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


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6 hours ago, appoo said:

Truly truly amazing.

 

The fans, the media, everyone so far a has been amazing.

 

We need to keep pushing the NFL & The Bills to keep supporting Damar after all this energy naturally fades away. 
 

Football and sport has an outsized, positive impact on our lives and communities.  These men get well paid to do what they do, and make a choice to risk their health for this sport. Still, I think it still pales in comparison to the positive community energy they bring as a team. 

 

With that it mind, if Damar is unable to play football even again, then I hope the NFL & The Bills fully support him financially until he’s able to financially support himself. As a 2nd year, 6th round draft pick, he’s probably earned less than a million dollars in earnings after taxes. A substantial sum of money, but certainly not enough to cover living expenses and long term care in recovering from this in the years that follow.  And as a 2nd year player, he is not vested.  I understand that “everyday” and “working class” folks don’t get these benefits (I hate both phrases in this context but am left without a better phrase it’s become so collloqueal), but I would suggest that I - and anyone else in my field - don’t have the same power as these players to bring a community together, to uplift a community after tragedy, to help instill pride in a community, among the other positive aspects of being a Buffalo Bill. That matters. 
 

Given the massive cultural impact teams

make on our community, and the limited amount of players (about 2000 roster spots each year between the active roster and practice squad), and the amount of money these clubs gets from TV deals and all the other revenue streams, they need to be a lot more upfront in how they take care of players who get processed out of this league due to injury and health. 

 

I hope the NFL and the Bills support Damar for the rest of his life, for as long as it’s needed, for being a part of such a powerful cultural phenomenon, and almost dying for it

 

Or put this way, what other person in the Buffalo community that’s not a member of this team, would inspire a rally around the community event such as what we with Damar?

This was incredibly well written. 

3 hours ago, Houston's #1 Bills Fan said:

So, is Damar "Questionable" for Sunday? 🤪

Dolphins doctors are still examining his back injury. 

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3 hours ago, Georgia Bill said:

I'm not sure if you're joking or not.  Seriously, we should just be really glad with the progress he's making without speculating about his future playing football.  It's way too early for that.


Oh I wasn’t talking about playing. Just leading the charge like they do when they bring back former players to lead the charge.

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10 hours ago, GaryPinC said:

Thanks for the info and excellent reference.   I gather from the article that this type of echo is really needed to assess limitations of physical activity including assessing transient blood flow restrictions during exercise.

So I see where you're coming from with what may have caused the arrhythmia in this case.

I'm still left with my original question that isn't this degree of hypertrophy measurable with a routine echo, even when Damar was sedated?

Is the exercise echo is more of a secondary assessment?

I'm not a cardiologist; I'm a cancer doc.  I have an interest in hypertrophic cardiomyopathy (HCM) due to friends and family with the condition.

 

Traditionally, the diagnosis of HCM has been made based on trans-thoracic echocardiogram (TTE) findings.  A LV wall thickness of > 15 mm is consistent with HCM, while a wall thickness of 13 mm is borderline.  This is made all the more confusing by the fact that high level athletes often have functional increases in LV wall thickness thought to be due to training effects.

 

Functional (stress echo) testing can help make the diagnosis by eliciting a pressure gradient between the left ventricle and left ventricle outflow tract with exercise.

 

My colleagues tell me that cardiac MRI is a better (but more costly and time-consuming) way to diagnose HCM, and may be the wave of the future.  Supplemented with genetic testing.

 

Please note that all of this may have nothing to do with Damar's episode, which was probably commitio cordis (and I stress probably since no diagnostic information has been reported by his docs).

 

I have to admit that I'm a bit puzzled that there are zero reports of commitio cordis in D1 college or NFL over the past 50+ years.  Why Damar, and why now?

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9 hours ago, appoo said:

Truly truly amazing.

 

The fans, the media, everyone so far a has been amazing.

 

We need to keep pushing the NFL & The Bills to keep supporting Damar after all this energy naturally fades away. 
 

Football and sport has an outsized, positive impact on our lives and communities.  These men get well paid to do what they do, and make a choice to risk their health for this sport. Still, I think it still pales in comparison to the positive community energy they bring as a team. 

