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Old 11-04-2013   #81
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Default Re: Kubiak Collapses at the half

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Originally Posted by TexansBull View Post
Sad. Really sad.

What concerns me too is how the Texans' org is so secretive with illnesses and revealing medical details. It concerns me because it could be worse than what is being reported and we won't find out for a few more days.

Here's to a fast and speedy full recovery.

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The family has requested, and has a right to, privacy in this matter. What part of that concerns you?
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Old 11-04-2013   #82
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Originally Posted by TexansBull View Post
Sad. Really sad.

What concerns me too is how the Texans' org is so secretive with illnesses and revealing medical details. It concerns me because it could be worse than what is being reported and we won't find out for a few more days.

Here's to a fast and speedy full recovery.

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I take the opposite stance. This is his health and there should be privacy. I'm sure the organization is sparing no expense to make sure he gets the best care possible. Football and the organization comes a distant second.
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Old 11-04-2013   #83
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Default Re: Kubiak Collapses at the half

There'll be plenty of health information leaks in coming years and decades. I'm okay with health privacy while we can still get it.
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Old 11-04-2013   #84
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Default Re: Kubiak Collapses at the half

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There'll be plenty of health information leaks in coming years and decades. I'm okay with health privacy while we can still get it.
Couldn't agree more with this.
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Old 11-04-2013   #85
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Default Re: Kubiak Collapses at the half

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Originally Posted by ChampionTexan View Post
The family has requested, and has a right to, privacy in this matter. What part of that concerns you?
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Originally Posted by PapaL View Post
I take the opposite stance. This is his health and there should be privacy. I'm sure the organization is sparing no expense to make sure he gets the best care possible. Football and the organization comes a distant second.
I never said we should know all his details. I said that this org so secretive with medical details that it could be a lot worse than we know. That is in my original post and I never said we need to know all the details now.
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Old 11-04-2013   #86
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Default Re: Kubiak Collapses at the half

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Originally Posted by RagingBull View Post
Atrial fibrillation very rarely causes syncope (passing out), and typically an a-fib related CVA occurs shortly after restoration of sinus rhythm rather than upon converting into atrial fibrillation.

I think that if they did indeed give TPA, he had to have had a significantly high NIH stroke scale and an ischemic stroke would be the most likely scenario.

If it were a STEMI (heart attack), he would have been taken to the cath lab directly.

Also, no one uses TPA for MI anymore, it is almost always TNK, and it would be very unusual in Houston for someone to be treated with thrombolytics. The only time I know of anyone being treated for MI with lytics (TPA or TNK) in recent times in Houston was during tropical storm Allison when all the cath labs were down due to power outage.

I have seen plenty of people having an acute stroke though and he didn't really look like that either.

And usually the strokes that cause a great deal of pain (which it looked like he was in) are hemorrhagic and he would not have received TPA for that.

The common cardiovascular causes of syncope (passing out) are brady arrhythmias (slow heart rate), ventricular tachy arrhythmias (fast heart rates), or a vasovagal episodes (all of the blood vessels dilating and the blood rushing down to your legs. Very rarely will a supraventricular tachyarrhythmia (like a-fib, a-flutter, AVNRT, atrial tach, etc) cause anything more than palpitations and feeling poorly.

V Tach and complete heart block can commonly be caused by a heart attack.

That being said, it didn't really look like he passed out all the way from what they showed on TV.

The problem with diagnosing a stroke is that it doesn't show up on a CT scan for 3-4 days usually. An MRI with diffusion/perfusion imaging can usually show an acute stroke, and it sounds like he was going to have one of those today. The decision of whether or not to give TPA usually comes down to clinical judgement of the ER doc and/or stroke team doc (usually a neurologist) because you only have 180 minutes from symptom onset to treat it.

As I implied, a heart attack seemed to have been ruled out, and I agree that the use of TPA would have been a very curious treatment for that condition anyway. However, paroxysmal (intermittent) atrial fibrillation can lead to syncope and lead to cardiac thrombo-emboli.........we have no idea if he had the AF condition for a while (some can be quite asymptomatic until an "event" leads to its diagnosis). Furthermore, AF through neural mechanisms can convert to tachycardia or bradycardia of vasovagal responses. Not only that, but an acute ischemic stroke can certainly be associated with intense cephalic (head) pain. As far as the MRI, I've seen quite a few that showed confirmatory changes consistent by 6 hours post event (although the maximal changes are usually evident 48 hours to 96 hours post event).
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Old 11-04-2013   #87
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Default Re: Kubiak Collapses at the half

