Nerve firing confusion in Jaylon's recovery

[waving monkey]

Yeah it's sarcasm to suggest the undermining and emasculating of head coaches that has gone on here for two decades has produced poor results.

well then please as I said earlier, continue this emasculation of Garrett it's brilliant

 

[waldoputty]

Waldo is Efren Herrera. Herrera is Waldo.

There you go:

 

[Trouty]

Waldo is Efren Herrera. Herrera is Waldo.

Lmaoooooooooo!!!!!!! Alex!!!!!

Einhorn is Finkle, Finkle IS Einhorn.

LACES OUT DAN

 

[waldoputty]

There you go:

Oh @Alexander , I got you mixed up with Risen
So sorry

 

[FuzzyLumpkins]

Interesting - results are quite different than the results from the researchers I know.

I do have a theory why the results are different.
Regarding the formation of the endplates, one poster in BTB mentioned that the condition of the neighboring Schwann cells are critical. That is, the longer it took the nerve regeneration to get to the muscle, the worse the results due to the Schwann cells changing over time.

This would suggest my friends' model may be closer to Jaylon's situation than your papers.
Obviously, my researchers' work involved several months before it reached the muscle, which is similar to Jaylon's situation. It seems the work you read did not involve the same time duration because the nerve was severed right next to the muscle.

LOL, who knows... but I will check with my experts and see what they say.

Details on my researchers' work
Involved rodent and primate models in which 2 types of surgeries were performed half way up the arm for direct comparison: (1) end-to-end suturing of severed nerves vs. (2) insertion of severed nerve 'ends' into nerve regeneration growth guides (tubes).
Obviously they were trying to show that the nerve regrowth channel product were superior to end-to-end suturing (standard of care).
The primate results were also definitely worse than rodent results (slower and lower % of recovery).

The nerve was severed and regeneration monitored using behavioral functional recovery.
That is the animal was trained to performed certain tasks before injury.
Then obviously they monitored the ability of the animal to recover its function over time - how much force and how many cycles.

It is interesting that both the injuries in the studies you read and my researchers' work were worse than Jaylon's injuries.
Jaylon's nerve was not crushed nor cut.

Both you and I suspect Jaylon's tweets lol.
I suspect the connection started early August and he was having a little function at that point.
You probably believe that reinnervation started early Oct or so.
I suspect there will be more info on this in the future...

Seeing that your cases involved cutting and surgical intervention, they are even less like Jaylon's case than the studies I am talking about. Crush and stretch are both categorized as type 2 or 3 given palsy whereas cutting is by definition the worst case, type 4. I specifically ignored all the stuff relating to grafts due to that.

No doubt the atrophy post injury is significant but Smith's injury was nowhere near as problematic in overall recovery just playing percentages of outcomes. If I recall correctly, not all of the reinnervations involved using the old synaptic endplate and instead formed new ones either.

Ultimately the lack of specificity means I cannot just look up prognosis for type 2 peroneal injuries.

Once the injury occurs it takes about a month or so before regeneration starts. Once the nerve regenerates to the distal region it takes anywhere from a month to several months for the endplate to form.

If you had minimal to no delays at the endpoints his January injury would reinnervate about August but I recall calculating that it could happen at September at the earliest given the delays.

He made several tweets late September and early October where he talks about God's timing and thanking God which were not similar to his tweets even his religious tweets before or after that time period. There is a difference between saying God is great or that you do what you do for God as he does the rest of the time and thanking god for something that he did at that time.

I don't think there is any question that something significant happened to him. I also cannot think of anything other than his medical situation that he would be so coy about that he would be willing to bring up on twitter in the first place but not tell us what it is.

 

[waldoputty]

Seeing that your cases involved cutting and surgical intervention, they are even less like Jaylon's case than the studies I am talking about. Crush and stretch are both categorized as type 2 or 3 given palsy whereas cutting is by definition the worst case, type 4. I specifically ignored all the stuff relating to grafts due to that.

No doubt the atrophy post injury is significant but Smith's injury was nowhere near as problematic in overall recovery just playing percentages of outcomes. If I recall correctly, not all of the reinnervations involved using the old synaptic endplate and instead formed new ones either.

Ultimately the lack of specificity means I cannot just look up prognosis for type 2 peroneal injuries.

Once the injury occurs it takes about a month or so before regeneration starts. Once the nerve regenerates to the distal region it takes anywhere from a month to several months for the endplate to form.

If you had minimal to no delays at the endpoints his January injury would reinnervate about August but I recall calculating that it could happen at September at the earliest given the delays.

