Jamie Cudmore is suing Clermont

[die_mole]

symptoms =/ how it affects your life

you can have mild PSTD symptoms but have to live your life in a way that would avoid situations that bring them up

I have mild crohn's symptoms at almost all times and have had to completely change the way i eat, sleep, what social activities i do and how much i work out

the mild symptoms they describe are slower coordination of dominant hand and less verbal learning skills... if you wanted to work in either a fast paced white or blue collar job you would no longer be able to do that

 

[Which Tyler]

" Overall there is not a suggestion of widespread decline in daily function in ex-rugby internationalists who had a high number of repeat concussions," said Tom McMillan, Professor of Clinical Neuropsychology.

"Although some differences in memory were found, these were mild overall and their cause uncertain.

"Despite a high number of repeat concussions in the retired rugby players, effects on mental health, social or work function were not evident some 20 years after they had stopped playing."

I still haven't seen the source, but the press on it is suggesting that "mild" means anything from O long-term effects to "some differences in memory"

 

[ratsapprentice]

I have mild crohn's symptoms at almost all times and have had to completely change the way i eat, sleep, what social activities i do and how much i work out

Then they aren't "mild".

 

[die_mole]

Then they aren't "mild".

yes they are... if they are moderate my life is shutdown, when they are severe I am in a hospital

but i'm sure you know more than my gastroenterologist

 

[ratsapprentice]

You may have symptoms that are "mild" relative to the worst symptoms of Crohns disease, but the symptoms themselves are not mild if they have such a great effect on your life.

A mild gunshot wound is not the same as a mild wound.

 

[RedruthRFC]

yes they are... if they are moderate my life is shutdown, when they are severe I am in a hospital

but i'm sure you know more than my gastroenterologist

This is nothing to do with medical expertise, it is to do with expertise in the use of the English language.

 

[Which Tyler]

Errr... Mild, Moderate and Severe are medical terms. When discussing medical conditions, then medical terminology should trump layman's mis-use

 

[ratsapprentice]

Their use of the term mild was in saying that there were some "mild differences in memory" - you don't think it's fair to extrapolate that that suggests mild effects in the context of day to day life?

 

[die_mole]

This is nothing to do with medical expertise, it is to do with expertise in the use of the English language.

No it has everything to do with a inability to understand relationships between variables and a failure to grasp that the strength of an input does not necessarily equal the strength of the outcome.

Symptoms and their effects on a personal loce have the same relationship as global temperature and ocean levels, price and quantity sold, and pretty much every other relationship between two things. The effect of y on x depends on a million different things.

 

[ratsapprentice]

At this point it seems to have more to do with obtuse pedantry than any lack of understanding.

 

[Which Tyler]

Their use of the term mild was in saying that there were some "mild differences in memory" - you don't think it's fair to extrapolate that that suggests mild effects in the context of day to day life?

In terms of the concussion effects - yes, partly because these memory changes don't break down well for a medical use of mild/moderate/severe, and partly because that part is taken from media briefings, not medical reports.
In terms of Chrones' disease - no, as they do break down reasonably well (IIRC), and are terms quoted from use in a medical setting.

- - - Updated - - -

At this point it seems to have more to do with obtuse pedantry than any lack of understanding.

You say that like it's a bad thing :mellow:

 

[die_mole]

At this point it seems to have more to do with obtuse pedantry than any lack of understanding.

The words we use have meanings for a reason.

 

[ratsapprentice]

In terms of the concussion effects - yes, partly because these memory changes don't break down well for a medical use of mild/moderate/severe, and partly because that part is taken from media briefings, not medical reports.

Exactly - in generalities it would be extraordinarily awkward to revert to technical language that clearly not everyone is going to be used to talking in. It's far more appropriate to describe the severity of symptoms relative to normal day to day function - not in the individual context presented by an ailment.

- - - Updated - - -

The words we use have meanings for a reason.

Yes - and you should learn to use language appropriate for the context... this isn't a medical briefing.
There's no need to adhere to medical syntax - in fact it's preferential not to.

I understand your desire to be accurate and specific, but there's no point in making a well written, accurate post if it's in Chinese.

 

[RedruthRFC]

This is one of the prime examples of where an HIA should not even come into it. George Smith was knocked out cold (which means automatically that he is concussed) and when he woke up, he was wobbly on this legs (a key indicator of concussion when there has been a head-knock). Under the current rules, the medical staff seeing this on the monitor would remove him from the field for the rest of the match regardless of the outcome of his HIA

Sorry for the bump @smartcooky. I was interested to read the above paragraph, it relates to a situation in a level three match in England in which there was a difference of opinion about a player's safety to play on. The player received a knock to the head and was observed to have been unconscious by the touch judge, the team doctor conducted a HIA (it was called this despite the fact that as non-elite rugby, they aren't sanctioned to use one) and assessed the play as fit to play on, the referee (correctly according to my understanding) disagreed and forced the player off. Based on what you say above, am I correct in thinking that any player at any level who has been unconscious should be removed from the field of play permanently? Do you have any links to the relevant guidelines for doctors and referees please? In particular, those that relate to the doctor's responsibility in this situation.

