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Luke Nelson suffered a brain injury while playing football for Dassel -Cokato high school, now he is back at school for just half day sessions. (Jerry Holt, Star Tribune photo)

It was late in the fourth quarter on the first Friday of September, and the game was close.

The Dassel-Cokato high school defense dug in on the line of scrimmage against Orono when suddenly, instead of setting himself for the play, linebacker Luke Nelson turned and staggered away.

Chargers coach Ryan Weinandt didn’t wait for a whistle. He bolted onto the field and rushed to the 16-year-old junior, helping him sit down.

“I’m hurtin’,” Nelson said, slurring his words.

From the home-side bleachers, Luke’s parents, Sara and Greg Nelson, saw their son rolled onto his side and figured he was vomiting. Then one of his legs suddenly straightened. Instinctively, they knew: He was in seizure.

Within 10 minutes, Nelson was loaded into an ambulance for the 15-mile trip west from Cokato to Meeker Memorial Hospital in Litchfield. Greg, a member of the Dassel Volunteer Fire Department, rode with his son.

No one knew for certain at the time, but Luke was bleeding on the brain, most likely from a hit during the game, and in danger of dying.

Concussions and head injuries have become the scourge of American football from the pro ranks through youth leagues. The effects range from players filing multimillion-dollar lawsuits claiming long-term brain damage to parents increasingly keeping their children from playing for fear of injuries like Luke’s.

Sara Nelson headed first toward Litchfield, alone in the family car. When the approaching ambulance emerged behind her, she pulled over unprepared for the emotions that hit her as it whizzed by, lights flashing and siren blaring.

“I just said, ‘God, please hang on to him.’ ”

Battling to live

About halfway through the ambulance ride, Luke looked at his dad and squeezed his hand. But things “headed south in a hurry” at the hospital, Greg said. Luke continued to seizure and struggled to maintain consciousness.

A scan showed bleeding on the brain. Luke was flown by helicopter to Hennepin County Medical Center in Minneapolis. Shortly after midnight, surgeons began their work and discovered a scenario worse than expected: A vessel was still bleeding. Luke’s brain was under a lot of pressure.

To combat potentially fatal brain swelling, doctors removed a portion of Luke’s skull on the right side. Three hours later, they emerged to tell Sara and Greg that they had saved their son’s life.

“When he woke up, he was Luke,” Sara said. “He asked what happened. He was mad they lost the game. And he asked if he could play next week against Fairmont.”

Luke had suffered a subdural hematoma, or brain bleed, regarded as a moderate to severe brain injury. Initial news reports suggested his helmet had collided with the thigh of a bigger Orono player several plays before he collapsed. Doctors studied video of the game and could not conclusively pinpoint a hit that led to his downfall.

As a freshman, Luke had suffered a concussion in football practice. His parents held him out for the rest of the season. Doctors do not believe the two injuries are related.

Greg Nelson had seen enough that his mind was changed. Luke was his second son to be felled by a head injury playing sports. Luke’s older brother Isaac suffered a concussion playing college baseball and can no longer play.

“I was a big ‘suck-it-up’ guy,” said Greg Nelson, who played quarterback at Dassel-Cokato. “I wouldn’t try to talk a kid out of playing football. But when it comes to the head — that’s not the same as an arm or finger.”

An Institute of Medicine and National Research Council report indicated the number of individuals ages 19 and younger treated in U.S. emergency departments for concussions and other sports- and recreation-related brain injuries increased from 150,000 in 2001 to 250,000 in 2009.

Luke’s injury — “a freak deal,’’ his father called it — fell into a dangerous subset.

“Most folks who have a sports-related brain injury are not going to have a subdural hematoma,” said Dr. Andrew Kiragu, medical director of HCMC’s pediatric intensive care unit and one of Luke’s primary doctors. “Why this hit caused him to have a bleed that ended up being life-threatening — that I can’t say I have the answer for.”

Joy in the little things

Luke was still in the intensive care unit during the Fairmont game, but he was on the field in spirit. The host team painted Luke’s number 43 onto its field. Nate Nelson, Luke’s cousin and fellow linebacker, wore No. 43. Dassel-Cokato won 31-21, one of two victories all year.

His hospital stay was full of victories and losses. He discovered joy in little things such as the ice chips fed to him by his brother Isaac. “I’m buying these online,” Luke said.

Other days were marred by fever, pain, nausea or vomiting. He lost about 30 pounds from his 180-pound body. He struggled with once effortless tasks such as sitting in a chair or walking down a hall.

Back at school, teammates rallied around the hashtag “#swolestrong,’’ playing off his nickname “swole Luke,” for his swollen appearance when lifting weights. Volleyball team members sent a photo of themselves holding a “#swolestrong” banner. About 1,400 white and navy blue #swolestrong bracelets were sold for $3 each as a fundraiser.

