YOU and Your Brain Injury: Concussions in Young Athletes Leading to Health Care Reform

After January 1, 2012, student athletes in Colorado sustaining a "head injury" (as they are commonly called, but ultimately is a 'brain injury' and we should be using THAT word to show the importance every time it's uttered) will finally have a fighting chance of a "concussion" (which is a physics word that the health industry adopoted, again, it undermines the importance of the BRAIN is INJURED) occurring during school activities not impacting the rest of their lives.   Or, in the worst case, ending their young lives due to 'second impact syndrome' (SIS).  It begs the question 'where are our priorities?'  I hope parents and young people all think this through.  As in really give it some time and thought.  

There is a fascinating story about how this came to be, with many "players" over seven years making an impact on changing how brain injuries are viewed, handled and recovered from.  Through students and their families/friends ("framilies" I affectionately call them) becoming more aware about brain injury and all things related, it will extent out to the community and eventually have a positive impact on older people as well.  

This new law is requiring the "student/framily unit" to collaborate to be the YOU in the middle of the team, and realistically, they might need an advisor there with them.  I realize I have a big different background than some occupational therapists today, and that is why I don't operate as an OTR but as a 'functional advisor and consultant'.  

In this series, I hope to provide a base of information for those who have young brains they're caring about protecting or healing/restoring to wellness or as close as can be to it, as that brain goes with YOU (the young person) for the rest of your life and YOU remain "chronically well" or end up in "chronic illness" (and everyone is somewhere along that continuum). Related to brain injuries, there are other topics in this forum so please navigate with the links above this topic's title and go 'up' to the forum and see the list.  

I'll also set people up for further exploration of various information based upon the brains I pick of the experts I know who specialize in things related to the brain.  I also am providing links and utilizing highlights of some exceptionally well done stories I've found related to how Jake Snakenberg's school psychologist has changed the course of how head injury is handled in Colorado.  

The History of The Jake Snakenberg Law

Initially responsible for us to appreciate in all this, and most importantly, is a young man from Aurora, Colorado named Jake Snakenberg, whose life ended in 2004 at age 15 related to head injuries sustained from playing football. Next, the school psychologist in his school at the time, Dr. Karen McAvoy, along with the many since, who have collaborated to create new organizations and processes, clearly progressing how we are handing head injury related to school-related incidents. She now heads a nonprofit which focuses on head injury in young people.  I provide more information about this story and links to my resources for writing this piece, below, and encourage those who are particularly interested, to follow and enjoy the details I've not included in this piece; as I say, it's an inspiring read, and for me, raised a lot of questions and ideas.  For one thing, there is a quote in a big newspaper story about it by a physician who says that there's nothing you can do for the brain but let time heal it.  That didn't sound right to me, from my perspective about medicine.  

By shining the light on the effects of head injury, even minor ones also known as 'concussions', I foresee The Jake Snakenberg Law to lead to the 'hammer of health care' to swing in new directions, eventually impacting in a positive way the health of Colorado's residents in a positive manner.  I forsee this to initially extend to other young people in schools injured in playground mishaps, slips/falls, and violence-related incidents.  

Due to the parents and family/friends ("framily") becoming educated about head injury from their children, the entire community will have much more awareness about brain injury in the short and long-term, much the way texting on cellular telephones has evolved in awareness as an issue for wellness/safety.  Medical providers are being educated about the law and are involved as key players on the team deciding if and when and how a student can go back to not only physical activity at school but cognitive/thinking activities.  Hopefully this will bring a long-overdue increase in interest in continuing education when the providers are making choices on where to put their continuing education resources of time, energy, and money. And I will work to provide quality information at Lumigrate.com for those who look to us for education from our perspective, which is an increasingly popularly held one, even among conventional physicians/medicine! 

The other exciting element, from my standpoint, is it has been wisely designed to be 'collaborative': the student and their adult teammates (typical parents), the school personnel, and the medical provider have to work together.  This will go far with 'reforming' health care.  The Lumigrate You Model, which has been our cornerstone since the beginning, lends itself well to this situation.  Here is how the Lumigrate You Model looks for the medical consumer when using a collaborative approach and integrative medicine, which addresses body, mind and spirit.   Integrating the Jake Snakenberg Law with the Medical System; Difficulties?

