DrPJax

Sorry , no disrespect intended , but you don’t know how Tua will be playing ; why would he go out if he is “ scared”.? Thats just speculation/ fan speak and if he is out there , with all the focus specifically directed toward him ,,he does not play without clearance so it’s out of his hands. Usually you expect a guy with three documented concussions in one year to be shut down, but if he has no symptoms and clears the protocol, I bet this coach goes with him with so much at stake. Even our own pro bowl center has SIX concussions, at least two within this year , and I have not heard he is playing scared (he has never said so ) and obviously he has not been “one hit” from “ his career being over “ ( related to his concussion history , yet EVERY player is ONE HIT from their career being over as Hamlin nearly or possibly demonstrated a week ago ) , ao speculating about Tua because you are a good Bills fan is being a little biased. It’s been a great year to be a fan of this team as they seem to keep winning despite making several mistakes that somehow they find ways to recover from ( another red zone int by Josh, lost fumble by motor , touching a punt and turning it over to the Pats , allowing Jones,who everyone on here describes as average at best , to go 17/17 in three TD drives as our d faced an 8-8, now 8-9 team), and truthfully we were behind by three to this bad offensive team on our home field at one point, so who knows what to predict? Despite the mistakes, they keep making spectacular things happen that they pull out wins with, like two kickoff returns for Tds , Tre making a key drive stopping int , and while Gabe seems to be dropping balls more than expected or not getting two feet down more than once , in comes Smoke from the past with a great Td catch, or Allen makes up for the red zone int with a perfect bomb to Diggs and extends another play finding Dawson in the endzone! Here’s hoping Dorsey will roll out some new wrinkles , like Beasley, Smoke , throwing downfield to Cook, running Josh inside the ten, using Shakir more etc. Predicting anything about Tua and the Fins just seems impossible this year and I personally hope he is out. ( alls fair in the playoffs cuz it’s one and done !) It’s a little concerning as he did lead them to one of the wins against us and they played well against us in cold weather: it probably will be another one possession game ( we won the last one here in the cold 32-29, they beat us by two in Miami, so seems it will be very competitive). We played at a different level last year in the playoffs, but injuries have really taken a toll this year. Hyde is out , Hamlin is out , Poyer and Tre are not 100% , and the guy Beane thought was critical to advance , Miller , is out. Throw in an OC in his first playoff game and it might make things a lot more even or unpredictable than we expected. Vegas tho must think Tua is not playing with that line, and any advantage to overcome the gift KC got having to play only two games to get to the SB, after losing head to head to both us and Cincy, is something I’m all for.

Seemed weird as he asked Kay adams as she interviewed him how much he should donate.LIVE; it was HERV choice for the 6900$ as he said from some minimum number up to. 15k$. She said that number as she was winking , smiling at gronk who continued to suggest he was bored and still might have “5 years “ left. It was perhaps tongue in cheek with Kay suggesting that number, but it seemed weird and awkward to me as it was her podcast / YouTube UP & ADAMS show. May have meant nothing more than a multiple of 3 but it was Kay who made up that # to donate. Why not choose 15 k as it was an option/ multiple of 3, or 8 $k , somewhere in the middle but more than 1/2 of the range Gronk offered to donate live BASED on Kates decision ? It’s Not gronks jersey or area code etc. ; anybody else see that cheeky , weird interaction , and know why Kay chose that figure ? ( I could see Gronk joking with the “69”00 $ contribution , but it was Kay’s choice and she had even earlier asked about Gronks Christmas gift for his girlfriend, so I just don’t get why that number ? Just joking or something else I’m not aware of ?). I was wondering about Hamlin’s feasibility to play again even if cleared. Right now I believe work comp law means any medical issues he has the remainder of His life related to this injury are by law covered by either the Bills or NFL. Does that remain in place if he goes back to THIS work specifically, and suffers another injury ? Any attorneys who know work comp law have a full understanding? I am not 100 % positive but I thought he was also being assured he would be getting a financial package from the NFL to help cover his financial future as well given this unique situation, considering he is on a lower tiered contract now and there apparently was to be some discussion about the 8 mil donated and how it’s all used in addition. Some undoubtedly will wish to be sure Hamlin received some contributions just to protect his future financial security should he not be cleared or he chooses to never take that risk again regardless of medical clearance ( I am no pro athlete , but if I had a unique arrest like that and walked away with my brain intact , not much chance I PERSONALLY would risk my heart/ brain again as there is no way any dr signs off saying there is 0 % chance of recurrence or some other related injury couldn’t happen in this violent , collision sport). Would you take a chance on a new contract even if “ CLEARED TO PLAY AGAIN”? 😊