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Originally Posted by CloakNNNdagger View Post
As I implied, a heart attack seemed to have been ruled out, and I agree that the use of TPA would have been a very curious treatment for that condition anyway. However, paroxysmal (intermittent) atrial fibrillation can lead to syncope and lead to cardiac thrombo-emboli.........we have no idea if he had the AF condition for a while (some can be quite asymptomatic until an "event" leads to its diagnosis). Furthermore, AF through neural mechanisms can convert to tachycardia or bradycardia of vasovagal responses. Not only that, but an acute ischemic stroke can certainly be associated with intense cephalic (head) pain. As far as the MRI, I've seen quite a few that showed confirmatory changes consistent by 6 hours post event (although the maximal changes are usually evident 48 hours to 96 hours post event).
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Old 11-04-2013   #88
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Stroke like symptoms and an anticoagulent means stroke.
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Old 11-04-2013   #89
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Default Re: Kubiak Collapses at the half

Ian Rapoport @RapSheet
#Texans coach Gary Kubiak has suffered what is called a TIA, per source. —a transient ischemic attack. Referred to as a mini-stroke.
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Old 11-04-2013   #90
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Default Re: Kubiak Collapses at the half

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Originally Posted by TheMatrix31 View Post
Ian Rapoport @RapSheet
#Texans coach Gary Kubiak has suffered what is called a TIA, per source. —a transient ischemic attack. Referred to as a mini-stroke.
That's a shame. Best wishes to coach and his family.

http://www.nfl.com/news/story/0ap200...on-texans-game
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Old 11-04-2013   #91
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Default Re: Kubiak Collapses at the half

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Originally Posted by TheMatrix31 View Post
Ian Rapoport @RapSheet
#Texans coach Gary Kubiak has suffered what is called a TIA, per source. —a transient ischemic attack. Referred to as a mini-stroke.
Well, if you're going to have a stroke, that's the best one to have. A very good chance of no permanent brain injury. This is known in some circles as a warning stroke.

With a little luck, he should be able to make a full recovery, given that they are able to find the problem that caused it.
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Old 11-04-2013   #92
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Default Re: Kubiak Collapses at the half

nvm...... not the place for it, sorry.
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Old 11-04-2013   #93
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Default Re: Kubiak Collapses at the half

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...flashes of average play...
That turn of phrase is really, really funny.
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Old 11-04-2013   #94
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Default Re: Kubiak Collapses at the half

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Originally Posted by CloakNNNdagger View Post
As I implied, a heart attack seemed to have been ruled out, and I agree that the use of TPA would have been a very curious treatment for that condition anyway. However, paroxysmal (intermittent) atrial fibrillation can lead to syncope and lead to cardiac thrombo-emboli.........we have no idea if he had the AF condition for a while (some can be quite asymptomatic until an "event" leads to its diagnosis). Furthermore, AF through neural mechanisms can convert to tachycardia or bradycardia of vasovagal responses. Not only that, but an acute ischemic stroke can certainly be associated with intense cephalic (head) pain. As far as the MRI, I've seen quite a few that showed confirmatory changes consistent by 6 hours post event (although the maximal changes are usually evident 48 hours to 96 hours post event).
That's exactly what I came here to post.
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Old 11-04-2013   #95
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This sucks. Kubiak is a good man.
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Old 11-04-2013   #96
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Default Re: Kubiak Collapses at the half

So,docs is this good or bad news? Is he out of the woods since they caught it before he had a full stroke? Will he be able to return to the team soon?
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Old 11-04-2013   #97
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Default Re: Kubiak Collapses at the half

Kubiak is done for the season. I expect Wade to be named interim hc very soon.
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Old 11-04-2013   #98
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Default Re: Kubiak Collapses at the half

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So,docs is this good or bad news? Is he out of the woods since they caught it before he had a full stroke? Will he be able to return to the team soon?
After googling it, which I don't know how accurate this information is; about 1 in 3 people who have a transient ischemic attack eventually have a stroke, with about half occurring within a year after the attack. A transient ischemic attack can serve as both a warning and an opportunity — a warning of an impending stroke and an opportunity to take steps to prevent it.
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Old 11-04-2013   #99
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Default Re: Kubiak Collapses at the half

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After googling it, which I don't know how accurate this information is; about 1 in 3 people who have a transient ischemic attack eventually have a stroke, with about half occurring within a year after the attack. A transient ischemic attack can serve as both a warning and an opportunity — a warning of an impending stroke and an opportunity to take steps to prevent it.
Thanks - I had Googled that as well. Just wasn't sure whether catching it like they did and treating it as quickly as they did greatly reduced that 1 in 3 number...?
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Old 11-04-2013   #100
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Default Re: Kubiak Collapses at the half

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“TIA is a warning stroke and gives a patient time to act and keep a permanent stroke from occurring,” Dr. Emil Matarese of St. Mary’s Medical Center in Langhorne, Pa. told the ASA’s website. “By recognizing TIA symptoms and getting to the hospital, the patient can get help in identifying why the TIA occurred and get treatment — either through medication or surgery — that can prevent a stroke from occurring.”

Fortunately, Kubiak received immediate attention from the stadium’s medical staff and was transported to the hospital quickly.
Link.

He was in a very favorable situation for medical attention. It could all be for the best if this occurrence prevents the big one.
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