Damar Hamlin - Now (1/11/2023) discharged from Buf Gen & “recovering at home”

[EasternOHBillsFan]

27 minutes ago, OrangeBills said:

 

They just said this was not the case, he was resuscitated just the once on the field, at least that's the latest I've heard

 

Great news! Thank you

[jimmy10]

1 hour ago, CorkScrewHill said:

He is just one of those guys you expect will be back on the Bills on a veteran minimum contract to end his career

Back when the Vikes acquired Harry, I told a Vikes fan buddy of mine they got themselves a real one with that dude. This morning, same guy texted me that bit of news and said I was definitely right. 

[Bookie Man]

                  Keep fighting.

 

🙏 3 🙏

 

[NyQuil]

42 minutes ago, Beck Water said:

 

If the blow throws the heart into fibrullation is that due to muscle damage, or does the blow actually damage one of the nodes or bundles?  Because if the node itself is damaged in some way (bruised?) that might explain the repeated cardiac arrest?

To my knowledge commotio cordis does not result in actual physical damage to the heart tissue. 
 

During the repolarization of the heart there is a small time frame when some of the cardiac cells, but not all, are depolarized and can generate an impulse. If the cells are stimulated (from the trauma) when some cells are still depolarized this can result in a disorganized rhythm that will progress to ventricular fibrillation.

Edited January 4, 2023 by NyQuil

[LOVEMESOMEBILLS]

2 hours ago, Pete said:

can we keep this thread about Damar please.  Keep your agendas to another thread kindly.

 

"Fight on, my men,” Sir Andrew Said “A little I’m hurt but not yet slain. I’ll just lie down and bleed a while, And then I’ll rise and Fight again."

Fight on Damar! Rise again!

 

2 hours ago, thenorthremembers said:

Thank you.  Needed that this morning.

 

 The 2022 version.

 

The Buffalo Bills Rise & Fight Again(2022 Remake).

 

 

 

Edited January 4, 2023 by LOVEMESOMEBILLS

[Beck Water]

10 minutes ago, EasternOHBillsFan said:

 

I understand that you're not trying to be a smart ass, that's cool. However, the word was concerned.... not ANY speculation as to his condition or what it might be or anything like that based upon ANY sort of medical diagnosis.

 

It has been over 24 hours... so you are not concerned?

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

[Beast]

3 minutes ago, Beck Water said:

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

It seems as if we are now hearing of improvement from sources close to the situation.

[Beck Water]

1 hour ago, GaryPinC said:

I work in cardiac research where we study rearrest and also reperfusion injury primarily to the brain.  I am not a doctor or health professional, just a bench researcher.  But a big part of our work involves animal models with clinical electrophysiologists and ER docs.

I can offer some perspectives and hopefully will keep it from getting into the scientific weeds.

 

The short answer to your question is the first cardiac arrest could cause multiple arrests, but it's truly an individual response.  The second the heart stops, in some corners of the circulatory system blood begins to clot immediately raising the risk of stroke and a massive inflammatory reaction is initiated.  The body quickly becomes hypoxic with reactive oxygen species (ROS) which damage DNA, RNA, proteins and can cause cell death.

 

In Hamlin's case, one could easily surmise he quickly became hypoxic given the physical exertion of the game.  

 

Also keep in mind that just because you restore sinus (normal) rhythm doesn't mean the heart is beating normally.  What usually happens post-arrest is despite the normal rhythm, electrical contraction(depolarization/QRS complex) is incrementally slowed(widened QRS complex) and relaxation (repolarization/T-wave) is usually a mess (ST elevation, elongated/elevated T-wave).  At this point the patient can be very susceptible to rearrest.  And this period can be as short as a couple minutes to nearly an hour in my animal model experiences.

 

Anyways, from my perspective, putting an arrest survivor under therapeutic hypothermia is about mitigating and controlling the inflammatory damage while also slowing the metabolic processes and the heart to hopefully prevent more arrests.

 

In terms of the brain, the inflammatory reaction compromises the blood/brain barrier, allowing blood and inflammatory cells into the brain to kill brain cells.  The first 24 hours are critical as the damage and cell death will evolve over the next couple of subsequent days.  Again, therapeutic hypothermia is crucial in arresting and limiting this damage.

