David Andrews Out with Blood Clots in Lungs

nattysez

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Starting center David Andrews has been hospitalized with blood clots in his lungs, and his season is in jeopardy, according to sources. The expectation is that he’ll miss a significant amount of time.
Not great, Bob.


Edit: Random aside: a few days ago, someone asked PatsCap "hypothetically" what would happen if Andrews couldn't play this year. I had a heart attack, but then couldn't find any info about him being hurt. Then this comes down. Patscap apparently remembered the tweet, too:
View: https://twitter.com/patscap/status/1166132597723996161
 

tims4wins

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Karras has 5 career starts with the Pats. Pats are 4-1 in those games. Lone loss was last year at Tennessee
 

dcmissle

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This is a massive downer on a human level.

And if you want to talk on field, obviously not good there either.

 

Mystic Merlin

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His disappearance without any explanation/apparent injury and then Dante’s comment made me uneasy, and I hate seeing that paid off.

Hope he gets well.
 

dcmissle

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Russell Okung the recent comp. Very scary. But for visit to a clinic, he may well have lost his life.
 

SMU_Sox

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His disappearance without any explanation/apparent injury and then Dante’s comment made me uneasy, and I hate seeing that paid off.

Hope he gets well.
We’re lucky to have Karras who should be experienced within the system. You look at other franchises and the Pats and you can really appreciate how much they have drafted and developed guys on the OL over the years. Andrews did a lot on the line. When you go from a pro-Bowl caliber center to anyone though you’d expect a bit of a drop off.
 

fiskful of dollars

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Actually, while these can be serious, even fatal - many pulmonary emboli (PE) are easily treated with anti-coagulation. As long as there is not right sided heart strain, patients usually have no long-term sequelae. As a clot travels (embolizes - usually from the lower half of the body) it gets stuck in the ever decreasing caliber blood vessels that carry blood/oxygen to the lungs. Sometimes this clot can sit atop the pulmonary artery bifurcation (the dreaded saddle embolism). If you get one of these, you are essentially dead where you stand. More commonly, the clot tumbles further into the pulmonary circulatory system until it wedges into a smaller vessel. Once lodged, the downstream section of lung is deprived of blood, oxygen and essential nutrients. Patients often report shortness of breath, chest pain and tachycardia (rapid heart rate). Fainting sometimes occurs as well. Many patients throw sub-clinical clots and they are never diagnosed (we find them at autopsy).

Smaller order clots are treated with anticoagulation for 6-12 months. Obviously, he can't play football whilst on anticoagulation. Season is over. More importantly, his medical team will have to understand WHY he developed a PE. They are caused by three things in general (Virchow's Triad, for those who care): Hypercoagulability - blood too thick, can be congenital. Hemodynamic changes (stasis - like a cast/long car trip/plane ride, trauma). Endothelial injury/dysfunction - self explanatory.

I
f there is a clear and episodic cause..i.e. he had an injury, surgery, etc. that temporarily predisposed him to developing a clot/PE then he should be able to resume playing. If there is a clotting disorder such as Factor V Leiden, or a Protein S, Protein C deficiency, he'll have to stay on anticoagulation for life.

Sucks. Hope he's better soon. If he's not in the ICU, he's gonna be OK generally speaking. With the caveat that this PE doesn't emanate from a metabolic issue known to cause a hypercoagulable state...i.e pregnancy (doubtful), cancer, etc.
 

dcmissle

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Any centers on the bubble due to cap issues?
Who could be had for any of the surplus we’re going to be able to deal as we cut down because our roster is so stacked?

This sport is chock full of sudden, head spinning turns.
 

PedroKsBambino

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Bryan Stork is available.

Ok, how about Karras?

Hopefully Andrews is ok...and I expect he will take care of himself (and the team will ensure he doesn't play unless he does). Next man up.
 

cheekydave

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Fiskful of Dollars tremendous explanation thank you.

See you healthy and whole next year ( Andrews) you are way too young a man to leave this earth. You can be a sideline coach if you like:>)
 

Jeff Frye's Face Mask

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A second location.
If his clot is determined to have been provoked by surgery (or some other transient risk factor) he could get away with three months of anticoagulation and then potentially return at some point soon after.
 

Jed Zeppelin

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We’re lucky to have Karras who should be experienced within the system. You look at other franchises and the Pats and you can really appreciate how much they have drafted and developed guys on the OL over the years. Andrews did a lot on the line. When you go from a pro-Bowl caliber center to anyone though you’d expect a bit of a drop off.
Was glad to at least recognize the name of the guy who will now be tasked with getting TB12 the ball. Familiarity/continuity so crucial on the OL, especially up the middle where it's tougher for Brady to dodge pressure.
 
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Main thing is David Andrews gets healthy and leads a good, long life.
The next thing, wayyyyyy down the page, is that the Patriots have the resources to mostly cover for him.
The next thing, down even way lower than that, is that in January and onward David Andrews is a sounding board and inspiration, Nathan Horton-style, as we head toward Lombardi #7.
 

DeJesus Built My Hotrod

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Thank you to fod and JFFM for explaining the condition, its causes and the different prognoses for Andrews. Your posts are why this place is fantastic.