To ease the difficulties of implementing this new law, specialists in function and problem solving could partner with the student's 'team' of health care/school professionals post brain injury from three ways:  

1) the "framily" utilizing an independent consultant to act on their behalf as an advocate, liaison, advisor and detective to 'bird-dog' the information needed and consolidate it,

2) the schools utilizing existing or additional occupational therapists and other qualified para-professionals to assist the school personnel with this added responsibility placed upon them and

3) the medical providers/clinics bringing on additional qualified staff since they are, by law, tasked with assessing where the head injury is at related to healing, which requires doing testing and knowing what the baseline/before head injury cognitive function was.  

Information to be taken into account includes grades in various subjects, standardized tests which can be compared with the results of the post-concussion cognitive testing, verbal report, etc. Depending upon the severity of the injury and how the student responds after it, there are going to be a LOT of variations to consider. 

This kind of decision-making is similar but different than what most physicians have been doing their careers, and this is going to be a cumbersome process that people essentially get thrown into instantly with a 'ring of the bell'/(concussion).  Technology and the short time allowed by insurances between provider and patient have resulted in physicians honing their skills and interpreting a lab result and offering a solution from there. So many people have stories of missed diagnoses or mis-diagnosis as a result. It's rampant and I know few physicians who don't have the best intentions at heart, or they used to before they became so overwhelmed by today's environment.

Over a decade ago, for two years I worked with 15-20 year old first-time drivers who had difficulties passing the driving program where I was the resident rehabilitation specialist (program director), and it took me the better part of half an hour to get a good oral history from the framily and student to find out what might be the underlying problem and then go about solving it.  

I'd previously been certified in the Assessment of Motor and Process Skills, a standardized tool for occupational therapists who are called upon in geriatrics to determine if a person is safe to stay in their home or assisted living with the support they have, or whether it's recommended to have them go to another situation with more (or less) assistance. These are the types of skills that are going to be required in making the best decisions about returning students to thinking or playing at school.  

Call it what it is: "Brain Injury" vs. "Concussion" 

I believe it is best to not call them 'concussions' anymore except parenthetically or in titles and search word strings, since that's what many people have historically called them.  Brain injury is brain injury, the is a continuum from mild to severe.  Calling it 'concussion' can perpetuate that word usage and times when a  'concussion' was something we just got up from and kept going; we now know that's not the right thing to do.  

"Seeing stars ... and we all get them at some point and it all resolves on it's own, no big deal".  I'm adamant about how big a deal it is, and I believe there are many health and learning problems in adults and younger people which have been caused by a deficiency of information in the public and medical providers' 'fund of knowledge'. "Brain injury" shifts the conversation to a different level, and I think it's the level that is best for people to really unplug from what they were thinking they were going to be doing right now and shifting it to focusing on the injury and healing.    

It is confusing to people to have them called "head injuries" because then it is though there has to be some outward sign on the head/cranium.  People may or may not have something sore or visually noticeable, and then the BRAIN, which is really the most important thing inside our bodies, get overlooked.  They're brain injuries, from "mild" to "traumatic" (TBI).  

From my research recently on this and my years of experience as an OT since 1996 and life-long experience having been born with a brain injury that went under/un/mis-diagnosed for over three decades, the overall medical community is really not very well versed in brain injuries and the strategies available afterwards to remediate them and improve outcomes for the person who sustained one.  So I am very concerned about this and am working to build additional information on Lumigrate to address this gap, for those who come to Lumigrate.  Naturally, I refer people to it when I am working with them as clients in the consultation aspect of my business.  

The Specialists Who Come Into Play After Brain Injury When Things Don't Completely Resolve

I find that many professionals are unaware of the various specialties which are very effective and proven to be beneficial post head injury and want to see people, whether younger or older, know about them at the least and, should they desire, be able to obtain them.  I want to suggest that providers and the public realize that the commonality in our frustrations with the medical system is we all feel overwhelmed, wish we had more time to learn, and wish we had more time to spend together in our visits.  Medical offices are extremely expensive to run, the overhead is staggering: I should know, I was run out of being in insurance-based occupational therapy because of it!

