Head Protection for Curling & Skating

November 8th, 2018 by Potato

Concussions are no joke. The more research we do, the more caution it seems we should be taking. We’re learning about the dangers of second impacts, and concussion protocols are more common in lots of sports, and after a suspected concussion players are getting benched more consistently. Helmets for more and more things are becoming a bigger part of our lives.

I’m good with that trend for the most part. I was wearing a bike helmet at school in the 90’s, before it was mandatory and when it was still kind of dorky (though that quickly changed with the help of the law). I still wear my helmet every time I go out on my bike. It just makes sense, and it’s totally socialized now to be the norm: you protect your lid on your bike.

I go years between falls in curling, and have never hit my head… so far. I fall more in recreational skating, but despite slapping a helmet on my kid, don’t wear one myself in either sport.

Plus, as such things go, a friend had a concussion (not from curling, but it still makes you think) and I had one of my rare, once-in-a-hundred-games fall a few weeks ago (not on my head, but again, it makes you think). There were some cases in the news, reminding us that while you fall less with experience, even pros take a tumble, and in rare cases they can be deadly. This year I’m playing mixed doubles, too, which involves more jumping up to sweep your own rock and generally more sliding around without a gripper on, which I figure is slightly more risky. So I think I’m ready to once again be the dorky kid protecting my noggin before it’s totally cool, which is helped along by my birthday present from my very generous parents: they gave me money for a whole new set of curling gear: new shoes, new pants, new brush head, and a head protector.

Recently, some head protectors that are not helmets have come out for curling and skating: some variation of a hat or headband with extra padding. And I’ve seen more being used on the ice (still a small minority of players, mostly older or newer players, but it’s moved beyond the “that one guy” phase to a growing trend).

And even without a standard to say exactly how much they help, any one of the options should be better than nothing (indeed, the warning label on one says that it’s not designed to be a helmet, just to be better than nothing). The different companies have tested their gear, with the two Canadian ones passing (of course) the test hockey helmets use for falls. I don’t know if I can reproduce the testing results they sent me, but roughly speaking these will cut down the impact of a fall by about a third to a half.

My research turned up three companies to look into:

So I ordered a few for myself, and for Wayfare for skating… enough to fit out a whole team so I could share with friends (with medium-to-large heads) when I inevitably try to drag them out to learn to curl at a funspiel, and of course write about them for the blog!

Ice Halo

I tried a flexfit ballcap style Pro-Hat and a Halo HD. For protection, Ice Halo uses a high-density foam: this will compress and spring back into shape if you give it a firm squeeze, but it’s for higher impacts, so this is not like a squishy pillow. The halo is, as the name implies, a ring all the way around, and will stretch to fit a few different head sizes. The had just has foam in an arc around the back and part of the sides, about half the thickness of the Halo HD. Both the hat and Halo HD use elastics cleverly built into the product to keep it snug on your head, and it does fit snug. Which, I suppose it has to in order to stay on your head in the event of a fall. The hat didn’t bother me while wearing it, but I was left with a bit of a mark from being tight on my forehead. I found the Halo HD could get uncomfortable after a while, especially if I tried to wear it right against my ears (and thus my glasses). However, if I positioned it just right, the gap where the two arcs open for size created a nice little nook for the top of my ears and the arms of my glasses. To be fair, I’m right at the upper edge of what the medium is supposed to fit (though Wayfare also thought it was snug and she’s in the lower end of the size range). The instructions say to pull at the front, which does loosen it up, but the elastics will tighten it up again in a minute or two, so you kind of have to constantly do that.

I didn’t mind it without my glasses (indeed, all of these options will be fine for people who use contacts to sport or who don’t need vision correction), but then I can’t play like that.

The Ice Halo products had no weird chemical smell when arriving, and coming from within Canada the shipping was the fastest. Though the impact testing results for all options look to be in the same general range, the Ice Halo HD did look to have the greatest cushioning of the options here (which fits with intuition, as there’s the most foam there to compress), but I’m not sure how meaningful the difference is — in my non-expert view, finding a head protector you’ll actually wear consistently may be the best criteria.

An Ice Halo HD on my head.
It’s a slightly thick headband that I’m not wearing over my ears.

An Ice Halo ProHat ballcap on my head.
It looks like a ballcap, with a bit of a bulge.

