GaryPinC

Nice. The author blurs the poster to limit the spread of misinformation and you decide therefore it isn't real. This is what makes me laugh when right wingers hold themselves up as some kind of intellectual compared to "mindless left wing sheep". Baaaaa, baaaaa, mindless right wing sheep.

Thank-you for acknowledging there are wackos on both ends of the political spectrum. You asked for any conservative source, and he provided them. Pretty much social-media based. But for you they are not major enough? "please provide a link to where any Conservative says that "they' have substituted a body double for Damar." Your words quoted. I (and he) have done that. Then you proceed to attempt to illegitimize the author, what is your point? The evidence is out there, is he playing it up a bit? Sure, but the evidence is there. You feel he didn't list enough specific sources? That wasn't the point of the article, go examine them yourselves. He's got a truthful point, no matter how you feel about him. Do you vet right wing sources also? Or are they infallible and only anyone reporting anything left of what you believe is the problem? It would be great if you actually applied intelligence equally, instead of feebly trying to dismiss the article. Wow, such a hypocritical response. Point the finger at yourself, and try to actually use some intelligent evaluation.

Social media at the top, websites at the bottom. Read the whole thing. https://www.yahoo.com/now/damar-hamlin-body-double-conspiracy-214838259.html

To that end, there's a very simple reality here. We have GOT to pressure Burrow and get him uncomfortable. DE's need to get after it and Frazier needs to come out of the gate with built in stunting and blitzing. Keep that banged up line and Burrow on their heels. He doesn't always have the greatest sense of the pocket and we need to exploit it.

My favorite part of Shady's article from the Tribune. Discussing the Jacksonville playoff loss in 2017: https://www.theplayerstribune.com/articles/lesean-mccoy-bills-fans-playoffs By the time we got on the plane to go home, my medication had worn off and my ankle had swollen back up. And I remember looking around the plane and thinking how much of a difference a week can make. Seven days earlier everybody was celebrating because it was New Year’s Eve and we had just made the playoffs. But that night, everything was different. It was just … quiet. We were scheduled to land in Buffalo around 1 a.m., the same time we had the the week before. And I remember thinking, Damn, if we would have won, I bet it would be the same as last week with all the fans there to meet us. If only we would have won…. After the plane touched down and we were rolling down the tarmac, I looked out the window. And that’s when I saw it. The Bills Mafia. Everywhere. Thousands of you. We all felt so bad that we had disappointed you. And yeah, maybe you were disappointed. But you were also proud. And you all showed up to let us know that. To show your support. To show love. That’s why I say: There’s nothing like Bills fans. Whether we’re winning or losing, you always have our backs. So thank you — for dealing with all the ups and downs … for being right there with us through all the adversity … for always sticking with us. That hasn’t gone unnoticed.

So, this is a really interesting story to me as a high ranking official is going off record about primarily Troy Vincent. In case you haven't, I strongly recommend reading the ESPN original article for better details: https://www.espn.com/nfl/story/_/id/35393227/how-bills-bengals-led-way-damar-hamlin-collapsed For me here are what I view as "facts" This person speaks entirely in first person about events, especially Dawn Aponte. They seem very closely tied to these situations. This person speaks about willingly forfeiting the game if needed. It was a team official, not an NFL person, ESPN person, or referee. This person really disparages Troy Vincent. "The league screws this s--- up because Troy Vincent screws this stuff up," the official said. "That's the wrong person in the wrong position at the absolute wrong time. ... He wants to be the hero, but he will never take accountability. That's him to a T." So for me, I think it comes from the Bills as they would have been the ones to forfeit if needed. Knowing how tight the FO is with their information, I believe this is Brandon Beane as the source. He can be a bit of a hothead as an old article references and this other quote about Aponte I can totally see him saying: " "Whatever crazy nonsense she was getting," the official added, "man, she held it. She held it strong." So, I think this source was extremely close to the situation which would be Beane, McDermott, Taylor, Aponte and the ref. If it came from the Bills, I think their management is such that it would be discussed and Beane would be the one to step up and take action. Some other interesting points was that DeMaurice Smith of the NFLPA talked to Goodell around 9:10 and recommended cancelling the game. Buck said they were putting out info about restarting for most of the entire hour and no one from the NFL called to correct them. Was Vincent trying to tell Goodell one story(players haven't decided) and the people under him another(get the game restarted)? Clearly the source's issue is with Vincent, and it sounds like there's a history there. I have no idea if Beane experiences align with this, but it is completely plausable that night. Why anonymous? Maybe it's a calculated game of chicken to put the info out to the public but force the NFL to deal with him and Vincent behind the scenes, instead of glossing things over and moving on. Is Vincent trying to extract retribution from those under him like Aponte? He switched sides and sounds like a very poor, duplicitous leader. Anyways, thanks to those who feel it came from Cinci and your reasons. Wonder where this one will end?

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.

Thanks, I appreciate the perspective and info. My mistake is looking at it as a individual/genetic susceptibility which I will correct and certainly it makes much more sense he can return.

Thanks, I'm not a doctor either but the ER doc I work with thought it at least appeared to be a classic example of CC with the way it went down. Certainly we don't know the cause yet, but I have trouble agreeing with your docs that CC recurrence would be an extremely low probability for a professional football player. If they don't have a way to prevent recurrence, I'd say end of career.

