Book Review by Dorothy Bedford: “Fourth Down and Inches”

February 24, 2014February 24, 2014Dustin FinkLeave a comment

Dorothy Bedford is an avid follower and contributor to The Concussion Blog. She has offered up a book review – out of the blue and appreciated – for me to post here. I have not read the book and if I get the chance may offer up my two-cents but until then I think that perhaps some of you may want to know about the book. With out further ado here it is (Thanks Dorothy);

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The history, the stories, and the latest science of football concussions

“Fourth Down and Inches: Concussions and Football’s Make or Break Moment” by Carla Killough McClafferty (2013)

Every week during the season, a few famous players’ concussions attract attention. They are attended by expert medical teams. Every week during the season, many youth and high school players suffer head injuries in silence because they don’t believe that a “ding” is a real injury, or they don’t want to “let the team down,” or the coach shrugs it off, or the parents don’t realize the medical or academic consequences. This book could change all that.

Carla McClafferty has written an excellent survey in a format accessible to a broad age spectrum of football players, their families, fans and youth football volunteers. With an extensive selection of heavily captioned illustrations and photos, and featuring short, punchy chapters the author presents a balanced view of the epic story of American football’s 1905 head injury crisis and the hidden, functional brain injuries underestimated and misunderstood until modern scientific methods began to reveal the truth in the 21^st century. The colorful historical tale fills about one-third of the book, while the unfolding of a new perspective on brain injury and clear explanations of the latest research mix throughout the balance of the 87 page text, (plus wonderful supplemental material in the form of notes, bibliography, and further reading suggestions).

As a concussion safety advocate and fan, I have Continue reading →

What About Return-to-Learn?

November 4, 2013November 4, 2013Dustin Fink9 Comments

Two important groups released information about concussions and youth recently. The Institute of Medicine recently released its Sports-Related Concussions in Youth: Improving the Science, Changing the Culture, addressing concussions for the youth (obviously by the title). This was on the heels of the American Academy of Pediatrics release of their second report on concussions, addressing the return-to-learn aspect. I offered some opinions on both of the reports via Twitter, but was really underwhelmed by the information in both documents. It seems to me that even though the car is pointed in the right direction the gas pedal is being confused with the brake pedal. At best I feel the community is driving though the rear-view mirror.

A loyal follower and some time contributor, Dorothy Bedford, a self-described “parent activist in concussion education, awareness and advocacy, and newly retired school board member in Princeton NJ,” has penned the following post regarding return-to-learn and the AAP paper. This is not your typical parent; “I come by the interest in return-to-learn honestly, both from my daughters’ concussion and from the point of view of a school board member – with the opportunity to help protect the brains of all students.”

With all of that said, below is her post. Thank you, Dorothy. As a reminder, the inbox is always open to contributors.

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The Pediatricians Weigh In on Returning-to-Learning – A Mixed Review

The American Academy of Pediatrics has released its second major clinical report on concussions. It’s a good first step which will help many pediatricians begin to address the second most important issue in concussion management (after “remove from play,” and before “return to play”). On the other hand, ten pages limits the territory it can cover; there’s little new for the ATC who takes a broad view of concussion recovery; the report wildly underplays the complementary role of the neuropsych, and omits any discussion of some important symptoms. I think the most important contribution this report makes will be nudging school administrators to action, especially those who have been inattentive or resistant to dealing with concussions in the classroom and gradual return to learn. It’s hard to ignore the AAP. I will confess, since its release my reaction has swung up and down with each re-reading. Five days later, I hope this will be a balanced review. I like to keep the conversation open.

“Returning to Learning Following a Concussion” was published on October 27 (full report here: http://pediatrics.aappublications.org/content/early/2013/10/23/peds.2013-2867.full.pdf+html) complementing AAP’s 2010 clinical report on “Sport-Related Concussions in Children and Adolescents”. The lead author on both reports is Dr. Mark Halstead, a specialist in non-operative sports medicine at Washington University in St. Louis. Neuropsychologist Dr. Gerald Gioia of National Children’s Medical Center was a consultant. Dr Gioia is a co-author of the CDC’s Physician’s ACE Return to School form, which should be in the hands of every student athlete and their parents for any concussion-related visit to a doctor (http://www.cdc.gov/concussion/headsup/pdf/ACE_care_plan_school_version_a.pdf ). Six other professional societies have endorsed this report.