Have seen this many times over this year and prior years. He did not have control of the ball in his hand after he was being hit from behind. If it’s not a fumble , explain how he had control of a ball and threw it forward END OVER END. Have to have control with ball fully in your hand as arm moves forward. It was agreed by the on air ref to be a clear fumble , and it was reviewed quickly and confirmed. If you have control and throw it forward the ball is rotating and not driven forward end over end by the hit. Try throwing one end over end with the ball still fully in your hand on the laces. Pretty simple call, took seconds to confirm. And I’m not a jags fan. Just straight forward call imo, and it stood. 🍸

It’s just easier to go forward if they Know he will at least live. They all know he faces a long, hard battle going forward. Pat Kirwin today on Sirius used the analogy of the jets DB Byrd , who suffered a spinal cord injury on the field. Finally , they got news he was going to live and not die. They still knew he faced paralysis, but he was going to be alive to at least possibly improve. Knowing that was positive news, their brother tho never playing again , would be there to live and have a chance to improve. Kirwin said it was a huge emotional lift for the team. They didn’t keep dwelling on his possible death , focused on his being alive , and it freed them emotionally to move forward together as a team , and they went on to win the following game. Without that , without being certain he was going to live , they were never going to focus on playing a seemingly meaningless game. Small positives matter ; the Bills know he is done for this year or more , but they don’t know yet if he will live. You can save the heart while still losing the brain. If they get news Damar suffered brain death , all the cpr/atls/acls doesn’t mean squat. But , if he breathes con his own , maybe grasps a finger , thst is a HUGE positive and he has a future , challenging to be sure , but he will still be here with them ! If that’s part of your family , you’re elated when for all purposes he should have died on the field! You can finally move forward ! Hope that makes sense. 😊👍

I think just about every expert , dr believes that was the mechanism. Other things like aortic dissection , Hypertrophic cardiomyopathy , coronary artery disease or anomalies would have been investigated and the attending physicians would not just allow a false narrative ti continue. We all saw what happened ; it’s the old saying in medicine if you hear hoof beats behind you and turn around , it’s usually a horse and not a zebra. This is yet ANOTHER CRITICAL CARE EXPERT all agreeing with the diagnosis , not still working on a differential. If you want other explanation or evidence , other than an autopsy , it’s just being argumentative for the sake of arguing. What else explains it and how can you support a different conclusion then? Will it take 1 more or a hundred more Drs saying the diagnosis for you to “ accept “ that if it quacks like a duck, usually it’s a duck ? Part if the art of medicine , and it is still largely an art where experience matters , these all very experienced Drs diagnosing visually ( we are in an age of legitimate, reimbursable telemedicine now, but most very good Drs agree, you can diagnose about 80% of the things patients present with just by getting a good history alone) , so arguing over semantics seems silly. . Again , if not that , please feel free to put forth some discussion as a colleague and we can gladly debate. Just negating things without some reasonable alternative seems a little light in the effort department is all I’m saying ;;it’s not how colleagues learn or debate ideas. At least it never used to be until suddenly it’s more convenient to just cancel things or not listen at all. No one has ever said commotio cordis is the ONLY DIAGNOSIS , BUT ARE YOU ACTUALLY ARGUING IT WAS NOT A FACTOR AT ALL? You are welcome to your opinion ; usually when negating something , at least where I have been in talks and rounds , people aren’t just called out without a counter discussion of ideas. Maybe it’s different in other countries, or planets , I don’t know !? 😊 I said it was an explanation and he uses diagrams and language that those not in the profession can easily relate too. He did use that as his working diagnosis in two videos now. It mentions the latest info I have heard , about lowering the o2 down to 50%. Of course that’s not brand new , nothing is brand new yet ! But again for the majority who are not medical personnel, it did discuss how the treating Drs might be seeing improvement with just positioning, and they did say they saw “ some improvements”. I would bet most people have not had ards explained relating to an arrest or have viewed how it appears on X-ray. This is for a message board , just tried to post something that helps visually. It’s not a grand rounds lecture, never alluded it as such, and I just quoted a Dr I have followed ( along with a million other subscribers, so the numbers might be on his side here ) who is board certified , treated these type of patients, and has a good demeanor. But let’s just criticize because that adds,,,,,nothing! If not up to your standards for info from a football message board, it’s ok to move on , it’s that simple as nothing was posted with bad intent or for click bait. He did confirm , and this was said by Damar’s relative speaking on CNN , that he was awake and then sedated and that is relevant for prognosis relating to preservation of his brain , pretty important as that’s the only objective thing we can measure; throwing around statements that the time of 9 min doing cpr etc mean nothing until we see if his brain was preserved. It’s sounds at least somewhat positive that he is less likely to have suffered brain death, tho we can’t be 100% sure, yet. This dr felt comfortable saying that to 1 million subscribers , so he must have some history of reliability; imo he has proven to be measured and reliable since 2020. It’s his reputation tho , not mine , so shooting the messenger again seems silly. It was posted to view as another opinion with some very good explanations and diagrams ( prob not many can visualize how the diaphragm and heart can affect lung expansion) IMO for people in non- medical professions. No one posted it was THE ONLY reliable info from the attendings at cincy, so of course it’s a general description. It really doesn’t need your disclaimer ; no one was harmed or misled and as far as I know , this is not a peer reviewed journal. Lol, man , his videos were posted by others before in this thread and received well ; it is what it is and it’s like the commercial , “ we don’t need a line monitor here”. Lol. Let’s hope his being awake was accurate info at the time and , who knows , maybe this dr has trained with or knows docs at Cincy as he spoke very highly of them! Have a better day ! 😉👍

