Lessons learned from near-tragic concussion on Front Range

KERSEY (AP) – In October, at halftime of a Platte Valley High School football game, the team’s student manager approached Marilyn Johnson as she sat in the visitors’ bleachers and relayed a vaguely ominous message.

“Trey’s acting weird.”

A former emergency-room nurse, Marilyn rushed to check on her son. Sixteen-year-old Trey Johnson, a wide receiver and defensive back, sat in a hallway outside the locker room and complained that the top of his head hurt. He begged her to make the pain stop.

“It hurts bad, it hurts bad,” he said.

When her son started vomiting, Marilyn told the trainer to call for an ambulance. Then, Trey lost consciousness.

Marilyn pingponged between the role of mother and nurse in the frenetic moments that came after: His blood pressure was good. His breathing was normal. But even after emergency responders administered oxygen, he wasn’t responding.

She recognized the signs of a severe concussion and knew that without quick medical intervention, she could lose him.

Marilyn rode in the ambulance that transported Trey to North Colorado Medical Center in Greeley from the Eaton High School football field. As it sped away, Trey’s father, Michael Johnson, and Trey’s twin sister, Haley, also headed for the hospital.

Michael, shifting to what he later described as an unemotional “go mode,” phoned Trey’s older brother, Cade, to meet them there.

“I wanted him to be there,” Michael recalled, “if Trey died.”

At the medical center, Trey was given a breathing tube, run through a CT scan and determined to have bleeding on his brain. He was quickly airlifted to Children’s Hospital Colorado in Aurora.

A vigil began that Friday night in the intensive-care unit, where dozens of Trey’s friends, teammates and neighbors from his hometown of Kersey slept in a waiting area, frightened but hopeful.

“It was weird, because he wasn’t moving or anything,” said Logan Sitzman, the team’s quarterback and a longtime friend. “He wasn’t breathing on his own. I didn’t know what was going on. I didn’t know if Trey would be Trey anymore.”

By early Saturday morning, Trey was able to squeeze hands and nod in response to voice prompts. But about 12 hours later, the swelling in his brain caused him to take a turn for the worse.

“You cling to things,” said Marilyn, who looked to the flashing numbers on Trey’s monitors for solace. “His pulse rate and blood pressure – I watched them pretty close.”

Twelve days into the watching and waiting, as Trey emerged from a medically induced coma, his eyelids fluttered and blinked. His eyes opened, but as Michael noted, “he was in a different world.”

They all were.

“I didn’t think it would happen to our team,” said Caleb Creech, a junior linebacker who grew up east of Greeley with Trey. “It’s stuff you usually just hear about.”

This wasn’t a typical concussion, and its precise origin remains a matter of conjecture. In the real-time flow of the game, no single impact or even multiple collisions appeared clearly responsible. And to this point, Trey recalls nothing about the game.

The drama unfolded in a time of heightened awareness of sports-related head injuries, when laws have been enacted in Colorado and elsewhere to underscore that concern. Coaches and staff members are trained to detect possible concussions and required to pull players at the first hint of abnormality. Athletes need written medical clearance to return.

But what family, coaches and doctors credit for averting possible tragedy that autumn night reflects what they consider a subtle but significant sports-culture shift – among the players.

Platte Valley coach Troy Hoffman describes exceptionally close ties that bind this team – ties that extend beyond the band-of-brothers mindset that propelled them to a 10-3 season, a second-place finish in the state playoffs and a slew of individual records. Ties that may have made all the difference for Trey Johnson.

“In the end,” Hoffman said, “they probably saved his life.”

Starting in 2006, Platte Valley student-athletes were among the first in the state to undergo baseline testing, a battery of computer-based exams administered every two years that measure the speed and accuracy of responses to tasks geared to particular cognitive skills.

The tests provide a comparative measure of brain function that can serve as a tool to gauge their fitness to begin a post-concussion, return-to-play protocol that can take days or weeks. The players regard the baseline testing with bored resignation at best and utter disdain at worst.

“I hated it,” admitted Sitzman. “I would cheat to make my score low so if I had a concussion, I could get back playing right away. I figured it would never happen to me or anyone I knew.”

