Josh Allen in concussion protocol: Update cleared 10/5

[TheFunPolice]

This might be a dumb question, but after a concussion is suffered, what has to "heal" for you to feel better?

 

Isn't the brain like pudding?

Edited October 1, 2019 by TheFunPolice

[YoloinOhio]

1 minute ago, TheFunPolice said:

This might be a dumb question, but after a concussion is suffered, what has to "heal" for you to feel better?

 

Isn't the brain like pudding?

They have to determine that he’s back to the baseline cognitive functions, which are recorded for each player in the preseason. If they do then they can start light activity and then football activity but any setbacks and they start over. 

[oldmanfan]

2 minutes ago, TheFunPolice said:

This might be a dumb question, but after a concussion is suffered, what has to "heal" for you to feel better?

 

Isn't the brain like pudding?

No.  The brain is living tissue with cells, blood supply, etc.  Concussion can affect and damage those so healing has to take place.

[Speedy Beebe]

2 hours ago, PromoTheRobot said:

 

Because they didn't want to negate the personal foul penalty, not realizing it was already negated by the holding call. I was at the game and saw Bills players pulling back their own teammates.

I could be wrong but I thought that I saw Ford go up to him but teammates corralled him back.

[TheFunPolice]

So is it blood vessels in the head? I thought brains didn't heal

[YoloinOhio]

3 minutes ago, Speedy Beebe said:

I could be wrong but I thought that I saw Ford go up to him but teammates corralled him back.

Yep it was Ford, the broadcast thought he was going to be flagged 

[RiotAct]

17 minutes ago, YoloinOhio said:

They have to determine that he’s back to the baseline cognitive functions, which are recorded for each player in the preseason. If they do then they can start light activity and then football activity but any setbacks and they start over. 

“Alright Josh, can you tell me where the free safety is?”

 

?

[DrPJax]

3 minutes ago, TheFunPolice said:

This might be a dumb question, but after a concussion is suffered, what has to "heal" for you to feel better?

 

Isn't the brain like pudding?

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

[CincyBillsFan]

Question for the docs posting, and thanks for sharing your expertise it's much appreciated.  What should we conclude, if anything,  by Allen running off the field to the locker room?  I would have thought if he was still "loopy" they would have had a trainer escort him rather then let him go on his own.  Should we be more or less hopeful that this was a minor concussion?

 

 

[PromoTheRobot]

16 hours ago, Gugny said:

 

Why were you not at Hammer's in the TBD area???

 

Because I had to be able to get out of Dodge quickly after the game. If I parked at Hammer's I'd be stuck in traffic longer. There's a lot on Southwestern that you can get of out fast. But I'm in for the Eagles and will park at Hammer's that game.

Edited October 1, 2019 by PromoTheRobot

[Bangarang]

7 minutes ago, DrPJax said:

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

[BillsFanM.D.]

1 minute ago, CincyBillsFan said:

Question for the docs posting, and thanks for sharing your expertise it's much appreciated.  What should we conclude, if anything,  by Allen running off the field to the locker room?  I would have thought if he was still "loopy" they would have had a trainer escort him rather then let him go on his own.  Should we be more or less hopeful that this was a minor concussion?

 

 

 

I don't think you can read much into it at all.  As noted, it's hard to predict how one might feel 30 or 60 minutes or a few days later.  Having said that, some common sense enters the equation:  Were he completely goofy and unsteady on his feet.....requiring assistance or even a cart to get to the locker room, I would not be terribly optimistic.  Every data point (including how he looks/acts immediately after) is a piece of information.  I view his 'running off' as a good sign.....but not proof of anything.  Much more 'data' already in hand for the team docs and more to come.  

[TheFunPolice]

10 minutes ago, DrPJax said:

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

Thank you! That makes a lot of sense.

 

 

[The Dean]

12 minutes ago, DrPJax said:

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

 

 

Excellent explanation, Doc. Well done. 

 

So does it mean anything that Josh looked fine going into the tent and while running into the locker room? He looked so good running to the locker room, at first I thought he was running out to come back into the game. It may mean nothing at all. But as I'm completely ignorant on  the subject, wouldn't a really bad concussion (I know there are no good ones) have left more short-term side effects?

 

 

Sorry I just saw BillsFanM.D.'s answer. But maybe you can chime in anyway.

Edited October 1, 2019 by The Dean

[DrPJax]

2 minutes ago, CincyBillsFan said:

Question for the docs posting, and thanks for sharing your expertise it's much appreciated.  What should we conclude, if anything,  by Allen running off the field to the locker room?  I would have thought if he was still "loopy" they would have had a trainer escort him rather then let him go on his own.  Should we be more or less hopeful that this was a minor concussion?