One solution is to utilize professionals who cost less, and all medical offices have to do that today, but I believe many don't consider outsourcing to qualified providers such as occupational therapists for things that would be completely in their realm of expertise potentially. The think 'nurse'. But nurses don't typically have much training about the brain and function.  

With the difficulty presented by the term 'occupational therapist' not being widely understood, the public/consumer/patient might have misconceptions about inviting and including occupational therapists to be on their teams. So perhaps give them a more descriptive title.   

Other disciplines don't refer to it frequently enough either; there actually is a bit of discrimination by the PT community against OTs, I'm sorry to say. I've seen it over and over; there are 'OT jokes' like 'blond jokes' or 'lawyer jokes'.  I am rarely around a mix of PT/OT anymore but even recently I was at a meeting of health care providers and there was one other OTR present who offered to be part of a demonstration and things were not going completely smoothly -- part of it was the presenter's transmission and the other part was the OTs receiving.  I was sitting next to a PT and could literally feel 'the 600 pound elephant in the room', so to speak.  It's like I got the telepathy somehow that they were about to make fun of OTs as a category, and JUST as I said 'oh, this is where someone could make an OT joke' the PTs mouth moved and out came the derogatory 'OT slam'. In my health education training prior to becoming an OT, it was drilled into us that you never make a joke about something that is at the expense of a category of people or an individual.  

Again, I have universally found the medical world to be one of the most difficult there is to navigate in; 'they eat their own' as I say. It is full of pressures, and I have a great deal of sympathy for the medical offices and providers this law is going to tax: I can 'commiserate"!  When I think about the burden of an average of 10 students/team/school/year on the doctors/providers who are already inundated with insurance-based paperwork and trying to communicate with other providers and keep up with it all, I have concerns for all involved.  

At the end of the day, my concern and loyalties have ALWAYS been with the patients getting what they should get from giving a professional their time, energy and money/insurance resources.  Too often today we hear of a person going to several or more providers without getting anywhere.  

Oprah's first show of the new year in 2009, when Lumigrate had recorded a video about hypothyroidism in the fall which was being edited for the new website which launched in March, was about how she had a viewer get ahold of her to say she saw the goiter on her throat; Oprah had been to a handfull of doctors about symptoms that were consistent with thyroid so she asked the sixth one 'have you tested my thyroid' and he looked and ......... none of them had! These stories are everywhere today, and that is why I created Lumigrate, it truly comes down to the consumers looking and listening around until they find something to perhaps take to their provider, the way Oprah did in the earlier example, though in that case it was someone reaching out to her.  My thyroid problem was seen by my massage therapist a week after I had been to my specialist who was working with me about low energy and insomnia .. and he had not laid hands on my thyroid nor done the necessary labwork to tease the problem out! Martine Ehrenclou's book we include heavily at Lumigrate, The Take-Charge Patient begins with the story of her going to over 10 providers about horrible abdominal pain and she so brilliantly waits to the end to reveal she had several invasive procedures to the abdominal area, so WE were baffled not being suspicious of herniation.  It's just unbelievable one let alone handfulls could miss it! She was doing online research about someone elses medical issues when she came upon information which matched several of her symptoms.  

My point is not to beat up the providers, we're already beat up enough overall just from showing up to work each day, but to underscore the importance of YOU taking the time to read about brain injury and what can come from it, so you'll know what you can do about it for someone you know or for yourself, perhaps! 

Patients are why we 'do what we do', most people weren't trying to get rich when they put themselves through tons of education -- there are much easier ways to get rich than become a medical provider.  All of us have gone to a lot of expense of time, energy and money resources to become providers and be in business for those of use who have ventured out as owners.  It frustrates us when we go home at the end of the day and don't feel we've done our best or there's something we might have done wrong.  And in my opinion, asking the type of providers tasked in the law with doing what they're going to have to do, I generally fear for the provider and the student/patient and everyone in between.  