 

I was in disbelief that the ambulance waited even 1 minute to allow Damar's mother to ride along.  Getting him to the medical center and started cooling is critical.  I just thank God he didn't rearrest in that ambulance with his mom right there.

 

Fantastic post, Thanks!  So basically, any cardiac arrest/ROSC leaves the patient susceptible to re-arrest? 

 

But now we have reports that he did not re-arrest so that's great if true.

 

On the ambulance, I'll give my perspective as a former EMT which could be full of wind, but whatever.  I think the ambulance most likely waited because the emergency physician or one of the paramedics was performing a procedure, in consult with the trauma center, that was quicker and easier to perform while the ambulance was not in motion.  You know how using your cell phone is hella easier when you're sitting still vs. jouncing around a city street?  Yeah, That.  It's kind of an unusual situation BECAUSE there is an emergency physician and airway specialist and a broader range of equipment and drugs available to them at the stadium.  So the physician/paramedics could well have been in contact with the trauma center and they mutually decided to do whatever they paused to do vs. waiting 10-15 minutes to arrive at the Trauma Center.

 

It's my understanding that since Kevin Everett and Ryan Shazier's injury, the NFL is "all in" on hypothermia treatment.  They reportedly started an IV - I'm told that chilled IV fluids are now maintained at Pittsburgh stadium, so quite likely elsewhere as well - and they could well have packed him in cooling packs or ice to start hypothermia, stadia most certainly are supplied with ice and blue ice packs.  They might even have paused to do this before heading for the ER.

 

Sal C reported that Damar's mom was on her way down while he was still on the field, standing behind the Bills bench saying "I want to be with my son" and he summoned Dane Jackson who got the attention of the Bills Chaplain, and they then worked with security to get her on the field ASAP.  I think she just got down to the while the ambulance was still there so they put her in, and if the ambulance had been ready to leave before she got there it would have left and security would have put her in a car and followed.

 

 

Edited January 4, 2023 by Beck Water

[Silvercrw]

16 hours ago, Silvercrw said:

I have been a board member since 1996-97 and injury to Hamlin as truly shook me. I am also am a Youtuber/filmmaker with multiple channels and I could not, not make this video. I also spoke about this board and inserted a message from one of you. Hope you guys like it.https://youtu.be/TdNUwWx7ums

Crazy as a forum lurker mostly since 1995-1997 I still don't know how to embed vids lol

[Dillenger4]

2 minutes ago, Beck Water said:

 

Fantastic post, Thanks!  So basically, any cardiac arrest/ROSC leaves the patient susceptible to re-arrest?

 

But now we have reports that he did not re-arrest so that's great.

"But now we have reports that he did not re-arrest so that's great."

That is great 100% - but the report specifically said he did not resuscitate "on the field". Very easily could have in the ambulance or the hospital later. None of us know. But I'm sure, very sure, his uncle knows and would not make that mistake. Saying it happened twice.... Hope for the best for Damar!!!

[Warriorspikes51]

2 minutes ago, Dillenger4 said:

"But now we have reports that he did not re-arrest so that's great."

That is great 100% - but the report specifically said he did not resuscitate "on the field". Very easily could have in the ambulance or the hospital later. None of us know. But I'm sure, very sure, his uncle knows and would not make that mistake. Saying it happened twice.... Hope for the best for Damar!!!

 

It was clarified this morning from his family spokesperson that there may have been miscommunication and he was resuscitated once, not twice 

[Big Turk]

8 minutes ago, Silvercrw said:

Crazy as a forum lurker mostly since 1995-1997 I still don't know how to embed vids lol

 

Just copy and paste the link if it's youtube.

[Fan in Chicago]

1 hour ago, stevestojan said:

I am truly impressed with the number of medical professionals, those is the field of science, and other relevant experts we have on this board. Thank you all for your unique perspectives. 
 

(re-read this and it sounded sarcastic. It’s not, I really appreciate the knowledge sharing). 

Agreed. As we wait for news on Hamlin, understanding the medical aspects of his injury, treatment have been beneficial to me.