Thanks in advance for your help.

 

[smartcooky]

Sorry for the bump @smartcooky. I was interested to read the above paragraph, it relates to a situation in a level three match in England in which there was a difference of opinion about a player's safety to play on. The player received a knock to the head and was observed to have been unconscious by the touch judge, the team doctor conducted a HIA (it was called this despite the fact that as non-elite rugby, they aren't sanctioned to use one) and assessed the play as fit to play on, the referee (correctly according to my understanding) disagreed and forced the player off. Based on what you say above, am I correct in thinking that any player at any level who has been unconscious should be removed from the field of play permanently? Do you have any links to the relevant guidelines for doctors and referees please? In particular, those that relate to the doctor's responsibility in this situation.

Thanks in advance for your help.

http://playerwelfare.worldrugby.org/?documentid=158

Second paragraph of Concussion information:What is concussion? just below the red "Concussion Facts" panel

[TEXTAREA]Loss of consciousness, being knocked out, occurs in less than 10% of concussions. Loss of consciousness is not a requirement for diagnosing concussion but is a clear indication that a concussion has been sustained. [/TEXTAREA]

I have spoken to a local doctor who is a head trauma specialist. He told me that if you get a head knock severe enough to make you lose consciousness then by definition, you have injured your brain, and therefore you have concussion. When I asked him if a player who has been observed to be unconscious after suffering a head knock, should be removed from play, his answer was emphatic... "Yes, most definitely."

Good on that referee, he did the right thing and followed WR's "Recognize & Remove" protocol (which by the way, does apply to all levels of the game world wide even if HIA is not mandated. The Touch Judge recognized that the player had concussion, and the Referee removed the player.

 

[Which Tyler]

I'm with SC and the ref on this one too. LOC means you have Traumatic Brain Injury, and starts the return to play protocol (min 5 days) - even if you can pass an HIA - I'd also query what type of HIA the Dr performed, let's face it Prem HIA is different to Rabo HIA (currently, though IIRC the extra test is non-binding and in a trial phase).

 

[Every Time Ref]

I don't usually like to apply the "It's just common sense innit" approach to complex issues, but in this case ... it really is just common sense innit? If someone has been unconscious in the last 2 days, never mind the last 30 seconds, there is no way they should be playing contact sport.

 

[smartcooky]

I don't usually like to apply the "It's just common sense innit" approach to complex issues, but in this case ... it really is just common sense innit? If someone has been unconscious in the last 2 days, never mind the last 30 seconds, there is no way they should be playing contact sport.

And more importantly, when it happens on the field. i.e. player knocked out, the HIA is NOT a tool for the team doctor to use in order to let him continue playing. I suspect this is what might have been happening (in the match RedruthRFC was talking about) before the referee overruled him and had him sidelined.


ETA: It in also worth keeping in mind that the referee does have the power to prevent an injured player from continuing...

[TEXTAREA]LAW 3.10 THE REFEREE’S POWER TO STOP AN INJURED PLAYER FROM CONTINUING
If the referee decides â€" with or without the advice of a doctor or other medically qualified
person â€" that a player is so injured that the player should stop playing, the referee may
order that player to leave the playing area. The referee may also order an injured player to
leave the field in order to be medically examined.[/TEXTAREA]

This is not a recent addition, it was introduced in the year 2000 Law rewrite, previously, this Law said

[TEXTAREA]Law 3 (6)
If the referee is advised by a doctor or other medically trained person or for any other
reason considers that a player is so injured that it would be harmful for him to continue
playing, the referee shall require the player to leave the playing area. For this purpose the
referee may also require a player to leave the field to be examined medically[/TEXTAREA]

 

[valley commando]

I hope Jamie Cudmore doesn't have any long standing problems as a result of concussion and wish him all the best in his efforts to be compensated and in highlighting the dangers.
I think this shows how little players are valued as human beings and how they are to some clubs just temporary commodities.
There have been several negative comments about Jamie, for me is one of the best 2nd rows of the last 20 years, I loved watching him play.

 

[RedruthRFC]

I'm with SC and the ref on this one too. LOC means you have Traumatic Brain Injury, and starts the return to play protocol (min 5 days) - even if you can pass an HIA - I'd also query what type of HIA the Dr performed, let's face it Prem HIA is different to Rabo HIA (currently, though IIRC the extra test is non-binding and in a trial phase).

I didn't know that there were different HIAs. The person who reported this incident admits that the club in question don't have permission to use HIA, but use it anyway, so what they consider a HIA could be pretty much anything. IMO it is at very least irresponsible to use it without being granted permission to do so by World Rugby.

Edit: thanks for your replies @smartcooky, very useful.