 

With that it mind, if Damar is unable to play football even again, then I hope the NFL & The Bills fully support him financially until he’s able to financially support himself. As a 2nd year, 6th round draft pick, he’s probably earned less than a million dollars in earnings after taxes. A substantial sum of money, but certainly not enough to cover living expenses and long term care in recovering from this in the years that follow.  And as a 2nd year player, he is not vested.  I understand that “everyday” and “working class” folks don’t get these benefits (I hate both phrases in this context but am left without a better phrase it’s become so collloqueal), but I would suggest that I - and anyone else in my field - don’t have the same power as these players to bring a community together, to uplift a community after tragedy, to help instill pride in a community, among the other positive aspects of being a Buffalo Bill. That matters. 
 

Given the massive cultural impact teams

make on our community, and the limited amount of players (about 2000 roster spots each year between the active roster and practice squad), and the amount of money these clubs gets from TV deals and all the other revenue streams, they need to be a lot more upfront in how they take care of players who get processed out of this league due to injury and health. 

 

I hope the NFL and the Bills support Damar for the rest of his life, for as long as it’s needed, for being a part of such a powerful cultural phenomenon, and almost dying for it

 

Or put this way, what other person in the Buffalo community that’s not a member of this team, would inspire a rally around the community event such as what we with Damar?

Man i love this. Im in Charlotte, and the ppl i talk to cant relate at all to me. 

 

So many "you cant come because theres a game on? watch it on youtube later"

"ill never get it, grown men blah blah"

"paid too much"

 

ive seen a ton of it in my life and its ramping back up.

 

"bills mafia" has been a great community, im pretty isolated in my state, and when im on the board and watching the games, i feel at home, community. 

 

so many ppl from all walks of life reach out to me when theres a good game, or bills news. idk certain ppl choose to avoid the sports community, and thats their choice, but it brings A LOT to me and the ppl i know

 

Hamlins literal miracle has helped me put my problems in perspective, its lead me into leaning back into my faith. i know im not the only one. Coach and the team culture is bringing a lot of ppl to God and putting a shared faith in the community. I know its silly, and it doesnt work like this but Coach deserves Christian of the year lollllllllll im kidding but serious too

 

/rant

11 hours ago, muppy said:

hey Beck I decided the next time I type Lamar instead of Damar Im sending 50 bucks to the Lamar Hamlin charity.  LOL  

 

🙃

Whos Lamar Hamlin? 😆

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41 minutes ago, pennstate10 said:

I have to admit that I'm a bit puzzled that there are zero reports of commitio cordis in D1 college or NFL over the past 50+ years.  Why Damar, and why now?

I'm not a doctor, but I did stay at a Holiday Inn Express last night. I believe the literature shows that commitio cordis has historically occurred in younger patients, possibly without fully formed rib cages. Does the fact that this has not happened to other players in college or the NFL after millions of hits lead you to consider that perhaps this will not be the diagnosis?

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19 minutes ago, KDIGGZ said:

I'm not a doctor, but I did stay at a Holiday Inn Express last night. I believe the literature shows that commitio cordis has historically occurred in younger patients, possibly without fully formed rib cages. Does the fact that this has not happened to other players in college or the NFL after millions of hits lead you to consider that perhaps this will not be the diagnosis?

 

As the physicians giving the press conference from UC noted, commotio cordis is a "diagnosis of exclusion" therefore, they will be carefully testing and ruling out structural and genetic causes before deciding that it's commitio cordis.  I had the impression that they're actually a little nonplussed that so many physicians are going on social media and beating (HA!) the commotio cordis drum.

 

It's certainly possible that the diagnosis will be something else, and if it isn't, it won't be for lack of doctors searching vigorously for another diagnosis.  The physicians treating Damar are not gonna be diagnosing based on the media and social media consensus.

 

I think you might be misunderstanding the literature just a little bit.  I linked a TBN article upthread about a college athlete from Lewiston NY who just suffered commotio cordis this fall.  He survived, thanks to his coach doing CPR and the presence of an AED.  I think he was 18. 