The Good:

For pediatricians in areas with thin or no sports medicine/neuropsych coverage, this report is going to be very important, Continue reading →

Delaware Youth Concussion Summit – Wrap Up

September 27, 2013Dustin Fink1 Comment

A regular reader and a very good friend to The Concussion Blog was fortunate enough to attend the Delaware Youth Concussion Summit the past week. I had asked her to write-up a report and she kindly and succinctly did that for TCB. Because of Dorothy Bedford I can bring you this information, thank you. This is also a reminder that if you attend a conference, symposium or summit and feel the information would good for the readers you are more than welcome to submit it so us in a .doc or .docx form and we will publish. Without further ado here is Dorothy’s contribution;

The Delaware Youth Concussion Summit, an initiative organized by the State Council for Persons with Disabilities Brain Injury Committee, Nemours/Alfred I. DuPont Hospital for Children, and the Brain Injury Association of Delaware, yesterday released its three-point Action Plan regarding the diagnosis, management, and return to activity for the rising number of young people sustaining concussions in sports activities. Participants in the summit and action work groups include leaders and experts in medicine, neuro-psychology, education, sports, advocacy, state agencies, and elected officials.

The Summit aims to further the aims of Delaware’s concussion legislation, signed in August 2011, which mandated both concussion training for all DIAA coaches and awareness training for parents and athletes, and set some rules around written medical clearances before returning to play.

After convening in May 2013, the Summit divided itself into working groups and today announced three focus areas for further action: Continue reading →

Daniels Dash: Why it MUST be run

February 19, 2013February 19, 2013Dustin Fink1 Comment

Our last “Outreach” writer, Ashlee Quintero, eloquently wrote about her experiences with concussion issues. As the Concussion Program Coordinator at UHealth Sports Medicine she is involved in many things, one of which is very dear to her. It is a 5k run in the honor of Daniel Brett, a South Florida kid that sustained concussions and was not properly treated for a long period of time. Below is his story and information on Daniel’s Dash (2013 Flyer). The following was written by his mother, Diana Pilar Brett;

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Daniel’s Story

On August 24^th, 2009, our son Daniel made starting linebacker for Cypress Bay High School’s JV football team. It was a victory for him and his first major step in actualizing his desire to play in college. It was also his last day ever playing football.

At 5’9”, 160 lbs. he wasn’t big, but he was tough and fearless, and he thought it was the way to be, to one day play for his dream team, the University of Miami Hurricanes. No pain, no gain.

Daniel began playing football at 11, and never looked back. Tough and versatile, he played offense, defense, and special teams, rarely getting off the field. He loved it, and he was good. Determined, he did all that was needed: kept in shape, practiced hard, kept up his grades, and never complained. No, he never complained and never told anyone when he was hurt up until August 24^th, 2009. Continue reading →

Parent Advocate: Tracey Mayer

November 13, 2012November 13, 2012Dustin Fink8 Comments

Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there. As time allows she will be submitting posts for you to read. I truly hope that everyone gets a chance to read about concussions from yet another perspective. Thank you Tracey! I thought I would pass along this note from Tracey Mayer she sent me the other day:

It’s been a bit over four years since Drew’s injury. Last night I was thinking holy crap; it was me against the world when I refused to let him return to the field. Honestly, there was no one on my side—not even my husband.

Clearly, concussion awareness was in its infancy stage at that time. Back then, I rarely recall seeing any media coverage on concussions, and now I read at least 8-10 articles per day. I was flipping through the mail yesterday and came across a newsletter from Rush with an article about resting the brain after a concussion – how it is necessary to take at least 2 weeks off from school, etc. I cannot imagine what things would have been like if there had been even a smidge of academic support when Drew was hurt. Even more, I can only imagine what might have happened to him had I not dug my heels in and held firm about him not returning to football.

Parents, you know your children better than anyone. If something doesn’t seem right, most likely it isn’t. Trust your gut – it costs nothing and generally holds value. Your child has one brain—the vital organ that runs his or her body. Protect it at any cost.

Tracey is right, we have come a long way in a very short time, alas we are only scratching the surface on the issue.

Recounting Tragedy: Austin Trenum Story

July 25, 2012July 25, 2012Dustin FinkLeave a comment

As the blog began in 2010 there were many things I hoped to accomplish by doing this project; I never dreamed this place would help springboard a family to recovery after the most horrible day of their lives. However, looking back I am glad the blog was here for them and will remain here, for them and anyone else who need answers.

