OMAHA, Neb. (KMTV) — When Miami Dolphins Quarterback Tua Tagovailoa stumbled after a hit in a Sept. 25 game against the Buffalo Bills, Omaha woman Dr. Linda Snider recognized what she saw.
"As soon as I saw," she said, "I was like 'He has ataxia!'"
Snider knew what to call it because she has ataxia. But while Tagovailoa's was a temporary symptom after a hit, Snider lives with it permanently.
"Like if you've ever had too much to drink," Snider explained. "Things feel a bit off balance. That's what it's like. But it's like that all the time."
Ataxia was added to the NFL's concussion protocol as a mandatory 'no-go' symptom. A player showing 'ataxia' during a game will not be allowed to return. It replaced "gross motor instability."
In the case of Tagovailoa, who returned to that game against the Bills, the NFL says the protocol was followed properly. But it did not prevent Tagovailoa's scary injury just four days later against the Bengals. He was carted off the field, but says he doesn't remember it.
Ataxia is defined by the NFL as an "abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue."
Snider's is genetic and gets progressively worse as she ages. It is life-threatening. Both Snider's father and younger cousin died of ataxia complications.
It's all about the little brain
The cerebellum, or little brain, has long been known to have a big role in movement and speech. But in recent decades, functions well beyond that have been discovered, says Steven Barlow, the associate director of University of Nebraska-Lincoln's Center for Brain Biology and Behavior.
When informed of Snider's case, he said: "We would call that a genetic variant of cerebellar ataxia."
"If there is an injury or disease process to the cerebellum, it can impact your ability to walk and move," he said.
That includes cases like Snider's and other conditions that harm the cerebellum such as a brain tumor there or heavy alcoholism.
But in Tagovailoa's case?
"The cerebellum is probably the least understood in terms of ... how it responds to a concussive input to the head," Barlow said.
A life-changing genetic test
Growing up, Snider knew something ran in the family. But because she didn't have symptoms in her childhood, she didn't know if it would include her. She was active as a kid, even winning a national championship in artistic rollerskating, she said.
But at 21, she had a genetic test to see if she had the gene that would lead to ataxia. She said she was the second in the country to be tested for it.
That test left no uncertainty: she would, like her father, eventually have trouble with muscle control.
"You'd have to explain that the people you were dating," she said. "Career-wise, you don't want to do something that you're going to have to stop doing."
So, although she doesn't need a wheelchair yet, she chose a career she that could do in one. She works in radiology at Methodist Hospital.
More, it changed her outlook on life. When asked to try something new, she'd say 'yes.'
"I wanted all the experiences possible," she said.
"Everyone says you're supposed to really enjoy today," Snider said. "Because you don't know what's going to happen to you tomorrow. But when somebody tells you something is going to be wrong, that becomes much more evident and prominent. Like, gosh, I really need to take advantage of every moment and every conversation."
New ways to do things
Snider likes to say it's not that she can no longer do some things: She's learned new ways to do things. She uses a device to move a cup across a room without a spill, for example.
And she does what she can to train her brain and hold off her symptoms. She tries to make the 'thud' of a balance board as quiet as possible. She does yoga (with a chair), and other exercises.
No longer a secret
"I didn't tell people I had it for a long time," Snider said. "I wanted it to be private. But then people started saying, 'Oh, have you had some drinks this morning?' Like, probably not at 8 o'clock in the morning!"
Though she walks around without a cane at home, albeit unsteadily at times, she uses one in public, she said. It serves as a visual clue to others: She's not drunk, it's something else.
She said she's been mistaken as drunk "a lot."
Local support
Snider finds plenty of understanding at a local support group she created: Nebraska Ataxia.
They met in November for a social. Not all cases look the same.
"You’ll see people here who are older adults, and then my son Elliot, who’s seven, and has ataxia," said mom Corie Sass. "He’s very smart, very bright. It’s just sometimes hard to tell because his body doesn’t work the way that it should."
The group helps cover costs for expenses insurance won't cover such as a wheelchair ramp. Nebraska Ataxia keeps getting "bigger and better," Snider said, as doctors tell their patients about the group.
Can the NFL bring awareness?
Even when opening up about her condition, Snider said she sometimes would call it multiple sclerosis, which can look similar. Unlike ataxia, people have heard of multiple sclerosis, Snider reasoned.
Although the circumstances were unfortunate, and her condition is not a temporary disorder, Snider hopes the NFL's high-profile use of the word changes things.
"I'm hoping now people are more educated about ataxia and will stop assuming that I'm drunk," she said.
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