Heartfelt Thanks for a Life Saved
November 13, 2012
By Geoff Kimmerly
Second Half editor
ELSIE – Like many who have played high school football, the practice field will always be more than just another piece of lawn to Ovid-Elsie’s Chris Fowler.
Over his right shoulder, beyond a few of the fields that surround his high school, sits his family’s house. To his left is the finish to the school’s cross country course his younger sister was preparing to run the day his heart stopped beating.
In this spot, on Oct. 9, the 16-year-old Fowler collapsed while he and his teammates ran 40-yard sprints. His heart, for reasons doctors could not explain, went into an irregular rhythm that caused him to go into cardiac arrest.
“It still doesn’t (make sense),” Fowler said two weeks later. “I try to forget it as much as I can. It’s not worth remembering. I don’t want to think about it.”
But the Marauders sophomore will always remember those who brought him back to life that day.
Thanks to the quick, calm response of Ovid-Elsie football coach Travis Long and his staff, and the speedy work of athletic director Sonya Latz to retrieve the school’s AED device, Fowler’s heart was shocked back to life.
Unlike too many national news stories lately of athletes who died far too soon of similar circumstances, this story ends well.
Fowler’s father Dave knows it is because every detail was carried out to perfection. Standing near the cross country finish line, he was there to watch it all.
“Truthfully,” Dave said, “I thought it was the end of my world.”
Trying to remember, trying to forget
Both father and son knew the story of Fennville’s Wes Leonard, who died from sudden cardiac arrest after making the game-winning shot in a basketball game March 3, 2011.
They hadn’t heard of the all-state football and basketball player before that day, but Dave began following the story as it became national news and spurred an effort to have AEDs in every school.
AED stands for automated external defibrillator. The device combats sudden cardiac arrest by detecting an irregular heart beat and delivering a shock that can put the heart back into correct rhythm. Ovid-Elsie High School has two. The first was purchased through the Kimberly Anne Gillary Foundation, which was started after Gillary, a student at Troy Athens, died of sudden cardiac arrest during a water polo game in 2000. The second was donated by alum and former basketball player Daryl Melvin, now a cardiologist in Lansing.
Chris remembers reading about Leonard’s death the day after and thinking there was no way it could happen again to someone like him.
Dave Fowler recounts in his head daily how it nearly did.
The image he can’t get out of his mind is that of Chris’ coaches flipping him over and starting chest compressions.
“It’s just like it was unreal. It was like a bad dream I was waiting to wake up from,” Dave said.
Chris remembers none of it.
He’s a strong student who even before this was considering becoming a doctor. He’s the middle child of three – sister Maria graduated in the spring, and Morgan is in eighth grade. Basketball is Chris’ favorite sport, and he also played soccer growing up – but frequently was carded for running over opponents.
So logically, in eighth grade, he gave football a try. Two years later, at 6-foot-3 and 265 pounds, Fowler was a starting offensive tackle on the varsity.
The Marauders’ Oct. 9 practice was dedicated to defense. Fowler took a shot to the ankle and rolled it, and remembers mentioning it to quarterback Jake Helms. That was probably about 25 minutes before the team began its daily conditioning, a set of 20 short sprints run at half to three-quarters speed.
Dave watched his son run while waiting for Morgan’s race to begin. Her mom Amy was at the starting line, and their grandparents also were in attendance, part of a larger crowd because the cross country jamboree included multiple teams from all eight schools in Ovid-Elsie’s league.
And then shock. “I knew what was going on,” Dave said. “But it was denial that I was really seeing what I was seeing.”
Call to quick action
Suddenly, Chris was face down on the ground.
Only moments later, Long and assistant Brad Sutliff were flipping him over. Long, a physical education teacher at the school, began the chest compressions. Another coach blew breaths into Fowler’s lungs.
Dave, perhaps acting on instinct as much as anything, yelled for anyone to find his wife. He took off toward Latz, who also had made her way to the cross country finish area, yelling for her to get the AED.
Word of Fowler's dire situation quickly made its way through the crowd. The Bullock Creek cross country team, surely among many others, began to pray. And Dave will never forget watching Chris’ teammates, standing a short way off, yell at him, “Don’t give up! Keep fighting!”