To my knowledge currently, medical offices don't have pathways in existance with the various schools to get the information, so it seems very inefficient to have each medical office setting all that up.  They already have to have that for all the other medical providers, pharmacies and insurance companies, so this is adding another big component to their already overfull plates.  However, I commend them in taking on all they do and realize there is an exodus of providers for these reasons.  "I can't take it anymore" is being said over and over, not just in medicine, a friend who is a public elementary teacher just said it to me as well.  Colorado receives the least amount of funding per student, on average, of all 50 states! So I commend the people who created this movement from a public school tragedy and are creating much OVERDUE change.  The medical industry meets the educational industry in this situation and it just has 'difficulties' written all over it to me, I am sorry to say. Again, I'm only reporting on things here as I see them, and offering the solutions I see as opportunities to pick up where any problems leave off! And I universally wish there are no problems but if so, please read on and at other areas of this forum or overall at Lumigrate (Search on keywords).  

Theories About Head Injury Treatment and Recovery

I'm proving the links, below, to the two Internet resources I found most helpful in learning more about The Jake Snakenberg Law and they're both excellent and I suggest you follow and read.  I bring into this piece the major portions to quote that I feel apply here.  In talking with providers over the years and currently, as is reflected in The Denver Post article I link out to later, there's a common belief among medical providers that 'time heals the wounds of head injury'.  

I disagree with this, as do the providers at Lumigrate that I have talked to about brain injury.  Time IS a factor but it is secondary to other things; primary is what we drink (or not) , breathe in (or not), eat (or not), stress about (or not).  This creates the environment in our body which affects the body/brain as time goes by, which translates into healing (more or less/not).  

"How we think" --  our 'mind' --  has an increasingly proven affect on the body, known as the mind/body connection.  Our spirituality (or not) affects our body/mind system as well and is embraced in 'integrative medicine', which is based on integrating providers related to body/mind/spirit.  What about restful, healing sleep? Much has to do in the body with the removal of cellular 'waste' as well, all of which is affected by what you put into the body and how you treat the mind and spirit.   

If two identical brains get identical injuries and one person goes home and has pure water to drink and the other drinks 'energy drinks' full of sugar and caffeine and artificial coloring agents, will the brains heal the same? NO WAY, so it's NOT 'time'.  

What about the effects of progesterone, which is used in the treatment of significant brain injuries at some ERs .. is there some application for young people related to head injury? Look around Lumigrate for this type of information, in this forum and elsewhere if you're interested.  Progesterone affects the GABA/calming neurotransmitter of the brain and therefore it has an effect on people with brain injury, fibromyalgia, and even seizure disorder!

Details of the Jake Snakengerg Law and Western Colorado's Organized Approach using ImPACT Testing

The Jake Snakenberg Law relates to return to school performance after concussion/traumatic brain injury and goes into effect in Colorado on January 1, 2012.  This includes not only physical tasks but cognitive/thinking performance.  When you are immersed in education and promotion of mind/body/spirit medicine like I am with Lumigrate, it is GRATE that this law and the processes it outlines addresses the mind/body aspect of head injury.  From my vantage point, the solutions to head injury come from not just looking at the head and the "obvious" related to not getting another hit to the head when the brain is still healing from the first one, but the relationship of the whole of person's body, mind and spirit related to the injury.

Treatment for head injury in the United States (and in Colorado) Varies Greatly

Brains aren't like bones, where it's either broken or it's not; there is a wide variety of types and extent of injury. I cannot tell you how many times my patients and clients have told me they had some sort of incident where you'd suspect brain injury and when they were at the ER there was a test done of some sort on the brain which showed there was no injury, so therefore there was no brain injury suspected.  Yet they clearly had symptoms that went overlooked and untreated, with ongoing symptoms they suspected was from the incident. I'm not a physician, I cannot 'diagnose' things, but since I get to have an hour with a patient not just 10 minutes, I could start putting things together and have been instrumental in many people being properly diagnosed.  

Once, a client had been misdiagnosed and treated with an arsenal of medications which, when the physicians collaborated to remove, lead to a 'miracle' of an improved / 'normal' brain on imaging studies.  The person's behavior was not normal but since the scan showed it looked normal they couldn't figure out what to diagnose and the legal system could no longer continue to intervene and order medical guardian and lawyer. Again, doctors today have not developed and have lost their clinical reasoning skills so frequently that it sets the patient up for failure all too often. Teams which think 'big picture' see that paying a bit for my time to intervene can save them in the long run.   