On another note, at present, Andrews has earned and is guaranteed something like just under $3mm total for his two contracts. While nobody should shed any tears for his paychecks, that isn't a lot of money for a guy who just turned 27 years old and has done nothing but play football during his professional life.

Its just another reminder that all of these athletes are an injury or medical condition away from being forced to start their lives over at a relatively young age. Most people around this board have a mature view on athlete earnings but this situation just reinforces why nobody should begrudge any players for maximizing their income. Their careers can and often do get interrupted or end abruptly, even when they are in their peak years physically.
 

chechusma

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If it makes anyone feel better, the other important context about PE (in addition to the excellent commentary from the other docs) is that if they are going to kill you, it is generally right when the clot initially embolizes to the lung. If you survive that, and are appropriately risk-stratified and treated, your chances of recovery to a relatively normal life are quite good (there are some exceptions for those who have significant right heart strain in terms of exercise intolerance and shortness of breath, but these are overall fairly rare ).

To wit - over the last several years we have started to treat a bunch of appropriate patients on an outpatient basis - come to the ED, get diagnosed with a PE, and sent home on a blood thinner. This would have seemed crazy during my training but it is safe.


That Andrews was hospitalized is a bit concerning to me (many younger patients fall into the outpatient treatment category), though it’s also possible he was admitted for observation because he’s a NEP.
 

lambeau

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Considering the dehydration problems Andrews was suffering, at least in Nashville, his return to training camp next year seems to me highly questionable.
 

InstaFace

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Smaller order clots are treated with anticoagulation for 6-12 months. Obviously, he can't play football whilst on anticoagulation. Season is over. More importantly, his medical team will have to understand WHY he developed a PE. They are caused by three things in general (Virchow's Triad, for those who care): Hypercoagulability - blood too thick, can be congenital. Hemodynamic changes (stasis - like a cast/long car trip/plane ride, trauma). Endothelial injury/dysfunction - self explanatory.

I
f there is a clear and episodic cause..i.e. he had an injury, surgery, etc. that temporarily predisposed him to developing a clot/PE then he should be able to resume playing. If there is a clotting disorder such as Factor V Leiden, or a Protein S, Protein C deficiency, he'll have to stay on anticoagulation for life.

Sucks. Hope he's better soon. If he's not in the ICU, he's gonna be OK generally speaking. With the caveat that this PE doesn't emanate from a metabolic issue known to cause a hypercoagulable state...i.e pregnancy (doubtful), cancer, etc.
As regards the underlined - is that what Serena Williams ran into? I was going to ask where that got classified, but I guess that's the first leg of your stated triad, it just had an acute cause rather than being genetic.
 

OilCanShotTupac

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A PE almost killed me in 2014.

After other interventions failed, I was put into an induced coma (see <--) and on a ventilator for a few weeks, with the intent of slowing my metabolism as much as possible so that the clots would dissolve and be reabsorbed. This worked.


It’s hard to envision even considering playing until you are off the clot related meds.
Not a chance in hell. A hard hit would cause internal bleeding.

Actually, while these can be serious, even fatal - many pulmonary emboli (PE) are easily treated with anti-coagulation. 1) As long as there is not right sided heart strain, patients usually have no long-term sequelae. As a clot travels (embolizes - usually from the lower half of the body) it gets stuck in the ever decreasing caliber blood vessels that carry blood/oxygen to the lungs. 2) Sometimes this clot can sit atop the pulmonary artery bifurcation (the dreaded saddle embolism). If you get one of these, you are essentially dead where you stand. More commonly, the clot tumbles further into the pulmonary circulatory system until it wedges into a smaller vessel. Once lodged, the downstream section of lung is deprived of blood, oxygen and essential nutrients. Patients often report shortness of breath, chest pain and tachycardia (rapid heart rate). Fainting sometimes occurs as well. Many patients throw sub-clinical clots and they are never diagnosed (we find them at autopsy).

Smaller order clots are treated with anticoagulation for 6-12 months. Obviously, he can't play football whilst on anticoagulation. Season is over. More importantly, his medical team will have to understand WHY he developed a PE. They are caused by three things in general (Virchow's Triad, for those who care): 3) Hypercoagulability - blood too thick, can be congenital. Hemodynamic changes (stasis - like a cast/long car trip/plane ride, trauma). Endothelial injury/dysfunction - self explanatory.

I
f there is a clear and episodic cause..i.e. he had an injury, surgery, etc. that temporarily predisposed him to developing a clot/PE then he should be able to resume playing. 4) If there is a clotting disorder such as Factor V Leiden, or a Protein S, Protein C deficiency, he'll have to stay on anticoagulation for life.