Shoutout to people like @Herc11, @GaryPinC, @Beck Water @DrPJax and other knowledgeable folks I may have missed. 

 

Get well, Damar !! 

[Ethan in Cleveland]

27 minutes ago, NyQuil said:

To my knowledge commotio cordis does not result in actual physical damage to the heart tissue. 
 

During the repolarization of the heart there is a small time frame when some of the cardiac cells, but not all, are depolarized and can generate an impulse. If the cells are stimulated (from the trauma) when some cells are still depolarized this can result in a disorganized rhythm that will progress to ventricular fibrillation.

This is true.  However the arrest itself and the subsequent CPR can result in heart injury from hypoxia and physical damage to the sternum and rib cage.  It's not liek TV. CPR is violent and broken ribs is not uncommon.  

A cardiac contusion which is different and is actual injury can occur from blunt trauma but usually a different mechanism. Think Jeremy Renner and MVA type accidents not baseballs hitting the chest at just the wrong time.  

[JohnBonhamRocks]

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

[Draconator]

1 minute ago, JohnBonhamRocks said:

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

There have been quite a few of those donations. Winners of Fantasy Football leagues are donating their winnings to the charity. 

[JGMcD2]

2 minutes ago, JohnBonhamRocks said:

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

A couple of leagues I am in are working through how to handle everything and that’s the conclusion being reached in all of them. 
 

Pretty cool others are doing the same. 

[Beck Water]

1 hour ago, OrangeBills said:

 

They just said this was not the case, he was resuscitated just the once on the field, at least that's the latest I've heard

 

Can you share where you heard this?  Who is "they"?

[SDS]

1 minute ago, Beck Water said:

 

Can you share where you heard this?  Who is "they"?

it was a quote from his marketing agent. However if you actually read the text he says he was only resuscitated once “on the field“. No one was ever claiming differently.

[EasternOHBillsFan]

27 minutes ago, Beck Water said:

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

 

I guess there is a difference between being OVERALL concerned and being concerned over grave complications... I just didn't think it was productive to quibble over something that isn't that important because we are ALL concerned. It's all good, I get your point.

[appoo]

Still the key moment is going to be how his body responds to being taken off the ventilator and how much it can operate on its own and his neurological functioning as they bring him out of sedation. 
 

Him needing less oxygen is optimistic about his bodies ability to operate on its own though

[Beck Water]

9 minutes ago, Fan in Chicago said:

Agreed. As we wait for news on Hamlin, understanding the medical aspects of his injury, treatment have been beneficial to me.

Shoutout to people like @Herc11, @GaryPinC, @Beck Water @DrPJax and other knowledgeable folks I may have missed. 

 

Get well, Damar !! 

 

Thank you for saying this.   I do understand that some people don't want to wade through technical discussions on the thread.  I think most of them arise because people re-tweet or bringing in numbers I don't think are consistent with the current state of the medical art, and then we get into Brandolini's Law

 

Anyway, I go back and forth about if I say something am I just annoying people, it's good to have the perspective "yes, but other people find it helpful"

 

We all cope with grief and fear in different ways.  Some of us pray most effectively with tools in our hands, and in this case information is a tool.

[Scott7975]

23 minutes ago, Silvercrw said:

Crazy as a forum lurker mostly since 1995-1997 I still don't know how to embed vids lol

 

YouTube videos and Twitter tweets you can just paste the website link and it should do it for you

[Big Turk]

3 minutes ago, SDS said:

it was a quote from his marketing agent. However if you actually read the text he says he was only resuscitated once “on the field“. No one was ever claiming differently.

 

His uncle yesterday in an interview actually stated that he had to be resuscitated twice, once on the field and again at the hospital.  Jordan then cleared up there was some miscommunication by him and that he actually only need to be resuscitated once.

Just now, Scott7975 said:

 

YouTube videos and Twitter tweets you can just paste the website link and it should do it for you

 

Mobile tweets, just make sure you space away from the link...for some reason if you don't do that it will just post the link and not embed it...figured that out only yesterday

[Beck Water]

21 minutes ago, Dillenger4 said:

"But now we have reports that he did not re-arrest so that's great."

