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Kubiak Collapses at the half

PHILLYTEXANFAN said:
I think Case's play sent Gary's brain into overload from excitement.
Quick side note, anybody else see Schaub wearing his helmet all game, just hoping he goes in
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Yes. My non-football-watching-wife even asked about that. Matt had to know his career here was ending before his very eyes. He's toast.
 
Adam Schefter ‏@AdamSchefter 14m

Gary Kubiak was given Tissue plasminogen activator (tPA), a protein that breaks down blood clots in people who suffer strokes, per sources.

Tania Ganguli ‏@taniaganguli now

#Texans head coach Gary Kubiak will remain with medical personnel for at least the next 24 hours, the team announced.
 
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Wow, they don't give TPA to just anyone unless they are pretty convinced that a stroke is occurring.

I have seen some pretty terrible complications from TPA administration causing intra-cranial hemorrhage that can be quite devastating or even fatal.

I certainly hope that Gary is going to be OK.
 
>I have seen some pretty terrible complications from TPA administration causing intra-cranial hemorrhage that can be quite devastating or even fatal.


The way they mentioned his family was "around him" at the hospital
gives me cause too.

I hope Gary walks out of the hospital on his own two feet.

The coach of our football team is secondary to the health and safety
of a guy that most people say is a really good human being.

TJ
 
IDEXAN said:
I could buy into the explanation of dehydration or maybe even a panic attack, but if the sideline reporters comments were accurate about Kubiak being in pain, I've got to think we are talking about some issues with the ole ticker here.
Don't have to have a heart attack with chest pains, but the pains often relate to a heart condition of some kind. Where's Doc when we need him ?
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So many possibilities. If the reports of no heart attack is indeed accurate, a sudden collapse like this could be a result of an arrhythmia such as atrial fibrillation.

Clots can occur in the heart secondary to the atrial fibrillation (AF).......and can then break loose to obstruct brain circulation (stroke). AF is associated with more severe ischemic strokes and "longer" transient ischemic attacks (TIAs) than emboli from carotid disease, presumably due to embolization of larger particles with AF. As a result, patients with AF who suffer an ischemic stroke appear to have a worse outcome (more disability, greater mortality) than those who have an ischemic stroke in the absence of AF, even after adjustment for the advanced age of patients with AF-related stroke.
 
I remember the commentators talk about spending the bye week basically in OT cramming for Case, then seeing a sideline shot of Kubes.. He looked TERRIBLE.

I'm going to believe when they say NO HEart Attack, for it to be true as they know it. That wouldn't rule out a stroke I suppose? But I would be more inclined to believe he's overworked, stressed, exhausted, the whole 9 yards.

He didn't look right at all prior to the half time, so what ever it was, likely didn't just come over him while walking to the locker room, but certainly escalated to what was reported.

Seems odd they are being so seemingly HUSH about it.
 
CloakNNNdagger said:
So many possibilities. If the reports of no heart attack is indeed accurate, a sudden collapse like this could be a result of an arrhythmia such as atrial fibrillation.

Clots can occur in the heart secondary to the atrial fibrillation (AF).......and can then break loose to obstruct brain circulation (stroke). AF is associated with more severe ischemic strokes and "longer" transient ischemic attacks (TIAs) than emboli from carotid disease, presumably due to embolization of larger particles with AF. As a result, patients with AF who suffer an ischemic stroke appear to have a worse outcome (more disability, greater mortality) than those who have an ischemic stroke in the absence of AF, even after adjustment for the advanced age of patients with AF-related stroke.
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Considering the symptoms, would the implementation of an anticoagulent suggest one possibility over others?
 
I had really good seats last night and we saw him go down . My #2 son was getting mad because all the medical folks i guess had a potty break . While he was down the camera men started hovering and I'm not sure who this guy was but he was in a suit and started running them off . There was a big dude in a white shirt who was trying to get close , that guy in a suit almost shoved him out of there . It was one of those moments that you thought they were going to pull out the AED .

