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

[Big Turk]

46 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.  

 

 

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.

 

Those people are retiring for the most part after they already have Medicare for their insurance. NFL players are not retiring anywhere near Medicare age(well, except maybe for Brady and a few kickers/punters) and as such have much longer to go without health insurance.

[YoloinOhio]

15 minutes ago, HappyDays said:

Still no official update on his status unfortunately.

 

 

I don’t think they will get any updates from anyone at UCMC.

[Big Turk]

Update from the gofundme page:

 

Today by Damar Hamlin's Team, Team Member

We're simply awestruck by the level of support and generosity we've seen over the past two days. With over $6 million raised, this fundraiser has become an overnight reminder of the incredible nature of humankind. Your actions directly reflect the type of human Damar is himself.

As representatives of Damar, the team at Jaster Athletes posted the fundraiser updates and will work with the Hamlin family, The Chasing M's Foundation, and the GoFundMe team to ensure the safe delivery of funds.

Because the situation is evolving, we'll continue to communicate any updates on the fundraiser. We will also work with GoFundMe to email all donors with more specifics regarding the use of funds as those details are available. As you can imagine, this has been a challenging time for the family. We appreciate your understanding as we give them the time and space they need to focus on Damar's health first.

We're hopeful about Damar's future involvement in disbursing the incredibly generous contributions. We thank you again for your support and look forward to updating you along the way.

Edited January 4, 2023 by Big Turk

[Low Positive]

5 minutes ago, YoloinOhio said:

I don’t think they will get any updates from anyone at UCMC.

I'm sure that we'll get updates when they have something to report. Right now, they have very little to report.

[Chandler#81]

3 minutes ago, YoloinOhio said:

I don’t think they will get any updates from anyone at UCMC.

Agreed and I’m always leery of family members giving medical updates. Required a 2nd resuscitation at the hospital? A 24 year old super fit athlete with no prior condition died twice that night?? Seems unrealistic -especially so if the medical opinion that the hit caused the heart to be knocked off timing and stop..

[Steptide]

1 minute ago, Chandler#81 said:

Agreed and I’m always leery of family members giving medical updates. Required a 2nd resuscitation at the hospital? A 24 year old super fit athlete with no prior condition died twice that night?? Seems unrealistic -especially so if the medical opinion that the hit caused the heart to be knocked off timing and stop..

Wasn't that report from hamlins uncle? 

[Chandler#81]

Just now, Steptide said:

Wasn't that report from hamlins uncle? 

Read: family member

[Big Turk]

3 minutes ago, Chandler#81 said:

Agreed and I’m always leery of family members giving medical updates. Required a 2nd resuscitation at the hospital? A 24 year old super fit athlete with no prior condition died twice that night?? Seems unrealistic -especially so if the medical opinion that the hit caused the heart to be knocked off timing and stop..

 

It was clarified after by Jordan that there was only 1 resuscitation and that was on the field and they wanted to clear up any miscommunication by his uncle.

[CoffeeDrip]

2 minutes ago, Chandler#81 said:

Agreed and I’m always leery of family members giving medical updates. Required a 2nd resuscitation at the hospital? A 24 year old super fit athlete with no prior condition died twice that night?? Seems unrealistic -especially so if the medical opinion that the hit caused the heart to be knocked off timing and stop..

The big issue is that doctors aren’t generally great at communications. A lot of good communicators don’t really understand science. So things definitely get lost in translation between the medical personnel to the family and the family to each other etc. 

 

That’s why I think they need a single spokesperson. But obviously they have more pressing concerns. I don’t think anyone is being intentionally misleading or seeking something by speaking to the media, they just aren’t the right people to do it.

[stevestojan]

4 minutes ago, Chandler#81 said:

Agreed and I’m always leery of family members giving medical updates. Required a 2nd resuscitation at the hospital? A 24 year old super fit athlete with no prior condition died twice that night?? Seems unrealistic -especially so if the medical opinion that the hit caused the heart to be knocked off timing and stop..

