Injury Report: Letang had a stroke

[MeticulouslyDishevel]

I'm not saying that it is the same as Letang's situation but it sounds exactly like my wife.

About a month after she gave birth to our first child, she started having really bad migraines and here face and arm would go slightly numb. We saw a neurologist and had some MRIs done and they determined that she had a "mini stroke". We then saw a cardiologist and they discovered that she had a very small hole in her heart and that clotting likely hit that hole in the heart and caused the stroke.

Very scary stuff at the time but they monitored it well and she never had to take blood thinners. We got the green light to have another child and she regular runs 5ks and triathalons...

Take it for what it's worth, I just wish Letang the best of luck in his situation...

Very scary. Sounds like a pretty similar situation to Letang's. Glad to hear that they were able to repair it and that she won't have any lasting effects.

 

[MeticulouslyDishevel]

Why does it feel like this doesn't happen to other teams?

It does. Just off the top of my head: Jiri Fischer, Vladimir Konstantinov, Saku Koivu, Josh Harding, Luc Bourdon, Rick Rypien, Phil Kessel, etc.

 

[Ugene Magic]

If you think about Letang's rigorous workouts in the summers it's really amazing it took this long to manifest.

Usually after a stroke people are put on light duty for a good while until test comeback good enough they can strain themselves without issue. How serious is this? Consider young highschool football player drop dead from these kinds of issues over exerting themselves not knowing there's an issue.

These are kind of tests that should be made automatic when kids are at the age that the hole should be closed. For one, their body is quicker to heal such a common issue. Every athlete should have this test done for sure.

 

[Mischa]

F* Rossi. He knows nothing.

getting that out of the way...



I hope he takes as much time as he needs. I'd rather see him healthy than playing

 

[KIRK]

Good medical info, guys. Thanks. TTEOT, too bad you had to follow it up with a hockey IQ comment.



MOD NOTICE:
Anyone making wise-cracks about hockey IQ or trades is going to get infracted. There's no call for that in this situation. Most of the fans coming in here form other teams are showing class. Do the same or just don't post.

Amen DV.

It's just unreal and pretty eye opening for anyone that he/she should never feel so invincible as to not seek medical help when something doesn't seem right.

Only thing anyone should add is to wish him a speedy and full recovery and to be thankful that it didn't manifest itself at another potentially more dangerous time.

 

[Tender Rip]

Best wishes for Letang.
Crazy.

 

[Shrimper]

If anyone wants to use my avatar to show their support then feel free.

 

[Domino666]

Total craziness about Letang, that has to be scary and life changing, I hope he makes a full recovery and can come back 100% but honestly before even hockey I just hope the guy will be ok and can enjoy his life, here's to a speedy recovery

 

[Til the End of Time]

letang will likely be fine, but this is just further evidence that the penguins cannot count on him to remain in the lineup. is it wise to have a number one d-man that is not consistently in the lineup and is remarkably inconsistent when he does actually play?

this team has enough high risk offensive players that are injury prone-- they need stability on the blueline, not more of the same.

 

[Jaded-Fan]

letang will likely be fine, but this is just further evidence that the penguins cannot count on him to remain in the lineup. is it wise to have a number one d-man that is not consistently in the lineup and is remarkably inconsistent when he does actually play?

this team has enough high risk offensive players that are injury prone-- they need stability on the blueline, not more of the same.

Not sure if I can see the connection.

It was a hidden genetic condition. It is equivalent of saying that Crosby is injury prone because he took a freak puck to the jaw.

 

[Miss Ausguins]

Woah, woke up to this about our Kris. Get well soon mate

On a serious note, my Mother had a partial stroke towards the end of 2011 and spent a few days in the local hospital. When she was released, she was not allowed to drive for a month - as I wasn't working at the time, I became her daytime chauffeur. A few months later, she ended up having some heart problem and ended up in hospital for a week. Even though she is now well and truly back at work and fine, her driving sometimes leaves a lot to be desired.

 

[edog37]

To be fair, we actually have no idea the severity of Sid's concussion considering his neck could have been causing the majority of his symptoms.

exactly, that's my point. It's completely stupid to call any injury to the brain or that area "mild". There's too many unknowns. Letang needs to make a life decision, not a hockey one. I hope it works out for him, I truly do, but this nonsense of the team saying he'll be out for 6 weeks gives the fans bad gouge. Just completely irresponsible.

 

[WVP]

Why does it feel like this doesn't happen to other teams?

First thing that came to mind - Red Wings had Konstantinov and Fischer, both pretty rare incidents.

 

[JTG]

I haven't had a chance to read extensively about this because I have been busy today, but when I was at work thinking about this, and people were saying, "Oh, but this is happening to a workout freak!" Maybe that's the problem? The guy is a gym rat...he pushes his body to the absolute limits it can go. He does these video worthy workouts all summer long that average joe's watch with awe. Then after he does all of that...he plays an average of 90 hockey games a year where he logs 25 mins a night. Where's the break? Maybe this is his body saying..."Dude...ease up a bit."

