Description: The Athletic Interviews Dr. Joshua Scott About New York Jets QB Sam Darnold Being Sidelined by Mononucleosis
Article Link & Article: https://theathletic.com/1206847/2019/09/12/whats-mononucleosis-a-doctor-breaks-down-the-illness-thats-sidelining-sam-darnold/ (Subscription Needed/Pasted Entire Article Below)
What’s mononucleosis? A doctor explains the illness that’s sidelining Sam Darnold
By Connor Hughes Sep 12, 2019
FLORHAM PARK, N.J. — Adam Gase made one thing abundantly clear this week: He is not a doctor. The Jets coach stated that nearly a half-dozen times on Monday, Wednesday and Thursday.
So when it came to the specifics of Sam Darnold’s still-can’t-believe-this-is-true mononucleosis diagnosis, Gase wasn’t very helpful. He didn’t know how Darnold got it. He didn’t know when he got it. He didn’t know when he might be back.
Like Gase, I too am not a doctor. I didn’t even stay at a Holiday Inn Express last night.
But Joshua Scott is.
So I called him.
As Scott — the primary care sports medicine physician at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles — explains it, mononucleosis is an infectious disease usually caused by the Epstein-Barr virus (EBV) that attacks the body’s white blood cells. It causes a host of symptoms that can include fatigue, fever, sore throat, swollen lymph nodes, a rash and swelling in the liver and spleen. The illness is most commonly contracted through the transfer of saliva. It’s nicknamed “the kissing disease” for a reason, but someone can get it by simply sharing food or drink.
Athletes can spread the virus by sharing water bottles. Most athletes get it the same ways everyone else does.
The first few weeks — which Darnold is just beginning — are the most challenging. This is when those symptoms take their toll. Because mononucleosis is a virus, no antibiotic will make anything better. Some medicines will help with the symptoms and supportive care is key. Some believe oral steroids can ease the lymph node and throat issues, but it’s best to just wait until your body builds up the antibodies to defend itself. It’s during this time that those with mono are the most contagious. That’s why Darnold isn’t allowed around the team.
It’s common for patients to experience weight loss, Scott said, because the fatigue makes them lose their appetite. The 22-year-old Darnold, as Gase said Thursday, is already down five pounds. Scott explained that hydration is key to keeping the weight on. It’s also important to “eat smaller meals more frequently” to ensure the caloric intake doesn’t drop.
The most dangerous part of mononucleosis deals with the spleen enlargement and swelling. This is what will keep Darnold off the field. Strenuous physical activity or contact to the area could result in a rupture, which in extreme cases could lead to death. Darnold cannot take the field again until his symptoms dissipate. And there’s no set timetable for when that will happen.
“With a contact injury, the absolute soonest I would allow an athlete to return is in three to four weeks,” Scott said. “That’s the absolute minimum to letting a professional athlete come back and play. This is an acute phase where you’re sick for one, two or three weeks, but then there’s a recovery phase that sometimes can last months. That’s the tricky thing about mono — it affects everyone different.
“It’s the enlarged spleen that you don’t want to risk. Most people who rupture their spleen do so during normal activities. (remember this is very rare). It doesn’t have to be contact sports. He could do it ironing his shirt. That’s why we recommend keeping athletes from playing any contact sport for a minimum of three weeks, then slowly work them back.”
There’s an outside chance, Scott explained, that Darnold could feel better within a week. If that were to happen, he could resume some physical activity such as running or throwing if symptoms free. Even in those cases, though, he probably won’t play a game until that 21-day timetable is met.
Darnold’s contraction of mono isn’t anything out of the norm. He’s right in the window (14 to 24) when most get it. He avoided contracting it in college, so he got it in the pros. Scott said 90 percent of adults test positive for the antibodies by age 35. Many non-athletes who contract the disease don’t even know. They simply think they’re sick for a couple of weeks, get better, then go on with their lives.
The positive of this, Scott said, is Darnold won’t have to worry about it moving forward. Once his body creates the antibodies he’ll be good. They’ll fight off the symptoms if ever they pop up again. Only in extreme cases of mono will complications, such as nervous-system issues, pop up. That’s very rare.
“Most people will recover from this just fine,” Scott said. “The only problem would be the possibility the fatigue and other symptoms last an extended period of time. Every person is different.
“Sam sounds like he’s a healthy guy. He’s an athlete. He’ll recover from this without any long-term issues.”