Plus after listening today on Sirius, Pat Kirwin was comparing this to when Dennis Byrd of the jets was paralyzed. He stated no one wants to see this Bengals / Bills game go forward now , interest is lost and no one want to go back thru that trauma , nor should they. That game and it’s once in an NFL lifetime need to be moved forward from , there is just no realistic way to jump back into it. It wasn’t until the players knew Byrd was going to live that they emotionally picked back up and it drew them together. They knew he was going to be paralyzed with a long recovery , but they knew he was going to LIVE ! The players still don’t knew that regarding Damar ant this is so rare , literally still life and death on the line , it’s impossible to expect those two teams to just go right back to it. Kirwin really believes it will be a no contest for both teams and if KC wins this weekend , they get the 1:seed. Seems disappointing to me if that happens , just giving the 1 seed to KC. Yes they won one more game , but in my eyes they lost to both the Bills and the Bengals head to head and rewarding them just because the other two teams suffered a unique tragedy and trauma , just feels wrong to me. It goes away if they would lose but that seems unlikely. The Bills controlled that 1 seed for most of the season , and just because they were 4 points down ( and they are the best scoring team at the end of the half’s ) is not a reason to take that away and ice it to cincy unless the Bills lose their 4 th game. Then I could see Cincy with the 1 , kc 2 , Bills with the 3 seed Should Kc get that 4 th loss , then for me with a Bills win over the Pats, they lock up the 1 and Cincy 2 aamd kc 3. I don’t concede an L just to move on ; they have fought all year thru so much and have never quit. I don’t see them playing more than 16 games and then have a no contest as the only fair solution and had no control over or did anything to make that happen. They have had a season unlike any other and if they win in the face of all this, they deserve some acknowledgement of all they have overcome. The Bengals / Chiefs can try to argue differently but they have not overcome anything close to what Buffalo faced this year. They deserve a week off after all the trauma and travel and let the others come in to Buffalo to face a small taste of adversity , and prove they really are better. The Bills got hosed with Covid and the Titans mismanagement in a prior year , plus they faced and lost in 120 degree heat to a team and league who allowed a concussed player to continue for the second half when admittedly he should have been disqualified from the second half. . What else do they need to overcome to be treated fairly and with some compassion ? 😔🤔