An Ice Halo ProHat ballcap on my head, more rear-view than the previous.
You can see the bulge of the protective foam from the back.

Crasche

Crasche builds their products around modular protective inserts, backed by strong polycarbonate and lined with neoprene, which would be reusable after impact.

I got a Crasche Curler touque, which has two thinner protective elements in the front and two tall, regular thickness ones in the back, as well as a Middie (designed for skating, but I might also wear it curling sometimes). The Crasche products are soft material with special pockets to hold the protective inserts, which you can easily slide out to clean or to adjust the fit (e.g., they suggest turning some pads upside-down to make your middie fit tighter, and presumably you can sacrifice some to make it fit looser).

Though the protective elements are rather different from the Ice Halo, for the Middie the look from the outside is quite similar: a black headband of about the same thickness. I found the Middie a touch more comfortable, despite their size guide suggesting my head was too big for the size I got. On my head it naturally sits just a bit above my ears (and glasses), and the segmented nature let me adjust the front a bit independently of the back (i.e., it could bend a bit in the middle to go around my ears while still being low on the back of my head). However, the harder inserts do play greater havoc with glasses if the fit does put them over the ears.

The touque I found quite comfortable to put on for short periods. However, it had a tendency to skootch up my head when I tilted my head far back (for instance, when throwing a stone) so I had to keep pulling it down. The band around the edge is also fairly tight (which I suppose it has to be to stay on your head in a fall), and the hat wasn’t quite big enough to totally cover my ears, which was awkward and meant that as I was adjusting it, I’d often end up screwing up how my glasses sat on my ears, which would lead to a cycle of adjustments. Wayfare thought it fit her well, so even though my 23″ head should fit the 21.5-23″+ size, it might be just a hair too small for me, which is affecting the comfort. I might try it with just the rear pads installed and update later.

A few nitpicks on the choice of neoprene: the Crasche products smell strongly of neoprene when they first arrive, which may be an issue for those with sensitive noses — they may need some time to off-gas (after about a week the smell is not noticeable to me). Neoprene also doesn’t absorb moisture, so if I’m doing anything more energetic than holding the broom, I’ll find droplets of sweat lining the pads (on the flip side, they’re easy to wipe down).

Also, the site also says that Canada is duty free for shipping, and while that’s technically true (no duties or crazy brokerage fees thanks to using USPS for shipping), I did have to pay HST to pick it up at the post office, so be prepared for that.

A Crasche Middie on my head.
The segmented plates let this bend around my ears a bit, but otherwise it looks very similar to the Ice Halo HD.

A Crasche Curler hat on my head.
In terms of style/look, the Crasche Curler was actually my favourite. Despite my lack of photograhy skills making this look black, the hat is their dark grey option.

Goldline

The Goldline headfirst line uses expanded polystyrene (EPS, the hard foam in bike helmets) to make their pads, which go inside a variety of holders — hats, bands, or visors. Whichever style you choose, the pads all cover the back of the head only.

This is by far the most common style I see other players wearing, perhaps in part because Goldline has a store on this side of town so people can buy in person rather than ordering online, and their products are also available at Spokes & Sports in Toronto.

A Goldline headband and Ice Halo Pro-Hat side-by-side on a table.
Side-by-side photo of the Ice Halo Pro-Hat and Goldline protective pad in a headband style.

Unfortunately I wasn’t able to find one in my size to show side-by-side with modelled on my head, but their marketing photos do a good job of showing what they look like. I did borrow one to show side-by-side with my Ice Halo pro hat how much thicker the pad is.

Summary

Really, any of these is likely better than nothing when out on the ice.

I preferred the hat styles to the band styles, and have the Ice Halo Pro-Hat and Crasche Curler in my curling gear bag to try out further, though after a few games I’m quickly gravitating toward the Ice Halo hat as my main choice. After all, a ballcap style is a very natural style fit for me (I often wear one anyway). I do want to give the headband styles (Ice Halo HD and Crasche Middie) some more game time, as they do seem to offer a bit more protection than the ballcap, and I like the idea of having some padding on the front as well as the back. However, while I shouldn’t be able to feel shame at this point my life, and certainly not about curling fashion, I’m not sure the headband is a look I can pull off.

I have to say that all three companies were responsive when I bugged them for more details, and you should be able to find something that works for you from one of them.