Latz, in the school’s Mule utility vehicle, raced to the trainer’s room, grabbed the AED and raced back. A parent from another school who is a nurse asked if she could help and took the AED to the coaches, who connected it to Fowler.
The AED gives the user explicit instructions on how to operate it, including where to attach connections and when to step away as to avoid also receiving a shock.
Sutliff was holding Fowler’s head and didn't want to set it down. But he had to – the shock was so strong it lifted Fowler’s body off the ground.
The jolt also reset his heart.
The next thing Fowler remembers, he was in the ambulance on the way to Sparrow Hospital in Lansing, vomiting. And he couldn't see. He flashed his hand in front of his face, trying to find it. It was then that he found out his heart had stopped.
After a night at Sparrow, Fowler was taken to the University of Michigan’s C.S. Mott Hospital, where he spent five days. Fowler went through the battery of tests. No problems were found. The family doesn't have a history of heart trouble. Doctors said there were no blockages.
“They said basically that it’s a miracle. There are no side effects, none whatsoever,” Dave Fowler said. “No heart damage, no organ damage. The neurologist said his brain function is perfect; there’s nothing wrong with it. And they all say that stems from the quick reaction from the coaches. … The doctor said he’s never seen chest compressions done that well.”
Ovid-Elsie has a disaster plan in place for situations like these, but had never had to put it into play for a life-threatening situation as long as Latz has been part of the athletic staff – dating back to her first year coaching in 1989.
It went off without a hitch. The whole process of starting compressions, retrieving and hooking up the AED and restarting Fowler’s heart took maybe a bit more than five minutes.
“The coaching staff is amazing, how smooth and calm everybody kept just to do their jobs. I’m just amazed,” Latz added. “I shouldn't say ‘amazed.’ Because I trust that they are very good. I’m just proud of the way they handled everything.”
She added that Ovid-Elsie’s National Honors Society has asked about raising funds to purchase an AED for a school that doesn't have one.
Many thanks to give
Fowler wears two bracelets he received while at U-M. One reads “Hearts working together,” and the other “And the beat goes on.” He was considering becoming a neurologist some day, but now cardiology seems pretty cool.
Fowler’s friends don’t ask much about that day. They know he’s trying to block it out of his memory. But others do ask the “ridiculous questions. Like, you know, what did it feel like to be dead?”
His response: “I just say I wasn't getting oxygen to my brain, so I don’t remember anything.”
The questions don’t make him angry. It’s easy to figure out quickly that Fowler is the type to let such things just roll off.
When Fowler does hear his story re-told, he feels like it’s about someone else.
But he’s a smart guy, and he’s heard enough doctor talk to understand what’s going on.
The biggest bummer is he can’t play basketball. His career in contact spots is over. That leaves golf, and he might take it up eventually. This winter, he’s going to be on the bench with his varsity teammates and he’ll help with the freshmen team and perhaps Morgan’s eighth-grade team too.
He still sounds like a football player. “It’s a lame scar,” he said of the small cut under the front of his left shoulder. Embedded in a “pocket” under his skin on the left side of his chest is an implantable cardioverter defibrillator – or ICD – meant to automatically shock his heart back into rhythm if it falls out of beat again.
Fowler came back for a football practice before the Marauders season ended, and also for the parents’ night game. He’ll still be part of that program next year too. “The joke around town is I’ll be the offensive coordinator,” Fowler said.
Dave still asks himself the what-ifs of that day. He looks at his family differently. Too many times during the day he pictures those chest compressions. It’s hard for him to leave home, and he doesn't sleep well. And he’s pretty sure Chris is getting tired of his parents peeking into his room at night to make sure all is well.
Perhaps. But Fowler also has never been one to take anything for granted – although that’s another part of what makes this situation tough. He’s always one to show gratitude, but he can’t remember right now all the people he’d like to thank. He’s just doing his best.
“I can’t remember. There are so many people. I saw some people at the football game, and I just walked up and said thank you,” Fowler said. “Because they were there, praying for me or whatever.
“I’m very fortunate. It’s unbelievable.”
Click to see more from the Wes Leonard Heart Team or the Kimberly Anne Gillary Foundation.
NOTE: Chris Fowler's parents Dave and Amy would like to give special thanks to those pictured with their son (in suit and orange shoes) above: athletic director Soni Latz and football coaches Brad Sutliff, Eric Jones, Jeremy Palus, Cody Staley, Travis Long and Dustin Thiel.