I think Coach Kubiak's greatest strength is becoming his greatest weakness . You see him on TV or listen to him on the radio and this is wearing on him . I think he is one who is more worried about Schaub and the coaches more than he's worried about himself . Take care of yourself coach and enjoy the grandkids to come .
 
Brisco_County said:
Considering the symptoms, would the implementation of an anticoagulent suggest one possibility over others?
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Sorry, but without seeing the MRI and/or more clinical information, that's all I can say. The anticoagulant can be used to dissolve established blocking clots and, in the case of AF, can help prevent more clots originating in the heart from being formed.
 
CloakNNNdagger said:
Sorry, but without seeing the MRI and/or more clinical information, that's all I can say. The anticoagulant can be used to dissolve established blocking clots and, in the case of AF, can help prevent more clots originating in the heart from being formed.
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Considering the pain he was in, I can't help but think that a chunk of clot was dislodged. My mind goes to worst case scenarios.
 
CloakNNNdagger said:
So many possibilities. If the reports of no heart attack is indeed accurate, a sudden collapse like this could be a result of an arrhythmia such as atrial fibrillation.

Clots can occur in the heart secondary to the atrial fibrillation (AF).......and can then break loose to obstruct brain circulation (stroke). AF is associated with more severe ischemic strokes and "longer" transient ischemic attacks (TIAs) than emboli from carotid disease, presumably due to embolization of larger particles with AF. As a result, patients with AF who suffer an ischemic stroke appear to have a worse outcome (more disability, greater mortality) than those who have an ischemic stroke in the absence of AF, even after adjustment for the advanced age of patients with AF-related stroke.
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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.
 
I wish nothing but the best for Kubiak and his family on this. I hope he comes out of this in good health.
 
First John Fox and now Kubes. Wow, was this ever a weekend of health scares for NFL coaches. It certainly is a reminder of priorities and that, well, in the end it *is* "only football".
 
Best wishes to Coach Kubes and his family. Hoping for a speedy recovery.
Have to admit that after he went down on the field, I had a hard time getting back into the game...can only imagine how the team felt. Wade looked like death himself in the post-game presser.
 
Best wishes to Kubiak and his family. Hopefully his hospital stay is just a precaution and he is back with the team soon.
 
My thoughts and prayers are with Coach Kubiak and his family. Wishing him a speedy recovery and full health.

This is a game at the end of the day. Kubes needs to get healthy, and find the priorities in his life that make him happy. If that is football so be it, but there MUST be some work/life balance. I know these guys put in crazy hours. The body can only take so much. Our bodies were designed for a cycle of activity and rest, and when you take out the rest, and add in an incredible dose of stress, that's a recipe for disaster.

Is it time that the NFL care as much about the coaches as it pretends to care about the players?

There are a million different rules in place regarding player safety - and limits on work hours. Interestingly, there are no such rules in place regarding coaches that I am aware of. Coaches burning out quite literally are common.

It's high time we limit coaches hours etc.. If everyone is restricted, it's a level playing field.
 
RagingBull said:
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.
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yes. i know some of those words.
 
VTexan said:
yes. i know some of those words.
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Sorry man, I was kind of targeting Dr. Jean with that to get his opinion. The gist of it is that none of it really adds up medically, but the most likely thing that I can come up with is that he probably had a stroke based upon the LITTLE we know.
 
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.

Sent from my RM-820_nam_att_100 using Board Express
 
TexansBull said:
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.

Sent from my RM-820_nam_att_100 using Board Express
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The family has requested, and has a right to, privacy in this matter. What part of that concerns you?
 
TexansBull said:
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.

Sent from my RM-820_nam_att_100 using Board Express
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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.
 
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.
 
ChampionTexan said:
The family has requested, and has a right to, privacy in this matter. What part of that concerns you?
Click to expand...

PapaL said:
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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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.
 
RagingBull said:
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.
Click to expand...


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).
 
CloakNNNdagger said:
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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English Doc. English
 
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.
 
TheMatrix31 said:
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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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.
 
CloakNNNdagger said:
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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That's exactly what I came here to post.
 
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?
 
houstonhurricane said:
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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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.
 
JCTexan said:
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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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...?
 
“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.
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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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