We've had a lot of dramatic examples recently publicized in the news, from Congresswoman Gabrielle/"Gabby" Giffords, to the thousands of military veterans and others from war-torn areas who are now living with the "the repercussion of concussion".  And the public and many providers tend to then think 'that's the bar' where you call it a head injury, rather than thinking the fall that lead to feeling tired after for a while was ALSO a brain injury.  A mild one, but it was an injury to the brain.   

Brain injury treatment in some communities includes treating with progesterone in the ER through IV; there are progesterone receptors on all cells of the body and when you think about it, there are nerves throughout the whole body (which obviously have cells). There are many opinions about this and MANY other things today with the growing variety of providers, beliefs and information the public is demanding and supporting.  

This is where I refer you back to look at The Lumigrate YOU Model, because increasingly the public is responding to/demanding this to be the treatment model and in schools the STUDENT'S PARTICIPATION AND SENSE OF SELF EFFICACY is the key from the very second a brain injury occurs.  If they don't accurately know the many repercussions of brain injury and treatment and respect what can happen if they don't stop activity immediately, they might live to regret it.  My concern is this law is so geared to the FEW cases where someone dies and not focusing on the MUCH MORE COMMON long term effects of brain injury.   

If someone told me "there are millions of brain injuries a year, and 3-4 a year die of second impact syndrome", I doubt even as an adult I'd stop playing! BUT, if I knew that it could affect my chances of ALL the things kids look forward to in life (such as working and having money when they grow up), they have a better chance of handling it correctly from the first impact/head injury. I was the kind of kid that if I knew about the long-term effects we know of today related to repetitive brain injury such as in football, I'd have said 'I'm not playing that sport, let me find another one'.  That's really 'all I ask' for starters, is that Lumigrate and I might reach students so they can decide to learn more, what sports to play or not, and certainly what to do if they get a brain injury.  Again, please do not minimize it by calling it a 'concussion' it is a 'brain injury'.    

Information on Lumigrate Re: Fibromyalgia and Chronic Fatigue Applies to Head Injury

Many of the people who initially followed Lumigrate as a resource for progressive health information did so because of my relatively good recovery at the time from a condition known to be fairly devastating, fibromyalgia. That recovery has much to do with things that I didn't obtain from insurance-based medicine, which does not support nutrition advisement, supplementation, nor the supplementation of biologically identical hormones.  

I know first-hand what happens when you only use the allopathic providers and insurances: I did that for a number of years and my health spiraled down to something I wouldn't wish for anyone to experience. Most of the time when I say in conversation to the public that I have fibromyalgia, people lately typically know someone who has it and they know it's something 'really bad' and some seem surprised as they don't think of someone who has it being as active as I am. I've had this relative success, thankfully, because of my using a mixture of insurance-based allopaths in the past and other providers, tests, and treatments that insurance doesn't pay for.  I also have invested in what I drink and eat differently than the average American or how I would have otherwise and believe whole-heartedly that my health and therefore life have benefitted from it.  

I therefore want to see the young people who get head injuries also have information about things that are not only coming from the school and allopathic communities which are at the crux of this law and new process.  And in the long run it will save money, just as my investing money into things others don't support has saved money on my health care. Naturally, for a new system like this to go into effect, it has to be set up on what ALL students have the ability to obtain related to medical providers issuing the required test and yielding a decision about how and when to return to motor and process tasks at school (and otherwise, presumably, but the law doesn't dictate what goes on outside of school).  Schools are mandated to provide treatment for anything they tease out and label as a 'problem' in public schools.  Today, with increasing variability related to insurance (or not) for diagnosing and treating things, there's been a drastic increase in providers being sought out who are outside of the insurance-based 'loop', and much of this has to do with they are less expensive.   

Naturally, the allopathic providers and schools offer us much that is of benefit, but we can't ask them to offer information on things that are outside of their area of strength and expertise.  "It takes a village to raise a child" and it takes an INTEGRATIVE team collaborating about the body, mind and spirit of a person whose brain has been injured to have ultimate healing and the best chance of full recovery.  There will be a great deal of variability for students, unfortunately, dependent upon their payor sources and those sources beliefs and support of those beliefs. And that is up to the student/framily unit to determine and move forward with.

