Heads in the Game

Plevretes redux 1-3

Monday, 03 January 2011 02:00 AM Written by

A wheelchair ramp to the back door by the garage. A wheelchair, from which he didn't arise for the first five months and still sits occasionally when weary. Glasses that don't completely help eyes that have no peripheral vision. His speech. His walk. His therapies. His life.

So much is different for Preston Plevretes.

The story of consequence, the story of second impact syndrome -- Preston's story -- was retold in Sunday's Post-Gazette.

It is such a complex, complicated tale that begins more than the collision five years ago at Duquesne University's Rooney Field, a sturdy LaSalle University linebacker complaining of headaches from a month-old concussion being felled by a punt-coverage collision that shook him, his family, even college football to an extent. It is a tale that will go far beyond today and tomorrow and even Preston's lifetime.

While only so much space in a newspaper could be allotted to one story, there is far more to relate about second impact syndrome, about Preston's plight, about his family.

Here are a handful of additional snapshots:

> A few weeks before that LaSalle-Duquesne game, there came a prank call to the Plevretes' Marlboro, N.J., home: Your son was arrested at school. Several frantic phone calls later, they discovered it was a prank.

So when they got a call from UPMC Mercy that they should rush to Pittsburgh, something had happened to their son, for a couple of seconds they wondered if it was another hoax. At least, Ted Plevretes said, he and Tammy hoped it was.

> They usually attended most of LaSalle's games, and they certainly under normal circumstances would've made the trip to Pittsburgh -- Tammy still has family in Westmoreland County, where her parents were raised. But it was Senior Day at Marlboro High for their other son, Perry, two years Preston's junior.

As it turned out, not long later, Perry dedicated his senior-season finale to his big brother laying in a UPMC Mercy bed, tubes throughout his head and torso, in a medically induced coma where he would remain for weeks, half the right side of his skull removed for months because his brain was so horribly swollen and bleeding. In that game, Perry wore Preston's Marlboro number. In that game, Perry scored a touchdown.

> The LaSalle team bus, Tammy said, didn't make it directly back to Philadelphia after that Nov. 5, 2005 Duquesne game. The way she told it, so many players became ill about halfway home, they had to pull over and stop for awhile. (LaSalle, citing dwindling competition in the non-scholarship Metro Atlantic Athletic Conference from which Duquesne exited shortly before, dropped football in Nov. 2007.)

> One week after the incident, the clinic director of the CentraState Rehabilition Center -- Brian Mason -- brought his son to Duquesne for a recruiting visit. Little more than one year later, he would become a weekday companion: Preston reports to Mason's clinic five days a week for speech, occupational, physical and even water therapy. As a joke, the day I shadowed him to therapy, Preston signed into the clinic as "Brian Mason."

> Friends and teammates were constant hospital companions. One family friend drove from central New Jersey to Pittsburgh, spent the rest of the day, then turned around and returned to Jersey that night.

> Between the tracheotomy tube and so many other tubes, he was unable to speak for the longest time. So their communication later become fingers, such as one for yes, or index cards. Speech remains difficult. Funny, but the most perceptible part of our conversation came when Ted held Preston's nose, to show how that bypasses the misfiring brain connection and overcomes the partially paralyzed tongue. In short, it provides Preston easier air passage to exhale his words. I tried to joke to the once-wannabe broadcaster: That's no way to go through life, having somebody hold your nose so you can speak.

Preston's clear response: "Hell no."

> Over time, such an incident begins to take its toll. Preston's girlfriend, some of his friends, some of his parents' friends no longer came around -- it hurt too much, or they didn't know what to say or. . . .

Perry dropped out of community college for a spell, declaring that he would stay home to help with his big brother's care. It required some nudging, but he resumed his college education; he's in Florida studying film-making.

> Less than a year after the incident, the Plevretes and therapists got Preston standing, then walking on a walker. Problem was, he didn't want to be seen using a walker to get around his own neighborhood. So he made his father drive him 15 minutes away, or more, to other communities where he wouldn't be instantly recognized.

> Wish I were able to put more tape or photographs into the video, too, but there was a snippet where Tammy showed me Preston's busy month-by-month calendar. Every weekday is filled with some sort of therapy or, currently, hour-long drives one way to Parsippany, N.J., and back for 60 minutes of oxygen treatments in a hyperbaric chamber. They don't let him sit still, his mother said, because he needs to get back as much of his life as possible.

> They have taken two trips to Germany and plan another for this coming summer for stem-cell treatments. Tammy called across the globe -- Russia, Mexico, you name it -- searching for the best available and agreeable methods of stem-cell treatments, particularly the course they wanted to try: implantation of his own stem cells. Millions of his stem cells have been removed from, say, his hips and implanted into his thighs, feet, brain, all over. After a few months, the parents see signs of improvement. However, they've also needed Botox shots in his ankles and thighs after one such treatment due to the pain and the muscle tone.