PHOTOS: (Top) Chris Fowler stands in the place on Ovid-Elsie's practice field where coaches worked to restart his heart on Oct. 9. (Middle) Fowler, in his game jersey, stands on Ovid-Elsie's football field. (Bottom two photos courtesy of the Fowler family.)
Staying Ahead on Head Safety
July 6, 2015
By Rob Kaminski
MHSAA benchmarks editor
Three stacks of concussion-related material offered precious little space on MHSAA Executive Director Jack Roberts’ desk, and perhaps consumed even more room in his head as he tried to wrap his mind around the seemingly daily “latest and greatest” documents outlining signs, detection and return-to-play elements involving head trauma.
Without a doubt, the scene is quite similar on any given day in the offices of his cohorts across the country as school sports leaders are faced with the daunting, dizzying task of devising plans to address concerns aimed at the health of their games.
Lawmakers, rules makers, medical experts and the court of public opinion all want the same thing for student-athletes: a reduction in the chances of head-related injuries. And they all are perfectly willing to offer instant fixes to those in charge.
They often expect those in Roberts’ position to analyze, digest and create action plans as soon as possible without considering the research and resources it will take to get there.
“All parties involved want the same thing. We all want to provide the safest environment for educational athletics through protocols and practices that will offer the most minimal risk of injury,” Roberts said. “But, this can’t be accomplished through unfunded mandates which would stifle the already struggling athletic budgets in many schools.
“Changes have to occur through training and education, orchestrated through state offices and executed locally. And, it takes time to research the best and most effective means. There is so much information, and so many devices in the field today that those in athletic leadership roles almost have to have a medical background as well.”
For instance, there are documents which list as few as five symptoms for concussions, and those listing as many as 15. There are sideline detection methods which purport to take 20 minutes and those which claim to determine concussions in 20 seconds. There are as many return-to-play protocols as there are state associations.
Increasingly, state high school associations are seeking opinions and expertise from local medical personnel. In March, in one of many such meetings, Roberts and other MHSAA staff welcomed several from the Michigan Department of Health and Human Services to their office to discuss sideline detection methods and return-to-play issues.
“There are two areas that concerned us most,” Roberts said. “One, sideline detection of head injuries is inconsistent across the state in terms of both results and resources. Two, we need methods which generate immediate reports and permanent records.”
As the group which convened in March discussed the topic, potential hurdles and new perspectives on sideline management came to the forefront.
On the money and manpower front, who would be responsible for administering sideline tools? Most ideally they would need to be overseen by medical personnel rather than coaches or team managers.
From a perspective standpoint, an interesting view was volleyed out to the group: could sideline detection actually speed up a student’s return to play rather than slow it down? Current protocol prescribes that if competition continues while an athlete is withheld for an apparent concussion, that athlete may not be returned to competition that day but is subject to the return-to-play protocol. And, clearance may not be on the same date on which the athlete was removed from play. Only an M.D., D.O., Physician’s Assistant or Nurse Practitioner may clear the individual to return to activity. With immediate sideline detection, are parties more vulnerable should a student pass immediate tests, only to have undetected effects of the incident increase over time?
“The group shed a different light on the various scenarios, which was a primary purpose for the meeting,” Roberts said. “As one can see, there are so many variables to consider when attempting to determine the next plausible and practical steps toward minimizing and detecting head injuries.
“Further, we have to take into consideration practice sessions as well as competitions, and all sports, not just select sports.”
Adding to the challenge is simply the nature of athletics. Competitors at any level are just that: competitive. Often, students – or their parents – will attempt to hide symptoms or be reluctant to come forward with injuries, particularly head injuries which can’t be seen.
In more cases, perhaps the symptoms simply are not recognized, which is why education is paramount.
First, association leaders have to tackle the due diligence of researching issues and potential solutions to situations currently threatening the well-being of scholastic sports. Considering that some 1,620,000 results are offered when “sideline concussion detection tools” is typed into a search engine, this is a laborious and continual chore.
Such information then needs to be packaged and presented to leaders at the local levels – athletic directors – to pass on to coaches, the individuals who have as much or more influence on students that perhaps any other adults, including parents in some cases.
This is why MHSAA rules meetings, Coaches Advancement Program sessions and other statewide forums continue to bang the drum on health and safety issues; to make sure the messages and procedures reach the student-athletes.
