Should KA just allow Eichel to have the surgery now?

[I-90 W]

Since it is all but certain that Jack Eichel has played his last game as a Buffalo Sabre, should the surgery now be allowed to remove the health issue from our trade asset? Or is this a mute point as the team physician has already made their recommendation?

[Drag0nDan]

6 minutes ago, I-90 W said:

Since it is all but certain that Jack Eichel has played his last game as a Buffalo Sabre, should the surgery now be allowed to remove the health issue from our trade asset? Or is this a mute point as the team physician has already made their recommendation?

Herniated discs don't always require surgery.  The team doctor made a recommendation to not do it and just rehab it.

[Marvin]

I have sympathy for both positions.  But based on my knowledge and understanding, my answer is no -- the Sabres should follow best practises.

Eichel's position is both simple and complex.  He wants the surgery because it is faster for more than just impatience: slipped disks can be very painful.  He also can't lift weights or do extended aerobics like jogging.  So the longer he goes without surgery, the worse off he will be when the season starts.  He wants to lead in the off-season, but he can't.

However, best practises are best practises.  Among other reasons, the surgery is not always effective.  Thus, unless the time elapsed is so long and the progress made so minimal, they should not budge.  While under contract, the Sabres are on the hook for his well-being.  They must continue their policy until their staff says it's long enough or a neutral board of neurologists and neurosurgeons say otherwise.

[I-90 W]

2 minutes ago, Drag0nDan said:

Herniated discs don't always require surgery.  The team doctor made a recommendation to not do it and just rehab it.

I guess what I am asking is, if he has the surgery and would be declared healthy for next season, does that increase his trade value? 

[Crusader1969]

If Jacks doctors say do it, Sabres say dont...why not find an impartial specialist?

[Drag0nDan]

Just now, I-90 W said:

I guess what I am asking is, if he has the surgery and would be declared healthy for next season, does that increase his trade value? 

I think the issue is he might be healthy if he just does his rehab.  

[SDS]

1 hour ago, Crusader1969 said:

If Jacks doctors say do it, Sabres say dont...why not find an impartial specialist?

Medicine is not exact science. It is risk and outcome-based opinions. 

I have mentioned my cervical herniated disk before. I had my ortho tell me I needed surgery ASAP due to risk of some level of paralyzation due to the herniation pressing on my spinal cord and my tingling arm. Others called the herniation "massive" and also recommended surgery.

Then I got vertigo. Then the world shut down. Then my body reabsorbed the herniation and my numbness went away. I haven't re-imaged the area yet, but I'm guessing the herniation is much smaller. I'm guessing now, no one would recommend surgery for a symptom-free patient (who doesn't play professional sports).

Risks and outcomes. Opinions vary.

[Thorner]

7 minutes ago, SDS said:

Medicine is not exact science. It is risk and outcome-based opinions. 

I have mentioned my cervical herniated dial before. I had my ortho tell me I needed surgery ASAP due to risk of some level of paralyzation due to the herniation pressing on my spinal cord and my tingling arm. Others called the herniation "massive" and also recommended surgery.

Then I got vertigo. Then the world shut down. Then my body reabsorbed the herniation and my numbness went away. I haven't re-imaged the area yet, but I'm guessing the herniation is much smaller. I'm guessing now, no one would recommend surgery for a symptom-free patient (who doesn't play professional sports).

Risks and outcomes. Opinions vary.

And with Jack’s health and livelihood on the line, and the Team’s 80 million on the line, of course a discussion about such things between them always had the potential to get testy. Add 6 years of a losing environment on top of it? Land mine. 

Edited May 11, 2021 by Thorny

[Marvin]

19 minutes ago, SDS said:

Medicine is not exact science. It is risk and outcome-based opinions. 

I have mentioned my cervical herniated dial before. I had my ortho tell me I needed surgery ASAP due to risk of some level of paralyzation due to the herniation pressing on my spinal cord and my tingling arm. Others called the herniation "massive" and also recommended surgery.