That is great 100% - but the report specifically said he did not resuscitate "on the field". Very easily could have in the ambulance or the hospital later. None of us know. But I'm sure, very sure, his uncle knows and would not make that mistake. Saying it happened twice.... Hope for the best for Damar!!!

 

I'll just put out here from personal experience - the adage "a lie (or misunderstanding, or misinformation) travels around the world before truth has a chance to put on her shoes" applies in emergency medicine as elsewhere. 

 

Doctors and nurses who are focused on saving a patient's life are understandably not the best communicators to relatives.  One layperson relative is not the best communicator to another relative.  In situations where someone close to me has required emergency care, I've been told things by an LPN relative that didn't make sense, and then received different information when I had a chance to speak to the physician. 

 

It's not deliberate, it's just the old "game of telephone" where things get altered as they're passed along.

 

 

[ALLinALLEN]

Looks like they re-stocked all the sizes for Hamlin jerseys on fanatics website.

 

I went in and got me one after I heard all proceeds were going to his charity. 

 

Praying for 3

[Cotton Fitzsimmons]

16 hours ago, Silvercrw said:

I have been a board member since 1996-97 and injury to Hamlin as truly shook me. I am also am a Youtuber/filmmaker with multiple channels and I could not, not make this video. I also spoke about this board and inserted a message from one of you. Hope you guys like it.https://youtu.be/TdNUwWx7ums

 

Fantastic work! I haven't been able to bring myself to post, since I sat in front of the TV Monday night in stunned silence. I still feel unbelievably numb over this whole tragedy. Like all of us, I'm just hoping to get more good news about Damar today. This video sums up the feelings and puts things into a perspective that I am sure so many of us have. Thanks for making this!

[Mr. WEO]

1 hour ago, Big Turk said:

 

Very few jobs take the type of physical toll football does on their body.  

 

Far more people in this country have far more physically demanding jobs that are more dangerous and detrimental to their long and short term health than pro athletes.  Most take these jobs because they don't have the opportunities/choices afforded elite athletes.  For their efforts, these people get a modest paycheck and no post retirement healthcare.  

 

1 hour ago, SectionC3 said:

The majority don’t retire as millionaires.  And, the majority don’t retire in a traditional sense.  They just stop playing football and move on to other vocations. 
 

Nobody has a problem asking these guys to take some Toradol on any given Sunday. So nobody should have an issue asking the league and its teams to buck up for medical care.   

And, define free. In my view, guys like Darryl Talley, for example, earned that health insurance in the field.   The fact that the payments are made after their ability to compete has ended makes no difference to me. 

 

They do---for 5 years after retirement. 

 

The "average NFL career" is frequently cited as 3 years---but that includes anyone who got a single check from an NFL team at any time....so that includes a lot of "camp fodder"--guys who never make a roster (and rarely take a big hit in a game).  But we are talking about guys who at least are on an active roster for several years--these are the guys who are being exposed to the big hits--not the PS guys. 

 

Talley made at least 5 million from the Bills/Falcons/Vikings (plus the Bills payed him in the range of 50-100K for years to be one of their "legends").  That was pretty good money in the 80's-90's.  Easily could have stashed away a chunk for his later years.  Now apparently the money is gone.  Some years ago, there was a online fund drive (disclaimer:  I donated) when the story of his recent health struggles was published.

 

The point is that every players knows exactly what they are getting into from college ball to the NFL, as far as risks to their health.   They negotiate how much they are going to be payed to subject themselves to this risk.  They also know that, like nearly all nonmunicipal unemployed/retired adults under 65, that at some point their employer will no longer be paying for their healthcare.  They can't then, after leaving the game, complain that years later the NFL isn't paying for their health care needs, or that they "earned" something they were never due.  That's not how it works.

[Beck Water]

18 minutes ago, SDS said:

it was a quote from his marketing agent. However if you actually read the text he says he was only resuscitated once “on the field“. No one was ever claiming differently.

 

I'm pretty sure Hamlin's uncle was interviewed and said he had been resuscitated again at the hospital.  Pretty sure that's been reported a couple times up thread.

So now it's being said that was a misunderstanding, which happens, and great news, but also explained by a couple of people here why that would not be medically unexpected if it did happen.