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?

That's interesting, I haven't read all the thread, is there a reputable source that he can play again if it is indeed commotio cordis? Routine hit to the chest on the T-wave upslope will induce a fatal arrhythmia. I would think that would be the end of his football career or is it somehow manageable?

Thanks for your input. I was curious, why would Hamlin need a stress echo to diagnose hypertrophy? If it had progressed to the point it contributed to the fatal arrhythmia on a routine hit, wouldn't it show up on routine echo wall dimensions and FS/EF measurements?

Thanks, this is a great summary. I only caught the end. I think HIPPA was a bit of a concern as they wouldn't go into specific tests like echo results and EF. Kind of surprised the questioner identified herself as a cardiologist and proceeded to ask those questions. Seemed a little classless and disrespectful of someone who should know the ins and outs of PHI, IMO.

Haha, I admit you can't see the back of their heads but those are most likely surgeon's caps and facing the proper direction. I like your take better though!👍

One of our ER docs was in today and I got to catch up with him. One of the smartest, analytical guys I know, around 60 years old. He felt from the film that it fits the profile of commotio cordis. He also mentioned UC Medical Center is a leader in neurological issues and couldn't be in better hands. Also, docs said Hamlin had ARDS (somebody page Mr. Weo) and that he was administered TTM (therapeutic hypothermia).

Thanks, that's a great source but I'm not sure if it's the standard of care (NIS) and how you quantify the moderate dysfunction, especially in Damar's case compared to time of discharge.

Yep, I can tell you from personal job experience that you can see the bluish color change back to flush or pink just by doing CPR. I definitely wanted to dovetail with others have said and encourage everyone to be CPR-certified. It could be the difference.

Great question, and I don't truly know the scope of what it means. Certainly critical autonomic functions and gross measures of brain activity/responsiveness. Physicians/neurologists would be best to answer this question.

F**king great news! My impression is lung damage/pulmonary edema is the driving factor now, which should be recoverable. 🙏 🙏 🙏

Not sure if you can even get sync to work with v-tach 😉

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.

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.

I work in cardiac research where we study rearrest and also reperfusion injury primarily to the brain. I am not a doctor or health professional, just a bench researcher. But a big part of our work involves animal models with clinical electrophysiologists and ER docs. I can offer some perspectives and hopefully will keep it from getting into the scientific weeds. The short answer to your question is the first cardiac arrest could cause multiple arrests, but it's truly an individual response. The second the heart stops, in some corners of the circulatory system blood begins to clot immediately raising the risk of stroke and a massive inflammatory reaction is initiated. The body quickly becomes hypoxic with reactive oxygen species (ROS) which damage DNA, RNA, proteins and can cause cell death. In Hamlin's case, one could easily surmise he quickly became hypoxic given the physical exertion of the game. Also keep in mind that just because you restore sinus (normal) rhythm doesn't mean the heart is beating normally. What usually happens post-arrest is despite the normal rhythm, electrical contraction(depolarization/QRS complex) is incrementally slowed(widened QRS complex) and relaxation (repolarization/T-wave) is usually a mess (ST elevation, elongated/elevated T-wave). At this point the patient can be very susceptible to rearrest. And this period can be as short as a couple minutes to nearly an hour in my animal model experiences. Anyways, from my perspective, putting an arrest survivor under therapeutic hypothermia is about mitigating and controlling the inflammatory damage while also slowing the metabolic processes and the heart to hopefully prevent more arrests. In terms of the brain, the inflammatory reaction compromises the blood/brain barrier, allowing blood and inflammatory cells into the brain to kill brain cells. The first 24 hours are critical as the damage and cell death will evolve over the next couple of subsequent days. Again, therapeutic hypothermia is crucial in arresting and limiting this damage. I was in disbelief that the ambulance waited even 1 minute to allow Damar's mother to ride along. Getting him to the medical center and started cooling is critical. I just thank God he didn't rearrest in that ambulance with his mom right there.

I'd put Swenson's at the top of the "luxury fast food burgers" and that's it. Reasonably tasty with some brown sugar added to the beef, they have a large variety of burger and drink styles. And fried mushrooms as a side. Bonus points there! People around Akron swear by them though. But thanks, if I'm ever down around Dover I'll look Blazin Burgers up. Best burgers: Milt's out in Moab Utah: https://miltsstopandeat.com/ You can choose between buffalo or beef and he locally sources as much as possible. Built-in quality in a small Diner. Best restaurant burgers: Back in the '90s, I always felt Ruby Tuesday really did a great job with Burgers. Haven't been to one in at least 15 years as they've died out a bit here in Cleveland. But these days any place that'll cook a legit medium rare is a contender.

I don't agree that Georgia brought their C game on defense, OSU was just that good. Kirby Smart even said post-game OSU probably should have won. Day was masterful at keeping them off-balance. OSU was equal to UGA last night, just unlucky. Michigan's performance (poor coaching and preparation) were more typical of why the Big10 under-performs and is disrespected. If Day moves forward coaching like this, I don't think Michigan wins 2 years in a row anymore. Harbaugh's coaching is not adaptable enough and lacks depth.