Aaron Hernandez had “Most Severe Case” of CTE: Family to Sue NFL

Ex-Patriot’s tight end, and convicted murder, Aaron Hernandez, was found postmortem to have had severe CTE.

Athletes who sustain multiple concussions are at high risk of developing CTE, Chronic Traumatic Encephalopathy.  This progressive, degenerative disease of the brain is also found in veterans and those who sustained repeated head trauma.  Symptoms include mood disorders, paranoia, impulse control issues, aggression, and memory loss to name a few.

A lawsuit (reportedly $20 million) has been filed by the family against the NFL and New England Patriots.  Hernandez was only 27 years old when he hung himself in his prison cell April 19th of this year.

Researchers from Boston University concluded the 27 year-old football star had stage 3 of 4 CTE.  This severity is rarely seen in someone this young.

The lawsuit claims that by the time Hernandez joined the NFL, the league knew of the dangers of concussions and led players to believe they were safe.  Attorney Jose Baez stated the Patriots and NFL were “fully aware of the damage that could be inflicted from repetitive impact injuries and failed to disclose, treat or protect him from the dangers of such damage.”

Neuropatholoigsts found loss of brain volume (atrophy), and tau protein deposits throughout his frontal lobes.  The frontal lobe of the brain regulates impulse control, memory, judgement, social behavior and problem solving.

What are the stages of CTE?

The CTE Stages are as follows:

Stage 1: Loss of concentration, attention, dizziness and headaches

Stage 2: Additionally short term memory loss,  mood disorder such as depression, and at times explosive outbursts

Stage 3: Worsening loss of memory, judgement, ability to do daily tasks, movement disorders, tremors and suicidality

Stage 4: Amnesia, severe cognitive impairment, evidence of dementia.

Image from Sites at PennState

This is a developing story.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Advertisements

Using the NFL Injury Report to Pick this Week’s Winners

The NFL Injury Report tells us all we need to know to make our picks.

For years I’ve been dissecting the NFL Injury Report and predicting who would win during the playoffs and Superbowl. When you’re a doctor who loves football, it’s not that difficult.

So my success has prompted me to make the risky move of posting my strategy and results.  There are varying levels of theory, just like layers of the epidermis.  And each deeper layer of prediction should confirm the simpler ones.  But if I can’t scientifically deduce the winner, I wing it.

Method 1 – Number game

Let’s take for example Thursday night’s game between the Chiefs and the Patriots.  According the NFL injury report, there were 3 injuries reported for the Chiefs and 5 for the Patriots.  A novice may just say 3 is less than 5 so the Chiefs will win.  But as a physician, this is not good enough.   We need to also look at the types of injuries.

Method 2 – Anatomy counts

According to the NFL Injury report, the Chiefs sustained injuries to the knee, another knee and ankle.  The Patriot’s sustained injuries to the  knee, shoulder, ankle, another knee but also hamstring.  Yes, Matthew Slater’s hamstring injury is very telling. Why?

Think about when you were playing football.  If you hurt a finger you still played.  If you sprained your knee, you toughed it out. But what happened when you sustained a groin injury.  You were leveled.  Probably couldn’t even get up.  So any injury involving the groin is physically devastating for a player, and from a psychological standpoint, the whole team.

If a groin injury specifically is not incurred and reported by the NFL injury report, then you look at the injuries closest to the groin.  A head injury is also very concerning so that will come after groin.  Hence the scale from most devastating to least in terms of injured body parts listed is:

Groin < head/concussion < hip< < glute < quad < hamstring  < eye < abdomen < chest < knee < shoulder < calf < arm < ankle < foot < wrist < hand < finger < toe.  

The Patriot’s hamstring injury is closer to the groin than any other injury hence the team wasn’t looking very good for Thursday night’s game.

If specific injuries are not listed, we can sometimes count how many did not participate in practice.

 

Method 3 – Colors 

In case of a tie….meaning both teams sustained equal numbers of groin injuries or subsequent proximal body parts, we look to the main colors of the Jersey.  Black, Blue, Green and Yellow will fare worse than White and Red, Brown. In medicine, Black may happen with necrosis, Blue is associated with hypoxia, Green- mucous, Yellow – gonorrhea.  White and Red are fairly routine and healthy colors in medicine (bones and blood).  Silver and Purple are colors that are fairly neutral as we usually don’t see those colors on a routine basis in medicine unless with hair.

Therefore, the color scale from most problematic to least is:

Black < Blue < Yellow < Green < Orange < Purple < Silver < White < Red.

