Alex Smith Out, Chase Daniel to Start vs. Chargers

QB Chase Daniel will start for the Chiefs in Week 17 against the Chargers

Rick Burkholder

Opening statement: "I just want to give you guys an update. Since I've been here for two years, since coach (Reid) has been here and Alex (Smith) has been here and John (Dorsey) has been here, we've been very transparent about what goes on injury-wise and so, we're at another situation with the Chiefs where we have to tell you guys about an injury.

"In the Pittsburgh game, early in the third quarter, Alex (Smith) took a shot to his abdomen and he subsequently has a lacerated spleen and so he will not play this week. It's a non-surgical case, it will heal on its own, but he's going to have to have some time down from contacts and collisions so with that in mind, let me walk you through where we went from Sunday until last night when we had a final diagnosis. Sunday, early in the third quarter, he threw a ball down the field to Albert Wilson and was hit in the abdomen.

"When I reviewed it on tape with Alex, it looks like as normal as can be, a fairly normal hit that he takes. I didn't even notice it during the game. In fact, the only questions that I ask him during the game and after the ball game were whether his knee was alright because he took a shot below the knee and he says he was alright. But then as we were clearing out the training room in Pittsburgh, he came in and asked Dr. Monaco, our team internist and Dr. Luke Thompson from KU to take a look at his abdomen because he had taken a pretty good shot.

"As I walk you through this, I'll try to tell you what we look for for spleen injuries. We had no idea at the time, so what you look for is increased tenderness in the four quadrants. His spleen is in his upper-left quadrant and he really didn't have any pain there the day of the game and you look for tenderness throughout his abdomen and fullness in his abdomen. With a spleen injury, you also look to see whether he has this urge to have a bowel movement and late manifestations are left-arm pain. All this is because of bleeding so as the spleen bleeds, perivascular organ, it's really a big lymph node, it'll bleed and then cause all this pain in his abdomen and then into his left arm.

"The reason Alex didn't have any symptoms Sunday that tipped us off were he didn't bleed very much. We went Monday, came in here, worked out, did fine, and orthopedically, doing coach (Barry) Rubin's workout and running, he was fine. On Tuesday, we practiced. If you remember, it was a little different schedule. [He] came in right after lunch and said you know, 'I just don't feel quite right.' If you remember back to the last couple of weeks, we've had a couple guys with a gastrointestinal virus, so we had guys miss all last week. We weren't sure whether he was getting sick or not. Dr. Thompson was in the building. He took a look at him. We got a urine sample on him to see whether anything was showing up and nothing was showing up. He wasn't getting worse, but he wasn't getting better either, so I had him see Dr. Monaco on Wednesday morning and Dr. Monaco walked him through everything, examined him, everything checked out and he encouraged Alex if he didn't get better, to go get a scan of his belly just to see what was going on.

"We weren't sure whether it was viral or whether it was actually the hit that he took. Wednesday afternoon after practice, which was Christmas Eve, obviously our coaches and Alex and the quarterbacks were still working and he wanted to wait until Christmas Day which was an off day for the players somewhat and he was doing Christmas with his family and then in the afternoon, we were going to check with him and see if he wanted to do the scan over at KU, which and Alex will walk you through this part, initially, didn't want to do it. Dr. Monaco and him exchanged some interesting texts messages and Alex decided to do it at Dr. Monaco's urging and so last night, we got the diagnosis through the scan that he had about a three-centimeter laceration in his spleen and he didn't have hardly any bleeding at all. We referred him to Dr. Michael Moncure at Kansas University Hospital, who's a trauma surgeon. He reviewed the studies, drew blood on him, determined that his spleen was slightly enlarged and that he has a small laceration.

"From a long-term standpoint and from a health standpoint for Alex, he's going to be fine. That's going to heal up. We'll continue to try to decide why his spleen is a little enlarged. It may just be him. It could be from the trauma, but we're doing a little bit more studies because we cover ourselves that way and cover him and make sure that we're on point. The problem is that to play with a lacerated spleen, even when it's probably a little less than three centimeters, it's just you can't do it and the reason being is, if you would take another shot there and that laceration would increase, then you have a medical emergency because that's a perivascular organ. It can bleed and all that, but my hat goes off to Alex for his toughness and also, we live on top of each other here and we all have a close relationship and he kept in constant communication with me and with the doctors and this was, Dr. Moncure said last night, this is a one-in-hundred find for our doctors because he didn't have any signs of the spleen, but they just have that, what I call 'blink,' so Dr. Monaco has blink where he says something's not right. And I'll take you back to the Eric Berry thing, Dr. Barnthouse, something's not right. So you get the study and then I won't go as far as to say that we saved a life, but you saved something that could go on Sunday and in this league and with our medical staff, we're life guards and we're supposed to do player safety and I think my group of docs through KU and through Dr. Barnthouse and Dr. Monaco, do as good a job as anybody in the league at protecting these players."