I am speaking of the Trenum family, specifically the tragic death of their son Austin, and how they chose to cope and “push on” after that dark day in September 2010. In one of the most powerful pieces I have read, Patrick Hruby worked with Michelle and Gil to recount the last few days of Austins life; as well as what has happened since. Due to my intimate history and wonderful bond with the Trenum’s I felt speechless after reading Hruby’s work in the Washingtonian;

It was Sunday, September 26, 2010. Michelle Trenum woke up around 8 am. Gil was out of town, returning that afternoon from a weekend drill with his Navy Reserve unit in New Jersey. Walker, ten, their youngest, was on the living-room couch, hiding under a blanket. He jumped up when Michelle walked in. Boo!

“Austin’s awake,” Walker said. “He’s in the basement playing a video game.”

That’s odd, Michelle thought. Austin never got up early on Sundays. Not voluntarily.

Not only will you be able to feel for the Trenum’s you Continue reading →

Transcript from Maryland State Board of Education Discussion on Concussions

July 10, 2012July 9, 2012Dustin Fink5 Comments

If you recall Tom Hearn from Maryland had the opportunity to present information to the Maryland State Board of Education about concussions. What resulted was a discussion among the board, Hearn was able to get a transcript (link at end) of this discussion and we have highlighted some key points (they begin on page 5). The time marking represents where on the audio file you can find the information (working on a link for that)

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11:17

Kate Walsh (MdSBE Board Member): I think the Board’s interest here was to get at testimony before the Board in public comment. I think these are all great things that you have done, but there were three complaints that were raised that we thought were quite compelling, and we wanted to hear them addressed. And I don’t hear you really addressing any of them.

So, can we go through this? What we heard was that there were regulations similar to those adopted by the Massachusetts Department of [Public] Health, have we done that? Have we adopted regulations that are similar to those?

12:00

Ned Sparks (MdSDE Athletics, Executive Director/MPSSAA Executive Director): No. Again, those were regulations of the Department of Health in Massachusetts.

Kate Walsh (MdSBE Board Member): So is that something you saying that we would not adopt be under another?

Ned Sparks (MdSDE Athletics, Executive Director/MPSSAA Executive Director): I don’t know the regulations exactly how they are in Massachusetts but I would think that that would certainly be a combination of the Department of Health and the Education Department regarding that. [It sounds like, since the Mass DPH regulations were brought to the attention of the State Board in the parent’s May 22, 2012 testimony—five weeks earlier, Mr. Sparks had not yet reviewed the regulations.] Now, again, we had a representative on that group as you can see from the Department of Health and Mental Hygiene, as a matter of fact two of them.

12:31

Renee Spence (Executive Director, MdSDE Office of Government Affairs): We work very closely with folks from the Department of Health and Mental Hygiene. Also, in Maryland, the Governor has put together a traumatic brain injury commission. There are a lot of folks working on traumatic brain injuries.

12:47

Kate Walsh (MdSBE Board Member): I just think it would be helpful if we could see why this Massachusetts Department of Public Health were cited as superior to our Continue reading →

Katherine Snedaker: Parent Advocate – Sportscapp.com

June 25, 2012July 23, 2012Dustin Fink3 Comments

I was asked to post this on The Concussion Blog, in full. I appreciate what another Parent Advocate is doing for raising the awareness of concussions. Katherine is doing a fine job and checking in on her is a must.

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10 ways to lower your Child’s Concussion Risk

BY Katherine Snedaker of www.Sportscapp.com ON June 20, 2012

Concussions are a part of youth sports at every level from elementary school years to college. Playing at the local playground, riding bikes or just being a kid can put your child at risk for a concussion. However, any parent can reduce their child’s risk of concussion with some simple steps:

1. Educate yourself on the signs and symptoms of a concussion along with the other members of your family so that an educated adult is always available during a practice or a game or by phone for your child to call. Always check in with your child on the car ride home from any sporting activity or play date, and ask their day, and how they are feeling. If your child complains that he/she hit their head, you should know the correct questions to ask to see if there could be an issue with a head injury.

2. Educate your child about concussions. There are simple, painless videos for the media savvy teenager of today. Studies show that kids are more likely to report concussions when they know what a concussion is. The earlier the diagnosis, the sooner a child can begin the rest needed to heal a concussion.