 

 

I think the only thing you can conclude is that the medical staff examined him and he was alert and able to respond correctly to the brief neurological exam done on the field at the time. For example, he was able to know where he was , situation , had short term recall ( like able to repeat three random objects or names back to the examiner ), and his basic neurological exam field side was normal. This is a very basic exam and is one point in time and has to be interpreted as such. Things can change as time goes on ; doesn’t mean they will but it is possible. So think of it as a Polaroid snapshot of his function right at that moment. That’s all that can be surmised. I was a little surprised he was not accompanied by someone just for legal purposes in today’s litigious environment. On the other hand there are so many people around he was really probably never out of the view of someone on staff. Hard to imagine a scenario where he was confused enough to just run off somewhere randomly without it being caught but you usually do see a trainer at least accompanying a player after that. He is a daredevil and may have taken off before they could keep up with him ! ?

[leh-nerd skin-erd]

16 minutes ago, DrPJax said:

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

Nice try with your neurons and resorbtions and oxygen content.  You didn’t mention anything about a bell getting rung, sawbones. What’s your name Pretond Uradoc, MD?   

 

(Thanks for the scoop-my son was concussed in HS, scary time.)

[DrPJax]

14 minutes ago, leh-nerd skin-erd said:

Nice try with your neurons and resorbtions and oxygen content.  You didn’t mention anything about a bell getting rung, sawbones. What’s your name Pretond Uradoc, MD?   

 

(Thanks for the scoop-my son was concussed in HS, scary time.)

Yep it is scary seeing a loved one go thru a head injury. Hope your son is well and never had further episodes. Funny story   I grew up in Ohio, trio state area around Pittsburgh pa, wheeling wva, and Steubenville Ohio ( home of Dean Martin of rat pack fame ).  So I was a huge skynerd fan growing up. So moved to jacksonville, Florida after getting done with Med training in Toledo, Ohio in 1985. So one night I am in a bar and there is Leon Wilkerson , bass player of skynerd partying at the bar. Introduced myself and ended up driving him to some other places that night. Man , no wonder these guys had short life span. Anytime I ran into him he was “ partying “ and people were always Buying stuff for him at bars. Later on I met Ronnie vanzants wife who opened a bar called free bird here in Jacksonville beach. I was able to have her become a patient and got to know her over several years. Also her daughter became a  patient and her daughter  was married to the original lead guitar player of shinedown. I was lucky enough to get to know him and his wife and they were all really neat down to earth people. Got to meet some other members of the various incarnations of the band over the years and they were all talented but humble people. Just a neat thing for a small town guy like me who grew up as a fan starting in high school, only to end up being fortunate enough to give back some to them with medical advice as I got older and moved to Jax where I never expected to end up!  Life is amazing and good and I will always be a rock fan till the day I am gone. It just boggles my mind that someday I would meet the guys who played on ONE FROM THE ROAD, after I had cranked that album so many times getting psyched for the weekend to arrive in small town rural Ohio !  Love your screen name and thanks for indulging me with my trip down memory road!  Go Bills! 

 

[Buffalo Barbarian]

Can we go the college route here and just go with targeting.

 

I think Jones intentionally went after Allen's head , but even if it wasnt intentional he should have been ejected.

 

Ejection is much more likely to reduce shots like this as penalties and fines have little impact on these types of plays.

 

 

[H2o]

2 hours ago, Buffalo Barbarian said:

Can we go the college route here and just go with targeting.

 

I think Jones intentionally went after Allen's head , but even if it wasnt intentional he should have been ejected.

 

Ejection is much more likely to reduce shots like this as penalties and fines have little impact on these types of plays.

 

 

I was thinking this yesterday as well. You start kicking guys out of games and costing them checks then things might actually change. 

[fansince88]

7 hours ago, DrPJax said:

Great question, not dumb at all!  Just imagine any bruise you have had in the past anywhere on the body. There is some leaking of fluid from damaged small blood vessels in the area of trauma. The bruise you see is actually from the breakdown of hemoglobin from red blood cells that have been leaked into the surrounding tissue in the area of trauma. Fluid leaks out of the blood Vessels as well ( fluid is predominantly within,the vessels as part of normal circulation ) and as the fluid leaks swelling occurs. The brain is somewhat unique because it sits on a closed space , the skull , and has little tolerance for the swelling as opposed to other non- closed areas of the body. As swelling occurs pressure increases. This presses on small neurons and causes them to have difficulty sending their electrical impulses or signals. Also the swelling compromises oxygen supply to Neurons and brain cells and which contributes to cells not firing like normally.  Symptoms like headaches, nausea , vomiting , confusion can develop in the area because of the cells not working normally. As time goes on and the blood vessels stop leaking and inflammation from the immune response subsides , the fluid is reabsorbed and normal pressure is reestablished and oxygen content returns to normal. Think of how a bruise color fades on your skin over time as the damaged red blood cells are broken down  and the swelling goes away. When this happens in the brain normal cell and neuron function returns and symptoms get better. So as edema , swelling fades , brain function and how you feel return to normal. Simplified explanation but I hope it helps. ?

So, you don't just play a Dr on a forum I suppose?