Three of Drew Brees‘ children huddled next to him on their couch.
Rylen, his daughter, used a toy otoscope to look into her dad’s ear. Bowen, his middle son, checked his dad’s heart with a toy stethoscope. And Callen, Brees’ youngest son, sat intently while watching his dad blow into a real spirometer.
In the moment documented on Instagram, the New Orleans Saints quarterback called his children “the best medical team in the world,” adding he’ll be back on the field “in no time.”
While a touching family interaction, Brees’ use of the spirometer — a device that’s used to measure the air going in and out of the lungs — also showed that he’s already rehabilitating his collapsed right lung.
Spirometers “can be really, really helpful,” said Dr. Ilan Danan, a sports neurologist and pain management specialist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute. “It can be very influential in ensuring that it lessens the risk of infections like pneumonia from developing in a setting such as this.”
The injuries
With just less than nine minutes to play until halftime on Sunday, 49ers defensive end Kentavius Street pushed through rookie guard Cesar Ruiz to pummel Brees for what would have been a forceful sack, but the play ultimately resulted in a roughing-the-passer penalty.
Brees winced as he peeled himself up off the turf, staying in for the ensuing play with Taysom Hill taking the snap at quarterback. Brees lined up out wide and stayed in the backfield as the play developed.
Brees then ran off to the sideline and threw passes back and forth with a staffer — a departure of the 41-year-old’s normal routine when Hill typically orchestrates the offense. Usually, Brees watches Hill’s play unfold before returning.
Ultimately, Brees missed one play on that drive before coming back in for third down — handing the ball off to running back Alvin Kamara for a 2-yard touchdown.
Brees led Saints’ final drive before halftime — completing five of his six passes with a touchdown on the series.
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Twenty-four hours after his collision with Street, Brees was diagnosed with at least five fractured ribs and a collapsed lung — though all of those injuries were not caused by that specific play, according to a report from ESPN’s Ed Werder.
Brees broke at least two ribs on his right side Sunday, and doctors believe that those fractured ribs created what’s called a pneumothorax, or a collapsed lung, according to Werder.
The medical imaging showed Brees also had at least three broken ribs on his left side, Werder reported; those likely stem from the previous game against the Tampa Bay Buccaneers.
What’s a pneumothorax?
A pneumothorax is the medical term for a collapsed lung. That happens when air leaks into the area between the lungs and the chest wall.
There are fewer than 200,000 patients per year in the U.S. who are diagnosed with pneumothoraces, according to Mayo Clinic, which is categorized as a “rare condition.”
Danan said collapsed lungs are typically seen with high-impact activities, car accidents, blast injuries or penetrating wounds — like knife stabs or gunshots.
“In sports, it’s awfully rare, but in higher impact sports such as football, it’s certainly something that can occur and needs to be taken seriously,” said Danan, the neurology consultant for a number of California-based professional sports franchises.
Collapsed lungs don’t typically happen with a standalone rib fracture, but when multiple rib fractures are at play, like with Brees, that can be more common, Danan said.
Brees reportedly has at least five fractured ribs, and there are 24 ribs in a typical human body, separated into two sets of 12.
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Using the spirometer regularly helps with recovery, and when dealing with a collapsed lung, it’s not recommended to put pressure on the ribs or to brace the chest — even if it might provide some immediate pain relief.
“The goal ultimately — especially for someone who may have suffered a collapsed lung — is to ensure that they are working their lungs somewhat aggressively, despite the fact that there may be a bit more worsening pain with that,” Danan said. “And more than anything, just doing everything they can just to ensure that they’re not worsening the risk of re-aggravation or re-injury.”
Broken bones in general, though — whether it’s an arm like Andrus Peat’s (or a leg or a thumb, in his case as well) — are all a part of the game.
The protective gear with pads and helmets shield players to some degree, but as Danan said, “when you’ve got a lineman that lands directly on top of you, sometimes it’s unfortunately unavoidable.”
The recovery
Moving forward from rib fractures, regardless of whether the patient is a professional athlete or anyone else, can be a painful process.
Breathing can hurt, so too can coughing, sneezing and moving in general.
“Individuals don’t realize how much they actively use their ribs in both an active and a passive setting until they find themselves suffering a rib fracture and experiencing pain as a direct result of it,” Danan said. “No question some of the most benign activities that one could think of, such as breathing, can be noticeably more disabling as a result of a fracture.”
Bones, no matter where they are in the body, take time to heal. Though, while other bones are placed in casts to help with recovery, that’s not an option with ribs — even without the complication of a pneumothorax — so, rest and breathing exercises are the course of treatment.
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Danan said the typical recovery time for patients with fractured ribs can take the better part of three to six weeks for full healing.
“Obviously, if there’s multiple ribs involved or a collapsed lung or a pneumothorax, we’re a lot more cautious in terms of that timeline,” said Danan, who isn’t treating Brees but is rather speaking in generalities.
“More often than not, bones will heal themselves, but, yes, it can be absolutely frustrating in terms of understanding or recognizing that it is a little bit of a waiting game. No question.”
Danan said he was surprised Brees was able to get up on his own after taking the hit from Street, let alone finish the half.
But what also stands out to Danan about Brees is how he recognized that his body was telling him to step away from the field for the second half.
“This guy’s as strong as they come,” Danan said. “He’s, what, 40, 41? So he has suffered his fair share of bumps and bruises, but I would anticipate a full recovery. It’s just a matter of timeline. Obviously, the doctors that are working with him directly have a much better sense of that, and I’m sure they’re going to do everything to ensure that they’re putting the healthiest version of Drew Brees back out there.”