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DrPJax

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  1. 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
  2. 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!
  3. 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!
  4. 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 !
  5. 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.
  6. 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.
  7. 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.
  8. 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!
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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 !
  16. 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!
  17. 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.
  18. 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.
  19. It’s a nice , very competent accomplishment. But the bar or goalposts have changed. It’s a league geared now for the offense and really geared to passing with even an additional game. He is a great team player so far ( but if our OC keeps allowing him to be taken out of games , Like today with 0: receptions in the first half against arguably the worst roster in the league , while ending up with two targets and two receptions, a crazy concept as we never shut down other teams great receivers like Kelce , Jefferson, Waddell, Hill to that extent ) , yet he is having discussions with the head coach on the sidelines during the game and he is visibly showing frustration while running routes during the first half of at least two games , something is either wrong or it’s being done purposely prior to the playoffs to avoid showing the oC’s plans for him come playoff time so this Buffalo “ first” may not Be so special as time goes forward. Maybe it’s Dorsey playing “ chess” regarding his playoff hand , but Diggs complaining and his lack of targets sure seems real at the moment. Zero targets for a half against possibly the worst pass defense unit in the nfl seems pretty odd and several analysts commented on it as well. It’s even more odd when you are behind 6-7; to a 3-11 team at the half with home field and the division title on the line! You can say we are 12-3 all you want but thats like getting your knowledge of The art of war” from reading the cliff notes version ,: that’s a shallow dive into a deep pool of knowledge and then acting like you are now a scholar in warfare! Go into battle with Cincy or Kc with your cliff notes Offense and you are probably headed to an early , disappointing exit. Just paying attention to only the final 35-13 score is the same analogy; you missed a lot and. I guess a couple of garbage tds at the end means the o is really clicking ! Hey, I hope all is well and we trounce the Bengals and pats because if we can’t win home field now, we spent a lot and have waited for 5 years with Mcd and endured things like hail Murray, 13:seconds, losing to Jax and Houston in the playoffs and learned nothing from those experiences. That’s just not my opinion, check opinions from content creators and guys like thurm and tasker. Happy for Diggs , but he is here for a bigger reason and his latest show of frustration is either a real issue or he is on course for an Oscar rather than a Lombardi ! Hoping Dorsey is playing chess against checker players! The cincy game and playoff time will fill us in on the truth. Not really interested about individual records; it’s about the super bowl now and Mcd and Beane have said so. 😀
  20. Really ? Kind of a very biased , closed minded approach. I guess your point is if someone doesn't see a game as you do , come to the same conclusions as you do , then in your rather elite world , no one else can possibly be as gifted as you and absorb an “,entire “ leagues play because only you could possibly be that gifted? Is that your point ; did I get that right ? 😀 Of course only you can possibly have realistic expectations and pro players who offer criticisms can’t possibly interpret an entire league or analyze the Bills play as well as you , even tho they were paid professionals who did that as a career, right ? Do you watch any other content creators, for example Finas show, or ostroskis show, or network shows with coaches like Bill cower or with players from other teams and eras? You are saying ONLY YOU are capable of such complex thoughts and only your views are correct and appropriate, is that right ? I would hate to misinterpret that complex three or four sentence dissertation you just provided ! ( Btw, did you work on that as your thesis for your masters or phd graduate program? I think you are really on to something here, like page one or or two of your first children’s Novel, such as Dick and Spot went up the Hill to Football practice; or maybe Spot was just exploring the fine art of Fetching!). You wouldn’t want to forget that or have it slip away one morning before coffee! Interesting how all these other content providers and network programs pay “ professionals “for their “ opinions “ and see flaws like normal people , such as coaches would while analyzing a performance.and coach their teams and players to become better, much like McDermott does after every game. But hey, I guess he is just after the impossible and unattainable because he on only watches the Bills and can't possibky absorb the play of a whole league in the same perfectionistic manner as you can , even tho he gets paid millions for his evaluations and you get paid ???? ,,, or is it you pay to watch games? Maybe I misunderstood that Mensa intellect you are working with and unparalleled ability to grasp the intricate scientific concepts of ,,,,,,football ?