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09 October 2015

Rugby's Jonathan Thomas talks about his epilepsy

As ex international Wales forward Jonathan Thomas watches the progress of his former team in the Rugby World Cup 2015, the 32-year-old talks about retiring from the game and about his diagnosis of epilepsy. 

'It is just about 12 months ago that I was diagnosed with epilepsy,' says Jonathan Thomas who last month announced his decision to hang up his boots with the Worcester Warriors. 'It has been a pretty difficult time. Any sportsman will tell you retiring from the sport that you love is tough, but to be told by my consultant to finish when physically I still felt in great shape was a hard thing to digest. The diagnosis was a confusing period last October. I wasn't sure whether my career would be over there and then, purely because I didn't know much about epilepsy.

Memory loss

'I had been having symptoms for some time but had been unsure of what was happening. The first sign that something was wrong was short-term memory loss. I would quite regularly forget what I was saying mid conversation.

'As a team leader in rugby I would often be going through two or three points with the other players either during training or after a match, and after the first point I would forget points two and three.

'I then started getting auras that would last for 20-30 seconds, often in the house or when I was driving. I didn't lose consciousness but would get a mild sort of seizure with flash backs or déja vu. Because they were quite subtle and I didn't lose consciousness, I didn't think anything was majorly wrong.

'Over the course of six to eight weeks the seizures continued. I consulted the doctor at the rugby club and she said she thought it sounded like a mild form of epilepsy. I was sent for tests - an EEG, MRI and CT scan - and these confirmed the diagnosis.

Bad concussions

'My consultant felt my epilepsy had been caused by playing rugby. He thought it could have been brought on by a single blow to the head or by repeated blows, either of which could have caused slight brain damage. It's almost impossible to say.

'I have had three bad concussions over a 14-year career in rugby which I don't think is too bad. But I have had innumerable smaller bangs where I have been left feeling dazed and groggy but where I have kept on playing. I know that under these circumstances my memory has tended to play up and I haven't been able to remember much about the game when I have come off the pitch. This is something that players, not just me, will often put themselves through. 

'My consultant says that often we tend to think of the nasty concussions when we are carried off the field, as the horrific ones. But in fact it can be the not-so-severe blows when we carry on playing with trauma that result in our brains getting knocked about and damaged.

Changing mindset of players

'To be honest it is the mindset of the players towards head injuries that must change. From a very early age we are taught that if you get knocked down you should get up again and just carry on playing. But this is not an attitude that works with head injuries.

'Rugby has plenty of protocols in place around concussion and return-to-play, but a player can always fool a medic into thinking they are ok. If you are in a cup final, then of course you just want to keep on playing at all costs.

'I don't think it will be possible to change the mentality of players of my generation but I think we have to start educating today's children to be more conscious of the importance of safety and to understand about and recognise the symptoms of trauma. 

'I don't mean we should teach them to be soft. It is just about educating them that if they get a head knock and start to feel fuzzy or not right, they need to stop. Very often you hear coaches shouting at 10-12 year olds to get stuck in, but there is a fine line between having a tough mentality, which you need in rugby and playing on with head trauma which is dangerous. Players and coaches just need to understand the difference.

'It is good that many players, both children and adults, wear headgear but I'm not sure they do a huge amount to protect against major traumas. They are more for guarding against cuts, low impact blows and cauliflower ears. I used to like wearing one but don't think they are the answer to solving this problem.

 It can be the not-so-severe blows when we carry on playing with trauma that result in our brains getting knocked about and damaged.

Side effects of seizures

'I was lucky that my seizures were relatively mild. The seizures themselves were controlled with medication - levetiracetam - and for the remainder of last season I was able to continue playing on the back of consultants' advice providing I felt ok.

'But during that time I noticed subtle personality changes, mental fatigue, sleep issues and of course the memory loss. I had always been a very laid back person away from rugby, but I was finding I was much more irritable. Also I didn't have the same capacity to train hard as I did before.

'I don't know whether this was the medication or the epilepsy or a combination of both. My consultant then decided it was time to finish.

'Now that I have retired from rugby I am gradually reducing the dose of my medication in consultation with my neurologist. Hopefully in the future I will have a trial period off my medication, just to see what happens as I've been seizure free for almost 12 months.

'Career wise, at the moment I am taking some time out. I'm not sure what the future holds but I'd love to stay involved with rugby in some capacity and potentially coach. The next few months though will be looking after my health and spending some time with my family.'

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