The Lehigh Valley Coalition on Sports Ethics presented a public forum March 24, on the impact of sports-related concussions at DeSales University.
Rev. Thomas Dailey introduced a panel of three experts and showed a ten minute video from ESPN that provided some background as to what the panel would be addressing. The video featured the case of a football player from Marlton, New Jersey.
Preston Pleveretes was the captain of his high school football team, and after graduation went to play football for LaSalle University. As a freshman, he was injured during practice in a helmet-to-helmet collision with another player. Four days later he played a game and told the coach his head hurt. The coach referred him to the student health clinic where he was diagnosed with a concussion.
What started out as a non-life threatening injury became a devastating and deadly situation. The nurse who diagnosed Pleveretes cleared him to return to play after sitting out one game. In the next game against Duquesne University Pleveretes went down during a hit and laid on the ground convulsing before turning onto his back and going limp.
Pleveretes was diagnosed with second impact syndrome. This is a rare phenomenon that occurs when the first injury has not had time to heal and another injury occurs. Potassium and calcium are released during a head injury, and in this type of injury calcium rushes into the neuron and causes major neurological damage. In a single concussion, potassium is released inside the neuron to help the brain and calcium outside the neuron goes in the bloodstream.
Four years later Pleveretes is going strong, but struggles to eat, walk and talk by himself.
Dr. Kevin Wagner, MD, director of sports medicine at St. Luke's Health Network provided the medical perspective.
"The biggest problem with a concussion is that it is not the first injury that hurts you it's usually the second," said Wagner.
Twenty-percent of his practice every day, because many athletes do not tell him the truth. Athletes by nature want to play, and know if they have a concussion they will not be allowed.
"The most important thing for the athlete to tell you is the truth. No athlete with a headache can go back," said Wagner.
Education of athletes, coaches and athletic trainers is vital. Every high school in the country is recommended to have an athletic trainer on staff. Trainers and coaches get to know the athletes on their team and are in a better position to make a decision about the severity of the injury and diagnose a concussion right away.
"This year the rules changed a little bit," said Wagner. "So this year we explained [to coaches] on the high school level we are no longer allowed to make any decisions. When a kid has a concussion, I don't care if it's a small or medium concussion or a large one. They do not return back to play, that's the medical and legal consequences."
According to Wagner, the amount of concussions today is the same as a few years ago. While the number of reported concussions is higher, many people think that the number has increased dramatically. But in reality, it is just that the athletes are now telling the truth about symptoms.
Mark Wojciechowski, DeSales Athletic trainer and a also high school athletic trainer, joined the discussion, giving his view from a trainer's perspective and as a survivor of a head injury. He said the perception of concussions has changed over the years. A lot of different sports are affected by this catastrophic injury to the brain.
He gave the following example of his 11-year-old nephew who plays little league football.
In a game the boy suffered a concussion. Wojciechowski went down to the field to run some testing on short term memory, long term memory and balance. The child had a concussion, and Wojciechowski informed the coach that his nephew was done for the day. The coach asked why, and upon hearing the child had a concussion told Wojciechowski the boy was lying. Wojciechowski's nephew did not step onto the field that day, the next week nor the next game.
"All coaches need to learn about concussions and how to deal with them," said Wojciechowski. "Just to make the awareness of what [concussions] can cause and what can happen needs to be brought up. "
The DeSales protocol states, if a person still has symptoms 15 minutes after the injury they are referred to go to a doctor. After the athlete is declared asymptomatic, they go through a couple different tests. The first day after being declared asymptomatic, the athlete rides a bike for 20 minutes. If the athlete remains symptom-free for 24 hours, the athlete then jogs for 20 minutes. If they remain fine after that, the athlete moves on to participate in a light practice, then a full practice.
Parents also play an important role in the diagnosis and treatment of sports concussions. Some parents do not believe the trainer when told their child has a concussion, and refuse to take them for treatment. At that point, Wojciechowski says he tells the parent they have two choices, either they can take their child to the hospital or he will call an ambulance to transport them to be checked out and evaluated.
"The awareness needs to be brought out," said Wojciechowski. "The NCAA is doing a good job of covering it."
Jim Tkach, a survivor of the second injury syndrome and a parent of a child who suffered many concussions and brain damage, and eventually committed suicide, concluded the discussion by emphasizing a lot of the same points.
All three stressed education of coaches and parents on recognizing the signs of and managing concussions, the importance of having an athletic trainer on staff, and teaching the athletes how to play their sport safely.
Tkach's son, Bo, never suffered a concussion while playing football, but he had several childhood accidents that led to hospitalization. These accidents most likely led to serious trauma to the brain that the family was not aware of. At age 13, Bo was diagnosed with OCD and depression. Later in life, he committed suicide. This same situation can occur if an athlete experiences a lot of concussions.
"I feel that there is a lot of progress is being made, I really do," said Tkach. "We need to teach everyone to take care of the brain."