Sucks. Hope he's better soon. If he's not in the ICU, he's gonna be OK generally speaking. With the caveat that this PE doesn't emanate from a metabolic issue known to cause a hypercoagulable state...i.e pregnancy (doubtful), cancer, etc.
1) They were amazed that I didn't have any right ventricular problems. Although I was (still am) overweight, my heart was in good shape, so it was able to handle the strain. Andrews, as a highly conditioned athlete, would have an advantage here, I would think.
2) This was me. Another few minutes later to the ER and I'd probably not have made it.
3) come to find out that I have hereditary clotting issues. They were exacerbated by high levels of homocysteine caused by environmental factors. I'll defer to the docs but it could be a combination of more than one factor (hereditary + trauma, etc).
4) This is me. There are certain activities I can't do anymore, like cycling - risk of internal bleeding and/or bleeding out from laceration in the event of a crash. Otherwise I'm OK but an NFL player obviously would not be.

Chris Bosh's career was ended by clotting issues. I hope it's a good prognosis but my gut is telling me he won't play again.
 

SMU_Sox

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I asked Brandon Thorn (OL, among other things, analyst on Twitter and has written for ITP) on Twitter about the magnitude of his loss.

Thorn wrote that of the 5 starters Andrews was the most irreplaceable. I asked him to expand on it. I thought that Andrews had a role in setting protections. It will be interesting to learn or relearn his responsibilities.

Ferentz had a couple of bad snaps in the pre-season and has looked shaky. I don’t love the depth behind Karras as Froholdt needs a year of coaching (which is fine!).
 

EvilEmpire

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This sucks. My oldest son had a PE last summer, discovered during football two-a-days. We were very fortunate that the trainer recognized that the swelling in his leg wasn't easily explainable due to normal football contact (he was an OG). Missed his senior season and is still on blood thinners now. Not sure if he will ever be off of them. We found he does have a hereditary (somewhat) elevated clotting factor that is possibly exacerbated by May-Thurner syndrome.

I hope Andrews makes a full recovery and he can avoid long term or lifetime blood thinners.
 

Eddie Jurak

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Ferentz had a couple of bad snaps in the pre-season and has looked shaky. I don’t love the depth behind Karras as Froholdt needs a year of coaching (which is fine!).
I thought I remember Bedard commenting that Ferentz looked all right at C, but terrible at G. Maybe there is room for a player like that if Andrews is out of the picture.
 

tims4wins

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Thank you to fod and JFFM for explaining the condition, its causes and the different prognoses for Andrews. Your posts are why this place is fantastic.

On another note, at present, Andrews has earned and is guaranteed something like just under $3mm total for his two contracts. While nobody should shed any tears for his paychecks, that isn't a lot of money for a guy who just turned 27 years old and has done nothing but play football during his professional life.

Its just another reminder that all of these athletes are an injury or medical condition away from being forced to start their lives over at a relatively young age. Most people around this board have a mature view on athlete earnings but this situation just reinforces why nobody should begrudge any players for maximizing their income. Their careers can and often do get interrupted or end abruptly, even when they are in their peak years physically.
I think it is more like $9M. It's still not a huge number for a starting player on his second contract but it's a major difference.
 

Ralphwiggum

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This is scary news. I used to work for a company that manufactured (among other things) compression stockings and sequential compression devices to help reduce the incident of DVT which can result in a PE., so I am familiar with how dangerous this can be. Sounds like they caught it in time to be able to treat him, here's to him living a long a happy life, football is obviously secondary.
 

RobertS975

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Another cause of pulmonary emboli is thoracic outlet syndrome. This is when the subclavian vein is compressed by the topmost rib. It is not a rare condition, especially in athletes. Definitive treatment consists of surgical removal of the offending rib. If you don't find an obvious source of the clots, they would need to consider thoracic outlet syndrome.
 

DeJesus Built My Hotrod

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I think it is more like $9M. It's still not a huge number for a starting player on his second contract but it's a major difference.
I could be wrong but I am only counting what he was paid for his first contract plus what he has already earned as well as guaranteed money.

That said, even if it is $9mm (the total expected value of his current contract), its likely not enough to allow the guy to retire for the rest of his life.
 

tims4wins

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I could be wrong but I am only counting what he was paid for his first contract plus what he has already earned as well as guaranteed money.

That said, even if it is $9mm (the total expected value of his current contract), its likely not enough to allow the guy to retire for the rest of his life.
Agreed on point 2.

On point 1, sportrac shows $1.639M in total yearly cash from deal 1 and $7.578M in total yearly cash from deal 2. His signing bonus was $1.6M and he had base salaries of $615K then $900K in 2017 and 2018 so that alone is over $3M. Then you add in base salaries, roster bonuses, etc from 2015, 2016, and 2019.

 

RedOctober3829

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Provided it is safe to travel with this, I wonder if Andrews will help out with Dante for the rest of the season. He is already a coach on the field as a center so it would be natural to lend his expertise to help Ted Karras out. Andrews is lauded as seeing the game like Brady does so to have that knowledge in the film room and practice field would be immense.
 

OilCanShotTupac

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Provided it is safe to travel with this, I wonder if Andrews will help out with Dante for the rest of the season. He is already a coach on the field as a center so it would be natural to lend his expertise to help Ted Karras out. Andrews is lauded as seeing the game like Brady does so to have that knowledge in the film room and practice field would be immense.
Flying can be a problem. That's what forced Chris Bosh into retirement with his clotting problem IIRC.