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About DrPJax

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  1. I think the team is looking good. With Singletary coming back , I think gore and Yeldon are great compliments. Now with Duke in and Zay out, foster and McKenzie should be enough for a deep threat esp since we don’t go deep much and josh Has not been accurate deep either. We will get kroft back for depth as well. I would let the year play out on O now. Doubt there is much out there to bring in. One thing i would consider strongly tho is that if the rumors are true about Denver wanting to move people, I would try to get Von Miller. Our D is how we will win most games so why not make it really dominant? We need a premier rusher and zo is getting up there. If you bring miller in somehow , you extend both their careers and can rotate and keep them fresh. Plus you have depth and even cover yourself for zo departing. That’s the only thing I would make a big move for , You are in the cusp of a really special d and just adding a premier rusher to get to Brady could make all the difference. Also would keep looking at punters but that doesn’t have to be a trade. We need a guy who kills it within th 20 more often. Just an idea if Denver really is looking to move on. What do you think ?
  2. I get your point Promo, not arguing that. I just wonder tho if they make those if the momentum stays the same. Also if one of those missed fgs turned out to be a td ( the one where mariotta crossed the line ) we are looking at them scoring 20. He only missed it by a foot and I bet you were holding your breath like I was during the break that the refs were going to give that too the titans. In fact the ref on tc was saying he would have given it tenn so it was a really fortunate win. Glad we got it but I think this team has the talent to be better. Need some coaching things cleaned up. Hey I think it’s ok to still love your team but be critical of stretches of poor play as well. I mean part of the fun of football if Monday morning qbing. How many of us called for duke two weeks ago and they finally , finally pulled the plug on the Zay excuses. Without duke they don’t win today and many on the board were harsh to people who were crtical of Zays play; turns out people should have been critical of his play. But that doesn’t negate loving the bills , at least for me my friend. Always like reading your insights for quite a few years now ! 😀 e
  3. It’s a good win,,, better than any loss. But you are not going to have many teams miss three fgs like that. We also had our OC call three pass plays when we finally got the lead and we burned zero clock. Luckily Dabol got a chance to redeem himself and saw that had should have called the gore runs sooner. We got some luck there , also titans had a holding , illegal formation , and we still have up a td before it was nullified by Mariotta crossing the line and he did that by literally a foot. I mean it’s great to win and enjoy it but you also have to not accept this as the standard you want to hold your team to. Good news is we somehow won and we hopefully can build on this from a confidence standpoint. Young teams need to learn how to win and we are developing that winning culture. But to be there at the end of the season we need to clean a lot up. We had another bad int that resulted in the game being tied and we should have kicked that fg early when points were hard to come by yet we choose to call a bad qb sneak. Just need to clean this stuff up so Sunday’s keep us all smiling! 😀😜
  4. Yep. He made a clutch adjustment with josh on that td. Josh moved him toward the line and it allowed an inside release. He was on same page with josh and he also caught it in traffic in a clutch play. Zay wa not doing that very often esp the catching part
  5. McKenzie with honorable mention on that jet sweep after misses fg and marriota crossing the line. That was great run.
  6. Saw him run on in the failed 4 th down qb sneak. Never after that
  7. No kidding. But hey they deserved that after gloating about that miracle thing! We got the miracle partially redeemed. Thought they might give one to marriota when he crosses the los but we lucked out!
  8. Ok now we are going to have to consider entering you in the TBD concussion protocol ,,,,,let’s see what posters think that protocol should be ! I am thinking one or two dirty martinis prior to reading any further posts about Josh and this dam concussion protocol ! 😀
  9. Hope you’re right but the game theory chick ,Cynthia, has the bills losing 21-17 and the probability of a titans win at 57% ! She also has the bills with only a 28% chance of making the playoffs. I don’t care for her but I think she has been correct in over 2/3 of her predictions. Not sure if this includes Allen or not. I am concerned this offense just has not shown it can consistently score. On the other hand the tots s score AED all their points against the falcons I the first half and none inthe second last week. Hopefully the bills won’t give up 21 cuz if they do I believe we could lose given our prior offensive production. However I do believe we will score more if Singletary is fully active and they quit limiting his touches. Here is the link to Cynthia http://www.nfl.com/videos/game-theory/0ap3000001061403/Game-Theory-Week-5-win-probabilities-score-projections