I didn’t see this posted , but if so I apologize and mods can delete. I just watched a second video /YouTube podcast by a very talented young critical care specialist and pulmonologist , Dr Mike Hansen. It’s been up just 18 hours , it has a pic of Hamlin with the words ; MEDICAL UPDATE across the thumbnail and the title is : DOCTORS WORK TO GET BILL’S DAMAR BREATHING WITHOUT A VENT. I think it’s a great , concise , hopeful update based on most recent reports coming from an expert in the icu/ critical care medicine. It’s good info for docs to lay people and I expect he will continue the updates. Please check this 5 min , 54 second video out on YouTube. ( His channel has over a mil subscribers. He does great work. Followed him since the epidemic started as he treated many patients and had it himself in moderate severity. His skips jargon and talks using humor when appropriate, and he has no hidden agendas ). This video is great as it confirms the diagnosis, but it really does a fantastic job showing the complications from cpr;the possible development of acute respiratory distress syndrome associated with cardiac arrest ; he mentions two resuscitation attempts; he shows the changes in the lungs on X-ray and why 100% oxygen was needed but is now weaned to 50% ; he discussed Damar being awake before they sedated him and explains in very understandable terms why he is sedated and what to expect ; he shows how prone positioning while sedated helped with the lungs requiring less oxygen (100% oxygen is actually harmful to the lungs. He is on 50% now and we breath 21% oxygen at normal altitudes / sea level ) ; he goes into detail why prone positioning is only safe on a limited basis ( you may remember many Covid pneumonia patients survived with prone positioning while on a vent) ; he uses great diagrams about the use of prone positioning , which has been shown to lower mortality or death rate, ; he describes once patient’s are down to 50% oxygen that’s when Drs start considering putting the patient lying on their back again to prevent pressure ulcers and other complications with using a vent ; proper positioning helps maintain iv lines more easily , especially central lines ( these are Large ivs placed into the subclavian or jugular veins which allows easy access for meds , nutrition , blood draws and monitoring things like central venous pressure which is important in assessing cardiac function and hydration as examples; he explains with lowering the oxygen levels they begin withdrawing the sedation so they can assess brain function ( can’t be done while sedated); finally he repeated the fact that Damar was awake and had to be sedated ( nice having this confirmed by a reputable critical care dr) for ventilator use is a “ telling and very good sign when it comes to the brain. “ No doubt about it he is receiving top notch medical care at the university of Cincinnati medical center , and I remain very optimistic and hopeful that he progresses in his recovery”! Tried to post the link, hope it works. I am working with an iPad Pro and sometimes for the life of me I can’t always find easy ways to post things to here with the iPad OS, but I just use it for teaching ARNP’s , PA’s , Med students , and mostly patients with all the great anatomy appps available for it and it’s so light and portable. 😊. If you have not seen this video or are not familiar with lung issues post arrest , how positioning in vent use works , this is a fantastic 5 min summary of what Damar is going thru and how these issues are solved in a very well diagrammed, fluent discussion by an expert who manages these type of patients daily. Highly recommended. Hope you find this informative Go Bills and Prayers for Damar

Good catch. Great guy. Loved him on empire sports! I had one of those huge umbrella shaped dishes installed in my yard way before the direct tv days, just to follow the bills from jacksonville1. Problem was I forgot you had to get the dam thing removed later when small dishes came out ! That was a pain, but it was great for following those great bills teams in the early 90’s!

Great story. Thx for sharing. Glad your mom did well! A small positive miracle would go a long way for the bills and Buffalo and the Hamlins. You guys are due up there for something good!

Great explanation. Literally his life was on the line. It takes a great deal of training to function intelligently and in the correct order when it ‘counts for real’ , and it was really life and death. It’s like witnessing someone having a seizure; I don’t care how many you have seen they are always very stressful and frightening! I think if he comes around ok tho, things might change dramatically mood wise and the players could be elated in that sense and might want to play. I didn’t feel that way at first , but if he is fortunate because the resuscitation was so rapid , it might turn the entire mood around and they could look at it as a miracle and be such a relief that playing might be perfect to put this behind them. I think it all depends on the outcome and how great would it feel if he was off the vent by wed or Thursday?unfortunately we just don’t know which way things are going To go. He and the Bills could sure use some good fortune and a small miracle would be amazing for Hamlin, the bills , and all of buffalo. Really praying and wishing that it goes that way,,,,,its still possible !

Yep, pretty sure that arm has a torn long head of his biceps. Can play with it but I bet he gets off season surgery. Now playing with a meniscus injury,,,wow he is a man’s man! That hurts with twisting , cutting. Guy is amazing with desire and placing team above himself. He is the heart of that backfield this year. Amazing how he didn’t let that guy hurdle him! Now with this Hamlin issue, I don’t know how they can overcome much more. Tre being out there shows a lot of heart too. It’s looking like we are running out of solutions against a team like cincy but what can you do ? Missing von doesn’t help either. Injuries may prevent this team from its final goal, but the future still looks good. I just feel for them putting in all that time and too many things going on they have no control of. They had a great roster that is slowly being decimated by freak injuries.

Very good points. I’m just not sure how you do what’s right for these young men emotionally. I didn’t sleep all night and I have 40 years in medicine and unfortunately as part of the career ,I have been there to see people pass. Was with my father who passed from non Hogkins lymphoma way too young at 72. It is always traumatizing. You never “get used to it”, that’s the truth. I hope they don’t have to face him passing , but they are facing his loss at least for this season. I’m just not sure how they go right back to playing without distraction. NFL has smart people, they surely can figure this out while remembering these are young men being affected.

