"I'm looking around and I'm getting really sleepy," University of Houston cornerback D.J. Hayden recounted to The Morning Journal's Jeff Schudel during February's NFL Scouting Combine. "My left eye goes pitch black. I can't see out of it." He knew something was very wrong.
"Lord, help me get out of this one."
Hayden probably never thought a football tackle—during practice, no less—would almost cost him his life, yet that is what nearly occurred last November. The fact that he survived to tell Schudel the tale is nothing short of a miracle.
"It was a regular day at practice. We were doing team vs. scout team. They threw the ball my way. Me and the safety ran into each other. His knee hit me in my chest. I fell to the ground. It felt like I got the wind knocked out of me. When I was breathing, I just wasn't breathing right."
Hayden immediately sought medical attention. As Houston's medical staff evaluated him, he began to feel cold. He was likely entering a state of shock—a condition characterized by impaired oxygen delivery to the muscles and tissues of the body.
Caregivers recognized the severity of the situation and wasted no time in rushing Hayden to the hospital. There, doctors diagnosed a tear of the inferior vena cava (IVC), or the largest vein in the body that is responsible for bringing blood from the lower half of the body back to the heart.
Quite frankly, the injury should have killed him.
According to a 2001 study published by Dr. Robert F. Buckman and colleagues in the scientific journal Surgical Clinics of North America, up to 50 percent of IVC injuries prove fatal before the patient even reaches the hospital. Of those that do make it, the majority die soon thereafter (h/t Pub Med, access required).
Basically, Hayden was in serious trouble, and doctors had few options. Along with hoping and praying, the only treatment for an IVC tear is the immediate surgical repair of the vessel. What's more, doctors must work against the clock—even a delay of a few minutes could prove fatal.
Hayden's case was no exception.
"The doctor said he was going to have to cut me open," he recalled.
According to Schudel's column, surgeons performed a thoracotomy to open Hayden's rib cage. Essentially, they sawed through his sternum, or breastbone, to look for the source of the bleeding. Though exact details are unavailable, they were almost surely greeted by more blood within Hayden's chest cavity than most people can imagine.
Why did the situation turn so dire so quickly?
As mentioned, the IVC is the largest vein in the body, touting a whopping 1.5-inch diameter in some people. It needs to be large, as it carries blood from the pelvis, abdomen, liver and both legs back to the heart.
However, that also means that when the IVC bleeds, it bleeds fast. Additionally, with a bleeding IVC, not only does the heart receive less and less blood coming back from the body, it in turn sends less and less blood back outward. Instead, blood pools in the abdomen or chest.
Pooling blood is useless blood, and without the quick actions of Houston's medical staff and his surgical team, Hayden would have surely died. Even once he was under the knife, there was no guarantee of survival, as Dr. Buckman's study also found that of the 50 percent of patients that make it to a hospital alive, the majority of those that then die do so during surgery.
Fortunately, Hayden made it through the operation.
"He put some sutures in, stitched (the IVC) back together, closed me back up and here I am today," he said. "They said it was like sewing together wet tissue paper. I don't know how he did it, but he did it."
As Schudel's report mentions, IVC injuries are among the rarest of all trauma diagnoses, and Hayden's case defies all medical logic.
For instance, while taking medical board exams, unless a question stem describes massive trauma—such as an unrestrained motor vehicle accident or a pedestrian-automobile collision—medical students and physicians are generally taught to eliminate diagnoses such as IVC tears from the list of potential correct answers. In fact, even after doctors performed imaging studies and saw massive internal bleeding, an IVC tear remained an afterthought.
"They saw a lot of blood in my abdomen. They thought it was my liver or my spleen," Hayden remembers.
Difficulty determining the exact source of internal bleeding is quite common, and usually open surgery is required to tease out exactly what is going on. As such, it wasn't until surgeons directly visualized the bleeding IVC that they realized the true extent of the injury.
Hayden didn't know until well afterward.