😀 Is that right,,,,that highly intellectual game where it’s possible to skip college entirely to participate in a pro league or play a season or two in college while working on those difficult communications courses and degrees, in preparation for highly advanced careers like coaching in high school or maybe someday being a rare color analyst ( you know , those guys that seem to turn over about every year or two as the field advances so rapidly that you never see guys hanging around from decades like the 70’s ,,,,well except for men with vast.intellects like a Bradshaw , Collinsworth, Sims, and Boomer ? Yep , guys like you who can grasp a “Entire ” league who are so few and far between!) Wow, we sure are lucky to have you to watch an ENTIRE LEAGUE and interpret it correctly for everyone.! It’s a good thing you’re outside of “ the fans “ as you put it ,yet you have learned to speak their language and interpret their “ experience” ! What a blessing it must be to have such clarity of thought and expertise! Hey , maybe you are so superior at this that you could offer a paywall type of service as your opinion is such a valuable resource! Certainly many would fork over large sums to access your unique understanding of this intellectually challenging game , that is if you have enough spare time from all your other entrepreneurial endeavors! Keep watching that “ entire league “ for us and let’s see this great product and how it sells! I am honestly excited ,,,about as much as I would be for a lemonade stand run by a first or second grader in my neighborhood! I feel so unburdened now knowing someone is capable of watching the entire league and breaking it down for us lowly “ Bills only” fans, ( hey maybe that’s what that “ only fans “ site refers to , you know the one where these thirsty idiot teenagers pay with their parents credit cards to see things they never can approach in real life, just like Pro Football !) to grasp the ONE AND ONLY , SOLE CORRECT OPINION AND INTERPRETATION THAT ONLY YOU CAN BREAK DOWN WITH YOUR NFL “FAN LANGUAGE” INTERPRETIVE SKILLS ! Here’s a thought , why don’t you run that first edition past Fina and ostroski and cower because I am sure they want to get it right too! Its sad , they have misunderstood constructive criticism of teams and players for so many years , it’s almost like they made a career out of doing such a thing! Just in time to help them get started off on the right path in this approaching new year and right before they really need help interpreting the playoffs and whoa,,,the SUPER BOWL! Wow, I am really happy for them and I’m sure CBS AND NBC will get you immediate and unrestricted access to help them so they possibly can retain advertising dollars ! Haha, just kidding. ! I know you were being completely sarcastic as no one could really be that completely lacking in self awareness ! Good one ! Really had me fooled there for a millisecond ! Pretty creative comedy you created there! You take it easy and don’t get all stressed out now! Happy holiday season! 😂😂 Man, you really almost made me fire a neuron or two! Go Bills , and the entire league too ! 🎄😂👍
  21. True , it has been a difficult schedule. I think it’s fair to say going in at half 6-7 against a 3-11 team with no effective passing game is not how McD would like to see his “ championship level “ expectations met. Throw in another red zone int , a fumble that while not lost set up a fg , a missed fg and point after, several holding penalties , Diggs with 0 targets and Gabe losing concentration on more than one play, and that’s not a half you want to see before playing in Cincy next week. Throw in another int, where according to a former pro in Archuletta, it’s hard to figure where Josh was throwing the ball , Dorsey going away from a really successful run game while we were leading and that resulted in 3 straight 3& out series , and it just seems despite a great 12-3 record you are left thinking if these situations should repeat against a team with talent in the playoffs (clearly the Bears are the worst team we have faced this year), like KC for example , we might not overcome those lost possessions. We have a very talented team which makes it difficult to understand the periods that seem to happen in almost every game where the offense struggles ( i mean how do you have 0 targets to your #1 wr, as it’s rare to ever see the Bills shut out guys like Jefferson, Kelce, Waddle etc) and has to often come from behind when everything pregame points to what should be a team leading from start to finish , perfecting their identity on their way to playoff success. They have a fantastic 12-3 record , but if that’s all you ever pay attention too , it seems analogous to the cliff notes version rather than understanding the bigger picture the author worked so meticulously to entertain you with. It’s like having major surgery , getting a severe infection because something was left behind as the sponge count was off, but with the help of an infectious disease specialist the patient survives to go home , yet in reality something more serious is waiting down the road. 🤨 It’s been a good season so far but there is a bigger goal that everyone has finally not been afraid to talk about; this team has spent and been set up to win a super bowl. It’s goal was clearly stated from the beginning , get home field advantage and win a Super Bowl. So far those things are still attainable so that’s amazing and Is something to be thankful for. Three afc east titles in a row! It’s just when your all world qb still throws 2 picks , including one in the red zone whole throwing to McKenzie, who people in the shout box were shouting why is Josh throwing to a double covered guy who has struggled to catch even while wide open, it feels like we could be glossing over some issues. Maybe not tho; maybe it’s as simple as it’s just the “ regular season” , like practice to a guy like iverson! It reminds me of one year in undergrad and making the deans list, only a few days later to get a letter from the Dean sent to all who made the list that stated, “ I hope this achievement is a TRUE REFLECTION of your work and accomplishments this semester”! Lol, I felt a little insulted! Of course I deserved to make the list! Honestly tho, not every class I took was biochem or experimental surgery as there was a music history class thrown in there , kind of like playing the Bears! I hope todays win and 12-3 , is a true reflection of how great this team is ! Merry Christmas , Go Bills! 😊
