Catcher Preston McFarlen was good at his
job, so when the pitcher’s curve ball
kept out-maneuvering him, he knew
something
was amiss. The previous inning a foul
tip had struck his mask, but not hard,
and then as unlucky as it seemed another
one hit the same spot a few moments
later. That one he felt. He shook it
off, was questioned by the umpire and
aside from a bent facemask, seemed none
the worse for wear. But that changed.
What happened next is a tribute to the
Lystedt Law (see home page) and the
work of those who made it a reality for
all youth athletes in WA State.
How It Unfolded
Preston is not only a great baseball
player, but an outstanding football
player as well. Under the Lystedt Law,
he and his teammates have been trained
about the dangers of continuing to play
with a concussion. Last spring, Preston,
his coaches, parents, and teammates
attended a concussion workshop at his
high school featuring Dr. Stan Herring,
Co-Medical Director of the Seattle
Sports Concussion Program, and a Seattle
Seahawks and Mariners team physician. So
when he walked into the dugout and told
his coaches he couldn’t go back into the
game, he had everyone’s full support.
Friday night, March 26: Preston’s mother
Penny hears the ball hit her son’s mask
and the sound reminds her of football
helmets colliding. It takes a few
minutes, but Preston starts feeling
nauseous, dizzy, he develops a headache,
and most noticeably, his depth
perception is impaired, which is why he
is having trouble at the plate. Putting
two and two together, he takes himself
out of the game. On the way home, his
mother reaches the on-call nurse from
their doctor’s office, and inquires as
to whether he should be seen right away.
“Preston’s symptoms subsided about two
hours after he was hit, so the nurse
didn’t feel he needed to go to the
hospital. Most of his headache had
dissipated, and he still had some
residual sensitivity to light and noise,
but he had definitely improved,” says
Penny.
Sat morning, March 27:
Preston’s dad, Bill McFarlen, a football
coach who has recently completed another
concussion training course, takes him to
their local doctor who spends approx. 45
minutes evaluating him. By this time he
is symptom-free, but the doctor asks
that he make an appointment at the Seattle
Sports Concussion Clinic before he
returns to play.
Monday, March 29: Preston takes a
computerized neuropsychological
concussion test (in this case ImPACT).
The results are sent to a local
orthopeadic surgeon and then hand-carried
by Preston’s family the following day to the Seattle
Sports Concussion Clinic along with his
baseline results which were acquired 8
months previously at his high school.
Tuesday, March 30: Preston sees Dr.
Scott Laker at the Seattle Sports
Concussion Clinic. He has been
symptom-free now for 4 days, and Dr.
Laker recommends that he not participate
in a game until he retakes the ImPACT
test and he and neuropsychologist Dr.
David Coppel (see
feature story) have a
chance to evaluate the results. However,
he can start a supervised, gradual
practice schedule, which he does, and
remains symptom-free.
Wed. March 31: Preston takes stats
during a missed game. (see photo)
Monday April 5:
Preston takes the ImPACT test for the
second time post-injury and receives
clearance from Dr. Laker and Dr. Coppel to play in tomorrow’s game.
Tues April 6: Preston plays in
his first game since his concussion. He
has been symptom-free for 10 days, and
his only activity has been a graduated
return-to-play program established by
his doctor and monitored by Preston, his
coaches and parents. He catches
the full game, hits well, and remains
symptom-free.
What Worked
-
Preston was educated enough
about concussions to realize he had
suffered one and removed himself
from the game
-
His coaches and teammates were
also educated about concussions and
knew to evaluate him frequently in
the dugout, looking for signs of
subsequent deterioration
-
Preston’s parents knew he needed
medical attention and a medical
clearance, when appropriate, before
he could return to play
-
His local doctor gave him a
thorough evaluation, and referred
him to specialists
-
He had taken a
computerized neuropsychological test
(ImPACT) to establish a baseline 8
months earlier
-
He was able to retake the ImPACT
test quickly and have the results
sent to qualified medical
professionals for interpretation
-
Preston was able to see the
concussion specialists a few days
after his injury
Preston and his family were thankful
the doctors at the concussion clinic
were able to see him right away. Program
Manager of the Seattle Sports Concussion
Program and the UW Medicine Sports and
Spine Physicians, Sandra Thompson, is
keenly aware of the need for urgency.
“We intentionally leave several
appointments open every week for
athletes who have suffered concussions.
We know most want to return to the game
as soon as possible, so we need to
evaluate them quickly and give them a
clear idea as to when they can safely
return to play.”
Prior to the implementation of the
Lystedt Law in July 2009, it’s unclear
whether Preston’s concussion management
would have followed the same course. But
it’s evident that concussion education
for all involved played an important
role throughout the entire process of
Preston’s recovery. The Lystedt Law will
save lives, there’s no doubt about it.
And it takes the guesswork out of the
concussion recovery process by putting
the return-to-play decision in the hands
of qualified medical professionals,
where it belongs.
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