  10. I think you are right , there is really no diff between stage 4 or 5 for a QB , except that stage 5 would imply a second day of full practice , followed by a computer test called the IMPACT test the next day to be sure josh has reached his baseline scores ( prior to the injury) and that his scores remain stable. If his score regressed tomorrow it would probably mean another day in stage 4 of the protocol which really only means he would be retested on computer again on Saturday. I believe if his score is stable tomorrow ( test done after sleeping after having finished a full practice ; the normal sleep part is important as many times patients with lingering symptoms or post concussion syndrome will have difficulty sleeping after exertion ) theoretically he would no longer need to be tested past Friday. The IMPACT test is the only FDA approved protocol for management of concussion and used by the NFL, olympics , FIFA, most high school athletic associations across the country and many colleges as well. Here is a link to the impact test site with a short video explaining its use. https://impactconcussion.com/?utm_source=google&utm_medium=paid_search&utm_campaign=impactproduct&ads_cmpid=6549852907&ads_adid=76904728725&ads_matchtype=b&ads_network=g&ads_creative=385367805553&utm_term=impact concussion&ads_targetid=kwd-314225683657&utm_campaign=&utm_source=adwords&utm_medium=ppc&ttv=2&gclid=Cj0KCQjwuNbsBRC-ARIsAAzITufx6xQwglg6Gk2R2C4wShszuAnxePkx9hEGac068cFN6ezuZRApp5gaAuudEALw_wcB ( hope that works ) . Here is a link for the SCAT5 ( sport concussion assessment tool version 5 ) that has a really nice handout used by clinicians and the last two pages really define the protocol stages for progressive return to exercise , school and studying that is a nice resource and defines what a concussion is and what cardinal signs to look for. This is used for quick ( ten min test Immediately after a witnessed possible concussion or brain injury) on the field ; sideline assessment for initial screening, then formal IMPACT testing occurs later or 24 hours after injury and compared to baseline. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf The following is the actual consensus statement on concussion in sport that was published from the conference in Berlin in 2016 and shows the multitude of experts brought together to develop the protocol or concussion policy that is in use today by the NFL. Don’t be put off by now formal it looks. It is nicely summed up in italics as you scroll thru the short paper. Pretty ingesting to see the actual report that was the basis for everything. https://bjsm.bmj.com/content/bjsports/51/11/838.full.pdf. Hope that is helpful. I think you are spot on tho that for a qb there is no function diff between stage 4 or 5 , except for just an additional 24 hours to show stability and no regression post exertion. 🙂
  11. I think you are right on it Kelly, he did take all the snaps and the PROTOCOL by definition means he has to have done or survived a normal practice ( which is everything but contact I would think for a QB, for a non QB contact would be the last step of the protocol ) and then NOT HAVE any recurrent symptoms tomorrow. I think by definition if wed was stage 4 , todays practice would be stage 5 . I believe by definition he has to take the computerized IMPACT testing tomorrow to be sure his reaction times , memory , impulse control , etc all have returned to baseline and remain at his baseline 24 hours after last full practice to fulfill the final step of the protocol. So I think by definition he could really only FULLY clear the protocol by as early as tomorrow so today’s announcement I believe still fits with normal progression and no one can say he definitely out yet. Initially this protocol was set up to be a minimum of 24 hours per stage , however that has been modified for adults allowing faster progression. I think he is following an early course and I bet he will clear it tomorrow only based on the fact that he got all the reps and the focus wasn’t on getting Barkley ready. I don’t believe they have Barkley Standing around like has been reported , without activating the other QB additionally, unless they are almost certain that Josh will be cleared. If for some reason he is not cleared by tomorrow, I don’t see how they could avoid letting Barkley get the lions share of reps. To me tomorrow is the telltale day. if I may, for all those guys ( not you Kelly ) posting that he probably wasn’t concussed or “ was barely “ concussed , you are missing the point. It doesn’t matter how he looks to untrained people on a video. The computerized testing picks up on memory and coordination and reaction times and then compares them to HIS baseline normals. He would not be in the protocol if he had all normal tests to begin with; there is no debate he had a concussion. This as stated is taken control of by outside independent neurologists so there is no way the team puts him in it ( esp since they have no control over the situation once he is in it ) to just protect him or to be cautious etc. By definition the whole process/ protocol is out of team control. To say he was “ never really concussed “, or this was for “ optics “ is laughable and shows how little some people still misunderstand concussions and why independent people are needed to protect the safety of players. How would you like someone with that type of understanding making a decision about the future brain health of your son or fiancé if you are in Allen’s camp ? Thank goodness we are beyond that.
  12. Wow , sorry to hear your kids have had those issues but imo sports are such a vital part of growing up and learning life lessons. I did tons of presports exams / clearance exams and we rarely try to disqualify anyone if there is a sound medical way around it. That one website , the impactconcussion.com, would be really useful for you I think. You can sign your kids up for baseline testing and they also have an app listed on the website for your phone that allows you to keep tract of all the testing related to your kids done on their site ( perhaps more as I haven’t downloaded the app yet.). They also have links to providers in your area tans have been certified by them in concussion protocol testing and interpretation. For someone with family in sports I believe it’s really important knowing the providers your kids are seeing have appropriate credentials. I think the fact that the olympics , NFL, FIFA, Imternational hockey association, etc have all contributed to their research and use the exact testing that is available to you thru the site. Also all the thousands of high school associations and colleges also use that site. BYW, I have NO affiliation financially with the site but thru my clinical research I believe they are currently state of the art for concussion management etc. Thanks for the feedback and wish you and you kids great health. Protect their health because without that nothing else matters much. If I can help with anything like Questions, just let me know, I am not a concussion expert but am a general clinician and have enough credentials that I am used for malpractice cases in family practice and urgent care as an expert to determine the merit of cases. Go bills !
