A Hard Hit: Concussions, the impact, the research, and the futurePosted: Updated:
"In the ER, while we're waiting, he starts having seizures. He starts getting real stiff and just going sideways."
Cerapio Carrillo sits in a doctors office treatment room in the Medical Arts Tower of Wesley Medical Center. But his memories take him back to the day his son suffered a concussion after a hard hit in a pick-up game of football at the local park.
Sports is a part of growing up in America. For many kids they're the best part of life. But, fewer kids are playing some high school sports as fears of serious concussions spread.
According to the Kansas High School Activities Association (KSHSAA) we've seen an increase over the last ten years in kids participating in extracurricular activities, up to 146,173 in 2017 from 138,384 in 2008. But when it comes to football there was a sudden 12% drop from the 2015 to 2016 seasons.
"I hit my head on the ground, And when I got back up, someone kneed me in the head again," said Kallie Hutchison, a junior at El Dorado High School.
"I hit my head first on the concrete, Didn't wake up for three days," said Antonio Carrillo, a student at Campus High School.
From pick-up games at the park to formal practices at the local high school the number of Kansas teens diagnosed with sports related concussions is up.
"When something happens to you, it's scary," said Cerapio, Antonio's father. "But when it happens to someone you love, it's terrifying."
Like more and more parents, Cerapio is re-thinking his child's plans to compete. He hasn't had that conversation with Antonio yet, but says he can describe it in one word, "disappointing."
Antonio is working with a physical therapist at Wesley Medical Center's Pediatric Concussion Clinic. He was just playing a pick-up game of football after school when he took a hard hit. knocking him out.
"We couldn't get ahold of him. His phone wasn't working. And then somehow I think his mom received the call," Cerapio said. "It's kind of scary. So we run out, I think without shoes, jump in the car, get down to the park."
There, they found medics already working on Antonio, who was unconscious.
Down the hall, Kallie Hutchison is recovering from her second football related concussion.
"I was playing linebacker on defense and we're going against the varsity," she says, describing her accident. "And I was supposed to tackle our running back. So I run him to the ground."
Weighing some hundred pounds more than her, she went down, too.
Dr. Kimberly Molik is treating both Kallie and Antonio. She hears stories like theirs all the time.
When asked how many of the concussions she sees are from sports, she answers quickly.
"Oh, far away the majority," she said.
Some believe that combination is leading to the drop in football participation we're seeing here in Kansas. According to KSHSAA Kansas schools lost a total of 2,025 football players between the 2015 and 2016 seasons. That's a 12% drop that held true for the 2017 season, as well. KSHSAA says rarely does participation statewide vary by more than 100 players.
"I think that the biggest contributor probably to the decline in between 2015 and 2016 was more a budgetary issue," said Bill FAflick, KSHSAA's executive director.
He says those budget cuts across the state led to elimination of freshman and middle school football teams. The Athletic Director at Hutchinson Public Schools has certainly noticed fewer teams out there to play against.
"Numbers fluctuate," Kevin Armstrong said. "But, you know, we've had to find some games the last few years... in football specifically."
Nationwide participation is falling, too. The National Federation of State High School Associations says the number of high school football players fell by 2% from 2016 to 2017, more than 6% over the last decade. The Federation blames budget cuts and concussions for the drop.
"I'm absolutely certain there are people that may have made that decision not to play football, to participate in other activities," Faflick said.
Despite the drop in players, football remains the most popular boy's sport in Kansas and the one most likely to cause concussions.
"In boys it's... football is always our number one offender. And then for girls it's actually cheerleading and soccer. Boys soccer, as well," said Dr. Molik.
What can start out as a trip to the park like Antonio's, can cause lifetime problems if not treated properly right away.
"Little things can sometimes...we can fix it and sometimes they get ignored," Dr. Molik said. "And then, all of the sudden, you have a senior in high school who can't read."
Antonio struggled with school after getting hurt. The hardest part for him?
"I'd say, like, homework," Antonio said. "Like, I couldn't concentrate on it."
For the first week after her latest concussion, Kallie found she couldn't stay in school for more than an hour at a time.
"I slept all day, couldn't do my homework," she said.
Light and noise was a big problem for both of them.
"I told... (my friends) not to talk very loud," she laughed.
