Archive for the ‘NHL Injuries’ Category

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Sudden cardiac arrest. The absolute last thing you want to hear as a player is hustled off the bench after a collapse. It rarely has a good outcome, but Rich Peverley and the medical staff of the Stars and Blue Jackets have beat the odds.

 

UPDATE: New information has surfaced in the recent days – it seems that the preseason procedure Peverley chose was an elective cardioversion followed by ongoing medication, so as to minimize his recovery time. Cardioversion is a non-invasive procedure that involves a shock delivered at a certain phase of the cardiac cycle that essentially resets the heart so that it can resume a normal rhythm. After his collapse March 10th and subsequent resuscitation, Peverley was wearing what the NHL calls a “monitoring vest” until he could have a corrective procedure (an ablation – described below), which was done Tuesday at the Cleveland Clinic. There’s been no word about whether he also had an ICD (implantable cardioverter-defibrillator) put in, but that can be done with just an overnight stay.

The monitoring vest is actually a LifeVest – a wearable cardioverter/defibrillator. It’s a vest that continuously monitors the heart rhythm, and delivers a shock if it senses an arrhythmia.

 

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The vest also sounds an alarm first so that if you’re still conscious you can stop it from shocking you. Why? Because if you’re conscious you’re (more or less) okay. You need to call 911 immediately and get to the ER, but you’re okay(ish). You really don’t want to get shocked unless you absolutely need it. While the shock can reset your heart and save your life, more shocks actually increase mortality – so you want to minimize your exposure to those times it’s truly absolutely unavoidable. If you’re unconscious, the vest gives you plenty of chances to deactivate it, and you won’t take any of them (because unconscious people can’t press buttons). It deploys conductive gel onto the pads in the back of the vest, and lights you up. The manufacturer (Zoll) has a pretty graphic demonstration of an EKG that degenerates into a shockable rhythm, the warnings the vest delivers, and what happens when a shock is applied. Turn your volume down a bit for this one, be patient and wait for the arrhythmia. It’s a hell of a process.

Peverley’s season is over, and his ablation will have a four to six week recovery, longer if he also had an ICD placed (and we have no idea if he did at the moment, but no mention was made of it at the Stars’ press conference). There’s been no move on the part of the Stars to commit to Peverley ever playing again after this season. Tincture of time is indicated on this one.

 

As part of preseason physical testing, Rich Peverley had an EKG that showed a “blip” (a term I apparently wasn’t fond of).

 

 

It turns out the blip was atrial fibrillation (afib) – the most common arrhythmia, present in about 5 million Americans. It happens when the part of the heart responsible for setting the pace doesn’t do its job properly, explained quite eloquently here (Pevs forgive me for the heinous misspelling):

 

Afib is exactly what it sounds like – the atria (upper chambers of the heart) don’t squeeze in a nice organized regular manner – they fibrillate (quiver). That increases the likelihood of stroke because blood doesn’t zoom through, it swirls around in the atria. Blood standing still is blood that likes to clot, and clots are things you don’t want in your body. The ventricles are responsible for pumping blood out of the heart to the lungs and the body, and they’ll keep doing their job, just irregularly as they follow the irregular impulses sent down from above by the pissy atria. Afib is something a lot of people live with (on anticoagulation), but in someone like Peverley, it had to be fixed. The odds of sudden cardiac death are already doubled during physical activity, and hockey is a sport with a lot of very intense activity in short bursts, which also increases cardiovascular risk.

 

Those are the atria.

Those are the atria.

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letang
The Pittsburgh Penguins broke their silence Friday and announced that the mysterious injury that has kept Kris Letang out since January 27th is a stroke. Not the flu, not mono, not any of the other usual garbage that young healthy people get, but a stroke. Strokes are uncommon in young people (but not impossible), and the team has said that they believe a congenital heart abnormality may have been the cause. How can this happen? And how can only six weeks possibly be how long he’ll be out?

 

Kris Letang’s last game was January 27th against Buffalo. An episode of nausea and dizziness on the 29th kept him out of the LA game on 30th, but he continued to travel with the team. When his symptoms still hadn’t cleared by the time the team hit Phoenix a couple of days later, he underwent some tests. Those tests were suspicious for a stroke, and Letang was sent back to Pittsburgh for yet more testing. In the course of all the diagnostics, doctors discovered “a very small hole in the wall of his heart since birth”, which could have precipitated the stroke. That’s a lot of information to take in all at once, and none of it seems to make sense in the context of a young, healthy athlete.

 

Nausea and Dizziness? That’s a stroke?