Eleven days after Luke was injured, doctors reattached the right-side portion of his skull removed in the emergency surgery to save his life. His mother wrote on his Caring Bridge site that night, ‘‘Today Luke is strong and whole.’’

Luke was home in Dassel on Sept. 22, seemingly on the road to recovery. But he was readmitted to HCMC five days later due to a blood clot and infection.

His second hospital stay lasted longer than his first. But when Luke left for good, on Oct. 15, he walked to the car rather than getting pushed out in a wheelchair. His 37 days of hospital life were over.

“Luke is a strong young man,” said Sara, whose Caring Bridge posts often invoked scripture. “He didn’t deserve this, but I believe there is a great plan for him.”

Readjusting

Luke returned to school on Oct. 29. Sara, who taught algebra and precalculus at the school for 16 years, dropped him off at 9:20 a.m. She said it felt “like the first day you drop your child off at day care, times 1,000.” She called the school nurse an hour later.

To combat light sensitivity and headaches brought on by his injury, Luke used antiglare sheets to place over papers and computer screens in some classes. He laid down to rest on padded benches in a darkened, quiet area outside the nurse’s office twice daily as scheduled.

By week’s end, he had enough stamina to stand in the boisterous student section cheering on Dassel-Cokato’s volleyball team to victory in a section championship match.

He remained cautious throughout November at school. Rather than join 150 students in his group, Luke and Nate ate together in a quieter classroom with fellow football players Dalton Asplin, Zach Martin and Tommy Halonen.

“People have shown lots of support, but they know I need some space,” Luke said.

One afternoon in early November, a family friend stopped by with chicken enchiladas and apple crisp and told Sara, “I’ve been worried about you a lot.”

Food deliveries are common, Sara said. “The amount of support has been incredible.”

‘Culture of resistance’

That report released last month by the Institute of Medicine and National Research Council found a “culture of resistance” to reporting when young athletes might have a concussion and to complying with treatment plans, which could endanger their well-being.

The NCAA and NFL face lawsuits over football-related concussions. Other sports are wrestling with the issue as well. Twins catcher Joe Mauer said symptoms of his Aug. 19 concussion, which kept him out of the Twins’ final 39 games, lingered into October.

Weinandt said when his players don’t feel right they “go right to the trainer. If their head hurts, they are out until they get cleared.”

The coach said he doesn’t think “we could have done anything differently” in Nelson’s case.

Added Kiragu: “I am not sure that [Luke’s] case is necessarily a cause for alarm but a more cautionary story that points to the need for parent, coach and player vigilance when it comes to brain injuries sustained when kids play contact sports.”

The road ahead

A yard sign in front of the Nelson house reads: “Home of a Chargers football player.” Inside is Luke, sporting a long scar, a pink line from his forehead to behind his right ear. It neither brings Luke pain nor any self-conscious feelings.

“Chicks dig scars, Mom,” he told Sara.

While Luke can joke about his scar, contemplating a life without playing his favorite sports — football and baseball — brings him to tears. Doctors have ruled out any more football. Luke cannot play baseball this spring and maybe beyond.

“Sports have been huge for me,” Luke said. “It took a while to get used to the fact that a lot was going to change.”

He has seen positive changes in his recovery. The meetings with his psychologist and the physical, speech and occupational therapy sessions have decreased from almost weekly to once every two or three weeks. He was cleared to resume driving.

He’s also working to get caught up on missed work. He’s using the antiglare sheets less often in class. Nov. 21 marked his first full day of school since Sept. 6. He plans to resume a full-time load after the Thanksgiving break.

He made good on an offer from Minnesota Vikings tight end John Carlson, a Litchfield native who visited Luke in the hospital, and attended the team’s Saturday walk-through practice before players flew to Green Bay to play the Packers.

Teammates who rallied around Luke this fall promised to stand beside him going forward. Nate said they will find new hobbies together as outlets for Luke’s competitive nature. Sara bought Luke a set of golf clubs as an early Christmas present. Weinandt said he hopes Luke stays involved with the team as a coach.

“It really hurts knowing he won’t be on the field,” Asplin said. “But we have to be there for him and make sure he’s not alone.”

On Saturday, Luke will be “redshirted’’ for the annual Nelson cousins vs. older uncles football game, part of the family’s extended Thanksgiving celebration. It will include one of Luke’s cousins, Alex Nelson, who returned from Afghanistan in October sporting a “43’’ patch made for his backpack.

“I don’t know what word describes how thankful we are this year,” Sara said. “But the bottom line is that our family, all five of us, are here and able to sit at the Thanksgiving table. We can share tears of the past three months, but we can also share laughter and smiles from the last three months and look to the future.”

David La Vaque • 612-673-7574

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