 

 

Edited January 4, 2023 by Beck Water

[SCBills]

Harrison Phillips picked up the dinner tab for Damar Hamlin's family, the Bills training staff and the doctors/nurses at the hospital. 

 

Everyone who becomes part of this organization, whether here or moving on elsewhere, just seems to "get it".   A testament to the organization, the culture and the type of people they bring in. 

 

 

Edited January 4, 2023 by SCBills

[Haslett_Stomp]

3 minutes ago, Beck Water said:

 

I'll just put out here from personal experience - the adage "a lie (or misunderstanding, or misinformation) travels around the world before truth has a chance to put on her shoes" applies in emergency medicine as elsewhere. 

 

Doctors and nurses who are focused on saving a patient's life are understandably not the best communicators to relatives.  One layperson relative is not the best communicator to another relative.  In situations where someone close to me has required emergency care, I've been told things by an LPN relative that didn't make sense, and then received different information when I had a chance to speak to the physician. 

 

It's not deliberate, it's just the old "game of telephone" where things get altered as they're passed along.

 

 

 

My family and I experienced this first hand during the experience with my father that I relayed last night.  We received different messaging from the Neurologist and "head ER doctor" (in quotes because I don't know the proper terminology).  They actually went into a room and we could hear them yelling at each other before they came out and provided an update.

[Mr. WEO]

17 minutes ago, appoo said:

Still the key moment is going to be how his body responds to being taken off the ventilator and how much it can operate on its own and his neurological functioning as they bring him out of sedation. 
 

Him needing less oxygen is optimistic about his bodies ability to operate on its own though

 

Unfortunately oxygenation isn't an indicator of much.  Assuming normal lung function and adequate cardiac output, he should have little difficulty oxygenating on the vent. The key moment isn't taking him off the vent.

 

There aren't necessarily going to be "good/improving numbers" in this scenario, unfortunately.  All that matters is what will be his mental status as the hypothermic therapy and sedation are stopped.  His heart can, right now, be fully back to baseline (no doubt he's had at least one echocardiogram since he went down)--the issue is did he suffer an anoxic brain injury before spontaneous circulation was restored in the filed.

[CoffeeDrip]

Honestly I think the family would benefit from designating a spokesperson officially and saying “if it doesn’t come from x individual please don’t report it, it isn’t official”. 
 

I think everyone means well in trying to get us updates but I’m of the opinion that there are too many cooks in the kitchen, so to speak. We all want news but in the end who is correct? 

[YoloinOhio]

 

 

[Mango]

Looks like Taylor took the initiative to close the game out for the Bills. 

Classy move. 
 

 

Edited January 4, 2023 by Mango

[Fan in Chicago]

37 minutes ago, Beck Water said:

 

 

Anyway, I go back and forth about if I say something am I just annoying people, it's good to have the perspective "yes, but other people find it helpful"

 

We all cope with grief and fear in different ways.  Some of us pray most effectively with tools in our hands, and in this case information is a tool.

If it's fact based, and relevant to the Hamlin injury, keep the information coming. Let the reader decide what to read or not. 

Much appreciated

[Bob Jones]

26 minutes ago, Mr. WEO said:

 

Far more people in this country have far more physically demanding jobs that are more dangerous and detrimental to their long and short term health than pro athletes.  Most take these jobs because they don't have the opportunities/choices afforded elite athletes.  For their efforts, these people get a modest paycheck and no post retirement healthcare.  

And a lot of them do it every day, every week, all year long, for many years, or even decades. Great post, btw.

[HappyDays]

Still no official update on his status unfortunately.

 

 

[CoffeeDrip]

4 minutes ago, Bob Jones said:

And a lot of them do it every day, every week, all year long, for many years, or even decades. Great post, btw.

A lot of ‘normal’ jobs come with risk - I’ve had a second cousin killed by road maintenance equipment on the job, had a distant relative killed by a falling equipment part on the job, and a kid I went to high school was crushed in a factory accident and permanently paralyzed. People don’t think about it much, unless they’ve been directly impacted. The risk isn’t mitigated with a huge paycheck like athletes get or with the “hero” status given to police, firefighters etc. But it’s still there.

[loyal2dagame]