I agree. It was best to go home. They can’t help in the hospital and it’s a very bad place to be unless you need care. Too many infection exposures walking around a hospital from antibiotic overuse and very resistant bacteria in there. On the other hand I tell family members , don’t leave your loved ones alone. It’s a shame but speaking as an insider for 40 years , the nurses are understaffed with too many pts per nurse and too much time now is demanded documenting everything for reimbursement and legalities and following endless algorithms. Too much human touch and compassion is being drained. Even cleaning staff has been cut for profit. Been on both sides , dr and patient , and do expert work regarding malpractice both for and against hospitals etc,, so try to stay unbiased. IMO, It’s not safe to be left alone as nursing staffs are so stressed and burdened. As a family member , it’s your right to question what is being given to your loved one. It never used to be this way , certainly differs hospital to hospital. But hospitals are run now by ceos who expect profit , outcomes are monitored but too often secondary to profit, and this kills me and breaks my heart , but drs have lost control and need to retake their profession. If you are afraid of being fired because you want to give full consent and not just the hospital byline, how do you expect to be trusted and how do you sleep having sworn an oath to do no harm? Everyone , nurses , drs , all agree they want the best for their patients , yet they have bills , mortgages, etc and many have to do what the hospital or insurance dictates. So , IMO, best for the Bills players to be safe at home and keep strong with their faith and away from infection exposure. Hamlin is in the best hands in the icu /ccu. The nurses have always been great in the units! Less patients per nurse in an icu and they do the brunt of the care. One positive tho is now hospitals have hospitalists who are drs who only do care in hospital 24/7/365, so response to issues is just moments away.

I watched this. This guy is a very good pulmonary and critical care doctor. He did a very good job on this and also had very many good videos on covid issues. Very reliable young dr and utilizes social media well and YouTube channel is very good. Mixes humor in and is not loaded with technical jargon. Recommended viewing!

I really do understand your point , yet losing a grandparent ( having lost all of mine and my father. 96 year old mom was watching and cheering for Bills tonight!) is not as unexpected as losing a peer in your age group right in front of your eyes while playing the sport you do as well for a living. There is a difference. Josh unlikely was there as his grandmother passed ( I could be wrong , just my experience over the years ) and many grandparents have chronic illness etc. Possibly losing a younger peer , who you spend more time with than grandparents usually, is a very unexpected trauma. Just a thought. Not sure he will be ready to play lights out in this situation; may be very affected as many team men were crying , and extremely shaken just witnessing the resuscitation, let alone considering the possibility of him passing. He did dedicate the game to his grandmother and did play well. This type of thing makes you realize your own vulnerability though.

This could possibly happen. I am hoping /praying for the best , yet sometimes in medicine that doesn’t happen. It’s still possible we wont know for days his response or prognosis. Also. 9 min doing cpr is a very long time as brain injury begins around 3 min. We have no way of knowing how long he was with poor circulation and lack of oxygen to the brain. It is still possible to save the heart but not the brain; this means he might never regain consciousness. Of course we all hope he makes a full recovery , but it is possible he might not recover at all. I can’t see how a close Bills team could be allowed to emotionally grieve and be expected to play a football game this week. That is of course the worst case scenario, but it is still sadly a possibility. Unless he shows signs of recovering , I don’t see how they play after watching their appropriate reactions tonight. If his recovery is delayed or doesn’t happen , these are young,20 something year old men ( and for Dawson it could be a second loss in a very short period). Some may need time to even evaluate if they wish to continue playing football at all. I have a hard time imagining them playing this week unless everything suddenly goes right. If the worst scenario happens and he suffers brain death, how do you ask these guys to play? I just don’t see how they recover emotionally from that visible trauma either way to want to play football in 2-3 days; seems like too much to ask. It’s just my opinion tho. I think they deserve time, they are not robots and even mcd was shaken. I would just drop it or take the L and hope they can recover to play the Pats. Going out there unfocused might be just asking for more bad things. We will know more as time passes and you can’t rush this. It was a terrible injury, his heart stopped functioning, and only time will tell how his Brain will recover. You don’t just forget watching something like that and then go out to play the game that the injury occurred in as if nothing happened. If you have lost a loved one or family member , you can understand as nothing else matters for some time. The med staffs did a phenomenal job, yet that’s not always enough. Now we just have hope until reality plays out.