"I didn’t think it was that serious until I woke up and was looking at the scar and all these bandages and all these machines I’m hooked up to,” he said.
Unfortunately, his saga had just begun, as the extent of damage due to internal bleeding is usually not known at the time doctors intervene. For all anyone knows, low blood flow to Hayden's brain, kidneys and other organs could have already taken its toll.
To make matters worse, Hayden would not leave the hospital any time soon, and even though he survived, Schudel's column makes it vividly clear that the situation began to take its toll during his hospital stay—both mentally and physically.
"At first I could barely sit up," he said. "I couldn't lift my shoulders. . .I could barely walk. My back was hunched over. It took me forever to sit up straight."
He even lost 24 pounds during the ordeal.
"The first couple days I was really depressed. I thought I'd never play football again. . .there was always doubt in my mind."
Sadly, Hayden's concerns were warranted. Once a bona fide NFL prospect, the freak injury caused his draft stock to become anything but a certainty. Matt Miller—Bleacher Report's NFL draft lead writer—explains:
Hayden was a top 100 player for me previously, but the heart condition is frightening enough to move him down to the sixth or seventh round. Depending on the severity of the issue, Hayden could completely move off my board as a non-draftable player.
While lying in his hospital bed, Hayden could probably think of nothing else but that possibility, as following surgery, doctors probably placed Hayden on constant heart monitoring. As such, warning alarms—designed to alert nurses and physicians of status changes—most likely sounded every time his heart rate or blood pressure changed.
In other words, Hayden likely endured frequent, audible and tormenting reminders of not only his precarious health status, but also of his questionable future.
What's more, thoughts of his poor performance in his last game against East Carolina tortured his psyche. After all, this couldn't be how his football career was going to end. Could it?
"I was questioning myself, 'Why did this happen to me?' I even questioned God because I was in a whole different state of mind."
Nevertheless, even in his darkest of dark moments, Hayden persevered. Then, slowly but surely, his athlete mentality took over—he wanted to come back, and he wanted to come back badly.
Soon, Hayden would be out of bed and walking. Next, he would be running.
"(He) was so determined to get back into football shape the trainer he is working with, Danny Arnold of Houston, had to put the brakes on his rehab," Schudel explains.
Those brakes did not slow his progress much.
On March 18 at Houston's Pro Day—a mere four months after doctors cracked open his chest to repair an almost universally fatal injury—Hayden clocked a blazing official 40-yard dash time of 4.40 seconds. He added a 33.5 inch vertical jump and a 10-foot broad jump for good measure (h/t Rob Rang, The Sports XChange/CBSSports.com).
Regrettably, a hamstring tweak prevented him from completing any other agility drills. He also forewent the bench press due to his recovering sternum.
It didn't matter. Jaws had already dropped.
Sure, athletes put up faster 40 times and higher vertical leaps than Hayden quite frequently, and Hayden may still very well go undrafted.
That isn't the point.
Rather, Hayden, a man who just 19 weeks ago survived an injury so rare and so serious that most doctors never encounter it in their lifetime, demonstrated that he is well on the way to a making a full physical and psychological recovery.
"I just want another opportunity to play another game and do what I can do," he explained.
NFL teams, take notice. That type of determination doesn't come around very often, and Hayden's love of the game is as sure as his will to return.
He also knows how lucky he is to even have the chance to prove what he is still capable of.
"The first sweat I broke (after the injury), I almost broke down and cried," he said. "I was just thankful I (was) doing what I was doing."
Given what he has gone through, if Hayden's name is called in April, him "almost" crying isn't very likely.
It's a darn safe bet those tears will flow.
Dave Siebert is a medical columnist for Bleacher Report who will receive his M.D. June 15. Medical information discussed above is based on his own knowledge except where otherwise cited.
Save Matt Miller's—which was acquired firsthand—all quotes and details regarding D.J. Hayden's injury were obtained from Jeff Schudel's aforementioned column from the Feb. 24 issue of The Morning Journal.