 

While there are two kinds of strokes – ischemic and hemorrhagic – the outcomes can run the gamut from death to major (or minor) disability to almost no side effects at all. Ischemic stroke is caused by an interruption in blood supply to a certain part of the brain – like from a clot. Hemorrhagic strokes are caused by bleeding into the brain. Letang’s stroke was ischemic, and his symptoms were mild enough that he obviously had no idea there was anything wrong with him until several days later.

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If this doesn't break your heart, you're a monster.

If this doesn’t break your heart, you’re a monster.

 

There are few players as universally well-liked or as incredibly talented as Steven Stamkos, and few injuries as overtly horrifying as the broken leg he sustained Monday against the Bruins. Viewers had a front-row seat to a leg bending a way legs aren’t made to bend, and to Stamkos’ considerable pain.

Stamkos broke his right tibia, and there’s video here if you’re of the rubbernecker variety. Be warned that it’s difficult to watch, not just because of the injury, but because of his reaction to it. He tries to get up and skate on it twice, then finally gives up and lies on the ice alternately covering his face and clutching at Tom Mulligan, Tampa’s head athletic trainer. It was every bad injury from the past several seasons all over again, and like Pitkanen’s heel, Fedun’s femur, Pronger or Laperriere’s puck to the face, it was one of those injuries that you instantly knew was going to be very, very bad.

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Smell my glove! SMELL IT!

Smell my glove! SMELL IT!

The Tampa Bay Buccaneers grossed out the sporting world recently with the announcement that several of their players are fighting MRSA infections. Football doesn’t get to have all the fun where nasty bugs are concerned, so this week we’ll take you on a tour of some disgusting locker room infections. You’re welcome.

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Claude Giroux

Cumberland, Ontario is a small town just east of Ottawa with the distinction of being home to the Camelot Golf and Country Club, an arena with water that smells like rotten eggs, and not much else. It’s also where Claude Giroux lacerated the extensor tendons in his right index finger in a freak exploding golf club incident.

Giroux was at Camelot preparing for the Ottawa Sun Scramble golf tournament, and apparently on a completely normal shot with a completely normal club the shaft of the club splintered, sending shards into his right index finger and lacerating the extensor tendons.

Oh really.

That’s an interesting injury seeing as how you hold a golf club in your palm, a place where you won’t find any extensor tendons. Those are on the backs of your fingers and hand. Giroux’s father Raymond told Le Droit that when his club splintered a piece flew up in the air and came down on his finger, causing the injury.

Oh really.

Regardless of what actually happened (a little smashy-smash of the old clubberoo?), extensor tendon injuries are fairly common and generally require surgery. Without an extensor tendon Giroux would be able to grip a hockey stick (or golf club) but straightening his fingers out to let go would be tricky.

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In the battle between chronic shoulder dislocation and cup final, cup final wins every time.

In the battle between chronic shoulder dislocation and cup final, cup final wins every time.

The first thing that should come to mind when anyone mentions chronic shoulder dislocations is Mel Gibson throwing himself against a wall after escaping from a straitjacket in Lethal Weapon 2. TOTALLY REALISTIC (not really). While Nathan Horton hasn’t escaped from a straitjacket and nobody has seen him launching himself into walls, the Bruins have admitted he has a “chronic shoulder issue.”

Horton’s problems began April 20th when a fight with Jarome Iginla ended with him skating off holding his left arm awkwardly. The fight itself wasn’t much to see – A few punches, and Iginla dumped Horton to the ice. They were holding each other’s jerseys when he went down, which could explain the injury – the weight of one’s body on an outstretched arm is a great way to dislocate a shoulder. It’s also a great way to suffer a shoulder subluxation, a similar injury in which the shoulder comes partway out of the socket, and pops back in. The problem of course is that once you’ve had one injury in which you’ve dislocated (or subluxed) your shoulder, you’re very likely to do it again. The other problem is that nonsurgical management isn’t a great solution for someone who needs a working shoulder and uses it for hockey things like slamming into people and taking shots. The other other problem is if you’re a UFA you probably don’t have time for a six month recovery unless you’ve kicked so much playoff ass that your team can’t help but re-sign you.

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2011-12 winner Max Pacioretty demonstrates how to be awesome

2011-12 winner Max Pacioretty demonstrates how to be awesome

 

The Bill Masterton Memorial Trophy is voted on annually by the Professional Hockey Writers’ Association and awarded to the NHL player who best exemplifies the qualities of perseverance, sportsmanship, and dedication to hockey. The writers have their work cut out for them this year, since all three finalists are unquestionably worthy of the award.

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