3. Check your child’s sports equipment at the beginning, middle and end of each season. While there is Continue reading →

Maryland State Board of Education Meets Tomorrow

June 25, 2012June 25, 2012Dustin Fink6 Comments

Tom Hearn, a parent advocate of Maryland provided initial testimony to the Montgomery County Board of Education earlier this spring. He had a further opportunity to provide testimony/information to the State Board of Education back on May 22nd. Due to that testimony (seen below) there has been a discussion item placed on the agenda for tomorrows regularly scheduled meeting.

I must say that Mr. Hearn has been working his tail off and I am very interested to see how his approach is handled, as most states have not involved the BoE. Mr. Hearn does take up the contact limits in practices; making Maryland and Illinois as the only two states that have been given such a proposal. Here is the testimony (minus the attachments);

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May 22, 2012

Maryland State Board of Education

Public Comment Testimony of Tom Hearn

Regarding Concussions in High School Football and Other Sports

Good afternoon, Members of the Maryland State Board or Education and Acting Superintendent Sadusky. I am Tom Hearn and I am a parent of a student at Walt Whitman High School in Montgomery County, Maryland.

I wanted to talk with you about concussions in high school football and other sports. As discussed further below, I am requesting that the State Board take three actions to improve the safety of Maryland high school sports athletes:

1. Adopt regulations similar to those adopted by the Massachusetts Department of Health for youth sports concussions; in Massachusetts, the Department of Health has gone through extensive notice and comment rulemaking procedures to develop workable policies and procedures to manage the risk to student athletes of sustaining sports concussions. The result is a set of state-of-the art best practices that are a suitable starting point for the State Board to align with those practices.

2. Impose limits on full contact practices per week in high school football given that the NFL and Ivy League have adopted similar limits in light of emerging medical research; and

3. Reorganize responsibility for sports concussion safety away from the Maryland Public Secondary School Athletic Association, which currently has the lead, to a new department within the Department staffed by a lead public health professional or sports safety professional, such as a certified athletic trainer with experience managing sports health in a large school system, who reports directly to the State Board.

Background

It may not be highlighted in the job description, but collectively you are the senior safety officers for public high school sports in Maryland, and this may be the most important position that you play.

In sports vernacular, collectively you are the Blind Side left tackle for the 15,500 students who play public high school football and the 100,000 or so other high school athletes.

No one ever died from a bad academic education, but high school student athletes die Continue reading →

“None of us is as smart as all of us.”

April 27, 2012Dustin Fink18 Comments

The quote in the title is a Japanese proverb, I have read it most recently in a very good book call “The Red Circle” by Brandon Webb; a biography of a Navy SEAL (you can learn a lot from these heroes). As with most proverbs you can take the meaning and apply it to whatever you want. In this case we are talking about concussions: awareness, education, assessment, recovery, treatment, etc.

One thing that I hope comes through is that I do not feel that I am a “be-all-end-all” expert, rather I am a devoted husband and father that is an athletic trainer that chooses to spend time paying it forward – so to speak. I have been asked many times why this blog is here and there are many answers to said question but the underlying reason is simple: raise awareness and bring together all who care to create more understanding and better protection from this brain injury.

The simple fact is that we have only just begun to really understand the concussion injury, each episode (aptly coined by Xenith) is unique; not only from age-group to age-group but from person to person. We know that males and females react differently, we know that youth and adolescent brains are much more susceptible to lingering effects than an adult brain, we know OR SHOULD KNOW there is no magic pill or course of action to prevent concussions other than living in a bubble, we know that there are very smart people out there with good ideas, we know that information can be controlled by many sources for many reasons, and we really should understand and know that the actual injury is not the elephant in the room, it is how it is handled from the beginning of the process.

Concussions are a process not an event; as soon as the injury occurs what happens next is what shapes the individual brain for eternity, yes eternity.

Where am I going with this? Continue reading →

A Program Worth Promotion

March 14, 2012March 14, 2012Dustin FinkLeave a comment

We have highlighted Advocates for Injured Athletes on here with the story of Tommy Mallon told through the eyes of his mother Beth. Not only are they continuing to fight for athletic trainers on the sidelines of every school they have come up with an initiative that makes too much sense – Athletes Saving Athletes.

What is Athletes Saving Athletes™?

Athletes Saving Athletes™ (ASA) is a +unique, peer-to-peer education program designed to empower student athletes with skills to help them recognize signs and symptoms of life-threatening injuries and conditions. The goal of ASA is to reduce the risk and incidence of injury and death for high school athletes using the power of kids talking to kids.

Why is the ASA Program Needed?

