Free e-book: Concussions, CTE and Football

From the Introduction:

When You Watch Your Next Football Game...

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From high school to college to professional levels, football dominates American sports and exposes millions to head traumas on practically every play.

It is a paradox of wide proportions. From opening day in September to the Super Bowl in February, the National Football League (NFL) dominates American sports and wins television ratings far beyond any other program--sports or otherwise.

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Increasingly, though, discussions of football (and other sports) include the medical terms concussion and chronic traumatic encephalopathy (CTE), a long-term degenerative and incurable brain disease. Although military personnel and others are vulnerable to the disease, the highest risk is among athletes involved in contact sports in which hits to the head are considered “part of the game.”

Ten years ago, few would have predicted that the movie “Concussion” starring Will Smith would be made. Fewer would have predicted that brain injuries would one day dominate the sports headlines. When former NFL star Junior Seau committed suicide in May 2012, the media focused almost entirely on whether the thousands of head blows he endured during his 19-year career as a middle linebacker were a contributing factor.

More than 3,000 former NFL players sued the league for allegedly misleading them about the risks of brain injury. The players and the league settled for more than $1 billion in damages. New policies and studies aimed at protecting the brains of athletes seem to be announced every week. But it’s not just professional athletes who are the focus of attention. No fewer than 40 states have passed laws requiring athletes in schools and recreational programs to schedule a doctor’s appointment when a concussion is suspected.

A progressive, degenerative brain disease, CTE can present itself  in athletes and others with a history of repetitive brain trauma months, years, or even decades after injury. Memory loss, confusion, depression, aggression, impaired judgment or impulse control, and, eventually, progressive dementia may result.

With this increasing awareness about the dangers of concussion, parents face tough choices about which sports their children should be allowed to play. Some of the more

New rules have since been designed to lessen brain trauma; but with every new horror story that emerges on the sports pages, parents worry even more.

dangerous sports for the brain, such as football, soccer, ice hockey, and lacrosse, are also the most popular. Although everyone agrees that brain trauma may have lasting and debilitating effects, and science continues to make slow progress toward understanding the disease, we cannot yet entirely quantify those effects. As a result, parents and even medical professionals are left to search their hearts and scour Web sites for answers. But a decade’s worth of research has made one thing clear: We need to find better ways to protect the brains of athletes.

Difficult to Measure

Concussions suffer from a perception problem. On the surface, they might not seem to have a lasting, serious impact. (In fact, sports programs and commentators continue to celebrate the most impactful “hits,” using euphemisms such as “getting your bell rung.”) They are an invisible injury: There is no blood, there are no displaced bones, and the patient rarely complains. Even when an athlete is knocked unconscious and observers react with panic, the concern quickly fades. Ninety-nine percent of concussed athletes wake up in seconds or minutes and then seem fine. When symptoms persist beyond the day of injury, in the vast majority of cases they dissipate within a month. The injury seems as if it is gone forever, leaving no scars or overt indication that it ever happened.

Children at Risk

Most brain trauma in the industrialized world occurs in children playing sports. Since participation is voluntary, and the rules of recreational sports are malleable, it seems reasonable to make every effort to reform each individual sport....

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CTE and real cost of football on Super Bowl Sunday

It's the biggest sports day of the year, Super Bowl Sunday, a festival of football. But a sport so celebrated is taking a toll on our youth and adults. Our book, Healing the Brain, gives a in-depth view of the science of concussions and CTE.

From KCCI.com

Another Iowa family is donating their son's brain in the name of CTE research, but they are doing so at the request of their son. Zac Easter's devotion to football started in third grade, one of those kids in the middle of the action hitting and getting hit.

"He's a young man who loved the sport, who like any other athlete didn't want to take himself out of a game -- unless somebody made him," said Brenda Easter, Zac's mother.

Zac played 10 years until he was forced to stop in the middle of his senior year at Indianola.
"He had three confirmed concussions and he had to quit," said Myles Easter, Zac's father.

During his final game, Zac was not backing down from an Ankeny lineman towering over him.
"I knew that last one was not good, at Ankeny, I could just see the look," said Myles Easter.
Zac's father was Indianola's defensive coach.

"I knew he was done. I knew that was it for football," said Myles Easer.

"'I'm good,' those were the words, 'I'm good to go,'," said Sue Wilson, Indianola athletic trainer of her conversation with Zac.

Wilson was on the sidelines in 2009 for each of Zac's concussions.

"Back then, they could return to the field 24 hours later -- sometimes they were back sooner than an ankle sprain," said Wilson.

In the fall of 2014, Zac complained of severe headaches, problems with balance and with his vision. His family remembers him commenting about memory loss problems -- having a hard time remembering things and some slurred speech.

It was a Des Moines doctor who first mentioned CTE, chronic traumatic encephalopathy.
"I remember looking at Zac and said 'What exactly is CTE' and he goes, 'It's like brain dementia mom,'," said Brenda Easter.

Several professional football players were among the first diagnosed with CTE after they died and the issue is the subject of the Hollywood movie "Concussion."

