Two years ago, Patty Phommanyvong was a healthy 17-year-old. Now she will never walk or talk again. She was injured while cheerleading -- an athletic activity some say is now among the most dangerous for young girls.
Then she suffered an accident that stopped her breathing. Her parents claim that her school's defibrillator failed and the 45 minutes she went without oxygen left her with a brain injury that caused permanent paralysis. Today, Phommanyvong can only communicate by blinking.
One blink means yes. Twice means no. Maybe is multiple blinks.
Cheerleading has long been an iconic American pastime, and it is now more popular than ever. By one estimate, 3 million young people cheer, more than 400,000 at the high school level. And cheerleaders are no longer only on the sidelines -- many cheer competitively.
The degree of difficulty of cheer stunts has exploded. So too has the number of accidents.
Cheerleading emergency room visits have increased almost sixfold over the past three decades. There were nearly 30,000 in 2008, according to the Consumer Product Safety Commission.
The numbers are all the more disturbing because some states don't even recognize cheerleading as a sport. That means there are no uniform safety measures and training methods.
Kori Johnson is the cheerleading coach at Costa Mesa High School in Southern California. She says the cheerleaders have had to step up the degree of difficulty over the years.
"The girls, they want to be the best," said Johnson. "They want to try harder stunts. So every year when we see new stunts we try them."
Costa Mesa High boasts a championship cheer squad.
Squad members say people who don't think cheerleading is a sport should just try it.
"They should be open-minded about it," one cheerleader said. "We throw people. Like our bases are lifting like people up in the air."
"It's like bench-pressing a person," a second cheerleader said.
A third cheerleader said not everyone could keep up.
"We had the water polo boys stunt with us last year and they like, quit, after like an hour," she said. "They said it was really intense."
Johnson is an experienced coach with safety training and cheer certifications. She says the key to avoiding major injuries is teaching stunts step by step.
"I would never ask them to do a stunt that they're not capable of doing and trying," said Johnson. "So we make sure they have all the basic stunting and it's like stairs. We move up the ladder."
But as many parents already know, injuries are now simply a part of cheerleading.
"It's scary. It's scary," said Lynne Castro, the mother of a Costa Mesa cheerleader. But Castro said cheerleading was too important to her daughter to stop even after she suffered a serious injury. "You see other sports figures that have injuries and they just get on with it, you know. You fix it, you rehabilitate properly, and you move forward."