As much as I’m high on the idea of something is better than nothing, I need to be clear that it’s hard to protect against concussions, and hard to test for that. There’s no guarantee that wearing one of these will prevent one.

There’s still a lot of research to do on concussions and how they happen and what a safe level of impact might be. There still isn’t, to my knowledge, a standard way to test for reducing concussion risk: the standards for hockey helmets and the like are designed around reducing traumatic brain injury and skull fractures. Don’t get me wrong, that is also good and should likely help with concussions, too, but for curling I’m not quite as worried about severe traumatic brain injury because it isn’t hockey: falling is the big risk, not getting beaned by a slapshot or checked into the boards at high speed or taking a skate to the forehead after falling in a tangle. So perhaps soft impact-dampening padding/foam is more important than a hard shell for mTBI. All products are careful to say that they are not helmets, cannot guarantee that they will prevent a concussion, and are designed simply to be better than nothing.

Note: All gear was paid for by myself or my parents, or borrowed from fellow curlers for pictures.

Another helmet option, not tested is from Asham. Consider this a kind of honourable mention

Never Weight — Q3-18 update

October 1st, 2018 by Potato

On August 29th my pants fell down while walking around the living room. So yeah, I’m feeling pretty good about my weight loss this quarter.

After the last update, a few things came together and I finally just did the thing I knew I had to be doing all along (but didn’t because it was hard): I started tracking everything I ate. I used measuring cups and a scale, and put it all into the FitBit app’s calorie tracker function (I had several recommendations for myfitnesspal, but I already had FitBit there to track my steps, and it worked well enough). I started eating a lot more fruit (helped by the fact that Ontario peaches and nectarines were in season so I just bought cases of those) and veggie sandwiches, and tracking, and paying attention especially near the end of the day as I was running out of calories in my budget. I bought just an absolute fuck-tonne of chewing gum, and had light breakfasts and lunches when I wanted to leave the ability to have pizza for dinner. And even on vacation, and even with all-nighters as a grant deadline came up, I stuck to my budget (though on vacation I was aiming for calorie balance for the week rather than a deficit, and with the all-nighters I chewed so much gum the artificial sweetners caused… umm… intestinal distress).

The final score: DOWN 19 lbs BABY. WOO!

I posted 7 days in about how hard it was to fight the cravings, but I stuck it, and it got better. I only have bad cravings every few days (and mostly after about 12:30am), so it’s become routine enough that it doesn’t take a tonne of conscious willpower any more. My habit is to check FitBit — can I eat that? Computer says no. Also, it wasn’t like full intermittent fasting, but I did delay or skip breakfast most days and put a limit on eating after midnight (pretending, as one does, that I was a mogwai), which also helped.

It’s still a total mystery though why I managed to actually do it this time. Yes, I had some extra motivation (a bad score on my cholesterol test, my dad going into the hospital, another quarter where the same-old wasn’t really cutting it), but I don’t think I was all that lacking in motivation before. I did have a bit of a mind-shift internally where I realized how much of my eating was not due to physical hunger, but I really can’t put my finger on how I managed to flip the switch to knowing that chocolate is not an emotion. That’s a bit disappointing because it makes it harder to help other people find that last bit of motivation or mindset or whatever, and also worrisome because I don’t know how easy it will be to stick to better habits for the long run (or re-start the diet after the inevitable future slip-up).

Of course, even this is a relatively minor achievement in the grand scheme of things. I hit my goal for the year, but the loss is still a fairly small change, percentage-wise — few people would notice if I didn’t tell them, and I’m a long way from being described much more charitably than having a “dad bod”. My BMI is still not great, and I have to continue being good for a lifetime to keep it off. And the “never weight” was something I set back in grad school as like a “ok, it would be ridiculous if I got that fat” level. So even losing ~20 lbs from that point still just puts me at about where I was in grad school — and no one was mistaking me for skinny then.

Looking ahead, the final quarter of the year features Thanksgiving, my birthday, Halloween, and Potatomas. I’m going to keep tracking, and the itty bitty candy bars may be a good way to have some treats but not bust the budget — I’ll have to see if I can be trusted, or if total abstinence is the only way to go. Either way, I’m going to take the season into account and adjust my budget & target to be a minor deficit (and I won’t freak if it averages break-even some weeks). I’m less than two pounds off my original goal for the whole year, but if I can make it through to New Year’s holding steady at this weight, I’ll call that a win for the year. My next plan is to get down to the “overweight” range according to my BMI by June next year, which means losing another 15 pounds, more gradually. And then keeping it off for a lifetime.