> Tammy had a question: How many football players read the warning label affixed to their helmets? In some places previously, she said, that was most if not all the warning a player received about the potential  for brain injury in a helmet while playing the game.

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Plevretes and second impact syndrome 1/2

Sunday, 02 January 2011 01:11 AM Written by

There are people out there who have been fortunate to escape dire consequences from sustaining one concussion atop another unhealed.

They just haven't become statistics, haven't become noticed, haven't become tragic stories.

Today, in the final installment of the series, we focus on one such tale: Preston Plevretes, whose life changed five years ago in a game at Duquesne U.

More on his story tomorrow.

If you know of athletes who have been through multiple concussions, perhaps even two healing at the same time, or even if you have another tale of concussions to share, please feel free.

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Of testing and. . . a trend? 12-31

Friday, 31 December 2010 01:09 PM Written by

Former Pitt star Larry Fitzgerald admitted that his memory was a bit dodgy after a helmet collision late in Arizona's game last week with Dallas.

It was deemed "merely a head injury," but not a concussion -- so Fitz won't be taking any concussion tests, reports a Cardinals blogger who has been following the case since the Pro Bowl receiver looked shakey after being hit on a game-winning drive.

This brings to mind the Hines Ward "neck" injury that later was called by what it initially appeared to be: a concussion.

And there have been a few other instances in the NFL this season where what looked everything for a concussion wasn't labeled such until later in the game, if not afterward.

In Arizona, Fitzgerald and the Cardinals apparently still decline to label it so.

Even if the "head injury" was simply a headache, isn't that a critical sign of a concussion -- the second-most often cited symptom, last I heard -- and enough evidence to remove a player from a game under NFL rules?

In other concussion news:

> In case you hadn't heard, researchers at Boston's Children's Hospital found that young athletes who take neurocognitive baseline testing are far more likely to sit out more than a week -- which, in layman's terms, means a more conservative medical approach that may allow their brains to heal and potentially save them from traumatic injuries.

It was published in the American Journal of Sports Medicine this month. Here is a copy of the research report.

Perhaps the most frightening statistic from the 2008-09 survey: one of every three athletes with a diagnosed concussion -- but no baseline test -- returned to action within  a week.

Maybe ex-Steelers fullback Merril Hoge of ESPN has an idea worthy of national discussion: Nobody returns to practice or play for 7-10 days after a concussion diagnosis, minimum.

> What a way for Brett Favre to potentially go out, unable to play because of a concussion.

> Oakland lineman Langston Walker, the opposite of Favre, scores beyond his baseline but his symptoms persist 10 days later.


FYI: The fourth and final installment of the Heads in the Game series is scheduled for SUNDAY'S POST-GAZETTE with stories and videos. More details on New Year's Day blog.


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Mossy Knoll? 12-29/30

Thursday, 30 December 2010 12:03 AM Written by

William Hayes just might be the most good-natured concussion sufferer in NFL history, if not all of sports.

He's the Tennessee Titans defensive end who, with his helmet off, got clunked in the temple by a Kerry Collins lob out of bounds Sunday at Kansas City's Arrowhead Stadium. You bet it hurt. Footballs in cold weather? Besides, it truly doesn't take much of a blow to cause the brain to move rotationally inside the skull.

". . . I thought somebody threw something out of the stands and hit me with it," Hayes told the Tennesseean's John Glennon. "I didn’t know I got hit with a football until [fellow linemate] Jason Jones told me. . . .  I was gone – ain’t no doubt about it. I was light-headed, everything was spinning. I couldn’t function."

 He has this theory. . .

"I’m always messing with [Randy] Moss, so Moss might have told Kerry to take me out. Who knows?"

In other concussion news:

> They've done it again. Minnesota media are reporting that Brett Favre "fails" another baseline concussion test. Think that might be a not-so-veiled shot at his cognitive function,  given the day's other Favre news about his $50,000 fine from the NFL?

> Colorado Avalanche defenseman Kyle Cumiskey returns after a 25-game absence due to a concussion.

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Concussions in the news 12-28

Tuesday, 28 December 2010 03:00 PM Written by

Now it's official:

2010 was the Year of the Concussion, and CNN's Dr. Sanjay. Gupta says so.

He breaks down some of the year's top stories, including the one broken here in Pittsburgh about Chris Henry's brain study by doctors with West Virginia University's Brain Injury Research Institute.

However, he did leave out a few extremely important 2010 mile markers:

> States such as New Jersey and others adopting forms of the Lystedt Law, whose cause the NFL and Commissioner Roger Goodell, among others, have vowed to help spread state to state.

> The National Federation of State High-School Associations and various states, such as the PIAA in Pennsylvania, adopting stricter guidelines for concussion education, detection and return to play.

> The NFL's continued, much to some players' chagrin, policing of helmet-to-helmet hits and usage of the helmet in collisions.

> And the 21-percent increase, through midseason, of concussions being reported in the NFL (specialists locally notice an unspecified uptick at the amateur level as well).