Time is critical for the brain. Each passing min is critical for saving heart and most importantly ,brain function and neural tissue. He was resuscitated immediately with the critical factor being the defibrillator used so fast. He was intubated quickly as well so oxygen delivery was recovered as quickly as could be expected. There is no exact way to tell from tv how long his oxygen levels dropped as basic cpr was being done. He got the quickest care and resuscitation possible , now it will be a matter of time to determine if he sustained any cns (central nervous system ) Or brain injury in that time. It’s a waiting game now to see how he responds once they begin taking him off sedating meds. They are used to rest the brain so it requires less oxygen as they suppress its activity and to rest muscle tissue to lower oxygen requirements and prevent agitation on the ventilator. They will eventually begin withdrawing the sedation to determine his responses like pupillary and other reflexes, and ultimately to determine if his breathing center in the brain responds and he begins breathing on his own. Right now the ventilator delivers each breath at a determined interval so currently he is on life support. As meds are weaned hopefully his own breathing center takes over and he can be weaned from the ventilator. So no way to exactly know prognosis right now. We can still hope for the best , but need time to assess how brain function was preserved. He may eventually have neurologists involved helping with those decisions.

The defibrillator is used to shock the heart back into a rhythmic beating , so it can effectively pump blood with oxygen to the brain, heart, and all organs. It is only used when the heart is beating in a non life sustaining rhythm or if it already stopped as in asystole. It does not stop the heart but synchronizes the electrical impulses so the heart chambers all contract as they do normally to be an effective pump. The heart has two types of tissue, muscle and electrical conducting tissues., but simply put , it is a pump and had to contract in synchrony to work as a good pump. Hope that helps.

With this arrest , it is pretty standard to be intubated so high concentrations of oxygen can be delivered and sedated to allow his brain to require less oxygen as it attempts to recover. You can have a heartbeat on your own or maintained with medications , but breathing on your own depends on the status of your nervous system. It will take time for them to know and assess his brain activity as we can assume there was some period of compromise while getting cpr. Right now he is given sedation meds to rest the brain and that lets it require less oxygen as it begins to recover /function. So far this is standard with an arrest. Time is important now and he is in a great hospital. Associated with med school and residencies I believe so that’s very good. Hope that helps.

I feel for you. He is in a teaching hospital so he is surrounded by icu/critical care nurses and most likely resident drs in addition to the lead or attending dr. If one ever suffers a cardiac arrest as he did, time is critical and other than arresting in a hospital, there is no place where action would have happened that quickly. Last tweet suggested his vitals are “stable “ and he is intubated on a ventilator and was sedated ( this is common using certain med so if he does wake up he doesn’t “fight” the tube in his trachea. ). Time will tell , but I am certain he is having neuro testing such as a baseline eeg to test for brain activity , ct probably and echocardiogram to evaluate his heart and aorta, and with time the meds sedating any function will be weaned to see how he reacts ( can he breath on his own or react to stimuli} to determine his prognosis. It’s a waiting issue now , he got great , the absolute best care. Cpr is done to preserve brain and heart tissue /function and we can only pray it was adequate to preserve as much function as possible. Great hospital, I almost did my residency there in family practice as I am from Ohio , but ended up training in Toledo Ohio. Teaching hospitals are.on the cutting edge of medicine , so now we can just add prayer nd hope. Might know more over next 24-48 hours but he is in great hands and I am sure God is there watching over all the family, team, and caretakers. Hope you can get some rest. Best wishes. Hopefully we see him leave and go home someday as we can hope for the best outcome.

You make some valid, great points ! I agree with your points and appreciate your thoughts. My only counter, that I hope is wrong , is Josh not playing up to his great talent. Absolutely love this guy as the Bills qb and driving force. I just believe he can’t make the mistakes like ints and fumbles that just don’t make sense for a really intelligent guy in his prime like he did against an inferior team like the Bears. . But like you said , the lines , the trenches.really dictate how he plays and that’s more often been an issue on the road. We have been forced to shuffle guys in and out and this is Cincys first o line disruption./.injury concern along that line , so they have a new experience to figure out. Hopefully we get something special from our d line as like you said we need to win the trenches. Both qbs have been sacked frequently. The pats had Cincy on the ropes but can’t ignore cincy was up the whole game and we once again came had to come from behind playing a team much worse than the Pats. If we can’t get to burrows, our dbs are prone to giving up chunk plays and Pi’s to elite receivers like Hill, Jefferson , Waddell., and these cincy wrs look pretty similar. Hard to ignore Joe hitting his wrs at almost 70% ( Josh at 63% I think) and I don’t see an advantage against them outside of poyers experience unless the refs allow Elam and Tre to be physical should the d line not get to burrows. Milano and Edmunds need to control inside the numbers. I don’t know the bengals dbs like you do ; so if our o line can protect Josh, he should not be committing turnovers like ints. If he doesn’t make those mistakes, he can take over the game and I like our chances a lot. Thx for the great points and hope on the road as I think this is a playoff atmosphere, and in past playoffs we are 0-3 on the road. This is a different Bills team tho and they seem to find ways to win, and this time they come in with a ton of playoff experience and they know this is actually playoff time. We go as Josh goes Monday and I’m hoping for his best playoff caliber performance. It’s time to control the afc and not return to KC !