Anyway, goal reached, so start the countdown: the price of the course is going back up!

One thing that I was amazed with when losing weight is how fast some of my other health issues settled down. FitBit tracks my resting heart rate, and that’s come down almost 10 bpm in just three months. I also used to have heartburn a few times a week, and last month only had it twice (though that is likely less losing weight and more the fact that I’m not eating a bunch of chocolate, chips, and other heartburn-inducing foods right before bed). If I go to a life expectancy calculator, I’ve lost enough weight this year to add a year back to my life (whoops, gotta adjust the savings plan now ;)

Footnote:
I noticed that I started calling it a calorie “budget” and not a “diet” or “allocation”, and that tracking let me immediately see my “funds” left each day. I’m explicitly trying to leverage my ability to be good with money to be good with food, but I needed an easy-to-use electronic tracker to get there. Also, I’m eating a lot of convenience-esque food: almonds that are packaged in small servings, so I know I get 170 cal/serving and don’t have to weigh them, etc. It’s more than double the cost for almonds vs. just buying the big jug, but I think it’s a non-negligible component to success so I’m more than happy to pay for it.

How to Discuss Uncertainty: Cancer Edition

September 9th, 2018 by Potato

My dad has read Atul Gawande’s Being Mortal, which discusses the suffering that people can experience near the end of their lives — particularly the suffering of medical treatments to extend those lives. There was no question about having surgery to remove his tumour — the cost-benefit there was huge (esp. as it had sent him to emerg). But he explicitly did not want to go through adjuvant chemotherapy, because chemo sucks and he knows that first hand, and he didn’t think it would have much in the way of benefits.

Then we met with the oncologist and found out that the regimen he’d have now would be much less severe than the kind of chemo he had a decade ago, and that the benefits were very real.

But exactly how to convey those benefits is a tricky matter. She told us, roughly speaking, that 50% of people with his kind of cancer would still be alive and cancer-free 5 years out — the surgery alone totally cured them, and taking chemo would be a pain in the rear but not actually help them because they were cured already. 20% of people would have had their disease come back, but not with chemo, while 30% would see their disease come back regardless of chemo. So, a 20 percentage point increase in chances, chemo sounded pretty good.

But it’s hard to frame that in a way that sticks. After hitting the first wall in chemo side effects, “20%” didn’t sound that great any more. So my dad wanted me to explain it to him plainly: he was giving up 6 months of his life (or at least quality of life) to chemo. What was he giving it up for? “How much longer will I live?” And I get it: he wants the benefit expressed in the same units as the cost, which would make decision-making so much easier. But the cancer stats just don’t seem to be expressed that way.

And it’s complicated: it’s not as simple as giving up 6 months, as there are probabilities and uncertainties there, like permanent adverse events, versus the probability of having a recurrence and dying (or having a much harsher round of treatment), or the probability of being cured of cancer for the rest of his life but then having a heart attack or stroke. Even if he was cancer free in 5 or 10 or 15 years, how much longer would he live otherwise? And giving up a year at 69 when he could go golf or enjoy the cottage is perhaps not worth gaining a year at 79 where he might not be having as much fun. These are all hard things to say.

Later, I found a chart that looked basically like this that helped show the survival benefit:

A rough sketch of a survival curve for colorectal cancer patients with and without surgery, where the benefit of adjuvant chemotherapy is about a 20% increase in 5-year disease-free survival.

But even that is lacking, as when choosing whether or not to take chemo the percentage point increase may not be as important as the percentage increase. That is, if you’ve already got a 50% chance of survival, bumping that up to 70% is a 40% improvement in your situation — taking the chemo is better than the “20 percent” figure makes it sound.

So I made a pictograph, which I think may be a better framing for showing the benefit of chemo. The MSKCC nomogram has a similar display.

An infographic with happy faces to visualize the relative survival benefit of adjuvant chemotherapy vs surgery alone.