Perhaps these are signs that football is in the midst of a sea change.

Other concussions in the news:

> Even the musical Spider-Man production is having concussion issues.

> USA Today writes about an issue addressed in Heads in the Games Part III -- post-concussion effects in the classroom.

> This, from a publication in mid-Missouri, sounds like the story of a young man who had consecutive concussions and emerged relatively unscathed, a radical departure from the second impact syndrome that has killed or paralyzed dozens of football players across America from youth football to college.


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Weekend wrap-up 12-27

Monday, 27 December 2010 11:54 AM Written by

In this post-holiday edition, let's pause for a gee-whiz moment in concussiondom:

Poor Tennessee Titans defensive end William Hayes.

He got a concussion while standing on the sidelines Sunday.

It was there that a throwaway pass by Titans quarterback Kerry Collins, he of Penn State, plunked him in the head.

The incident had Titans coach Jeff Fisher shaking his head afterward. . . about a pass described as "floated." It shows that the injury can happen anytime, anywhere, and to anybody -- and even in a full-grown, 6-foot-3, 272-pound professional athlete it doesn't take much to cause the brain to rotate or move violently inside the skull.

Also on the concussion front:

> Green Bay's Aaron Rodgers donned a helmet with extra padded and looked none the worse for his two-week absence, dissecting the Giants.(More here from Rodgers about the league's protocol, helmets and stuff from last week.)

> Indianapolis Star columnist (and onetime Pittsburgh Press writer) Bob Kravitz offers advice to Colts receiver Austin Collie.

> Yes, Nebraska, there is even a concussion problem in Omaha. (Notice the mention of ImPACT, too.)


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Concussions in the news (pre-Steelers) 12-23

Thursday, 23 December 2010 05:13 PM Written by

Had to add the paranthetical remark, of course, because you never know nowadays. (And it will be interesting to see how long Heath Miller plays, and how well. I'll stick by my original concern about that Baltimore hit he absorbed: It may be some time before he fully recovers. Though I'm sure the medical staff put him through an ImPACT retest and an exertion test, seeing if symptoms returned at a high-level of physical activity, before allowing him to return against Carolina in a few hours.)

Today's heads in the pregame headlines:

> Brett Favre, now that every bone and muscle in his old body hurts at the age of 78, didn't practice today due to a concussion. One Vikings blog ran the headline: "Favre flunks concussion test." Sorry, but that sounds an awful lot like failing an intelligence test. Rather, he scored below his baseline, ergo his cognitive function ain't where it's s'posed to be usually.

> Austin Collie went on injured reserve, and the Colts are moving on just two works prior to the playoffs. Two words: Al Toon. People might start wondering if this young man is done after one NFL season and change, or has significantly shortened his career with three concussions in his past four games played.

> Here's the strangest tale of the day, and you have to wonder about: (a.) NFL players who refuse to consider the futures of their brains, (b.) NFL players who refuse to consider the fates of other brain-injury sufferers before them, some hardly out of their 30s, and (c.) Philadelphia Eagles who refuse to remember the late Andre Waters or the early-season hoo-hah when linebacker Stewart Bradley returned to a game without medical clearance for his concussion.

But the Eagles' Jason Avant, who Sunday was admittedly "knocked out" on his big block to spring the game-winning, last-second touchdown over the Giants, now denies he ever had a concussion. Funny, but one of his post-game quotes began, "Me being knocked out. . . . " Hard to misconstrue that. Note that the Philadelphia writer points out how wobbly Avant appeared in that post-game interview.

No matter, for Eagles coach Andy Reid announced that Avant passed the team's concussion-clearance muster and will return to play.

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Sign up your youth football team 12-22

Wednesday, 22 December 2010 11:13 AM Written by

Sorry, been sick in bed the past couple of days, hence the darkness on this blog front.


UPMC Sports Medicine is looking for a few, good young men.

Preferably as young as 8 to 12 years old.

Preferably youth-football players in the city and suburbs.

As part of a $1.6 million array of grants announced by NFL Charities on Tuesday, the UPMC Sports Medicine concussion program will launch next fall a study about concussions' neurocognitive affects on kids of those ages playing youth football -- an area hardly researched previously.

Dr. Anthony Kontos, newly hired from Cal State-Humboldt to direct the program's research efforts, said 15 to 16 teams around Pittsburgh will be chosen so they can monitor the players. They'll provide the pediatric ImPACT test to get a preseason baseline result, examine and retest players believed to have sustained concussions, and then retest the group at season's end. In all, the study -- in which they'll partner with East Tennessee State -- is expected to involve about 400 kids.

Other concussion news:

> Louisville men's basketball coach Rick Pitino: "The new thing is everybody has a concussion. If you walk out and slightly brush the door, you have a concussion."

> Green Bay quarterback Aaron Rodgers is cleared to play.

> What is the future of Indianapolis receiver Austin Collie?

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