On Alex Smith's recovery timeline: "He's got a small laceration. Generally, they take six weeks, but everybody's different. He's a young, healthy guy that's got high metabolism so if we're playing three or four weeks from now, we'll rescan him and see where he's at and send him back to the general surgeon, confer with Dr. Monaco and any doctors that Alex wants to see whether he can plan, but like I said, generally, they take six weeks to heal up, perivascular and they do fine."

On possible long-term issues: "No. Full recovery."

On whether he would miss about six games if this occurred midyear: "Probably. He's out right now."

On whether he's out through the Super Bowl: "Well, the Super Bowl's six weeks from the time he got hurt. Does he heal up faster? I hope we have that problem."

Alex Smith

On the injury timeline: "Rick (Burkholder) was pretty spot on. I didn't notice anything. I walked Rick through the game. I'm kind of guessing as far as the hit. I think it was that one, but it wasn't until after I showered up, even dressed, adrenaline kind of got out of me and I noticed some discomfort for sure in my stomach area. Pressure, cramping and I thought it was, I don't know, something I ate. I didn't even necessarily relate it to a hit. But definite discomfort down there. I went and saw Doc, he examined me. [He] told me some things to kind of keep an eye out for. I literally took some antacid stuff there. I didn't know what to make of it and it just didn't go away. It kind of--same day, next day, same thing. Day after that, same thing. I practiced on Tuesday, I worked out on Monday, I ran. It certainly wasn't something that was prohibiting me athletically. I didn't feel like it was muscular. I just kind of had this discomfort. Nausea kind of coming and going. I knew a bug was going around. I thought maybe it was that. Like I said, I practiced both days, I felt great athletically running around, throwing. Kind of just had this constant deal going on and thankfully Doc kind of urged me to get the test. I was pretty reluctant yesterday, Christmas day. I was telling him I'm fine. I'll be alright. He really kind of pushed me to go get it checked out and make sure everything was OK. Then I obviously got the call and get told I had the laceration on there and it was enlarged and so, I was learning this all of last night."

On whether he had put himself at risk at practice:"Not really with the (yellow) jersey on. We practice well. Our guys stay away from us as QBs and that's the strange thing. I was running around practicing. I felt like I had* *two really good days of practice. I felt good about them. I felt really good about them and strange to get this. I don't really feel like it's anything that's hindering me athletically. Obviously, he's talking about me taking hits on it and what could happen. Obviously, a very strange thing to be dealing with."

On what could happen if he took a hit: "They were talking about it rupturing and so you're talking about emergency surgery or bleeding out. Obviously, pretty scary endings. You're dealing with that. It's a different deal when you're getting told those types of things. Obviously, you remember the pass. I know Chris Simms kind of had to deal with his spleen and an emergency situation going to the hospital and potentially getting on an airplane and potentially really be dealing with some dangerous stuff."

On his initial reaction of getting the call:"I didn't know what to make of it when they were telling you. You don't know all the medical stuff that comes with the spleen, so you're kind of learning it as they tell you. Once you start hearing how serious it is, obviously, you start knowing implications can come of this as far as not playing and that's the last thing you want to hear. At the same time, you're not crazy. I had this deal going on and it wasn't going away and I'm really happy that Doc kind of urged me to go get it done. Get the test done. Like I said, I was very close from bailing on him yesterday and just hanging out with my family."

On what made him decide to get the test: "I think that it hadn't gone away and it was just still there and it was a quick trip, he had set it up and really kind of him urging me. 'Let's go get it. Let's take a look and make sure what's going on down there.'"

On his role on Sunday: "It quickly changes. Tough. I talked to Chase (Daniel) last night. I really felt like I ate up two practice days of his. They would have been important had we known this earlier but tough. Really kind of on me I feel like but, any way I can help us now. Whatever it is. Helping him prepare, passing on anything that I had been thinking this whole week and getting ready for. Doing anything I can to help us get ready to go win a game."

On whether it was the third quarter hit: "Yes. We're thinking. It literally wasn't until I was getting dressed that I started to feel what was going on and it's still strange for me to describe. Cramping, pressure, enough that I was aware of it and it was uncomfortable that I had to go see Doc and it just never went away for three or four days. It was still there and it was enough. It just kind of kept hanging and I didn't know what to make of it and so you kind of then push me to get the test."

On whether he'll be on the sideline Sunday: "Yes. I'm planning on it. Yes. I'm planning on being there. The big thing is just no contact, so really I think other than that, it's just normal activities I think I'm OK with, which is strange in itself to kind of digest. I practiced, I feel OK, but you get hit right or you get hit there, it's you know."

Photos of QB Chase Daniel from 2014

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