And, it’s why the MHSAA is asking coaches and ADs to be accountable in verifying that the plans in place are being carried out.
Less Could Mean Less
There are times when it’s good to say, “less means more,” but in the case of contact sports, practices and competitions, the idea is for less to mean less. As in less time for collisions to occur yielding fewer injures.
It’s early yet, and one year does not constitute a large sample size, but the MHSAA Football Practice Policy instituted last August could be one step toward reducing head injuries.
Beginning this past football season, the number of practices with helmets, shoulder pads and full pads were limited to start the season, and preseason “collision” sessions were limited to one per day. During the season, such practices were limited to two per week, while the length of practices was also regulated.
Dr. Steven Broglio of the University of Michigan Neurosport department is conducting a three-year study of the Ann Arbor Gabriel Richard football program with the assistance of Richelle Williams to determine the “Effects of Concussion and Sub-Concussion.” The study began in 2013, one year prior to the new MHSAA guidelines.
Research in 2013 showed approximately 650 “impacts” per player. In 2014, the number dropped to approximately 500 impacts per player. Impacts are defined as greater than 10 gs of acceleration. Williams stated that a slap on the back is 4 g, coughing is 3.5 g. On average, a helmet hit is 25-45 g. Concussions usually happen (roughly) between 80-150g.
An encoder is embedded into each football athlete’s helmet which monitors head impacts and exactly where the impact is located. Williams sits at each practice and game and through a pager identifies the player’s number and impact from a hit of 90g or more.
They are also looking at those who do not sustain an impact concussion, but rather sustain multiple head impacts and whether those multiple head impacts lead up to brain changes (measured through EEG).
The initial findings, as submitted by the study team, indicated two reasons why there were fewer overall impacts from 2013 to 2014:
Primary reason: The MHSAA adoption that became effective in August 2014 with new limitations that were placed on “collision practices” and conditions that full pads could not be worn until the fifth day of team practice.
Secondary reason: Fewer players evaluated in 2014 than 2013.
Fit for a King?
Editor’s Note: There are many sideline detection tools on the market, as a quick Google on the topic will reveal. The following, the King-Devick test, is among the highly recommended tests, summarized here simply to provide an idea of the types of systems available and how they operate. The following is from King-Devick’s website.
The King-Devick Test is an objective remove-from-play sideline concussion screening test that can be administered by parents and coaches in minutes. The King-Devick Test is an accurate and reliable method for identifying athletes with head trauma and has particular relevance to: Football, Hockey, Soccer, Basketball, Lacrosse, Rugby, Baseball, Softball and Other Collision Activities.
King-Devick Test is an easy-to-administer test which is given on the sidelines of sporting events to aid in the detection of concussions in athletes. King-Devick Test (K-D Test) can help to objectively determine whether players should be removed from games. As a result, King-Devick Test can help prevent the serious consequences of repetitive concussions resulting from an athlete returning to play after a head injury.
How King-Devick Test Works
Concussions are a complex type of brain injury that is not visible on routine scans of the brain, yet are detectable when important aspects of brain function are measured. King-Devick Test (K-D Test) is a two-minute test that requires an athlete to read single digit numbers displayed on cards or on an iPad. After suspected head trauma, the athlete is given the test and if the time needed to complete the test is any longer than the athlete’s baseline test time, the athlete should be removed from play and should be evaluated by a licensed professional.
Remove-From-Play vs. Return-To-Play
Both remove-from-play and return-to-play decisions are crucial in concussion recovery. It is critical to remove a concussed athlete from play in order to prevent further damage. It is also extremely important to keep the athlete from returning to play until they have made a full recovery. There are tools to assist in making both remove-from-play and return-to-play decisions.
King-Devick Test for Remove-From-Play Decisions
- Quick, objective sideline testing
- Measures impairments of speech, language and other correlates of suboptimal brain function
- Instant screening feedback in minutes
- Administered by parents, coaches, athletic trainers and medical professionals in remove-from-play decisions
- Neurocognitive Testing for Return-To-Play Decisions
- Computerized concussion evaluation system (in the computer lab)
- Measures verbal and visual memory, processing speed and reaction
- Tracks recovery of cognitive processes following concussion
- Assists clinicians in making return-to-play decisions