In my case from my past, a patient was referred to me and when I pulled all the specialists documents together I recommended something and educated about the intervention.  The patient and framily checked into it, the patient was well off financially but the framily were leaders in the established allopathic philosophy and guided the patient to pass on the intervention I was requiring to proceed working with me for driving rehab. I made it clear that I was available in the future if they changed their minds.  After a competitor passed the patient with some restrictions on hours/light/dark for driving and using adaptive mirrors, there were two incidents in slow situations (thankfully) with the left-neglect problem and they then sought out the treatment I'd originally suggested.  A decade has passed with no further incident and has included city, highway, and 'cross' state and Continental Divide driving, which most who drive the route agree it's a challenging drive. So it's sometimes a long process of trial and error, but it starts with identifying the problem and education about options.  

The "Occupation of Health Care" and The Lumigrate You Model

From my vantage point from obtaining a degree in occupational therapy in 1996, whose career has more recently focused on education of professionals and the public related to what I call "the occupation of health care", the occupational therapist has much to provide when it comes to the young athletes and others in school-related incidents which are being captured in this new law.  In the last handfull of years, I have focused, with great success for those who embrace the concept, on getting the public/patients/consumers educated about what is important to them and putting themselves as the "YOU" in the middle of the health care team and surrounding that "YOU" with the appropriate experts to consult with for advisement on their health. They, in essence, lead the medical providers and the medical community and system to change and adapt; any provider doesn't sincerely embrace this concept doesn't last on my medical team.  

It isn't a pain-free transition, but in the end it puts the responsibility of my body/mind/spiritual health and wellness on me, the patient/consumer/client.  When you pause and think about the repercussions of that on each person and on the medical system, which includes the legal system related to litigation and the mounting friction between providers and consumers/patients, it is an enormous paradigm shift which greatly affects costs and outcomes. Whether it's the 'terrible two's and three's' or the tween/teen years or the years in between, giving youth the responsibilities they are up to taking on, with support from the adults and 'framily' in their life, yields the best results.   

I therefore see this as a huge opportunity to make significant change in the health of many people as well as the 'system' of our interaction with health care providers, particularly if we include them appropriately in the process. Young people who are known to have a head injury in school-related events are going to now have a process initiated which requires collaboration between them, their parents and I prefer to use the word 'framily' to capture today's different social structures in the home and community, and the medical system.

What Type of Medical Providers and How They Medically Clear Student for Return to Play/Think  

The medical provider responsible for determining when the head injury is resolved enough to allow for return to limited or full thinking/mental and physical activities has the burden of responsibility legally to be making a good assessment; if they clear someone who in fact is not healed and there's another head injury, the patient might die. This law only holds the medical provider responsible if a second impact syndrome occurs, but it opens the doorway for other legal action related to other long-term effects of head injury.  MDs, DOs, NPs, PAs, PhD Psychologists with concussion training are listed in the law to give the medical clearance. 

It's not really different than any time a provider makes a recommendation to take a medication or not, have a surgery or not, etc., but there are some challenging complexities related to compiling the information (which is more an administrative time demand) and then cyphering that and determining how the person's doing compared to before the injury which are difficult for the typical primary care physicians and related providers who are tasked with this responsibility. To me, this is something that takes a lot of specific experience and expertise, and I believe occupational therapists can be a very good tool for assisting the responsible providers.  

When I read about the specific case of Jake Snakenberg's last week of life, where his symptoms were acknowledged and reported by him to be tingling hands, I don't only wonder "what if the initial head injury had been recognized by him, his family and coaches", but also "if a young person in 2012 has tingling in the hands as he did, and the schools are now teaching all involved to know the signs and symptoms to look for and then sending them to medical providers within 24 to 72 hours for assessment, will the medical providers consulted know what interventions to recommend?"  I wonder "if he'd not had a second impact but also hadn't had any treatment, what would his health and learning/school wellness have been like?"