 

It's certainly rare, and only 25% of the diagnosed cases occur in people >16 - which means the fact that it hasn't happened to other Div 1 college and NFL players is not surprising and doesn't make it less likely that it happened to Damar.  Rare events do occur.

 

Your rib cage fully forms at a far younger age than kids playing sports that hurl projectiles with enough force to cause commotio cordis.  However, thickness of the chest wall (including muscles and fat) is thought to be a factor. 

 

The fact that participation in contact sports and sports involving forcibly hurled projectiles such as hockey pucks, baseballs, and lacrosse balls falls off quite a lot after HS has also been pointed to as a factor.

 

 

 

 

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6 hours ago, pennstate10 said:

I'm not a cardiologist; I'm a cancer doc.  I have an interest in hypertrophic cardiomyopathy (HCM) due to friends and family with the condition.

 

Traditionally, the diagnosis of HCM has been made based on trans-thoracic echocardiogram (TTE) findings.  A LV wall thickness of > 15 mm is consistent with HCM, while a wall thickness of 13 mm is borderline.  This is made all the more confusing by the fact that high level athletes often have functional increases in LV wall thickness thought to be due to training effects.

 

Functional (stress echo) testing can help make the diagnosis by eliciting a pressure gradient between the left ventricle and left ventricle outflow tract with exercise.

 

My colleagues tell me that cardiac MRI is a better (but more costly and time-consuming) way to diagnose HCM, and may be the wave of the future.  Supplemented with genetic testing.

 

Please note that all of this may have nothing to do with Damar's episode, which was probably commitio cordis (and I stress probably since no diagnostic information has been reported by his docs).

 

I have to admit that I'm a bit puzzled that there are zero reports of commitio cordis in D1 college or NFL over the past 50+ years.  Why Damar, and why now?

Maybe the protective gear has slimmed down to a point where this could happen. Both the shoulder pad being small enough to make a “sharp” impact and the chest plate thin enough to not absorb it better. It has happened with pucks and baseballs in the past. 

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9 hours ago, pennstate10 said:

I'm not a cardiologist; I'm a cancer doc.  I have an interest in hypertrophic cardiomyopathy (HCM) due to friends and family with the condition.

 

Traditionally, the diagnosis of HCM has been made based on trans-thoracic echocardiogram (TTE) findings.  A LV wall thickness of > 15 mm is consistent with HCM, while a wall thickness of 13 mm is borderline.  This is made all the more confusing by the fact that high level athletes often have functional increases in LV wall thickness thought to be due to training effects.

 

Functional (stress echo) testing can help make the diagnosis by eliciting a pressure gradient between the left ventricle and left ventricle outflow tract with exercise.

 

My colleagues tell me that cardiac MRI is a better (but more costly and time-consuming) way to diagnose HCM, and may be the wave of the future.  Supplemented with genetic testing.

 

Please note that all of this may have nothing to do with Damar's episode, which was probably commitio cordis (and I stress probably since no diagnostic information has been reported by his docs).

 

I have to admit that I'm a bit puzzled that there are zero reports of commitio cordis in D1 college or NFL over the past 50+ years.  Why Damar, and why now?

Thanks so much for sharing your knowledge and I'm sorry to hear it hits so close to home with loved ones.  I know I truly value my friends who are physicians and I can lean on in troubled health times.  I know your loved ones feel the same about you, it is an unequaled blessing to have physicians as friends and family looking out for you.  

 

I also wondered about  the rarity of commitio cordis in these sports and assumed a familial/genetic susceptibility.   But it's never been established, in part because it's so rare.  Literature theoriorizes that the bones and chest structure matures at the end of the teenage years to cut the incidents but who knows?

 

Thanks for the tip about pressure gradient between the LV and LVOT.  My group doesn't focus on hypertrophy but you never know.  

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14 hours ago, Chicken Boo said:

I'm just glad we're at this point.  Absolute best case scenario.  


I agree. I keep reading on all these all message boards about the Bills or Bengals getting screwed, seedlings, and whatever.

