Cole Van Oosten's recent nearly perfect grade point average at Kalamazoo Christian High School was not that much of a surprise for the bright, gregarious 15-year-old freshman.
Yet it was part of the continued sense of relief for his parents, Beth and Scott, after Cole suffered a serious concussion last October at school when his head collided with another student's knee as Cole dove for a Frisbee.
For several days after the injury Cole struggled with memory problems and for weeks had debilitating headaches. Initially, he stayed on the living room couch, too sensitive to light and sounds to watch TV or look at the computer.
And while a CT scan taken immediately after the injury showed no apparent damage to his brain, the confusion and discomfort that followed exceeded what normally can be expected in a concussion of his type.
"Immediately after the accident, no one thought it was a serious injury," said Beth, who came to the school to pick up her son that October day and take him to the emergency room.
"He seemed fine when I arrived at school but the secretary gave me this panicked look," she said. "At first I didn't understand why but when I saw Cole he kept asking the same question over and over. He didn't know what day it was or even the season."
The physician at the ER told her that he was concerned about Cole's condition. There was some relief when the CT scan showed that there was no internal bleeding. Cole was sent home and told to rest and Cole’s parents were advised to take him to the family physician periodically to be examined.
Initially, Cole's parents woke him every two hours to check his condition.
Cole remained out of school for a while to rest and was told that his symptoms may disappear quickly or it may take longer. Cole’s father found information online that noted that in most cases of concussions such as the one Cole had, confusion and other symptoms begin to improve in a week or two. “With Cole, however, it was two weeks then three weeks and then four weeks and he still had symptoms," Scott said.
What happened next was fortuitous. Cole had hurt his back in football practice well before the concussion and was under the care of Dr. Thomas A. Goodwin of the Borgess Bone & Joint Institute's sports medicine practice.
After the concussion, his regular appointment with Dr. Goodwin had been rescheduled and when he did see his physician, Cole told him about the concussion. "He asked if we would want him to track Cole's concussion symptoms," Beth said. "He said that he had a good way to measure improvement over time and that was just what we wanted to hear."
Dr. Goodwin said that when Cole returned for the rescheduled appointment, he told the doctor about the concussion and that the family didn't know what they should do. "I told them they had come to the right place," Dr. Goodwin said.
"There aren't any blood tests or X-rays or CT scans for concussions so we use a scoring system to measure cognitive function," he said. "After testing it was obvious that Cole had a concussion. Some kids deny that they've had a concussion but Cole was honest. He knew that the headaches and dizziness meant that something was not right."
Dr. Goodwin said Cole's brain had to continue to recover before he could begin more extensive cognitive testing and he put off the back treatment until Cole's brain healed.
Dr. Goodwin is an excellent physician, Cole’s parents said. "We saw him once a week and when Cole's symptoms improved to a certain level, he started the cognitive testing," Beth said.
"At first he would tell me five words and ask me to repeat them," Cole said. "I might remember three. But after about three weeks it was like a light-bulb going off in my head. I could remember them all and even the more difficult tests."
Cole's concussion, Beth said, "was like a veil pulled over his brain. You couldn't see it but as Cole improved you would notice the improvement as he got better on the tests."
Cole also benefitted from a growing trend at high school and college athletic departments to measure baseline cognitive skills of normally healthy athletes. The program is called ImPACT testing. If a student subsequently suffers a concussion, tests can be used to determine when the student's cognitive function has returned to the baseline measures.
"Concussions in sports have been grossly under-reported," Dr. Goodwin said. "But there's more awareness now, with stories on ESPN and other places. And the governing body of Michigan high school athletics now has rules that players who have had a concussion cannot participate in athletics again until they have been cleared by a physician."
Under Dr. Goodwin's care, as well as the staff at the high school, Cole improved dramatically, although he wasn't allowed to play football.
"At first I wondered if the testing would help, but now I'm glad we did it," Cole said. "I think it knocked some sense into me."
"People don't really understand the degree of insult that a brain can have from a concussion," Beth said. "Dr. Goodwin was very helpful with his guidance and he showed us just what we needed, and Cole listened.
"We got our son back."
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