UCMC just clarified that what the uncle said is incorrect and he “only” needed to be  resuscitated once on the field. 

[Big Turk]

 

That's my coach....*sniffle*...said with sunglasses on at a podium.

[Blank Stare]

Class act by Zac Taylor in his presser. 

[CoffeeDrip]

Just now, Big Turk said:

 

That's my coach....*sniffle*...said with sunglasses on at a podium.

Absolutely the best man to be leading this team right now.

[Toledo Bill]

2 minutes ago, Big Turk said:

 

That's my coach....*sniffle*...said with sunglasses on at a podium.

And I complain about how he uses timeouts. What a great leader!

[GaryPinC]

1 hour 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 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.

 

 

Thanks for all your input and feedback!  I definitely appreciate your ambulance perspective, but as a former EMT would you want the mom in there if things go south?

 

To answer your question, yes, but so, so much goes into it.   Things like myocarditis/pericarditis temporarily changes ERPs and sensitivity of the heart to arrhythmia.  

In Hamlin's case, young and in top shape, with no significant risk factors you would anticipate restoring sinus rhythm quickly and minimal chance of rearrest.  But we don't know what underlying genetic and environmental factors there were.  Immediate CPR is a big help also, but the longer it takes to restore sinus rhythm the odds you can't bring the person back rise precipitously.  My understanding from the docs is humans fall off the cliff of being able to resuscitate very quickly.  Just happy they got him back, 8 minutes is a fairly long time but they were doing CPR for most of it.

 

[Joe Ferguson forever]

58 minutes ago, Mr. WEO said:

 

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.

Not if he has ARDS.  Then improving oxygenation is very important.  Many other measurables could be important.  But it's true that without brain function, it doesn't matter.  Pray that his brain is ok.

[TheBrownBear]

4 minutes ago, CoffeeDrip said:

Absolutely the best man to be leading this team right now.

Given everything this team has been through, it's hard to believe he isn't given more consideration for Coach of the Year honors.  I don't think the national audience quite understands how trying this season has been for the Bills.

[HappyDays]

22 minutes ago, YoloinOhio said:

I don’t think they will get any updates from anyone at UCMC.

 

I saw a few journalists on Twitter say that the hospital was supposed to give an official update, but then the hospital came out and said there was no update to give yet. So there will hopefully be one at some point.

[YoloinOhio]

 

[SectionC3]

1 hour 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.  

 

 

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.

So then why do you care when someone on the players’ side complains about the health insurance provided by the league? I strongly suspect it’s going to be an issue in the next CBA.  It’s the right of the players to negotiate it.  I think they’ve earned it, and have for a long time.  

[iccrewman112]

26 minutes ago, YoloinOhio said:

I don’t think they will get any updates from anyone at UCMC.

that is because it is illegal for them to provide any updates.

[Mango]

1 minute ago, HappyDays said:

 

I saw a few journalists on Twitter say that the hospital was supposed to give an official update, but then the hospital came out and said there was no update to give yet. So there will hopefully be one at some point.

 

Not a doctor, so I am basically just guessing/hoping.

Hoping that since his breathing/O2 has improved they are letting his body decide when to start to bring him off ventilation and cooling. Maybe hoping his respiration can return to normal before waking him up? 

[34-78-83]

Just now, SectionC3 said:

So then why do you care when someone on the players’ side complains about the health insurance provided by the league? I strongly suspect it’s going to be an issue in the next CBA.  It’s the right of the players to negotiate it.  I think they’ve earned it, and have for a long time.  

retroactively too...

[YoloinOhio]

5 minutes ago, HappyDays said:

 

I saw a few journalists on Twitter say that the hospital was supposed to give an official update, but then the hospital came out and said there was no update to give yet. So there will hopefully be one at some point.

We just got one from the Bills, but that espn reporter is asking hospital reps directly for updates and that just isn’t going to happen. They will update the family and team and then it is up to them how/if they want to share. 