 

I am over here like “who cares”. A guy died on the field. His teammates watched. Find a way to play your best football and everything else will fall into place.

 

 

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12 hours ago, Sammy Watkins' Rib said:


Oh I wasn’t talking about playing. Just leading the charge like they do when they bring back former players to lead the charge.

Shady is leading the charge tomorrow.

 

I'm sure he'll be with the team in a couple weeks 

 

Also check out this scene from the stands. I'm sure this was going on throughout the stadium 

 

9 minutes ago, T master said:

🙌  Glory to God for answered prayers !! 

Seriously! The speedy recovery he is making is miraculous

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6 minutes ago, YoloinOhio said:

 

 

Gronk was on Kay Adams' pod cast and mentioned that he hadn't donated yet. And he asked her live how much money he should donate between 5-15k. He said he'd give whatever amount she said. And so Kay Adams was actually the one who suggested $6,900. Although she soon mentioned that she was just repeating what her producer was saying in her ear. 

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16 minutes ago, Motorin' said:

 

Gronk was on Kay Adams' pod cast and mentioned that he hadn't donated yet. And he asked her live how much money he should donate between 5-15k. He said he'd give whatever amount she said. And so Kay Adams was actually the one who suggested $6,900. Although she soon mentioned that she was just repeating what her producer was saying in her ear. 

Yeah, ok. It was pretty obvious watching the interview she wanted to be Gronked. 

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21 minutes ago, Motorin' said:

 

Gronk was on Kay Adams' pod cast and mentioned that he hadn't donated yet. And he asked her live how much money he should donate between 5-15k. He said he'd give whatever amount she said. And so Kay Adams was actually the one who suggested $6,900. Although she soon mentioned that she was just repeating what her producer was saying in her ear. 

 

She should have said $15k.

 

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12 hours ago, pennstate10 said:

I'm not a cardiologist; I'm a cancer doc.  I have an interest in hypertrophic cardiomyopathy (HCM) due to friends and family with the condition.

 

Traditionally, the diagnosis of HCM has been made based on trans-thoracic echocardiogram (TTE) findings.  A LV wall thickness of > 15 mm is consistent with HCM, while a wall thickness of 13 mm is borderline.  This is made all the more confusing by the fact that high level athletes often have functional increases in LV wall thickness thought to be due to training effects.

 

Functional (stress echo) testing can help make the diagnosis by eliciting a pressure gradient between the left ventricle and left ventricle outflow tract with exercise.

 

My colleagues tell me that cardiac MRI is a better (but more costly and time-consuming) way to diagnose HCM, and may be the wave of the future.  Supplemented with genetic testing.

 

Please note that all of this may have nothing to do with Damar's episode, which was probably commitio cordis (and I stress probably since no diagnostic information has been reported by his docs).

 

I have to admit that I'm a bit puzzled that there are zero reports of commitio cordis in D1 college or NFL over the past 50+ years.  Why Damar, and why now?

 

My first posted guess after Hamlin went down was HOCM, given the atypical mechanism of injury (not a projectile the the chest) for commotio cordis.

 

The latter would be a better diagnosis for his long term health as it denotes an otherwise normal heart with normal function.  One in a million hit causing v-fib, easily shockable rhythm. HOCM rules him out for any significant, pro level activity.

 

I thought most D1 schools screen top signings for HOCM though, with ECHO.  You would think NFL teams would make it mandatory before signing a contract.

 

 

   

 

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Beane is undisputed NFL Executive of the Year, correct? (Would be his second in 3 years).
 

Managing the countless moving pieces, player and staff emotional well being, and communicating as much as possible when appropriate, all with the entire world watching, with his standard of giving all credit to others, (sorry, lots of commas)… kudos to Brandon yet again. 

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51 minutes ago, Mr. WEO said:

 

My first posted guess after Hamlin went down was HOCM, given the atypical mechanism of injury (not a projectile the the chest) for commotio cordis.

 

The latter would be a better diagnosis for his long term health as it denotes an otherwise normal heart with normal function.  One in a million hit causing v-fib, easily shockable rhythm. HOCM rules him out for any significant, pro level activity.

