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March 12, 2014

Not Out of the Woods Yet A Story of Recovery and Hope

It has been just over two years since traumatic brain injury (TBI) crashed into the lives of the DeGroot family. While downhill skiing at Nordic Mountain on January 13, 2012, 13-year-old avid skier Jacob DeGroot tried to avoid other skiers who had fallen. To avoid injuring these people in his path, he veered off and ended up airborne, striking his head against a tree in the woods head-on at a high speed and suffering a depressed skull fracture and underlying brain bleed.

It has been just over two years since traumatic brain injury (TBI) crashed into the lives of the DeGroot family. While downhill skiing at Nordic Mountain on January 13, 2012, 13-year-old avid skier Jacob DeGroot tried to avoid other skiers who had fallen. To avoid injuring these people in his path, he veered off and ended up airborne, striking his head against a tree in the woods head-on at a high speed and suffering a depressed skull fracture and underlying brain bleed. His story is a compelling one of courage and relentless spirit matched with a great test of will along with some “natural plasticity” helping him grow to be the man he is meant to be.

The Nordic Ski Patrol responded immediately to Jacob on the ski hill. Both Waushara EMS and ThedaStar were dispatched. Jacob was unconscious after the incident, with blood draining from his left ear. He regained consciousness for a brief period and responded to verbal stimulation. Then he rapidly declined and required advanced airway interventions. A lucid period followed by unresponsiveness is indicative of an epidural arterial brain bleed.

At Theda Clark Medical Center in Neenag, a CT scan confirmed the diagnosis of an epidural bleed; he was rushed to the OR, where neurosurgeon Dr. Karl Greene performed a decompressive craniectomy and evacuated the epidural hematoma causing pressure on the brain. Craniectomy means removal of a section of the skull bone to accommodate for brain swelling after injury. ThedaStar flew Jacob to Children’s Hospital of Wisconsin in Milwaukee, where he spent seven days in the pediatric ICU and seven days on the neuro rehabilitation unit. His skull section was replaced almost 10 weeks from the date of injury. And then his real work began. While formal rehabilitation set in motion the process of adaption and change, Jacob still required hundreds of grueling hours of outpatient therapy. He still attends speech therapy two times a week. Jacob encountered many uphill battles at home, testing both his and his family’s depth of character and perseverance. 

“It is hard to understand the long-term impact that TBI imposes on the injured person, family members and friends unless you have experienced the loss, heartache and the ripple effects that brain injury can inflict,” said Jacob’s mother, Patti DeGroot. “Sometimes a different person emerges after a brain injury, and you have to embrace that person while mourning the loss of the ‘old’ one that is gone for now,” she continued. Her family has learned to embrace life’s new challenges. Patti said it is important “Jacob focus still on being a kid right now while she sees qualities and insights in him mature beyond his years. Jacob is most mindful of the changes in him, and he is his own most positive advocate for trekking forward.

Currently not cleared for any contact sports or skiing, Jacob can play volleyball and feels truly normal on the court these days. “He never gives up.” Nor does his family. They have made their unthinkable situation manageable. Jacob’s sister is a pediatric neuropsychologist at Froedtert Hospital in Milwaukee and was able to consult with the Packers’ concussion physician regarding Jacob’s case. Jacob’s brother Andrew is class valedictorian at Kaukauna High School and hopes to be a neurosurgeon. It’s evident that Jacob is surrounded by unconditional love as his family navigates the uncertain road of recovery. They will be “there for him for the whole journey,” his mom said.

Our brains are the fuse boxes for our bodies. Chemical substances called neurotransmitters allow specialized cells called neurons to communicate within our central nervous system. Chemical signals are sent from neuron to neuron, allowing us to perform specific functions. TBI disturbs the delicate chemistry of the brain so that the neurons no longer function normally. This results in changes in both thinking and behavior. Jacob initially suffered seizures now controlled by continually adjusting his medicine as he is growing. His mood changes differently now, too. However, the brain is a dynamic organ that has the natural ability to adapt and change with time. After injury, the brain can set up new connections to carry messages. This is called natural plasticity (ability of change) of the brain. Plasticity is more likely to occur when the brain is active and exposed to a stimulating environment, prompting these connections to engage. These changes do not occur quickly; thus, recovery goes on for months and even years. This is why Jacob is “not out of the woods yet” and can keep working toward a full recovery.

Jacob and his family want people to be mindful of the consequences of risky behavior.  Traumatic brain injury does not discriminate. It can happen at any time to anyone, and there is inherent risk in most things we do. Jacob has answered his “casting call” for helmet safety: He is the face of the National Ski Patrol’s helmet campaign. Nordic Mountain, where Jacob was injured, has been proactive and now includes helmets with all ski rentals. 

Jacob and his family face a challenging journey but see a positive future ahead. Their message is: “Use your head. Use your helmet. We assume it will never happen to us; we are living proof that it can happen to anyone. The decision is yours.”

By Jeff Grimm and Pam Witt-Hillen