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

[EasternOHBillsFan]

27 minutes ago, OrangeBills said:

 

They just said this was not the case, he was resuscitated just the once on the field, at least that's the latest I've heard

 

Great news! Thank you

[jimmy10]

1 hour ago, CorkScrewHill said:

He is just one of those guys you expect will be back on the Bills on a veteran minimum contract to end his career

Back when the Vikes acquired Harry, I told a Vikes fan buddy of mine they got themselves a real one with that dude. This morning, same guy texted me that bit of news and said I was definitely right. 

[Bookie Man]

                  Keep fighting.

 

🙏 3 🙏

 

[NyQuil]

42 minutes 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?

To my knowledge commotio cordis does not result in actual physical damage to the heart tissue. 
 

During the repolarization of the heart there is a small time frame when some of the cardiac cells, but not all, are depolarized and can generate an impulse. If the cells are stimulated (from the trauma) when some cells are still depolarized this can result in a disorganized rhythm that will progress to ventricular fibrillation.

Edited January 4, 2023 by NyQuil

[LOVEMESOMEBILLS]

2 hours ago, Pete said:

can we keep this thread about Damar please.  Keep your agendas to another thread kindly.

 

"Fight on, my men,” Sir Andrew Said “A little I’m hurt but not yet slain. I’ll just lie down and bleed a while, And then I’ll rise and Fight again."

Fight on Damar! Rise again!

 

2 hours ago, thenorthremembers said:

Thank you.  Needed that this morning.

 

 The 2022 version.

 

The Buffalo Bills Rise & Fight Again(2022 Remake).

 

 

 

Edited January 4, 2023 by LOVEMESOMEBILLS

[Beck Water]

10 minutes ago, EasternOHBillsFan said:

 

I understand that you're not trying to be a smart ass, that's cool. However, the word was concerned.... not ANY speculation as to his condition or what it might be or anything like that based upon ANY sort of medical diagnosis.

 

It has been over 24 hours... so you are not concerned?

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

[Beast]

3 minutes ago, Beck Water said:

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

It seems as if we are now hearing of improvement from sources close to the situation.

[Beck Water]

1 hour ago, GaryPinC said:

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.

 

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.

 

 

Edited January 4, 2023 by Beck Water

[Silvercrw]

16 hours ago, Silvercrw said:

I have been a board member since 1996-97 and injury to Hamlin as truly shook me. I am also am a Youtuber/filmmaker with multiple channels and I could not, not make this video. I also spoke about this board and inserted a message from one of you. Hope you guys like it.https://youtu.be/TdNUwWx7ums

Crazy as a forum lurker mostly since 1995-1997 I still don't know how to embed vids lol

[Dillenger4]

2 minutes 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.

"But now we have reports that he did not re-arrest so that's great."

That is great 100% - but the report specifically said he did not resuscitate "on the field". Very easily could have in the ambulance or the hospital later. None of us know. But I'm sure, very sure, his uncle knows and would not make that mistake. Saying it happened twice.... Hope for the best for Damar!!!

[Warriorspikes51]

2 minutes ago, Dillenger4 said:

"But now we have reports that he did not re-arrest so that's great."

That is great 100% - but the report specifically said he did not resuscitate "on the field". Very easily could have in the ambulance or the hospital later. None of us know. But I'm sure, very sure, his uncle knows and would not make that mistake. Saying it happened twice.... Hope for the best for Damar!!!

 

It was clarified this morning from his family spokesperson that there may have been miscommunication and he was resuscitated once, not twice 

[Big Turk]

8 minutes ago, Silvercrw said:

Crazy as a forum lurker mostly since 1995-1997 I still don't know how to embed vids lol

 

Just copy and paste the link if it's youtube.

[Fan in Chicago]

1 hour ago, stevestojan said:

I am truly impressed with the number of medical professionals, those is the field of science, and other relevant experts we have on this board. Thank you all for your unique perspectives. 
 

(re-read this and it sounded sarcastic. It’s not, I really appreciate the knowledge sharing). 

Agreed. As we wait for news on Hamlin, understanding the medical aspects of his injury, treatment have been beneficial to me.

Shoutout to people like @Herc11, @GaryPinC, @Beck Water @DrPJax and other knowledgeable folks I may have missed. 

 

Get well, Damar !! 

[Ethan in Cleveland]

27 minutes ago, NyQuil said:

To my knowledge commotio cordis does not result in actual physical damage to the heart tissue. 
 

During the repolarization of the heart there is a small time frame when some of the cardiac cells, but not all, are depolarized and can generate an impulse. If the cells are stimulated (from the trauma) when some cells are still depolarized this can result in a disorganized rhythm that will progress to ventricular fibrillation.

This is true.  However the arrest itself and the subsequent CPR can result in heart injury from hypoxia and physical damage to the sternum and rib cage.  It's not liek TV. CPR is violent and broken ribs is not uncommon.  

A cardiac contusion which is different and is actual injury can occur from blunt trauma but usually a different mechanism. Think Jeremy Renner and MVA type accidents not baseballs hitting the chest at just the wrong time.  

[JohnBonhamRocks]

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

[Draconator]

1 minute ago, JohnBonhamRocks said:

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

There have been quite a few of those donations. Winners of Fantasy Football leagues are donating their winnings to the charity. 

[JGMcD2]

2 minutes ago, JohnBonhamRocks said:

Saw a fantasy football league donated its full $600 pot to the charity saying who cares about winnings and a title. Thought that was very cool.

A couple of leagues I am in are working through how to handle everything and that’s the conclusion being reached in all of them. 
 

Pretty cool others are doing the same. 

[Beck Water]

1 hour ago, OrangeBills said:

 

They just said this was not the case, he was resuscitated just the once on the field, at least that's the latest I've heard

 

Can you share where you heard this?  Who is "they"?

[SDS]

1 minute ago, Beck Water said:

 

Can you share where you heard this?  Who is "they"?

it was a quote from his marketing agent. However if you actually read the text he says he was only resuscitated once “on the field“. No one was ever claiming differently.

[EasternOHBillsFan]

27 minutes ago, Beck Water said:

 

My point was that imposing a deadline of 24 hrs as a point to be concerned, is intrinsically speculative.  What is it based upon?

 

To answer your question: Obviously, it would be great if 24 or 48 hrs brought positive news but no, I'm not concerned because 24 hrs have gone by without news.

 

Obviously, I'm very concerned and worried that he needed to be resuscitated 2x and that he was said to not be breathing on his own after resuscitation - though, there seems to be some contradictory info on that.   But, I know that patients who are initially unconscious after resuscitation do recover fully, so I'm still hoping for the best.  I also know that sedation with or without hypothermia are used to reduce oxygen demands by the brain and allow time for healing.

 

Some of the hypothermia protocols call for 24-48 hrs of hypothermia, followed by gradual rewarming - with no attempts to look for return of spontaneous breathing until rewarming is complete. I said up-thread that we might not hear anything until today at the earliest, and some others with experience said Thursday.

 

The NYT article linked upthread quoted experts saying that if there is no improvement within 72-96 hrs that would be concerning.  The hypothermia protocols from Johns Hopkins and U Penn note that improvement may not be seen immediately after the protocol, and that decisions should not be made for 72 hrs after the protocol is fully completed.

 

So I'll go with the experts, and say that if we don't hear of improvement ~96 hrs post incident (Friday night), I'll be concerned.

 

 

 

I guess there is a difference between being OVERALL concerned and being concerned over grave complications... I just didn't think it was productive to quibble over something that isn't that important because we are ALL concerned. It's all good, I get your point.