Again this is only used if predictions cannot be made due to an anatomical tie.  Again I must stress we do not use the color method unless we are unable to predict using the NFL injury report.

With Thursday night’s game, the Chiefs wore white and the Patriots wore blue.   But despite this method, the Patriots were at a disadvantage with the hamstring injury all along.

So what will happen this Sunday?  Let’s use what we learned to predict the winners!!

Jets vs. Bills  

1 Eye injury vs. 1 Concussion

Prediction:  Jets

********************************

Falcons vs. Bears

A Falcon chest injury vs Bears’ two ankles, a knee and finger injury

Prediction:  Falcons

********************************

Jaguars vs. Texans

1 ankle, 1 hamstring injury vs. 1 ankle and 1 shoulder

Prediction:  Texans

********************************

Raiders vs. Titans

foot, quad, knee and back vs Titan’s groin injury – very close but…

Prediction:  Raiders

********************************

Eagles vs. Redskins

0 injuries vs. hip and knee

Prediction:  Eagles

********************************

Colts vs. Rams

Groin, foot, shoulder, hamstring, lumbar plague the colts – zero injuries reported for the Rams

Prediction:  Rams

********************************

Seahawks vs Packers

Calf, shoulder, thigh, wrist, knee ankle vs. ankle

Prediction: Packers

********************************

Panthers vs. 49ers

knee, groin, ankle shoulder vs. hamstring and back injury

Prediction:  49ers

********************************

Giants vs. Cowboys

Concussion and ankle vs. ankle

Prediction: Cowboys

********************************

Ravens vs. Bengals

The Raven’s concussion is up against the Bengal’s ankle and elbow.  Tough call…..

Prediction:  Bengals

********************************

Steelers vs. Browns

A knee and shoulder injury vs. a knee injury

Prediction:  Browns

********************************

Cardinals vs. Lions

Ankle, tricep and calf injury vs. knee and foot

Prediction:  Lions

********************************

We pray that no one gets hurt and those who do recover quickly.  Here’s to a safe season of one of the best sports ever!!  FOOTBALL!!

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Bishop Gorman Remains Undefeated

The undefeated Bishop Gorman Gaels now boast a 55 game winning streak as a result of Friday night’s season opener.

Playing DeMatha Catholic High School of Maryland on Fertitta Field, the Gaels trumped the Stags, with a final score of 35-23.

Led by Coach Kenny Sanchez, the Gaels start this season 1st in the state, 4th nationally.

Their 55 game winning streak began back to 2013.

Dorian Thompson-Robinson Quarterback (UCLA),  Palaie Gaoteote Linebacker (USC),  Brevin Jordan Tight End (Miami), and Jimmy Telles wouldn’t let a 17-13 DeMatha lead in third quarter stop them.

Turning it around with three touchdowns and a 2 point conversion in the final quarter cemented their domination in high school football.

Bishop Gorman plays Mater Dei in Santa Ana, CA September 1.

This is a developing story.

 

 

 

Tiger Woods DUI Tox Report Positive for Benzodiazepines, Narcotics and Sleep Meds

Tiger Woods’ toxicology report in regards to his May arrest suggests his DUI was caused by a mixture of pain, sleep, and anxiety medications.

The report released Monday revealed the 41 year old pro-golfer had the following in his system when he was found asleep in his car on the side of the road while the lights were on and turning signal was flashing:  Ambien, Xanax, Dilaudid, Vicodin and Delta-9 carboxy THC (tetrahydrocannabinol).

Woods had undergone spinal fusion surgery weeks prior.

Vicodin is a narcotic made of hydrocodone and acetaminophen.  It is used for pain and most commonly prescribed post-operatively.

Dilaudid is hydromorphone, a stronger narcotic.

Xanax is a benzodiazepine used for sedation, relaxation and to lower anxiety.

Ambien is a hypnotic type of sedative used for sleep and works within 15 minutes of ingestion.

Delta-9 carboxy THC (tetrahydrocannabinol) is the psychoactive ingredient in marijuana.

None of these medications are to be used while driving.  Additionally none should ever be used in combination.  The respiratory depression of one narcotic combined with the sedative effect of the benzodiazepine or hypnotic could cause death.

Woods entered a plea of not guilty to DUI, as alcohol was not involved and a mixture of medications was to blame, but its been reported a deal was made among prosecutors including a lesser charge of reckless driving and a stint in a “diversion program”.

Last month Woods stated he completed a private intensive program on his own.

On Monday he stated, “Recently, I had been trying on my own to treat my back pain and a sleep disorder, including insomnia, but I realize now it was a mistake to do this without medical assistance.”