"I was in denial, you know we're tough guys in this family. We'll get through this you know heal up over time is what I thought," said Myles Easter.

Of course, mom went looking for help in research, and she discovered what her son already understood.

"He just looked at me and said mom, 'There's no hope for me. There are no treatment programs. I know more than most of the medical professionals I've talked to and there's no hope,'" said Brenda Easter.

Zac moved back home last fall as his condition got worse.

The family said it was very difficult to see a strong young man -- very intelligent -- really go downhill so quickly.

Zac knew CTE could only be diagnosed by direct tissue examination of the brain, after death.
"And he said to me, 'Mom, I want my brain donated to science,' and I said, 'Nope, someday Zac we'll do that but I don't think you're done with it yet so let me find the right help for us -- don't give up on me," said Brenda Easter.

Just after midnight on Dec. 19, Zac drove to Lake Ahquabi and shot himself. He left a note in his car apologizing to the first responders and called the sheriff's dispatch to tell them where he was.
"They heard the gunshot go off on the phone," said Myles Easter.

"We drove out there as fast as we could, and it was too late," said Brenda Easter.

Zac took care not to damage his brain preserving it for research. He left two notebooks in the family room including a journal that documented his daily battle with whatever had taken over his body, his thoughts and his life.

Mike Hadden is a professor in sports sciences at Simpson and just finished a sabbatical studying CTE.

"Through his journaling, we have so much material and information from this that it's almost as if, I mean, it's a firsthand experience and so we can tell that story," said Hadden.

Zac writes in detail about each concussion and other blows to the head his parents and coaches didn't know about.

"His buddies had to carry him off the field because he could hardly walk, he was that dazed but he wasn't going to tell anybody and his buddies were buddies so they didn't either," said Brenda Easter.
Concussion protocol has changed dramatically since Zac played his last game at Indianola six years ago. Wilson said these days any symptom, even a headache means the player is done for the game and won't come back until doctors clear them.

"I feel a little responsible because he was in our care. As an athletic trainer, our ultimate goal is to keep kids safe. That's why you go into athletic training," said Wilson.

In Zac's writings, he expresses his desire to tell young athletes it's OK to tell coaches if you're dizzy or have a headache, OK to take yourself off the field wanting to tell everyone that all those concussions changed him that helmets need to be safer that more research needs to be done on CTE.

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Carolina Panthers' player cries after concussion; Crowd, media gasps

In a recent NFL game against New Orleans, Carolina Panthers star player Luke Kuechly suffered a concussion. According to reactions by fans in attendance and media, they were questioning Kuechly's manhood. Notably, one year ago, Chris Borland of the San Francisco 49ers walked away from a lucrative contract because he saw the large risk of permanent brain damage from continued football head trauma. In Healing the Brain, we look at concussions. Here is an excerpt:

Understanding Concussions and CTE

MontanaPrepFootball.wordpress.com Public attention has focused on the vulnerabilities of young football players to head injuries.

It is fairly remarkable that “Concussion,” the movie, exists. Ten years ago, the public did not know much about concussions and other forms of brain trauma. People weren’t watching football games and thinking about the long-term neurological effects of the brutal body contact. A veil was lifted on a topic rarely discussed as more and more football players reported disturbing neurological symptoms after their careers had ended. A disturbing series of suicides were reported. Around 2009, the National Football League (NFL) started getting criticism for its outdated concussion policies. In 2013, a book and corresponding documentary that tackled the issue, “League of Denial,” were released. At the end of 2015, Hollywood brought us a major motion picture that stars Will Smith as a neuropathologist fighting to reveal the truth about head trauma in football players.

Parents around America began to reconsider their willingness to allow their children to play the sport, one that plays a major role in the sports and cultural life of the country.

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain.

Concussions Are Serious

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Chronic traumatic encephalopathy (CTE) is the term used to describe brain degeneration likely caused by repeated head traumas. CTE is a diagnosis only made at autopsy by studying sections of the brain.

CTE is a very rare condition. It has been found in the brains of people who played contact sports, such as football, as well as others. Some symptoms of CTE are thought to include difficulties with thinking (cognition), physical problems, emotions and other behaviors.

The condition is a very controversial condition that is still not well-understood. Researchers do not yet know the frequency of CTE in the population and do not understand the causes. There is no cure for CTE.

Some of the possible signs and symptoms of CTE may include: difficulty thinking (cognitive impairment), impulsive behavior, depression or apathy, short-term memory loss, difficulty planning and carrying out tasks (executive function), emotional instability, substance abuse, and suicidal thoughts or behavior

Other suspected symptoms may include: irritability, aggression, speech and language difficulties, motor impairment, such as difficulty walking, tremor, loss of muscle  movement, weakness or rigidity, trouble swallowing (dysphagia), vision and focusing problems, trouble with sense of smell (olfactory abnormalities), and dementia

The full list of symptoms of people with CTE at autopsy is still unknown. It is unclear what kind of symptoms, if any, it may cause. Little is known right now about how CTE progresses.

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