2 minutes ago, iccrewman112 said:

that is because it is illegal for them to provide any updates.

Exactly. 

Edited January 4, 2023 by YoloinOhio

[newcam2012]

3 minutes ago, TheBrownBear said:

Given everything this team has been through, it's hard to believe he isn't given more consideration for Coach of the Year honors.  I don't think the national audience quite understands how trying this season has been for the Bills.

This makes football so insignificant to me. I wanted that Super Bowl win so bad.

 

Now, I just want Damar to recover and function like a normal young man. 

 

I will watch the NE game on Sunday and thereafter. However, it just won't be the same w/o knowing if Hamlin is OK. 

 

Bills have the number one seed perhaps 2 and in the playoffs . Nevertheless, this season in a big way is lost for me...

[Greg S]

Just now, Mango said:

 

Not a doctor, so I am basically just guessing/hoping.

Hoping that since his breathing/O2 has improved they are letting his body decide when to start to bring him off ventilation and cooling. Maybe hoping his respiration can return to normal before waking him up? 

 

Last night on the NFLN they were talking with a doctor who specializes in these types of injuries. She said you typically won't get any updates for 24-48 hours and in that same time frame that is when they will slowly bring him off ventilation and cooling. 

[Herc11]

3 hours ago, Beck Water said:

 

 

Hi Herc,

I had that phrase in quotes because it was used in the post to which I was responding to.  I think the person in question was thinking of weaning off the vent, but unsure what exactly they meant and probably should have asked not quoted.

 

IF (and we don't know this) Damar Hamlin has been placed in a post-cardiac arrest hypothermia protocol, information on the interwebs from two major medical centers seems to differ from your corrections in terms of the protocol they use.

 

Johns Hopkins has a writeup explaining the treatment for patients and family:

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/therapeutic-hypothermia-after-cardiac-arrest  (which someone cited upthread) says the following:

 

University of Pennsylvania has a protocol online:

https://www.med.upenn.edu/resuscitation/hypothermia/assets/user-content/documents/TherapeuticHypothermiaProtocolforCardiacArrest.pdf

 

This protocol also mentions that the patient is maintained on sedation while being cooled, maintained in hypothermia, and rewarmed (Phase 1 2 and 3).  They use the term "sedation vacation" as you use "spontaneous awakening trial":

 

Last, a study in the New England Journal of Medicine comparing hypothermia to normothermia calls into question whether hypothermia has a benefit and there are several similar studies:

(possible benefit for out of hospital arrest with no bystander CPR, but this doesn't apply to Hamlin) and reiterates that the protocol is not used if the patient was conscious and responding to commands after pulse was restored (which in one interview, Hamlin's friend and marketing manager said he was at one point, prior to sedation and intubation). 

 

Again, the hypothermia protocol may not have been used, but if it was, the protocols and patient reference from two major medical centers appear to differ from your information/the protocol with which you're familiar, to say that gradual rewarming IS part of the protocol, and sedation vacations/spontaneous breathing trials are not used during hypothermia treatment.

 

In my experience, we do not gradually rewarm the patient. These studies may reference what you are speaking of. But doesn't really mean it is adopted as best practice or that all hospitals follow it. 

 

Also, I did state that you do not reduce the sedation at any point while the patient is being cooled. In fact we will watch to see if the patient is shivering. A paralytic is also used, Nimbex, to control shivering. Any time a paralytic is used the patient must be in a sedated state that is completely unresponsive. We use a scale called RASS, Richmond Agitation Sedation scale to determine level of sedation. For paralytic you want a RASS of -5 and you NEVER reduce sedation while the paralytic is running. Any attempts for an SAT are not until cooling measures are stopped and the patient is back to normal temps. 

 

Sedation vacation is different than a SAT. In a SAT the goal is to determine the patients responsiveness. Sedation vacation is typically just a reduction in sedation medications.