Then I got vertigo. Then the world shut down. Then my body reabsorbed the herniation and my numbness went away. I haven't re-imaged the area yet, but I'm guessing the herniation is much smaller. I'm guessing now, no one would recommend surgery for a symptom-free patient (who doesn't play professional sports).

Risks and outcomes. Opinions vary.

Based on your experience and what you have seen, how much of the disagreement could be over the level of pain?  I could see Jack saying, "I just want this pain to go away."

[Cal Naughton Jr]

Yes. This is a no brainer 

[Shootica]

1 minute ago, Marvin, Sabres Fan said:

Based on your experience and what you have seen, how much of the disagreement could be over the level of pain?  I could see Jack saying, "I just want this pain to go away."

I'd wager that it has more to do with him not being able to train.  Jack is a known gym rat and probably has an off-season regiment he wants to get in.  He wants to get surgery with enough time to rehab, recover, and get some training in before the start of next season.  And it's probably driving him crazy that he's been sitting around for a month and a half without the ability to do anything, just watching time go by.

[Shootica]

But two things here:

1. This isn't KA's call.  This gets delegated to the folks with medical degrees, and for good reason.  You don't want the GM to have authority over medical decisions, that opens up huge conflicts of interest.

2. If you're a team orthopedist and are changing your recommended course of action to maximize a player's trade value, I'd have some serious doubts about your credibility to be in that position.

[nucci]

A spine surgeon needs to make this call. Get 2 opinions. I had a herniated disc for many years in lower spine until pain was too much and had the disc replaced. Rest and rehab will help but the disc will probably get worse over time and eventually surgery would be necessary

[SDS]

53 minutes ago, Marvin, Sabres Fan said:

Based on your experience and what you have seen, how much of the disagreement could be over the level of pain?  I could see Jack saying, "I just want this pain to go away."

That’s the thing. Nobody knows the details. If the herniation is pressing on your spinal cord it could also be pressing on a variety of nerves extending down your arms, etc. We don’t know what level the herniation is at.

I had tremendous pain in the month of December when I got my herniation and then it went away, and then I had numbness in January with no pain. 

“Getting surgery“ doesn’t mean anything. What’s the surgery for? Disk fusion? Artificial disc replacement? Just cleaning out the herniated disc material?

Peyton Manning went through this and his arm strength deteriorated precipitously year after year as he continually dealt with fusions in his neck.

None of this is to be taken lightly, unless the details are known.

[Scottysabres]

Just now, SDS said:

That’s the thing. Nobody knows the details. If the herniation is pressing on your spinal cord it could also be pressing on a variety of nerves extending down your arms, etc. We don’t know what level the herniation is at.

I had tremendous pain in the month of December when I got my herniation and then it went away, and then I had numbness with no pain. 

“Getting surgery“ doesn’t mean anything. What’s the surgery for? Disk fusion? Artificial disc replacement? Just cleaning out the herniated disc material?

Peyton Manning went through this and his arm strength deteriorated precipitously year after year as he continually dealt with fusions in his neck.

None of this is to be taken lightly, unless the details are known.

Had this exact problem 1 1/2 yes ago. Went to Dr. GARACIE? in Williamsville, had a cortezone/steroid injection in the neck spinal cord, arm stopped going numb, neck felt great, until the past 3 or 4 months. Arms still fine, but neck and shoulder sore constantly again. Tender.

[bob_sauve28]

1 hour ago, Marvin, Sabres Fan said:

I have sympathy for both positions.  But based on my knowledge and understanding, my answer is no -- the Sabres should follow best practises.

Eichel's position is both simple and complex.  He wants the surgery because it is faster for more than just impatience: slipped disks can be very painful.  He also can't lift weights or do extended aerobics like jogging.  So the longer he goes without surgery, the worse off he will be when the season starts.  He wants to lead in the off-season, but he can't.

