The morning-after brief for crash week.

Nobody reads a long article the week after a wreck. You are on the phone with an insurer, you are trying to find a rental, you are sore in places you did not know could be sore, and you are telling everyone you are fine. So this edition is built the way the week actually unfolds, one morning at a time, with the longer explanations parked in other editions for when you want them.

The morning of

If anyone in the car hit their head, lost consciousness even briefly, has chest pain, trouble breathing, numbness or weakness down an arm or leg, or a headache that is getting worse by the hour, that morning belongs to the emergency room, not to this desk and not to a clinic. The CDC's HEADS UP materials list the danger signs plainly: one pupil larger than the other, drowsiness you cannot shake, repeated vomiting, slurred speech, convulsions, or confusion that gets worse. Any of those means go now.

If none of that is happening, the first morning is mostly adrenaline and logistics. You will probably feel stiff and rattled but functional. Write down, in your own words and in your phone, what happened and where you feel it, even if the answer is "nowhere yet." You are not building anything by doing this. You are giving a clinician a starting point later in the week, and giving yourself something better than memory.

Morning two: the stiffness shows up

This is the morning most people are surprised by. The neck that turned fine yesterday does not want to check a blind spot. The low back is tight getting out of bed. A headache sits behind the eyes. This is not weakness and it is not imagination; it is what soft tissue does after a sudden load, once inflammation has had a day to develop. The desk's 72-hour lag edition walks through the mechanics, but the short version is that a delayed onset is the normal pattern, not the exception.

This is also the morning to make the call. Missouri Injury Clinic has three rooms across the metro, and the one nearest this desk is in O'Fallon at 2163 West Terra Lane. When you call, say it was a crash and say when. Ask for an exam this week. The first visit edition covers what to bring and what to say, but the call itself takes two minutes.

Morning three: the head check

Somewhere around here is when people notice the quieter things. Trouble finishing a paragraph on a screen. A short fuse with the kids. Waking up tired after a full night. Light feeling too bright in the kitchen. These can be signs of a concussion, and you do not have to have been knocked out to have one. The CDC describes concussion as a mild traumatic brain injury caused by a bump, blow, or jolt to the head or body, and a rear-end hit is exactly that kind of jolt.

The clinic publishes a dedicated TBI and concussion rehab lane, and names the tools it uses: vagus nerve stimulation, neurofeedback, Alpha Stim, sensory motor integration, exercise with oxygen, oculomotor rehabilitation, and cognitive rehabilitation. The desk's concussion edition explains what those words mean in plain English. The point for this morning is simpler: if your head feels off, say so on the phone and say so at the exam. It is not a separate problem from the neck. It is part of the same week.

Morning four and five: the exam

Ideally you are sitting in a room by now. The exam itself is unglamorous: a history of what happened, a physical exam, findings written down, a diagnosis if the findings support one, and a plan you can repeat back. That plan is the difference between a recovery that is a mood and a recovery that is a schedule. Setbacks become visible early. Progress becomes measurable.

If you already have an attorney, bring their contact so records can be sent where they need to go. If you do not, that is fine too. You do not need to have decided anything about a claim before you get examined. The exam is a care document first, and it exists so the next clinician works from facts, not memory.

The weekend: gentle and prompt

Both at once. Rest what hurts and skip the heroics. Do not test the neck by seeing how far it turns, do not clean the garage to prove you are fine, and do not stop moving entirely either, because a body that does not move at all tends to stiffen further. A clinician who has examined you will give you a better answer than any of that, which is the whole reason to get the exam before the weekend rather than after it.

If days or weeks have already passed while you waited to feel normal, go anyway. A later exam is still a real exam, and being honest about the timeline is part of the record. The clinic is built for planned care, and if it sends you to an emergency room instead of booking you, that is the system working, not a wasted trip.

What this desk does not do

It does not examine anyone, hold anyone's chart, talk to insurers, coordinate claims, or put a number on anything. It is a reading desk, paid to point readers at one clinic, and it says so on every page. Joseph L. Hollingsworth, DC, is a chiropractor. Nothing here is legal advice or medical advice. Everything here is an argument for getting examined by a person who can.

Sources: CDC HEADS UP, concussion danger signs; CDC, traumatic brain injury and concussion; NINDS, whiplash information page.