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Damar Hamlin’s Neurological Recovery Reaches a ‘Turning Point’

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Damar Hamlin’s ability to speak with medical personnel and members of his family after a cardiac arrest on Monday night bodes well for his brain’s recovery, in accordance with the doctors caring for him and outdoors medical examiners.

“This marks a very good turning point in his ongoing care,” said Dr. William Knight IV, director of emergency medicine on the University of Cincinnati Medical Center, which has been treating Mr. Hamlin since he collapsed on the sector during a Buffalo Bills-Cincinnati Bengals game. “But he still has significant progress that he must make.”

While experts have reasons to anticipate that Mr. Hamlin could also be on an excellent path for neurological recovery, questions remain in regards to the health of his other organs, including his lungs.

In a news conference on Thursday, Dr. Knight and Dr. Timothy A. Pritts said that Mr. Hamlin was still critically in poor health, was in intensive care and was still flippantly sedated and on a ventilator, and so unable to speak. But he can now communicate by shaking his head and nodding. He even wrote a matter on a pad of paper, asking his nurse who had won the sport.

Dr. Knight and Dr. Pritts said in the course of the news conference that they weren’t yet certain why Mr. Hamlin had gone into cardiac arrest in the course of the game. But one explanation they’ve not ruled out is that he had incredibly bad luck when he collided with a Bengals receiver, sustaining a severe blow to his chest. When that happens at exactly the appropriate 20-millisecond moment in the center’s cycle, when the organ is relaxing and filling with blood, the blow could cause the center to stop.

The results could be dire even when, as in Mr. Hamlin’s case, the person receives immediate cardiopulmonary resuscitation and his heart is restarted with a defibrillator.

“The massive issue in cardiac arrest is not any blood flow to the brain,” said Dr. Andrew Luks, a critical care and respiratory disease specialist on the University of Washington who is just not involved with Mr. Hamlin’s care.

Even though it is not possible to do an entire neurological evaluation while Mr. Hamlin is on a respirator, “the proven fact that he follows commands and communicates in writing may be very reassuring,” Dr. Luks said. “The likelihood of severe neurological damage may be very low.”

“There’s every reason to think he’ll return to a standard neurologic function,” said Dr. Michael Mack, chairman of cardiovascular services at Baylor Scott & White Health in Dallas.

But recovery is just not instantaneous, he added. Patients undergo a phase where they’re slow to process and respond in conversation.

One other major concern when an individual has a cardiac arrest is damage to the lungs, a severe injury called acute respiratory distress syndrome, or ARDS. One study found that almost half of people that had cardiac arrest developed the condition.

Sometimes CPR injures the lungs in the course of the repetitive, deep compressions of the chest wall. Patients can also breathe stomach fluids or saliva into their lungs, injuring them. And the impaired blood flow during CPR can contribute to lung injury.

Mr. Hamlin didn’t escape this complication.

There isn’t any specific treatment for ARDS, said Dr. Douglas White, professor of critical care medicine on the University of Pittsburgh Medical Center, aside from ensuring that the ventilator is ready to deliver smaller breaths than normal to stop additional injury to the lungs. Doctors then monitor patients and wait for them to heal, which might take days or even weeks.

While most patients fully recuperate, some are left with scar tissue of their lungs, Dr. White said. For a lot of, the scar tissue is just not serious — but, he said, “for a world-class athlete,” who performs at physical extremes, “it’s a unique problem.”

Scarring becomes a priority when someone has been on a ventilator for per week or more, Dr. White added. Thus far, Mr. Hamlin has been on a ventilator for 3 days.

“The subsequent big milestone,” Dr. Pitts said, “might be getting him to breathe on his own.”

Mr. Hamlin’s doctors declined to predict when or if he would fully recuperate and whether he would give you the option to play football again. They said they were just taking things day-to-day.

“It’s been an extended and difficult road for the last three days,” Dr. Knight said. Mr. Hamlin, he said, was “incredibly sick.”

But, he said, “he’s now demonstrating signs of excellent neurological recovery.”

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