Every year, more than 1.4 million high school athletes in the U.S. suffer a traumatic or fatal injury. Most of these accidents are preventable. While some schools staff a certified athletic trainer, these personnel cannot be present at all the practices and competitions of every school sport. The ASA program provides student athletes basic knowledge and skills that could help save a life.

With the cost and really the viability Continue reading →

New Doctor, Different Results: Tracey Mayer

February 21, 2012February 21, 2012Dustin Fink39 Comments

My son, Drew, suffered a severe concussion during a freshman high school football game in September, 2008, and has not played football since. He would have stepped back on the field the next week and would still do so if he was allowed to. It was not his first concussion, but it was clearly the most severe. My earlier posts on here explain the details of what he has gone through. Clearly, he has made tremendous progress, but he still has some cognitive difficulties. He also suffers from migraines, which are typically provoked by intense focusing or from being hit on the head. It does not happen often, but there have been a handful of incidents over the past 2 years. Two weeks ago, he was elbowed in the head very hard during a basketball game, which resulted in a migraine with major fatigue that lasted for 4 days.

Drew saw a leading neuropsychologist out of Loyola who is an expert in concussive injury last week. I chose to not reveal his name Continue reading →

School Policy Update: Tracey Mayer

December 15, 2011December 15, 2011Dustin Fink2 Comments

I recently met with one of the Vice Principals at Drew’s high school for a non-concussion related matter. During our conversation, the topic of concussions came up because he is aware of what Drew has gone through, and he was asking how he is doing. He told me about two female athletes who both suffered fairly significant concussions recently. He said they were really struggling academically, which was such a perfect opportunity for me to enlighten him about the policies put in place in Prince William County, Virginia. I sent these policies to the Superintendent Continue reading →

Getting Closer To College: Tracey Mayer

November 15, 2011November 15, 2011Dustin Fink2 Comments

Although Drew knows the university setting is challenging, I think he sees it as a fresh start. Now that he is 18, he will have to advocate for himself even more, so it is very important that he fully understands his disability and what his needs will be. The strategies that have worked for him in high school may or may not work in college.

As I mentioned in a previous post, Drew’s original plan of study at ISU was the College of Business. Post-concussion, he can no longer Continue reading →

My Son Is Going To College

October 17, 2011October 17, 2011Dustin Fink15 Comments

Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there. As time allows she (and possibly her son Drew) will be submitting posts for you to read. I truly hope that everyone gets a chance to read about concussions from yet another perspective. Thank you Tracey!

Drew was accepted into his first college of choice, Illinois State University – the only school he wanted to apply to. This is wonderful news. We were all holding our breath with anticipation, after all, Drew’s freshman and sophomore year transcripts held quite a few C’s.

I called our school psychologist, hoping for some guidance on how to approach the college in regard to accommodations for Drew. Unfortunately, she more or less told me that we are on our own, and I will have to contact the disabilities office at ISU and find out what services they offer. I can’t say that I am surprised to hear that, although it is disappointing.

I am going to make that call tomorrow, and there are so many thoughts in my head. How do I approach this? How do I organize the information so it’s as clear as possible? Do I even have the right or enough information? Are they even going to understand what I’m talking about? Or will they care? College is very different from high school, so is extra time on tests going to be what he needs? Will he need breaks on tests, tutoring, etc.? Who will help us determine this? So begins another search for answers and based upon my previous work, you can see where I might be a bit concerned.

When I applied for extended time on the ACT for Drew, Continue reading →

Another Mom Lends A Hand To TCB

September 19, 2011September 18, 2011Dustin Fink12 Comments

As The Concussion Blog enters into its second year of existence many have given their opinion of our work here; some negative but a great majority has been positive. Along with the critiques (always welcome) has come an urge for people to write and share experiences. This has mainly been accomplished in the comment section of the posts, but others like Michelle Trenum have given time to write and send information.

Today I would like to introduce another Parent Advocate, Tracey Mayer. She will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there. As time allows she (and possibly her son Drew) will be submitting posts for you to read. I truly hope that everyone gets a chance to read about concussions from yet another perspective. Thank you Tracey!

TRACEY MAYER — Thursday, September 14, was the three-year mark from the date my son, Drew, sustained a concussion during a freshman high school football game. My heart was heavy that day, as it is to some extent every day, but I also felt energized on the anniversary; based upon all that has been accomplished in the areas of concussion awareness, education and research since his injury.

Drew attended a day of training for a leadership program at his high school on the anniversary. One of the topics the students will be presenting to underclassmen is depression. The leadership group was looking to find someone Continue reading →