His workout regime is obviously not helping him. It doesn't keep him healthy, and I think even if he toned it down a bit, he would be just fine in regards to strength and stamina.

 

[Iffyiffiffer]

exactly, that's my point. It's completely stupid to call any injury to the brain or that area "mild".

Well that's a little extreme.

 

[Jaded-Fan]

Trying to get this time frame down. If Letang actually should end up back around six weeks, it would be a couple weeks or so before the end of the season, which ends on April 12 against the Flyers.

I also am trying to wrap my head around the blood thinner part of this. From all that I was told that is the last thing that you want to do, you want to close the hole as soon as possible and have him begin recovery from the procedure. So the two reports, about the hole in the heart and six weeks, and the blood thinner for six weeks and observation, seem at odds with one another.


It also will make some interesting decisions for Shero at the deadline, regarding whether he thinks that Letang would be back for the playoffs.

 

[Honour Over Glory]

I feel bad about saying stuff about the guy now, but in any case, I wish him a speedy recovery and hope he's ok before he decides to get back to playing again.

 

[BADoglick]

If Rossi says we'll see him in twelve weeks, I'll look forward to seeing him in 6

 

[NMK11]

I haven't had a chance to read extensively about this because I have been busy today, but when I was at work thinking about this, and people were saying, "Oh, but this is happening to a workout freak!" Maybe that's the problem? The guy is a gym rat...he pushes his body to the absolute limits it can go. He does these video worthy workouts all summer long that average joe's watch with awe. Then after he does all of that...he plays an average of 90 hockey games a year where he logs 25 mins a night. Where's the break? Maybe this is his body saying..."Dude...ease up a bit."

His workout regime is obviously not helping him. It doesn't keep him healthy, and I think even if he toned it down a bit, he would be just fine in regards to strength and stamina.

So just to put this in there, this has absolutely nothing to do with his workout routine. I could buy all of the musculoskeletal injuries due to fatigue, and that is a known thing, but this stroke is a combination of something he's lived with his whole (get it?) life, and a clot. If anything the workouts probably minimize clots, which means he has a hypercoagulable disease or it was a freak occurrence, with my money on the latter.

 

[Acekicker123]

Hi guys, MD and surgical resident here chiming in.

Briefly:

When you're a baby in utero, there is a hole (foramen ovale) in your heart that allows you to oxygenate your blood without your lungs (the placenta). Usually this closes when you're born. In a fairly common percentage of the population (approx. 30%), it doesn't. If you are to become symptomatic, most of the time it happens as a very young baby. Otherwise, the rest will grow up without ever realizing they have it.

The persistently open hole (patent foramen ovale) creates a mixing of blood that has not yet gone to the lungs and blood that already has. Therefore, you have a mixing of oxygenated and deoxygenated blood, resulting in a lower than average oxygen level. That's important because it explains the potential symptoms.

From not having that normal level of oxygen, symptoms can include headaches and migraines (which it sounds like Letang has had in the past). Strokes happen when your brain doesn't get enough oxygen long enough to create a more lasting effect. This hole puts you at higher risk of stroke for two reasons: 1) it may allow a clot from somewhere else (legs) to climb up your circulation and into your brain, and block circulation to an area or 2) the level of oxygen in the blood may be temporarily insufficient from time to time.

In terms of what to do about it, it's an area of ongoing research and debate. The thousands and thousands of patients that have been studied so far haven't shown us that surgery, medication or even doing nothing is conclusively the best option. It sounds like the physician they've consulted is leaning towards taking a blood thinner (usually Aspirin is the first step), which is quite reasonable and consistent with the field recommendations.

What does it mean for Letang? Well in terms of recovery time, that will depend on the severity of the stroke. It seems to be more on the lower end from what we've heard. As for his career in general, that will be a risk-reward discussion between he, his family, his team and his doctors. As you can imagine, putting someone on blood thinners increases their risk of bleeding. As a hockey player at the highest level, he suffers his fair share of bumps and bruises (which are bleeding from superficial skin vessels), and a blood thinner will make that worse. In addition, his risk of internal bleeding has also increased. We don't typically tell our patients on blood thinners that they are no longer allowed to play contact sports, just that there is an increased risk they have to accept if they want to do so.

Hope that helps,

Alex

 

[JTG]

Hi guys, MD and surgical resident here chiming in.

Briefly:

When you're a baby in utero, there is a hole (foramen ovale) in your heart that allows you to oxygenate your blood without your lungs (the placenta). Usually this closes when you're born. In a fairly common percentage of the population (approx. 30%), it doesn't. If you are to become symptomatic, most of the time it happens as a very young baby. Otherwise, the rest will grow up without ever realizing they have it.

The persistently open hole (patent foramen ovale) creates a mixing of blood that has not yet gone to the lungs and blood that already has. Therefore, you have a mixing of oxygenated and deoxygenated blood, resulting in a lower than average oxygen level. That's important because it explains the potential symptoms.