 

I thought most D1 schools screen top signings for HOCM though, with ECHO.  You would think NFL teams would make it mandatory before signing a contract.

 

That's a really good question - what screenings do they do? (and also, intending no aspersions so college football fans please don't beat me, is Pitt a top program that would screen?  My friend's daughter went to a D1 school and they didn't screen her.

 

I had thought (and this is just chit chat with cardiologists during my mom's CHF diagnosis) that there was a bunch of work about detecting HCM by 12 lead EKG now.   This kind of thing, which was just published when my mom was being diagnosed

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344534/

 

The idea being that echocardiograms don't detect HCM before the heart muscle actually thickens, but they were able to pull out subtleties from the EKG that did.

 

I haven't kept up, and like a lot of research it may or may not have panned out in wider use.

 

I won't speak again what I feared it was.

Edited by Beck Water
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55 minutes ago, Draconator said:

 

Awesome 

Our guy Levi Wallace! And Edmunds brother 

True story about Levi I've said on here before.  A year or 2 ago in the off season he gave out his # on ig or Twitter and wanted ppl to text him.

 

I did and he called me back and we had a nice 5 minute convo. Great dude!

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24 minutes ago, JerseyBills said:

Awesome 

Our guy Levi Wallace! And Edmunds brother 

True story about Levi I've said on here before.  A year or 2 ago in the off season he gave out his # on ig or Twitter and wanted ppl to text him.

 

I did and he called me back and we had a nice 5 minute convo. Great dude!

The Edmunds family id great too.  Had the opportunity to meet them a couple times, just great people.  I hope we extend Edmunds this year.

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1 hour ago, Mr. WEO said:

 

My first posted guess after Hamlin went down was HOCM, given the atypical mechanism of injury (not a projectile the the chest) for commotio cordis.

 

The latter would be a better diagnosis for his long term health as it denotes an otherwise normal heart with normal function.  One in a million hit causing v-fib, easily shockable rhythm. HOCM rules him out for any significant, pro level activity.

 

I thought most D1 schools screen top signings for HOCM though, with ECHO.  You would think NFL teams would make it mandatory before signing a contract.

 

 

   

 

 

Penn State has had three players medically retire due to hypertrophic cardiomyopathy (HCM) diagnosed in asymptomatic players, in the past five years.

 

Two (one was a DB, one an OT) were high profile recruits that were diagnosed by screening (most likely a conventional echocardiogram, but this is an assumption) on arrival at PSU.  This makes sense to me, as high schools typically dont do any cardiac screening for athletes, so the first time D1 student athletes get cardiac screening is when they enter college.  

 

The third case is a bit more complicated.  Journey Brown played 3 years, and was considered a day 2 draft pick going into the 2020 season.  But, because of Covid and the threat of myocarditis due to Covid (not Covid vaccine, since this was in the days before Covid vaccine, think Tommy Sweeny who had Covid myocarditis), all PSU players had additional baseline cardiac testing.  It was during this second round of screening that the docs discovered that Journey Brown had HCM.  But he had played 3 years without any reported cardiac problem before the diagnosis became evident with a second round of testing.

https://www.espn.com/college-football/story/_/id/30299931/penn-state-journey-brown-retiring-football-due-heart-condition

 

HCM is a genetic condition that you're born with, but, as with many genetic conditions, the condition may become evident at different times in life.  

 

Why did the initial set of tests not discover HCM? 

 

The above notes are facts, but now I'm going to speculate.

 

My guess is that either he had a normal echo on enrollment at PSU, but that the disease progressed, such that a second echo now picked up the disease.

 

Alternatively, he may have had a borderline echo with the second echo, such that he was sent for additional testing.  He did in fact have an additional evaluation at Hershey Med Center (100 miles from PSU), where the diagnosis was made.  My guess is that Brown did indeed have additional tests, such as cardiac MRI,  stress echo, and molecular genetic testing to assist in making the diagnosis.

 

My guess, and this is speculation, is that NFL teams do screening echos on players.  But these initial screens arent perfect, as illustrated by Journey Brown's case.