He made several tweets late September and early October where he talks about God's timing and thanking God which were not similar to his posts before or after even his religious tweets before or after that time period. There is a difference between saying God is great or that you do what you do for God as he does the rest of the time and thanking god for something that he did at that time.

I don't think there is any question that something significant happened to him. I also cannot think of anything other than his medical situation that he would be so coy about that he would be willing to bring up on twitter in the first place.

I recall the researchers talking about how severing near the muscle is an easy case.
I dont know which is a better match for Jaylon's stretch case 6 inches from the muscle, having to regenerate some distance after cut and suture or your case with the crushed nerve next to the muscle.
Given that end-to-end suture has high success rate (~75%), I tend to think it is not that different than stretch (~90%) - % are from recollection only.

In either case, Jaylon has a decent chance for playing near the end of the season.

Wow, you really did a lot of research into this.
I only read the literature because I was writing a business plan for the researchers.

In terms of the recovery, I recall it was 1 month delay + 1 month/inch = August 8th or so.
Not sure how you got to Sept.

I will ask the researchers about your papers.

About Jaylon's tweets, I think we have the same suspicions.

 

[CalPolyTechnique]

He made several tweets late September and early October where he talks about God's timing and thanking God which were not similar to his tweets even his religious tweets before or after that time period. There is a difference between saying God is great or that you do what you do for God as he does the rest of the time and thanking god for something that he did at that time.

 

[DallasDW00ds0n]

Great breakdown, but we dont know where Jaylon is in his healing process and everyone is different.

 

[waldoputty]

Great breakdown, but we dont know where Jaylon is in his healing process and everyone is different.

even better summary
we are just reading tea leaves (actually a little better than that...)

 

[Echo9]

Well he has been doing linebacker exercises for quite a while.
That may already qualify for practicing.
No sure you have to be in the field with the team?

Do you know?

Yeah. I'm pretty sure it's with the team. Each weekday, there's a practice report released listing who was out, who was limited, and who was full. Jaylon hasn't been listed yet, but he will have to be next week. If they are listed as practicing, that means team drills and such. Not sure if he can be listed as "limited", but if he's 'out' then it's basically over for the year.

 

[waldoputty]

Yeah. I'm pretty sure it's with the team. Each weekday, there's a practice report released listing who was out, who was limited, and who was full. Jaylon hasn't been listed yet, but he will have to be next week. If they are listed as practicing, that means team drills and such. Not sure if he can be listed as "limited", but if he's 'out' then it's basically over for the year.

Right, I suspect limited is fine - otherwise all those listed as limited would not be on the 53?

 

[Avery]

One thing most aren't considering with Jaylon's diagnosis: will this injury and rehabilitation now give him superpowers?

 

[Echo9]

Right, I suspect limited is fine - otherwise all those listed as limited would not be on the 53?

I don't think it has anything to do with being on the 53 at this point. It's just that next week is the deadline for Dallas to announce that he is 'practicing'. They can't say he's not practicing without having him practice to some degree. Doing stuff on his own like LB drills and rehab does not count. He needs to be at team practice, practicing. Whether it can be classified as "limited" or not, I don't know. There are 3 classifications. Practiced, Limited Practice and Did Not Practice. If he's DNP on tuesday, he's done for the year. Same with MacFadden. If not, then the idea that he plays this year is a reality. (a slim one, but one nonetheless).

Man, I'm writing practice so many times it's starting to look misspelled.

 

[waldoputty]

I don't think it has anything to do with being on the 53 at this point. It's just that next week is the deadline for Dallas to announce that he is 'practicing'. They can't say he's not practicing without having him practice to some degree. Doing stuff on his own like LB drills and rehab does not count. He needs to be at team practice, practicing. Whether it can be classified as "limited" or not, I don't know. There are 3 classifications. Practiced, Limited Practice and Did Not Practice. If he's DNP on tuesday, he's done for the year. Same with MacFadden. If not, then the idea that he plays this year is a reality. (a slim one, but one nonetheless).

Man, I'm writing practice so many times it's starting to look misspelled.

Right, but if limited practice does not allow Jaylon even to count as practice for practice status, then how could the 53 include players that are doing limited practice?

 

[Echo9]

Right, but if limited practice does not allow Jaylon even to count as practice for practice status, then how could the 53 include players that are doing limited practice?

Because the 53 players are on the 53 already? Maybe I'm not getting your question though. I would guess that "limited practice" does count as practicing for this status thing, but I'm not sure what the details are with that. Maybe they have to ease him in as limited first, and that's good enough? Or maybe they'd feel he's ready for a full go. I have no idea.
The only thing that matters is if he's DNP next week or not. If he's on the field with the team, the story continues.