Easy maybe to say with hindsight. Our OC/ qb have shown a reluctance to be patient with the run game , even in games with successful runs happening. I can see a d plan to defend the big pass play , which they did and don’t forget, Josh threw another two ints with one in the red zone yet again. We were trailing 6-7 at half , Diggs with zero targets in the half , is a highly successful strategy against a 11-3 team while you are 3-11 ! The ints weren’t a big deal against the worst roster in the NFL, but throw those pics against Cincinnati and lose two possessions to that offensive premiere trio of receivers and a qb completing just under 70 % of his passes , and it’s a recipe for disaster. We stayed patient with the run against a team who had no ability to make big plays against us. That was unusual for Dorsey, and even tho we didn’t pull away till late , he persisted running the ball with success. I agree with you that perhaps late in the game the Bears might have adjusted more against the run yet our history is we tend not to stick with the run game even when working. That was our best all around running game this season I think , so you have to give credit to dorsey for sticking to what worked. The Bears didn’t deserve to be in that game at all based on roster talent and that final score wasn’t indicative of the actual talent difference as we played a team with NO EFFECTIVE PASSING GAME! That’s why many analysts are on Cincy ; if our o starts slowly again, we commit drive killing penalties ( as Samford, Brown have been prone to do ) and Josh refuses again to stay patient especially in the red zone , we won’t get away with playing like we did against the Bears. Expect that same type of D , forcing Josh to be smart ( please , let’s not hear the post game “ I can’t do that “ , or “ I want that back “ ). So many were insulted by Cris Sims pointing out evidence of our inconsistency this year, yet when he talks about “ my boy blue” , they are all in with him. Fans only want to see or hear positives, but Sims was just pointing out there is a big difference in talent between the Bengals and Bears. Cincy will never be out of this game imo as unfortunately we are not a great sack producing team now unfortunately lacking Beans hand picked sack artist ; it’s a rough year for our d backfield to have hyde out with po less than 100 % , Tre still a step slow or at least less than 100% , Hamlin learning yet prone to taking bad angles , and Jackson / Elam not having a clear winner in their competition, and they struggle tracking the ball in the air as all the dbs ints have dropped off. So we can’t play like last week , but I don’t expect us too! This is the start of the playoffs really, and the team knows that. Josh has been 0-3 in the playoffs on the road and I think that finally changes as he lives up to his talent and plays knowing this is the road to the Super Bowl. If he doesn’t throw any picks , it tells me he was patient like he was against KC , and he is starting to peak! If he can just stay away from turnovers ( fumbles as well) we should have enough possessions to overcome our defensive backfield liabilities against a SB experienced , prior AFC champion QB , and that means we’re ready to compete for the Lombardi. Burrow seems to be doing lots of talking and I’m not sure that’s the best thing against this team that has a d line that might be dangerous if really motivated!

They did not have to make up anything , that whiplash of his head off turf, FOR A PLAYER ITH TWO KNOWN CONCUSSIONS IN A SHORT SPAN THIS YEAR BY VERY SIMILAR WHIPLASH INJURIES, ESP THE TEAMS REACTION TO THE MILANO HIT WHICH TRIGGERED ALL THE CONTROVERSY, is a simple observation IF THEIR OBSERVATION PEOPLE WERE PROPERLY TRAINED and as I said in a prior solution, they have enough observers for this type of speed and impact game. His head bounced with his occipital area slamming into the turf , exactly the mechanism involved with the Milano hit ! IF THE PROTOCOL was correctly done, he needed to be pulled into the tent or locker room after that hit and checked with physical and cognitive testing. IF THEY did do that, then I would say things worked as the algorithm is supposed too. He may not have had symptoms until the following day , but if they did NOT do the formal physical and cognitive exams required after the whiplash injury ( and the observers must know those who are higher risk as that’s one of the reasons for the protocol , to prevent second impact syndrome. Eg. Morse should be watched more closely than other line players , medicine is about assessing risk as it is not an exact science like repairing a car. Medicine HAS ALWAYS BEEN ABOUT RISK STRATIFICATION. WE CAN ALL AGREE AS another example a healthy childs risk of death from a certain virus approaches zero , while a 96 year old with co morbidities is unlikely to survive the same infection). One with prior similar concussions is at higher risk and so the threshold for exam is lowered and thats just basic medicine , Med student level type analytical taught processing. If they pulled Tua aside after the whiplash , then the system is working and it’s possible he was fine and later developed symptoms. I may Be wrong as I didn’t watch that whole game , but I was under the impression he wasn’t examined at all after that head impact , and was only placed in the protocol after self reporting symptoms the following day. This is about player health and you don’t do the protocol SOMETIMES. It’s with ANY observed impact that could cause a concussion and cognitive testing is part of that. If the NFL is stating THAT hit is not the type that needed follow up in a player with a recent history of concussions, I call BS and it’s just another example of inadequate preparation and training of observers and probably proof the observers are understaffed. Players have to also have skin in self reporting and there has to be documented poof they are being checked at intervals ( like half time for at risk players) or asking about symptoms DID NOT happen. The NFL protects THE NFL BOTTOM LINE , and they usually have to keep being dragged into progress fully.