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38 minutes ago, Beck Water said:

 

That's a really good question - what screenings do they do? (and also, intending no aspersions so college football fans please don't beat me, is Pitt a top program that would screen?  My friend's daughter went to a D1 school and they didn't screen her.

 

I had thought (and this is just chit chat with cardiologists during my mom's CHF diagnosis) that there was a bunch of work about detecting HCM by 12 lead EKG now.   This kind of thing, which was just published when my mom was being diagnosed

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344534/

 

The idea being that echocardiograms don't detect HCM before the heart muscle actually thickens, but they were able to pull out subtleties from the EKG that did.

 

I haven't kept up, and like a lot of research it may or may not have panned out in wider use.

 

I won't speak again what I feared it was.


this “machine learning” EKG is pretty interesting.  The issue becomes: a player is screened, it’s positive, they get referred to the Cardiologist for stress ECHO, etc which does not show hypertrophied.  Do they prevent the player from playing with a functional and structurally normal heart?

2 minutes ago, pennstate10 said:

 

Penn State has had three players medically retire due to hypertrophic cardiomyopathy (HCM) diagnosed in asymptomatic players, in the past five years.

 

Two (one was a DB, one an OT) were high profile recruits that were diagnosed by screening (most likely a conventional echocardiogram, but this is an assumption) on arrival at PSU.  This makes sense to me, as high schools typically dont do any cardiac screening for athletes, so the first time D1 student athletes get cardiac screening is when they enter college.  

 

The third case is a bit more complicated.  Journey Brown played 3 years, and was considered a day 2 draft pick going into the 2020 season.  But, because of Covid and the threat of myocarditis due to Covid (not Covid vaccine, since this was in the days before Covid vaccine, think Tommy Sweeny who had Covid myocarditis), all PSU players had additional baseline cardiac testing.  It was during this second round of screening that the docs discovered that Journey Brown had HCM.  But he had played 3 years without any reported cardiac problem before the diagnosis became evident with a second round of testing.

https://www.espn.com/college-football/story/_/id/30299931/penn-state-journey-brown-retiring-football-due-heart-condition

 

HCM is a genetic condition that you're born with, but, as with many genetic conditions, the condition may become evident at different times in life.  

 

Why did the initial set of tests not discover HCM? 

 

The above notes are facts, but now I'm going to speculate.

 

My guess is that either he had a normal echo on enrollment at PSU, but that the disease progressed, such that a second echo now picked up the disease.

 

Alternatively, he may have had a borderline echo with the second echo, such that he was sent for additional testing.  He did in fact have an additional evaluation at Hershey Med Center (100 miles from PSU), where the diagnosis was made.  My guess is that Brown did indeed have additional tests, such as cardiac MRI,  stress echo, and molecular genetic testing to assist in making the diagnosis.

 

My guess, and this is speculation, is that NFL teams do screening echos on players.  But these initial screens arent perfect, as illustrated by Journey Brown's case.


I agree he may have had evolved HOCM (back in the day in med school, we still threw in the “O” for Obstructive) since (if) he was screened for it

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13 minutes ago, Mr. WEO said:

this “machine learning” EKG is pretty interesting.  The issue becomes: a player is screened, it’s positive, they get referred to the Cardiologist for stress ECHO, etc which does not show hypertrophied.  Do they prevent the player from playing with a functional and structurally normal heart?

 

Again, way above my knowledge base,but if it's felt to have a genetic component, I would think genetic screening and from @pennstate10 knowledge, cardiac MRI as perhaps the most definitive test, would be next steps.

 

But that doesn't address your fundamental issue which seems to be: if the genetic screening is positive, but the functional diagnostic tests (stress echo, cardiac MRI) do not show current disease, do you keep them off the field?  And I can make arguments both ways on that.

 

I would think they would keep him from playing. 

Edited by Beck Water
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18 minutes ago, Albany,n.y. said:

I hope someone has a way for Damar to watch the Bills game on Sunday.  The TV in the hospital will be showing the Bengals game based on the 506 maps.  

Might be advised against watching the game.

AnxiousQuickDairycow-size_restricted.gif

 

Edited by The Wiz
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