  13. Thanks ! Hope it was useful with all the talk about the concussion protocol. It also points out despite the objective tests it still comes down to individual clinician judgement approval for final clearance. 😊
  14. https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf Public service post. Hey guys with all the concern over Josh, I thought it might be a good opportunity to post a couple of links to help us all be in the same page with concussions. The link above is to the SCAT5 ( sport concussion assessment tool 5) and I like it because while it is for a clinician to use on field / immediately post injury, it’s pretty basic and has good info on what symptoms are looked for , what are worrisome or red flag things or observations, and it talks about the things for clearing ( the protocol for increasing activity ) for sports and even for returning to school and studying. It has a good explanation on its last two pages. This information is collected prior to injury and then after for comparison. This is used quickly to determine need for transport to hospital, need for cat scans etc. I am sure Josh was examined by trainers or docs quickly after the injury. Note in red print about player not returning to action on day or injury and this is mandated in all 50 states for high schools. Just wanted you to see the various symptoms and also the protocol for returning defined. Josh is in stage 4 on wed which is good but all that means is he is progressing. So if he is symptom free after practicing Thursday, he MIGHT progress thru stage 5 which means he is ok after full practice (I doubt they allow anyone to have “ contact “ with their qb). That still doesn’t mean he will play. There is a known buffer zone where clinical symptoms ( patient feels better ) improve before physiological complete healing. A big study of around 3000 college athletes with concussion showed the biggest risk for further injury or second impact syndrome was within the first 7-10 days of the initial injury. About 1 in 15 had another concussion within the same year, most within that 7-10 day period. If someone had 3 concussions their risk for more was 3x that of someone with no concussions, so you can see the associate worry surrounding CTE. https://scipol.duke.edu/track/immediate-post-concussion-assessment-and-cognitive-testing-impact The second link is about “ impact”., immediate post-concussion assessment and cognitive testing. This is the computer testing that is the only FDA approve program I know of for managing concussion and returning to participation and one that the NFL , Olympics, FIFA and others use. Also your your high school students do this. It is done prior to injury for baseline and then post injury for management. After a concussion the test would be done 24 hours later by using a computer online portal with a certified trainer present. So I would think Josh is doing this daily. This test has to do with memory, impulse control , reaction time, processing etc. This is important as these things are objectively measured so a competitor athlete can’t underreport symptoms just to be able to play. Also , as some of you have addressed, this is hard to fudge initially by underperforming because if an athlete attempts that, red flags stand out showing statistical things that trained observers catch and make the person perform the test again. This does happen about 10% as self reported on the website, and apparently they have a good success rate catching this. So to be clearer to play the athlete has to return to baseline at a minimum to be cleared. Even doing that tho does not guarantee they will be cleared to play. These tests are all still just clinical “ guides” and it still comes down to the clinical judgment of the independent neurologist to give the full go ahead. That is just a legal way to protect the testing comapny and it does out the onus on a seasoned real life dr and I think that’ s good as these computerized tests are still building data and there is much ongoing research about brain injury. https://impactconcussion.com. BTW, this is the link to the actual company website where the computer testing was developed and marketed. You can actually even purchase a baseline test for your son/ daughter if you wish to have that data. I think the cost was around 20$ or so. Most high schools should be doing this already but I put the link there just for you to see the actual site and place the NFL does use. ( guys I couldn’t test the links prior to posting ,,just a doc and not an IT guy . All the links are public tho so I am sure you can google the info if links don’t work for some reason. ). So , it looks good that Josh is progressing and I expected that for a young healthy guy. He looked good in the video I saw of practice. Will probably know more on Friday if he fully practices Thursday and has no recurrence of symptoms. The one thing I am a little concerned about regarding him playing ( from my fanboy standpoint) is that Mcd is very conservative ( this is obviously a good thing ). He doesn’t even commit to Knox getting more plays when listening to him At the presser almost saying they won’t overload expectations on young guys. Mcd still emphasizes Josh being young and inexperienced. So that makes me LEAN, imho, to a position where I am thinking regardless of protocol, Josh may be sitting until after the bye. I just think Mcd errs on being conservative and just passing a protocol , while that would justify Mcd allowing josh to start, won’t be the only factor in his decision. I know it’s a huge game, yet I am ok with Barkley (sp) with a week of full reps. I would love watching Josh get a chance to “ redeem” himself, but maybe it’s best to believe you have Barkley on the roster just for this purpose and better to give Josh no pressure to recover so quickly. Don’t shoot me, it’s just an opinion and I have no idea what actually will happen. Hope the links provide some basic info so we don’t have to rely on opinion regarding how a concussion is evaluated and followed. 😀
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