Really good point. It is a good learning point. First , he is more at risk as you pointed out with 2 prior concussions THIS season. It shows things can develop after the hit as he self reported symptoms later. I’m not sure if he reported during the game or today and then was placed in the protocol, BUT HE COMPLETED THE GAME ! It does definitely prove the “ neurological spotter” missed the play and whiplash smack into the turf. For a multibillion dollar industry , this needs improvement. . I think it can be and the NFL can’t be cost conscious over safety issues with this. This game moves too fast and is stretched over a large area where head injuries can happen. With missing this obvious situation it has be proof that they have understaffed the observers whose job is solely to watch for head injuries. They have multiple refs because of the games speed and multiple areas of action , so the same thought process should apply for head injury observation. I admit I don’t know how many observers they use per game but it must not be enough, just knowing the NFL , they probably started with as few as possible. I think they need to at a minimum do something like this ; 1) just like they have a central area for reviewing calls in New York , they need to set up a bank of screens for medical reviews with someone devoted to each game ( assuming this isn’t already going on ) 2) set up observers who are constants for each venue , so they remove as much subjectivity and variation as possible ,and be sure these observers are taught , have a course they must pass every two years like cpr/ acls as a model. You need trained, certified observers. There are many physician assistants / arnp’s / nurses etc. who could do this for extra money or retired / disabled Drs who could be great for this. Whatever criteria they choose tho , I think some prior form of medical background would be helpful as experience counts. 3) they need to break the area to be observed into manageable quadrants. You can’t expect one observer to cover the whole field as the action point changes , for example on pass plays. The focus moves from qb to wr/ db area or wherever tackles will happen. If the observer shifts his view away from the qb to the wr , a late fall or hit on the qb is easily missed. Again, I don’t know if they already do this but if so , how did they miss Tuas head bouncing off the turf as it appears happened this week? The game moves so fast and they should break down the areas a certain observer is responsible for. For example. one would be responsible to always follow only the qb as they are at very high risk; another should be assigned to observe the line area , and then a third could be assigned to follow where ever the ball goes and evaluate the area where the tackles occur. This is just a quick thought and could be tweaked with football and neurological experts, but the point is there is no way to have just a single person responsible for evaluating multiple areas of contact that happen in a few seconds. This is a pretty inexpensive way to help protect players before someone dies and the NFL is sued again and forced to make changes. Plus you have the “ bank” of people watching each game in New York and it can’t be the same people reviewing penalties. You need a separate group who know medical issues, have training just as the refs do to perform their jobs, and this makes helps ensure safety for multiple medical issues addressed in a reliable , reproducible way. Plus as a corporation, you want liability protection and the current system seems inadequate. The final step I would do is if the NFLPA is actually concerned , they have to help, share liability risks as well. For example , I would devise a quick form with 5 questions on it that is given to each player , personalized with their name / number. Those questions are quick cognitive checks that can be checked off in a min at half time. One question , and you vary where it’s placed on the form weekly , could be something like are you having any new issues of concern that are new since the game started , like headache , nausea , dizziness, or new head injury that is affecting you , and do you feel safe returning to play? Tweak it with lawyers and neurologists and make it mandatory to complete before cleared for the second half. This would take under a min, but it would place some legal responsibility on each player as well so they can’t come back later and sue you for not having adequate protection against sending a confused or symptomatic player back out to play. This is standard in medicine , informed consent , and then if a guy wants to lie to still play, you at least have their own signed statement that they were ok and willing to continue playing. Have each player sign and date it at half time and collect , file each form. It would protect you from Tua , as an example, coming in the next day saying he reported symptoms but was ignored and sent back out. Just some thoughts in 10 min and I’m sure it could be improved but Tuas situation proves the NFL still needs their head trauma screening improved.