From not having that normal level of oxygen, symptoms can include headaches and migraines (which it sounds like Letang has had in the past). Strokes happen when your brain doesn't get enough oxygen long enough to create a more lasting effect. This hole puts you at higher risk of stroke for two reasons: 1) it may allow a clot from somewhere else (legs) to climb up your circulation and into your brain, and block circulation to an area or 2) the level of oxygen in the blood may be temporarily insufficient from time to time.

In terms of what to do about it, it's an area of ongoing research and debate. The thousands and thousands of patients that have been studied so far haven't shown us that surgery, medication or even doing nothing is conclusively the best option. It sounds like the physician they've consulted is leaning towards taking a blood thinner (usually Aspirin is the first step), which is quite reasonable and consistent with the field recommendations.

What does it mean for Letang? Well in terms of recovery time, that will depend on the severity of the stroke. It seems to be more on the lower end from what we've heard. As for his career in general, that will be a risk-reward discussion between he, his family, his team and his doctors. As you can imagine, putting someone on blood thinners increases their risk of bleeding. As a hockey player at the highest level, he suffers his fair share of bumps and bruises (which are bleeding from superficial skin vessels), and a blood thinner will make that worse. In addition, his risk of internal bleeding has also increased. We don't typically tell our patients on blood thinners that they are no longer allowed to play contact sports, just that there is an increased risk they have to accept if they want to do so.

Hope that helps,

Alex

Nice writeup...thanks

 

[TheStinger]

Wow, someone with actual medical knowledge and information. How novel.

Thanks mate. It doesn't sound quite so life threatening when it is explained like that. Hope he takes his time recovering though. Life after hockey is important too.

 

[MeticulouslyDishevel]

Trying to get this time frame down. If Letang actually should end up back around six weeks, it would be a couple weeks or so before the end of the season, which ends on April 12 against the Flyers.

I also am trying to wrap my head around the blood thinner part of this. From all that I was told that is the last thing that you want to do, you want to close the hole as soon as possible and have him begin recovery from the procedure. So the two reports, about the hole in the heart and six weeks, and the blood thinner for six weeks and observation, seem at odds with one another.


It also will make some interesting decisions for Shero at the deadline, regarding whether he thinks that Letang would be back for the playoffs.

I don't think he's going to be back in 6 weeks. I think he's just going to be reevaluated in 6 weeks (like the team will hear about how he's responding to treatment). He had a stroke so the blood thinner part makes sense. Closing the hole in his heart would be done through a catheterization process through a vein (not open heart) so the two aren't incompatible.

 

[Shrimper]

Kristopher Letang ‏@Letang_58 19m
Thanks for all the kind messages. Means a lot to me and my family #bestfans

 

[alcanalz]

Hi guys, MD and surgical resident here chiming in.

Briefly:

When you're a baby in utero, there is a hole (foramen ovale) in your heart that allows you to oxygenate your blood without your lungs (the placenta). Usually this closes when you're born. In a fairly common percentage of the population (approx. 30%), it doesn't. If you are to become symptomatic, most of the time it happens as a very young baby. Otherwise, the rest will grow up without ever realizing they have it.

The persistently open hole (patent foramen ovale) creates a mixing of blood that has not yet gone to the lungs and blood that already has. Therefore, you have a mixing of oxygenated and deoxygenated blood, resulting in a lower than average oxygen level. That's important because it explains the potential symptoms.

From not having that normal level of oxygen, symptoms can include headaches and migraines (which it sounds like Letang has had in the past). Strokes happen when your brain doesn't get enough oxygen long enough to create a more lasting effect. This hole puts you at higher risk of stroke for two reasons: 1) it may allow a clot from somewhere else (legs) to climb up your circulation and into your brain, and block circulation to an area or 2) the level of oxygen in the blood may be temporarily insufficient from time to time.

In terms of what to do about it, it's an area of ongoing research and debate. The thousands and thousands of patients that have been studied so far haven't shown us that surgery, medication or even doing nothing is conclusively the best option. It sounds like the physician they've consulted is leaning towards taking a blood thinner (usually Aspirin is the first step), which is quite reasonable and consistent with the field recommendations.

What does it mean for Letang? Well in terms of recovery time, that will depend on the severity of the stroke. It seems to be more on the lower end from what we've heard. As for his career in general, that will be a risk-reward discussion between he, his family, his team and his doctors. As you can imagine, putting someone on blood thinners increases their risk of bleeding. As a hockey player at the highest level, he suffers his fair share of bumps and bruises (which are bleeding from superficial skin vessels), and a blood thinner will make that worse. In addition, his risk of internal bleeding has also increased. We don't typically tell our patients on blood thinners that they are no longer allowed to play contact sports, just that there is an increased risk they have to accept if they want to do so.

Hope that helps,

Alex

Wonderful writeup, thanks.