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Another high school football season will soon be coming to a close. It's the first season on the books since a new Indiana law took effect July 1 to try and better protect high school athletes when it comes to concussions.
So has the new law worked? Some of the area's premier sports medicine physicians say the law is working. They're seeing a 300 percent increase in the number of cases of high school athlete concussions since that law kicked in.
So clearly everyone is doing a better job identifying concussions, but then what? What happens to these students after the diagnosis?
Take 18-year-old Josh Money for instance. He's a former Buchanan High School wrestler and football player who has been sidelined by seven concussions.
"I got my first concussion my freshman year in football," Josh explains.
It ended his contact sports career and meant academic struggles during all four years of high school.
"During school I couldn't remember anything on tests. That's not going to happen. I can't remember anything unless it's in front of me and I can look back at it," Josh said.
"Each time it takes longer for him and now he has trouble concentrating. He has short term memory loss," according to Sherry Money, Josh's mom.
For parents like Sherry, the decision of when or if to let kids back in the game can be agonizing.
"It really was heartbreaking to see him sit on the sidelines," Sherry recalls.
Dr. Mark Lavallee at Memorial Hospital's Sports Medicine Institute has been treating Josh. Dr. Lavallee advised Josh not to return to contact sports. Josh went back to wrestling anyway and ended up with more concussions.
"They are ten feet tall and bulletproof. They don't look at life the same way as mature adult people and they don't realize that decisions made at 15, 16, or 17 may impact them for the rest of their lives," Dr. Lavallee observed.
Penn High School sophomore Ryan Walsh has chosen a different path. He got his second sports-related concussion last spring playing lacrosse.
"We did an MRI and I had spots in my brain like scar tissue," Ryan said.
Typically at this time of year Ryan would be involved in his hockey season. But he's hanging up the skates and putting away the lacrosse stick for good.
"We decided not to play lacrosse or contact sports anymore because of the risk of getting more damage," Ryan said.
So now instead of practicing sports, Ryan does daily exercises at home to help heal his brain. Some of those regimens include visual tracking exercises.
The school work is getting easier now, but at first it was very difficult. It was hard for Ryan's parents to watch.
"He struggled and struggled just to be able to memorize simple lists of things," recalls Meghan Walsh, Ryan's mom.
Since his concussion, Ryan has been under the care of Dr. Steve Simons at St. Joe Regional Medical Center's Sports Medicine Institute. Simons has been pleading with some area school leaders to re-think what goes on in the classroom when kids like Ryan come back after a concussion. Simons says they need to quit using their brains in order to let the brain heal.
"A term they will use is called an energy crisis early on with a brain injury. In a concussion event there is a very big demand for fuel to repair the brain," Simons said.
He went before the P-H-M School Board earlier this fall to explain that and to urge them to cut students more slack when they return to school after a concussion.
Dr. Lavallee agrees, saying, "You do need to allow the brain to shut down and let the brain take a rest."
The doctors liken it to a broken bone that would be put in a cast and isolated and not used so it could heal. Essentially they say that same approach needs to be applied to the brain when it is injured to give it a chance to mend.
Penn High School Principal Steve Hope says the school will support doctor's orders. But the schoolwork still has to get done.
"The student is still responsible to meet the standards for every class," Hope says.
Another aspect of concussion that makes it so challenging for students returning to school is that there is no "one size fits all" approach. The recovery can be unpredictable in terms of the length and the nature of the symptoms. Dr. Simons says it's not like chicken pox or the flu or mono where schools know what to expect when it comes to student recovery. Simons says fortunately about 90 percent of student concussion cases clear up in two weeks, but 10 percent linger for an unpredictable period of time.
For that 10 percent, like Josh Money and Ryan Walsh, the road to recovery continues to be paved with post-concussion problems they hope to one day be free of.