However, best practises are best practises.  Among other reasons, the surgery is not always effective.  Thus, unless the time elapsed is so long and the progress made so minimal, they should not budge.  While under contract, the Sabres are on the hook for his well-being.  They must continue their policy until their staff says it's long enough or a neutral board of neurologists and neurosurgeons say otherwise.

My sports doctor told me if you don't need surgery, don't get it! 

 

But then I also think of Bruce Smith, who had like 20 surgeries. So ya, it's not an easy decision 

[aristocrat]

This is such a tough call. You can get so many opinions from docs so i cant really have an opinion on it.  Jack needs to understand the team has his best interest in mind. 

[nucci]

2 minutes ago, aristocrat said:

This is such a tough call. You can get so many opinions from docs so i cant really have an opinion on it.  Jack needs to understand the team has his best interest in mind. 

Do they...or their own interests?

[Marvin]

5 minutes ago, nucci said:

Do they...or their own interests?

I understand your cynicism.  Heck, I started where you are.

However, in this case, it is likely to be in both sides' best interests over the long-term for Jack not to get the surgery unless the pain becomes as bad as SDS described..  If Jack does not recover from this, Jack AND the team are both screwed.  The team probably likes the non-invasive route because it is, eventually, over 90% effective if the herniation is small enough.

This is a tough call.

[woods-racer]

7 minutes ago, nucci said:

Do they...or their own interests?

In this case their interests run parallel. Jack gets surgery that has a slim to good chance of ending his career the Sabres are still paying his contract. Lose him for a year while he does a less invasive form of treatment and he recovers and gets on with his career. Either way they both lose or they both win.

[SDS]

Just now, Marvin, Sabres Fan said:

I understand your cynicism.  Heck, I started where you are.

However, in this case, it is likely to be in both sides' best interests over the long-term for Jack not to get the surgery unless the pain becomes as bad as SDS described..  If Jack does not recover from this, Jack AND the team are both screwed.  The team probably likes the non-invasive route because it is, eventually, over 90% effective if the herniation is small enough.

This is a tough call.

With regards to your last statement, paradoxically I don’t think this is true. I’m not sure if they know the reason why, but from the research I have seen, the larger the herniation the more likely it is absorbed by your body. 🤷🏻

[nucci]

2 minutes ago, Marvin, Sabres Fan said:

I understand your cynicism.  Heck, I started where you are.

However, in this case, it is likely to be in both sides' best interests over the long-term for Jack not to get the surgery unless the pain becomes as bad as SDS described..  If Jack does not recover from this, Jack AND the team are both screwed.  The team probably likes the non-invasive route because it is, eventually, over 90% effective if the herniation is small enough.

This is a tough call.

we don't know the severity of the herniation to form an opinion but those involved should know

[SDS]

Just now, nucci said:

we don't know the severity of the herniation to form an opinion but those involved should know

If they don’t see eye to eye then it must be a middle case. The only thing that stopped me from getting surgery is that the numbness went away in my arm. If it continued, I would’ve gotten it. 

i’m guessing he’s in a state where the immediate pain and symptoms are gone, but the danger is still there for a future reoccurrence. Thus the difference of opinion.

[nucci]

2 minutes ago, SDS said:

If they don’t see eye to eye then it must be a middle case. The only thing that stopped me from getting surgery is that the numbness went away in my arm. If it continued, I would’ve gotten it. 

i’m guessing he’s in a state where the immediate pain and symptoms are gone, but the danger is still there for a future reoccurrence. Thus the difference of opinion.

I waited till the pain was too much to even walk but then again I'm not a pro athlete, so I see both sides. If it's replacement then it's a serious operation. 

Edited May 11, 2021 by nucci

[aristocrat]

50 minutes ago, nucci said:

Do they...or their own interests?

what's the difference?  don't they want him at tip top shape?