Duluth, MN (NNCNOW.com) --- St. Scholastica sophomore women's soccer player Catherine Fisco knows that concussions can be serious.
"It's a different kind of injury that can last a lifetime," Fisco said when asked about the potential severity of a concussion.
So when she suffered her third this fall, she was suddenly faced with a big decision.
"If I wasn't confident in what the doctors are saying, I would consider not playing," she said. "I've heard of other people, and it's ruined their life. I'm not willing to sacrifice that."
Fisco may be level-headed about her injury, but some athletes will seemingly sacrifice anything to be with their team.
That's where Dr. Susan Hoppe, the athletic trainer of the UMD men's hockey team, says teaching awareness plays a huge role.
"We try to educate our athletes, first and foremost, about the fact that it is a serious injury. It's not just 'getting your bell rung.' They've actually gotten rid of that term," Dr. Hoppe said. "The more educated the athletes are and know what could happen, the more they take care of themselves. They know, too, that as soon it's safe for them to go back, we're going to let them."
Determining if it's safe, though, is an entirely different animal. Every concussion is different, says Dr. Kenji Sudoh at Essentia Health-St. Mary's Hospital, so making "return to play" decisions depends solely on the individual and the severity of the injury.
"With a concussion, it's different than an ankle sprain where we can check to see if there's pain or if they're feeling all right," Dr. Sudoh said. "Returning from a concussion is very different for individuals, whereas some may be able to return after a week and some might take longer depending on how quickly their symptoms clear and the injury improves."
Besides possibly returning to game action, both high school and college students must also return to the classroom -- a process that can be difficult considering that post-concussive symptoms can include blurred vision, concentration problems, and sensitivity to light.
"We try to avoid video games and concentrating really heavily on computer screens, which could include smart boards and that type of thing," said athletic trainer Terry Hanson, an athletic trainer at Essentia Health-St. Mary's Hospital. "If they're struggling in school, we let the teachers know and they try to make accommodations."
That's where we bring in Duluth Denfeld senior Kevin Marshall. He suffered a sixth concussion earlier this fall and has been told by doctors his days of playing sports are over.
"When I'm taking a test, it's hard just to read every question," Marshall said. "Now it's just about how do I deal with it and how do I deal with the symptoms that I'll have for the rest of my life."
"With multiple concussions, we know there are effects on people and their function," Dr. Sudoh said. "We're seeing this with high-level boxers and professional football players where we're seeing these effects now after they continued to play through them. They're coming forward now and saying these are symptoms that I have from injuries I had when I was a player."
It's those long-term effects that doctors and athletic trainers want to avoid with their athletes.
It's also the scenario that perhaps will force Fisco into reevaluating the importance of her athletic career.
"I've seen people try to play their sport for one more year and have it affect the rest of their life," she said. "I want to stay in school. I want to think like I normally can and not have any cognitive problems. Later in life, I think I would regret it if I had to deal with something long-term."