None of this really helps answer the question in the way my dad wants, with the benefit in the same units as the cost. I started to go down the road of maybe integrating under those survival curves, to try to quantify what the expected increase in lifespan was. I even went into some of the quality-adjusted life years research and found a set of results that I could use as a weighting function — after all, an extra month of good health at 69 is not quite the same as an extra month at 79 or 89. But I stopped because that’s guaranteed to be an exercise in false precision, and I’m not sure giving him what he wants there is the best way (and I’m also doubting myself because no one that I’ve seen in health science presents results in this way to patients — at most such things are used in health economics to talk about big picture costs and programs).

Decisions in Bad Times

September 8th, 2018 by Potato

Following my dad’s surgery for the big C, the standard of care is to give 12 cycles of chemotherapy to kill any cancerous cells that may be out there and help prevent the cancer from spreading or coming back. He had chemo just over a decade ago, and it is not a fun time, so he was a bit apprehensive at the notion before meeting the medical oncologist. But the oncologist laid out the plan and the stats and he said that it made sense and agreed to do it.

About a week after his first cycle the worst of the effects were hitting him hard, and he was done. No more chemo, no thank you. Making life miserable now for a chance at some extra years when you’re like, 80, is a bad deal and why would he have ever agreed to do it?

I went over the next day, made some soup, he started to feel better, and we went through some literature together. He agreed that a declaration that chemo was over may have been hasty, and went back for his second cycle yesterday.

That chemo causes nausea surprises no one. This was a known trade-off going in, but once he was actually experiencing these highly unpleasant side effects he was ready to quit.

You don’t want to be rewriting your plan while your head is in the toilet. On top of just feeling awful, there may be some chemo brain that makes it extra hard to make a good long-term decision.

But even beyond chemo, that’s a generalizable lesson. We’ve seen it often enough in investing: the midst of a market crash is not the time to re-evaluate your risk tolerance — you were aware that there were risks to investing and accepted those risks when deciding on your asset allocation in the first place.

The story also underscores the need to write things down. And not just the result of the plan: we didn’t need to write down that he’d be going to chemo every other week for 12 weeks, we needed to write down how he came to that decision. That there would be nausea, and that it would be temporary, and it would be worth it because the survival stats said so. Because it’s while he’s feeling that moment of doubt and urge to quit that he needs to be reminded of why he’s putting himself through this.

Day 7

July 8th, 2018 by Potato

Day 7. The wild calories continue to call at me. Their taunts and siren songs pick up at sunset. So far I have not been tempted out to the wilderness to investigate…

It’s been a week of actually doing the stuff I’ve known all along I should have been doing, and things are going well. I’ve run a calorie deficit every day. I’ve lost over a pound in a week — an amount that took 3 months in my “let’s just fart about with trying to eat a bit more sensibly and be a bit more active.” None of this should be much of a surprise (except the surprise that I’ve actually been good for a whole week).

I’m not physically hungry at all, so far it’s a fairly achievable calorie deficit. I’m taking a bit of a cue from the intermittent fasting ideas, with late breakfasts (~10-11am) and no snacking after 10pm, which I think helps, as I’m used to the idea of missing breakfast in a crazy morning rush. Psychologically I’m craving all the things. Like, I just want to transmute my stress into nothingness via the catalysis of chocoloate, even though that is a reversible reaction, with some nasty by-products. I’ve been whining, and likely will continue until I get to the point where eating healthy is more natural, and where I don’t want to eat a box of cookies just to prove that I can complete some kind of task.

The deeper question is how did I get here, and how would I get here on purpose faster in the future? Whether it’s losing weight, starting to budget, or starting some uncomfortable project, how can you get to the point where you actually just buckle down and do it? I don’t recall a particular epiphany — hitting my never weight should have taken me right to this point, but instead it took another year and a half to actually take it seriously and use all the tools at my disposal. My dad getting sick did re-surface the idea of mortality, but then why July 1st and not June 1st?

It’s an important question, because while I expect I’ll be good next week, and hope I’ll be good the week after, and the week after that, ad nauseum, I know there will come a time where I will slack off or fail. And when that happens, how will I dust myself off and get myself back here again? How, when I’m not sure how I finally stumbled in in the first place? For that matter, I’m not even quite sure what it is that I stumbled upon: willpower? Wisdom? The incubation time for a good idea to finally take root?

Anyway, had a decent week health-wise. There have been other decent weeks, but this one felt a little more on purpose, what with the tracking and not eating all the timbits when work got busy. Not quite sure how I managed it or how to do it again.