 

[waldoputty]

Because the 53 players are on the 53 already? Maybe I'm not getting your question though. I would guess that "limited practice" does count as practicing for this status thing, but I'm not sure what the details are with that. Maybe they have to ease him in as limited first, and that's good enough? Or maybe they'd feel he's ready for a full go. I have no idea.
The only thing that matters is if he's DNP next week or not. If he's on the field with the team, the story continues.

I think you got me.
Possibly regarding "because the 53 players are on the 53 already", but like you said, neither you nor I know.

 

[Nightman]

I think you got me.
Possibly regarding "because the 53 players are on the 53 already", but like you said, neither you nor I know.

It is a loophole.......he can practice and not be on the 53 man roster yet......that is the beauty of PUP/NFI list

 

[waldoputty]

One thing most aren't considering with Jaylon's diagnosis: will this injury and rehabilitation now give him superpowers?

compare to our current rushers?

 

[waldoputty]

Seeing that your cases involved cutting and surgical intervention, they are even less like Jaylon's case than the studies I am talking about. Crush and stretch are both categorized as type 2 or 3 given palsy whereas cutting is by definition the worst case, type 4. I specifically ignored all the stuff relating to grafts due to that.

No doubt the atrophy post injury is significant but Smith's injury was nowhere near as problematic in overall recovery just playing percentages of outcomes. If I recall correctly, not all of the reinnervations involved using the old synaptic endplate and instead formed new ones either.

Ultimately the lack of specificity means I cannot just look up prognosis for type 2 peroneal injuries.

Once the injury occurs it takes about a month or so before regeneration starts. Once the nerve regenerates to the distal region it takes anywhere from a month to several months for the endplate to form.

If you had minimal to no delays at the endpoints his January injury would reinnervate about August but I recall calculating that it could happen at September at the earliest given the delays.

He made several tweets late September and early October where he talks about God's timing and thanking God which were not similar to his tweets even his religious tweets before or after that time period. There is a difference between saying God is great or that you do what you do for God as he does the rest of the time and thanking god for something that he did at that time.

I don't think there is any question that something significant happened to him. I also cannot think of anything other than his medical situation that he would be so coy about that he would be willing to bring up on twitter in the first place but not tell us what it is.

Fuzzy, talked to the researchers.

They said the end-plate studies are not a good comparison for Jaylon's surgery because it does not require much regeneration.

They did not work on simply-stretched nerves so they cannot say how much worse the cut case is. If they had to guess, the difference is not huge because they did compare cut/suture with cut/remove-section-of-nerve/stretch/suture. The cut/suture did better obviously, but the cut/remove-section-of-nerve/stretch/suture was not that much worse (may be 30% of the functional recovery test in which animal had to exert force and repeat).

I asked more specifically about Jaylon's injury. They said Jaylon will almost definitely have significant rehab needed - like shown in the posted video. They said even if the trainers exercised those muscles for Jaylon, it would not be the same as if he used them himself.

Finally, their opinion is EVEN if Jaylon thinks he is 100%, they should not play him this year because he is such an important player.

Again, they are not MDs who sees these cases frequently.

 

[FuzzyLumpkins]

Fuzzy, talked to the researchers.

They said the end-plate studies are not a good comparison for Jaylon's surgery because it does not require much regeneration.

They did not work on simply-stretched nerves so they cannot say how much worse the cut case is. If they had to guess, the difference is not huge because they did compare cut/suture with cut/remove-section-of-nerve/stretch/suture. The cut/suture did better obviously, but the cut/remove-section-of-nerve/stretch/suture was not that much worse (may be 30% of the functional recovery test in which animal had to exert force and repeat).

I asked more specifically about Jaylon's injury. They said Jaylon will almost definitely have significant rehab needed - like shown in the posted video. They said even if the trainers exercised those muscles for Jaylon, it would not be the same as if he used them himself.

Finally, their opinion is EVEN if Jaylon thinks he is 100%, they should not play him this year because he is such an important player.

Again, they are not MDs who sees these cases frequently.

Cutting in any way shape or form is a type 4 injury. Type 3 is when there is no cutting but damage to the exterior support system and type 2 is a stretch or crush where the exterior remains intact. Type 1 is partial or short term palsy.

We know he had a type 2 and there is no way that it is 'similar' to cutting the nerve and suturing it back together. I'd have to go back and look but we are talking upwards of a 40% less chance of a complete or near complete recovery of strength and function.