Edited January 4, 2023 by Herc11

[YoloinOhio]

 

[YoloinOhio]

 

[BigdaddyinOrlando]

20 minutes ago, Big Turk said:

 

That's my coach....*sniffle*...said with sunglasses on at a podium.

This man is as genuine and caring coach that we all are proud to be our coach and leader of this team!! And why this team will always run through a brick wall for him!!

[YoloinOhio]

 

[Mango]

7 minutes ago, YoloinOhio said:

 

 

 

Taylor and McD have cemented their tenures in CIN/BUF for as long as they want to be there. 

[YoloinOhio]

 

 

 

 

 

[The Frankish Reich]

13 minutes ago, Herc11 said:

 

In my experience, we do not gradually rewarm the patient. These studies may reference what you are speaking of. But doesn't really mean it is adopted as best practice or that all hospitals follow it. 

 

Also, I did state that you do not reduce the sedation at any point while the patient is being cooled. In fact we will watch to see if the patient is shivering. A paralytic is also used, Nimbex, to control shivering. Any time a paralytic is used the patient must be in a sedated state that is completely unresponsive. We use a scale called RASS, Richmond Agitation Sedation scale to determine level of sedation. For paralytic you want a RASS of -5 and you NEVER reduce sedation while the paralytic is running. Any attempts for an SAT are not until cooling measures are stopped and the patient is back to normal temps. 

 

Sedation vacation is different than a SAT. In a SAT the goal is to determine the patients responsiveness. Sedation vacation is typically just a reduction in sedation medications.

As I said to our other medical expert here: a sincere thanks. People want information (it’s a natural human reaction to a tragic event), and I’m glad we have people willing to share their expertise and experience. It is much better than relying on speculation and internet sources. 

[mannc]

20 minutes ago, iccrewman112 said:

that is because it is illegal for them to provide any updates.

Not illegal with proper authorization from the family.  I hate to say this, but the lack of any real information directly from the doctors is seriously concerning. 

[YoloinOhio]

 

[YoloinOhio]

 

 

[Herc11]

3 hours 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?

 

In my understanding, it is not about damage. It about the timing of the blow. If the blow occurs at the exact millisecond when the heart is in a specific point of the T wave it can disrupt the electrical signal causing arrhythmia, V fib. 

 

The same principal can occur when delivering a shock to restore the heart from certain arrhythmias. For instance, in v-tach or SVT before shocking you MUST use the "sync" button before delivering the shock. This allows the device to detect the rythtym and deliver the shock at the appropriate time. If it is not used and you deliver the shock during a point in the T wave, you can put the heart into v-fib which is worse than the rythym you were trying to correct.

 

In v-fib the heart is basically just quivering so the use of "sync" doesn't apply. 

[GaryPinC]

1 hour ago, Mr. WEO said:

 

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.

Is there one key moment?  I would say it's a series of them.  "Assuming normal lung function" is not smart after a patient had an arrested heart, been defibrillated, had CPR and is on ventilator.  To add to what Redtail Hawk posted, varying degrees of acute pulmonary edema is not uncommon in this situation.

 

Oxygenation coupled with CO2 levels confirms whether or not the lungs are properly exchanging and functioning.  That's pretty damn important.  

 

To take the patient off ventilator and see their breathing reflex (and autonomic nervous system) functioning normally is a huge moment in my little world.  You're not wrong that assessing overall brain function is very important but if the autonomic nervous system is compromised, well I've never allowed an animal patient make it back to consciousness.  There are different degrees to anoxic brain injury, many quite recoverable, but autonomic compromise is a dark indicator IMO.  

[Since1981]

35 minutes ago, YoloinOhio said:

that is because it is illegal for them to provide any updates.

Yup. What part of HIPAA doesn’t any modern adult (reporters) not understand? Hamlin’s  uncle + internship friend obviously acting as family comms people. And anyone with life experience also knows, major health recoveries are a slow process—not Twitter paced.