And for weeks this season, nothing happened.

But on Oct. 12, in a Friday-night game at arch-rival Eaton, Trey suffered a severe injury that did not appear to arrive with a single vicious hit. In fact, only in retrospect do observers – from players to coaches to Trey’s own family – zero in on plays that may have triggered the life-threatening bleeding and swelling in his brain.

With Eaton up 7-0 in the first quarter and driving toward another score, Trey – from his cornerback position on defense – watched the quarterback roll to the left and spot an open target. Trey cut in front of the intended receiver and intercepted the ball. With Trey’s hand in his face, a tackler grabbed for whatever he could find, gripped Trey’s jersey and pulled him forward. Trey fell headfirst to the ground, unable to use either arm to break his fall.

Trey popped up immediately, energized by the interception, with no obvious ill effect.

A few plays later, Trey, now playing wide receiver, hauled in a pass and scrambled into the end zone. With the interception – his fourth in five games – and now a touchdown reception, he looked to be on his way to a stellar performance.

Trey was on the field, performing his appropriate defensive coverage, when Eaton scored another touchdown.

His teammate, linebacker Creech – another part of that core group of childhood friends – noticed something definitely un-Trey-like. Normally, in a situation like that, he would have spewed anger, at himself and anyone else involved in the play.

Now, he stood emotionless.

“Dude, you all right?” Creech asked.

No response. Creech repeated the question.

“I don’t know,” Trey said.

“He was just acting funny,” Creech recalled. “We know each other pretty well; we know when something’s wrong. He was just not being Trey. I asked if he was all right, and he just grabbed his head.”

After the extra point, Creech went to the sideline and, while Eaton kicked off, approached his head coach.

“You got to check Trey out,” he said.

“What do you mean?” Hoffman replied.

“I don’t know. He’s just not with it,” said Creech. “You’ve got to check him out.”

Hoffman pulled him off the field and instructed Alissa Coufal, the trainer, to assess him.

Trey took his helmet off and stood blinking at the stadium lights. Coufal noticed a cut on his face, around the bridge of his nose, and asked him whether his helmet had caused the abrasion. Trey sounded confused.

“Right then,” Coufal said, “is when I knew we’ve got a problem.”

The ensuing weeks were a zigzag of highs and lows as Trey adapted to his rehabilitation routine.

Communication remained a challenge. Trey could grunt and emphasize syllables, but his facial muscles strained to pronounce words. He used a small whiteboard and a marker to articulate his thoughts.

And then, as he progressed, he gradually became more aware of his limitations. At times, he would grow tired and frustrated and lash out, almost in slow motion, at his therapists – even his mother.

It meant he was progressing. But for his parents, it was still difficult to watch.

Trey now progresses through a regimen of therapies as he battles to regain his speech and fine motor skills with a goal of returning home before Christmas. Still, his recovery has miles to go.

Trey’s parents see another opportunity for progress in the way young athletes approach the growing concern about concussions. Marilyn calls this “the steepest part of the learning curve,” where players need to take responsibility for one another.

Coaches are being educated, and parents are learning more. But the experience with their son has convinced the Johnsons that there’s value in having other eyes watching for telltale concussion signs as well.

“Troy is ripped up about this,” said Michael, sympathizing with his son’s coach. “But he can’t watch all the kids. They know each other intimately. The kids are the key to this.”

Hoffman recently sat in the school computer lab, as he has many times since that Eaton game in October, watching videotape of the play in which Trey intercepted the pass and got flung headfirst to the turf.

“This is a great play by Trey,” he said, narrating. “He undercuts it; he picks it. Right here’s the end of the play. ... He bounces up. ... He’s running off the field. And no worries.”

He skipped through the video, following Trey’s movements on offense and defense, looking for any trace of abnormality – lining up wrong, missing an assignment, anything.

He has found nothing. But that doesn’t stop him from second-guessing himself.

“I’m responsible for these boys,” he said. “But there’s nothing in this game that led me to believe there was anything we did wrong. Nothing. But honestly, if Caleb hadn’t said anything, we wouldn’t have checked him when we did.”