I have a former patient who had multiple 'concussions'/head injuries in his youth and then in his young adulthood had another head injury related to a motorized vehicle crash and the initial medical team and the patient and framily hadn't had enough education related to 'concussion' back then, helping me form my opinion about calling them 'head injury' instead.  That patient started with treatments for the body/brain and mind paid for by insurances, then outside of insurances,  and after exhausting all known possible treatments turned to more emphasis on spirituality there was a big improvement which came at that point.  Naturally, it appears that it was 'time', but from my vantage point it was the interventions for body/mind/spirit which occurred over time which finally resulted in a return to work and being considered 'within normal limits' for activity (which is generally considered 80% of ideal for age and background when looking at chronic fatigue.) 

History and Resources about Jake Snakenberg Law

I am finding the story behind the Jake Snakenberg Law an intriguing one, not only because of the aspect of something good for many young people coming out of the circumstances of one 'untimely and unfortunate' death in 2004, but because I forsee the process of school and medical professionals collaborating together with each other and the student and his/her family leading to more changes for ALL in this country related to medical care.  Where small grooves are created, they are deepened by more that follow in the tracks of the previous, whether that be wearing a pathway, creating a new waterway, or changing how we obtain our medical care.  

The youth who are handled for head injuries are going to be like a bulldozer for this process by the time they are parents with children following in their footsteps in school athletics.  At least I hope I am seeing this correctly, for their sake, as the current health care system is the number one challenge for the majority of people in the United States no matter what their income and education.  I find it what we all have in common and the greatest place to focus on change. Hence my anticipation about where things change in 2012 with this new law and process.     

The law is inspired by an infrequent but serious condition which has occurred in the United States about 30-40x/decade in the past, called "second impact syndrome", which can occur when there is a second concussion/head (brain) injury sustained before symptoms have cleared from an initial injury to the brain, causing swelling, death or severe disability.  Naturally, we wouldn't want this to happen to any one of our young athletes, so I believe this is big and good step forward for the people of Colorado -- and beyond.  

More importantly, it is casting a light on head injury from things 'we can all relate to'.  We've had a lot of exposure recently to the head injuries sustained by our military with the types of weapons being used increasingly in combat, but unless you've been in Hummer driving down main street and had a bomb detonate nearby, you might not 'relate' to having had a head injury in the past.  But with this, everyone might stop and say "I had a head injury when I was younger, I wonder if that has anything to do with what I'm experiencing today".    

As a person with a history of complex medical issues, the first step, as with anything, is awareness and education. Then the next step is to take action; as Nike's famous slogan says "Just Do It".  I prefer to call it "patient proactivity" and believe it relates to feelings of self-efficacy.  That applies here particularly since we're talking about athletic-related injuries in this piece, which can have lasting and insideous but profound affects on people's lives. (For those who wish to read more about the details of how I came full circle on this, more can be found at the following link related to as much as I have come to understand and can relate related to my case: LINK HERE

For every instance where someone dies as a result of concussions not properly recognized and treated, there are uncountable numbers of others who end up with life altering changes. Sometimes these are long-term effects which cause significant change in function and affect a person's life, at great expense to them as people and to all who are affected by the finances related to that person.  That ends up having an impact on all of us in the society, but mostly devastates the life of the person and potentially their family.   

I have seen it said that the average student athlete's costs for athletic competition is $10,000; I hope when an unfortunate injury occurs the treatment plan for these students and their supervising adults includes education about the positives and negatives about the things which affect the body. Unfortunately, health care costs have not historically been something Americans think of as being one of 'their' responsibilities, but that is changing and many are now seeing the wisdom in being proactive and shifting resources to do things preventively.  But inevitably, there's a time/money/energy equation many are constantly challenged by.  

The Effects of Nutrition on Youth/Injuries

History of Jake Snakenberg and the events from 2004 to now: 

 

The Denver Post's Ryan Casey reported beautifully on how Jake's school psychologist, Dr Karen McAvoy's life changed with the phone call from Jake's athletic trainer about his death, and I encourage using the link at the bottom of this piece to follow and read the entire piece.  "I remember greeting the freshman football team, all in tears, in the auditorium first thing on the following Monday morning. I was there as their psychologist to help with grief.  It was almost unbearable."

 Dr. McAvoy was unaware, while she was immersed in helping others cope with this devastating tragedy, that the course of her own life would be altered as well. "Jake changed my life that day," she said, "I didn't know how extraordinary, and just how profound those changes would be."