Polypharmacy, or taking multiple medications at the same time, can increase the risk of serious adverse events if the drugs act synergystically or mask side effects of one another.

Many overdoses occuring with pain pills may not always be a quantity issue with the narcotic but rather a mixture of the narcotic with another medication such as those taken by Tiger Woods.  He was lucky to still be alive when found as were those pedestrians or drivers on the street that evening.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

 

 

NFL celebrations are coming back…well almost

The NFL is set to relax some of the touchdown celebration rules but will hold off allowing the ever-so-popular twerk.

Commissioner Roger Goodell announced using the ball as a prop (as Antonio Brown perfectly executes in the above picture) and snow angels will be allowed.

 

 

Twerking however will be prohibited.  Goodell stated, “Offensive demonstrations, celebrations that are prolonged and delay the game, and those directed at an opponent, will still be penalized.”

 

 

Antonio Brown’s celebration above after scoring a touchdown against the Redskins cost him a $24,309 fine and the team a 15 yard penalty.

The NFL frowns upon “unsportsmanlike behavior” and “taunting”.  Hence, the bans were originally put in place to promote good sportsmanship and prevent fights in the end zone.  However, players many times use their celebration to reinforce their identity and please their fans.

 

 

Some, such as Dallas Cowboy’s Ezekiel Elliot, have used their celebration to help promote charity.

 

 

The NFL, coined the “No Fun League”, will be praised for this move as the sport is viewed by an average 16.5 million people each year who love watching their team make a touchdown.

 

 

                                                                                                       LearnHealthSpanish.com                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

49er legend Dwight Clark diagnosed with ALS

The legendary wide receiver for the San Francisco 49er’s, Dwight Clark, reveals that he has amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease. The 60 year old first noticed weakness in his left hand in September 2015.

In a blog post, Clark suspects his diagnosis was caused by his 9 years in the NFL.  The two-time all-pro and Super Bowl champion stated, “I don’t know for sure. But I certainly suspect it did.”  He continued, “And I encourage the NFLPA and the NFL to continue working together in their efforts to make the game of football safer, especially as it relates to head trauma.”

He wrote that he couldn’t run, play golf or walk any distances, and that lifting anything greater than 30lbs was a “chore”.

What is ALS?

Amyotrophic Lateral Sclerosis (ALS) was first discovered in 1869 by French neurologist Jean-Martin Charcot.  Known as “the Father of Neurology”, he and is colleagues discovered that spinal cord lesions, depending on where they occurred, would present differently in a patient as his paralysis progressed. Even though it was named ALS by the 1870’s, many still refer to it as “Charcot’s disease”.

In 1939, baseball Yankee legend, Lou Gherig was diagnosed with ALS.  Two weeks later he retired, giving his famous farewell speech.  It began with “Fans, for the past two weeks you have been reading about a bad break I got. Yet today I consider myself the luckiest man on the face of the earth.” For most of the nation this was the first time they heard of the disease, and Lou Gherig died two years later.  Today people still refer to the disease as “Lou Gherig’s Disease”.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes the death of neurons responsible for innervating muscles.  When the muscles do not receive nerve signals, they eventually weaken, twitch, and then atrophy.  Muscle atrophy leaves a patient unable to move and eventually the patient cannot speak, eat and breathe. Most people affected with ALS die of respiratory failure.

Image from Reactive Training Systems

Could head trauma cause ALS?

As Dwight Clark alluded to, head trauma has been suspected in some cases of ALS.  In 2010 a study out of Boston University discussed the abnormal protein called TDP-43. Dr. Ann McKee, associate professor of Neurology and Pathology at the Boston University School of Medicine found high levels of this protein in the brain and spinal cord of two former professional football players and a former boxer who sustained repeated head trauma and all developed ALS.

Another study in 2007 found an 11 X increased risk of ALS among Italian soccer players who had suffered multiple head injuries when compared to those who never sustained head trauma.

An additional study found that those who served in the military were at higher risk of ALS.  Genetics and smoking may also play roles. Another theory is glutamate, a chemical messenger in the brain, which appears high in those with ALS, could be affecting the nerve cells as well.

Approximately 15,000 Americans have ALS. There is currently no cure.  The “Ice Bucket Challenge” fortunately raised over $115 million for research of the devastating disease.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Using the NFL Injury Report to predict Conference Championship winners

The concussions listed hurt the Packers and Steelers so this week it will be

Patriots

Falcons close though but Packers deserve a spanking after last week’s Dallas game

We pray that no one gets hurt and those who do recover quickly.  Here’s to rounding out a safe season of one of the best sports ever!!  FOOTBALL!!

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician