Kids Day

Valley Children’s Hospital dealing with sharp increase in concussion patients

Nolan Hirayama, 16, suffered two concussions while playing basketball for Clovis North High School in 2015. He is undergoing therapy through Valley Children’s Hospital under the care of Dr. Jennifer Crocker.
Nolan Hirayama, 16, suffered two concussions while playing basketball for Clovis North High School in 2015. He is undergoing therapy through Valley Children’s Hospital under the care of Dr. Jennifer Crocker. ezamora@fresnobee.com

It took only a split second for Nolan Hirayama’s life to change.

One day he is a socially active, straight-A student who is a member of the Clovis North High School junior varsity basketball team. The next, he is on a spiral that has him staying home, his grades crashing and the 16-year-old wondering if he will ever play basketball again.

All it took was a pair of concussions that came only weeks apart.

“They both happened while I was playing basketball,” Nolan says. “My first one (Oct. 11, 2015), I banged heads with another teammate. Second one (Nov. 6, 2015), I jumped for a ball and my legs got cut out from under me. I hit my head on the floor.”

Concussions have become a serious concern in all levels of sports, especially for football players. The Center for Disease Control and Prevention estimates 1 in 5 high school athletes will sustain a concussion during the season. In 2012, that added up to 3.8 million reports of concussions.

Football accounts for the most, but not all, cases. Almost every sport, including cheerleading, has growing numbers of concussions. The CDC lists boys’ basketball 10th on the list, just behind girls’ softball.

Dr. Jennifer Crocker, medical director of Valley Children’s Hospital’s Rehabilitation Center, sees more patients every year who have suffered a concussion. She doesn’t deal with them at the time of the injury; she is more involved with how patients deal with the long-term effects.

“It’s been a dramatic increase,” Crocker says. “The important piece of it is that it has been going on for a long time and reported in the professional and college areas. The increase that we are seeing that is so dramatic is the middle school, junior high population.”

She attributes the increase to a combination of coaches, faculty and parents being more aware of concussions and reporting them and with how kids are starting to play high-velocity tackle football at an earlier age.

Crocker has seen 5-year-old kids playing tackle football with helmets and pads.

Nolan didn’t lose consciousness with either accident, but he has been dealing with dramatic changes since. Following his first concussion, his motor skills were not right. After the second concussion, he started having headaches and a loss of short-term memory. Nolan’s eyesight was affected so dramatically, he had to get new glasses.

“His vision was impaired, so he couldn’t see as well. Plus he has something called convergence disorder where he can pull his eyes in so reading is still very difficult,” says his mother, Lisa Hirayama.

Working with local athletes who have suffered concussions is just part of Crocker’s job, which blends sports and medicine. Her Adaptive Sports Program – designed for individuals with physical and health impairments and conditions ranging from cerebral palsy to spinal cord injuries – includes water and snow skiing, rock climbing, kayaking, basketball, tennis and power soccer.

Crocker says that generally the effects of a concussion go away in a couple of weeks. The fact Nolan had two concussions within a few weeks made it more difficult to return to what his life was like before.

After a child has suffered a concussion, the symptoms (headaches, confusion, dizziness, nausea, slurred speech, etc.) are monitored closely. If there is no improvement, that’s when Crocker begins her work. She gets a baseline of the patient’s cognitive level and then makes long-term recommendations for their education and return to athletics.

In Nolan’s case, Crocker has been working with him on school work. Nolan’s attempts to get back to school as quickly as possible were hurting him. He dropped out of his AP World and Honors Chemistry classes because trying to deal with school the same way as before the concussions was causing him setbacks.

The process started with Crocker taking away all electronic items in Nolan’s life and making him get lots of rest. He started to feel better, but he has to be careful not to push too hard.

“Nolan watches very little television, but he wanted to watch all of the Super Bowl. He had a huge relapse. So it is a step back in our efforts to move forward,” Lisa Hirayama says.

Nolan’s mother says after meeting with Crocker, they went back to “ground zero” and then slowly built up the school work and activities for Nolan. The sophomore has hopes that he will be well enough to return to the basketball court and his academic accomplishments.

The effects may or may not be permanent. Crocker says changes that involve attention and emotional ability can continue because the injury happened in a developing brain. It’s less likely to happen in adults.

Rick Bentley: 559-441-6355, @RickBentley1

By the numbers

Sports concussion statistics from the CDC

  • 33% of all sports concussions happen at practice.
  • 47% of all reported sports concussions occur during high school football.
  • 33% of high school athletes who have a sports concussion report two or more in the same year.
  • 4 to 5 million concussions occur annually, with rising numbers among middle school athletes.
  • 90% of most diagnosed concussions do not involve a loss of consciousness
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