  22. Lol. Dude spends more time flipping his hair than 90% of female Jag fans. The high humidity down here has resulted in several bad hair days and if you have to keep trying to find the right “:product” to maintain that trademark “ bounce” , its impossible to go head first or hurdle cuz he has to get ready to flip the “do” appropriately as soon as that helmet comes off on the sideline! I think he has finally found something that works as the hair flips perfectly now , and the helmet is coming off less now as drives are ending in the no split end zone (tm) and he is smiling now! ( air is cooler now and much less humid as well !) Its a breakthrough and he is the best coiffed QB in the NFL ( no frizz league) and he’s much happier with Urban no longer around confusing him with all those Blondes just asking for selfies! I’m a tad concerned he may wear out those cervical discs tho if that o keeps hitting the no split end zone and he may need to shorten that mop to avoid all the unavoidable high humidity effects when they are driving toward POOL END of the stadium! Soon there should be a new chain of Salons with the first one opening poolside here in our “ football” stadium! No distractions allowed in this football first Rebel Riviera! 👍
  23. Warner was a prototypical pocket passer who was immobile. Qb play has changed. Kurt is consistent in his pointing out flaws he always sees with Josh’s style of play. Even Rex Ryan said do not coach Josh “ down” ! Warner does not want to acknowledge his time has passed and I think he only believes his way is the correct way to play qb. I like Kurt , but his analysis of Josh is always the same , critical analysis and it’s tiresome. When did Kurt leap for a drive sustaining first down or run 50:yards? He also had three other hof guys playing with him, including Faulk. He is always critical of the Bills ; one must have critiqued his wife’s “ unique” hair styles at some point, as most women from the mafia at least look very feminine while having good football knowledge! Lol! Kurt needs to get rid of that dam Michelin coat he wears and accept Josh is the type of qb / athlete who will surpass Warner’s passing stats while also being a complete “ football “ player , not just a pocket passer. Some guys can’t accept someone being a superior athlete at their position, Kurt strikes me as that guy. It’s time for guys like him and Bradshaw to move on. The game has given them life changing wealth so like all careers , it’s time for new generational talent. Let’s see them succeed in other fields or just go enjoy your families. These networks hold on to stale talent and wonder why these pregame shows are criticized. There should be term limits for these old athletes who played in a different era , just like term limits are needed for politicians like the senate and congress as it has lead to the same ineffective bottom line. 😊🎄
  24. Most analysts are comparing us to offenses who are hard to stop when they get a viable third option. For example miami with their two wrs and now running backs / game ( btw even rexy and that group said that loss was on the fins coach for not calling runs on three critical third downs and they said the bills were out coached and game planned that night ! Also they see the bengals with chase , Higgins , and mixon as more dangerous than the bills current offense. It’s true. Josh / Diggs are superstars and hard to stop. We need that running back as opposed to knox to have a consistent run game to really close out games and make the o less predictable. Plus they were very critical of Mcd having been there over 5 years and not having stabilized the o line. Those are fair critiques , so don’t rip me. Beane / Mcd have to address theses issues as we have seen teams close the gap , and these people are even predicting cincy gets the 1 seed which would be no small matter.this year ! They do have injury issues now so that evens things a little. But while we have Josh , they do need to fix this o as it’s not as supportive for josh or as good as it COULD BE. We have the qb to be unstoppable and yes we lost three games by 8 points , but only one of those type losses in the playoffs keeps you from a Lombardi! We should not delude ourselves , this o is having problems and without Josh , we are an average team ( not my words , from Rex and Pats ex LB. ) Others noticing we were out coached by younger less tenured coaching staffs may be valid that our chance to be that dynasty we deserve to see while we have Josh , who we waited for over 17 years, could be being mishandled. I think they made fair points. A loss is a loss regardless of margin and yet we have the qb and the potential to be dominant. Buffalo shouldn’t waste this time , as we can’t not progress as the others may move past us. Mcd being a d minded coach , drafting that way, needs to re think how to be the best version of this team. Just opinions from others as we squeaked out a win Saturday. I love Mcd as the ciach to lead thus franchisee forward , but it is concerning watching first year guys compete already with his roster. I hope he and Beane learn you can dominate with this qb with a great offense and nit keep so focused on drafting so much defensively oriented !
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