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November 1, 2005 - Difficult choice for Primeau

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Difficult choice for Primeau


By WAYNE FISH
phillyBurbs.com

The same questions face every player - many of them great ones - who has suffered concussions.

Can I go on?

Do I go on?

Some, like Hall of Famer Pat LaFontaine, were forced to retire.

Others, such as Jeremy Roenick and Eric Lindros, press ahead.

Now Keith Primeau may be joining that list of those who have faced such difficult decisions.

Monday it was confirmed that the Flyers captain did suffer a concussion from last Tuesday night's hit to the jaw by Montreal's Alexander Perezhogin.

Primeau underwent neuro-psychological baseline testing by team neurologist Dr. Gerri McGinnis at Jefferson University Hospital in Philadelphia and was told that he has a concussion.

No grade (degree of severity) has been assigned, but Primeau, according to guidelines set by the NHL collective bargaining agreement, must remain inactive for a minimum of two to three days and then be evaluated again in a week (if he is symptom-free) before he can participate in any form of strenuous exercise.

It's unclear whether this is a new concussion or simply the recurrence of one he suffered on Feb. 12, 2004 (on a hit by then New York Ranger center Bobby Holik). Primeau has said on several occasions that he really didn't feel symptom-free from that injury until this past summer.

Either way, it's a troubling time for the 33-year-old center.

Flyers head trainer Jim McCrossin, after consulting with team doctor Gary Dorshimer, told the media that it's unclear what long-range effect this latest injury will have on Primeau's career.

"That is why we have experts in the field," McCrossin said. "That is why we are monitoring his symptoms daily. I wish I could answer that. That at six [concussions], we're gonna call it quits, and Keith, you have to call it quits. That is where Dorshimer and Dr. McGinnis and all the doctors who evaluate Keith have to come up with a decision.

"Keith's health is our first priority. There is life after hockey."

Concussion treatment continues to be an inexact science, and predicting what a player can or can't do can be risky.

"Injuries vary person to person and blow to blow," McCrossin said. "... In terms of damage done, I don't know if anyone can tell you that."

Primeau, who was unavailable for comment, has been experiencing a variety of symptoms, including pain in his neck (similar to the effects of whiplash), headaches and a feeling of fatigue in his eyes.

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McCrossin believes that through certain forms of treatment to relax the neck muscles they can alleviate some of the pressure to reduce the headaches. The neck problem may hold the key to a quicker recovery.

"It's causing an irritation and can slow down your circulation," McCrossin said. "The muscles in the neck go up into the head. If they are tight, they are pulling down on the head and causing a headache. We're trying to relieve that symptom."

Right now it's difficult for Primeau to rest.

"When he lies down, he feels like he is spinning, and he also said his eyes feel busy," McCrossin said. "He may be focusing, but his eyes are going back and forth and they get fatigued."

No one knows for sure if a line can be drawn between the '04 concussion and this one.

"That's a real good question," McCrossin said. "We're treating it as that (a continuation) ... that this is numerous concussions. To say that this is his first concussion, I really couldn't say that because obviously, we had some earlier.

"Going back to the year 2004, if he had three then, this is his fourth or fifth. We have to do it that way. We have to look at the symptoms. Each of the concussions Keith had, the symptoms were delayed onset. I've been monitoring him. I've had more conversations with him than his wife."

Unofficially, Roenick has had 10 career concussions and Lindros eight. Both are playing this season.

Is there a point where it becomes dangerous to continue a career under the cloud of multiple concussions?

"Each and every one of them are different," McCrossin said. "What level they were. They grade concussions. When I spoke to Dr. Dorshimer today, they did not put a grade on it. How many can he sustain? That goes to an individual basis and is beyond my scope."

McCrossin said all concussions are reported to the NHL (Kristen Hawn, based in Pittsburgh, heads the league concussion program).

"The league wants to stay on top of it," McCrossin said.