After a childhood spent playing soccer, volleyball, basketball, curling and lacrosse, Nicholls fell in love with field hockey. Her passion and talent led her from Winnipeg to York University in Toronto, where she competed for 4½ seasons with the Lions before a pair of concussions ended her career.
Nicholls' first diagnosed concussion, in her first year of university, was unrelated to sports.
"I fainted and I hit my head really hard," she said.
"So that was my first kind of serious concussion, and I went through the concussion protocol for that. I was cleared after about five months to play back on the field hockey team."
Nicholls didn't think anything of it after she was cleared. She played for four more years.
In her final year she suffered another major concussion, this one during a practice.
"My teammate accidentally hit me with their stick," she said. "It was pretty lightly. She got me just in the cheekbone."
Nicholls continued to play despite knowing something was wrong.
"It was very clear to me I had a concussion, and I think a lot of my teammates were wondering the same thing, because I wasn't myself and didn't play very well," she said.
"I think adrenaline kind of took over during the games.… I felt fine but it was after the game that I really felt the effects."
After games she felt foggy and exhausted for longer periods of time. She ended up missing half the season in her final year.
Headaches, dizziness, light sensitivity
Despite her head injuries, Nicholls was able to graduate from York with a kinesiology degree before returning home to work for Sport Manitoba.
But for the last two years, she's continued to struggle with post-concussion syndrome.
"It's been difficult," Nicholls said. "Things like social gatherings for me are really, really tricky."
The 24-year-old has had issues with her vision, frequent headaches, dizzy spells and sensitivity to lights and noise. Events and activities she used to enjoy now cause her pain.
"I love going to watch the Jets, but I know I need, like, three days to recuperate," she said. "The lights and all the noise — I have really bad headaches."
Nicholls is sharing her story in the hopes of teaching other athletes to take concussions seriously.
"I think the No. 1 thing with concussions is we need to remember that it's not like another injury," she said.
"You only have one brain. You don't get a second shot at it."
Nicholls has spoken on panels, written an article and tweeted out a video through Sport Manitoba.
Dr. Mark Bayley, the medical director of the Toronto Rehabilitation Institution's brain and spinal cord program, has researched rehabilitation following brain injuries.
Post-concussion syndrome can vary among individuals and include headaches, dizziness and blurred vision, but range to more serious symptoms like insomnia, difficulty with memory and emotional changes, he said.
For most patients, post-concussion symptoms last two to four weeks, but in rare cases, symptoms can last for extended periods of time.
"There is still a small percentage who are in what they call (the) 'miserable minority,' who unfortunately do not get better."
The reasons include the number of concussions suffered and vulnerability to symptoms, Bayley said.
"Some people have really quite a vicious cycle," he said. "They get overwhelmed easily and anxious, and that makes it worse."
Some of Bayley's research took a closer look at who is getting better and why.
"We recognize that some people have a tendency to do too much, too early, and other people have a tendency to not do enough," he said.
"We probably need to take the individual and provide them with a program that's based on their type."
Research and awareness of concussions, particularly in sports, is leading to improvements in diagnosis and treatment, Bayley said.
"I think many in sport have adopted protocols that pull the individual athlete out of the field or the arena and do specific testing," he said.
"I think those protocols have been really instrumental at reducing the number of people who get repetitive concussions."
There is still room for improvement, especially in education and awareness for athletes themselves, he said.
"Over the age of 12, we should probably teach them the signs of a concussion," Bayley said. "We probably should tell them that if they're not feeling right, they need to get out of the game."
'I hope to get back to 100%'
Nicholls has seen many specialists in Manitoba and is working with a chiropractor who has helped improve her vision.
She hopes she will be able to be an avid reader again and believes she will make a full recovery.
"I can't pick up a book anymore and just read. That's really difficult, so that's what we're working on right now," she said.
"I hope to get back to 100 per cent in the near future."
Nicholls is still involved in field hockey as a coach for the girls' team at Miles Macdonell Collegiate in Winnipeg.
Many people have reached out to her with questions and their stories, she said.
"I wish someone had sat me down when I had my first concussion and had talked to me," she said.
"I think every time someone shares a story, we're able to reach one more person who's feeling a little bit alone in their concussion journey, and for people to be honest with how they feel."