"Some of the most common things that we see are headaches, and sometimes disabling headaches," said Dr. Molik. But that's not all. "We see some imbalance issues that sometimes the kids don't ever regain back their normal balance. We definitely see some cognitive issues, difficulty reading, difficulty comprehending,"
Dr. Molik says the best thing parents can do is be their child's advocate, pull them from a game after a hard hit or fall ,even if they don't think they've been hurt, and get them checked out by a doctor. This is especially the case if your child has already had a concussion before.
"It can be additive. And the second concussion can be far worse than the first," she said.
On concussion number two, Kallie is thinking of giving up football to concentrate on her preferred sport, basketball, and lower her risks of a third concussion.
"They will make me drop sports. They told me because I've had two really bad ones where I was in the hospital," Kallie said. This is an idea that scares her. "Sports are kind of my life."
Despite the growing concerns over concussions, Dr. Molik believes the increase she's seeing is really about better reporting, not more injuries.
"I don't think there's anything that we could have done to prevent it because if you said, 'Hey, I'm going to the park play?' I still would have said, 'Yes!' Cerapio said.
"The average high school athlete gets...around 10,000 impacts throughout a four year... athletic career," said Dr. Molik.
Treating concussions and other head injuries in Wesley's ER left her with too many unanswered questions.
"We were just never sure. How are the kids doing in school? Are they developing seizures afterwards? Are they able to return to sports? What is their quality of life?" she explained.
Those questions led to the development of the Pediatric Concussion Clinic every Tuesday. The only pediatric facility of its kind in Kansas, one of just three clinics to specialize in concussions in the state, other hospitals are now turning to Dr. Molik and her team for training in concussion treatment.
"There's a significant amount of public awareness that I don't think existed several years ago," Dr. Molik said.
The Kansas High School Activities Association is a big part of that. It now has carefully outlined concussion training requirements for both coaching staff and players.
"Kids are trained, as well, to recognize signs and symptoms. So, you know, you're in the huddle with your teammates and you recognize that something's not right...our phrase is pretty simple: 'When in doubt, send them out!'" Faflick explained.
That's now part of the rules for all schools, in all KSHSAA sponsored activities.
Kallie says she didn't realize at first how hard she'd been hit. Her coach saw the signs.
"We did more drills of hitting and hitting and I got really cold, really fast. Dizzy," Kallie said. "And, finally, my coach took me to the trainer."
Many schools, like Hutchinson's Public Schools, now work with professional sports trainers. But coaches say even the training they and the kids get is making a big difference.
"I think about me specifically," Kevin Armstrong, said. "I really didn't know what a concussion was when I was in high school.... Now, when they watch the (training) video, they get to see and they learn. So, just the education piece of it, they know what the warning signs are."
Armstrong says that knowledge is changing how they play the game.
"You're almost having to relearn how to tackle."
Not to mention the difference new developments in safety equipment is making. New designs mean more effective helmets and shoulder pads. More explicit maintenance rules make sure they stay in good working order.
"It used to be that you wanted to send it off (for repairs) and you had somebody come in and check those (helmets) for cracks," Armstrong said. "Now there's an eight year and out policy."
But Faflick says sports aren't the only source of concussions.
"We've had concussions from band," he said. "Kids tripping over an instrument, falling out of the bleachers."
That's why KSHSAA this year started a concussion tracking program, recording the details around every concussion a student suffers, in every activity.
"Our sports medicine will get it at the end of the year," Faflick said. "We use it for not just 'return to play' protocols but for 'return to learn,' which is very big. We want kids back in the classroom."
Both Kallie and Antonio report their concussions hurt their grades.
"Yeah, I have a B," Kallie laughed.
While most districts now provide concussion awareness training to teachers as well, the students report not all teachers were as helpful as they needed.
"There was some stuff like that throws me off," Antonio said. "Like my vision, like behavior sometimes."
"The one I got a B in didn't work with me," Kallie said. "A lot of the students helped me with assignments and walking me through them. Some of the teachers made me not take tests. And they didn't want me on the computer so they'd print stuff out for me."
Then there was just all the catch up needed due to missed time in class. Antonio missed three weeks of school. Kallie reports missing 32 blocks.
Despite the pain and the struggle of getting back to a normal life, Antonio and Kallie say they still plan to play sports. Kallie hopes her younger brothers will also play competitive sports someday.
"It makes me really happy," she said about playing sports. "I really want them to do stuff like that....It doesn't scare me because I feel like, by the time they're in high school, we'll have something that will help."