U.S. Soccer: Brian McBride--Another Entry in the Medical Log

Brian McBride has rebounded from his most serious injury setback and is eager to play against Mexico Feb. 28 in front of his own fans in Columbus.

A year ago, Brian McBride had come off an ambiguous showing at the CONCACAF Gold Cup that once again cast into question his durability.

He missed the U.S. opener against Haiti with a heart condition that puzzled doctors. They kept him out of action while trying to diagnose what had caused a rapid heartbeat.

Nothing was detected. He returned to the lineup for a 1-0 win over Peru, then scored a goal and set up another in the 2-2 quarterfinal tie with Colombia that the United States lost on penalties.

"It was just one of those things," said McBride, who has also survived a pair of fractured cheekbones - once to each side of the face - suffered in past seasons. "My mom has had it, and my brother has had it, but it's nothing serious."

Fate saved something serious for last September. A seemingly innocuous moment of contact caused a freak injury that sent McBride rushing back to the United States for emergency treatment.

McBride shrugs off the procedure and follow-up care that kept him out of competitive play for more than three months. Columbus team doctor Pete Edwards is not so dismissive of the massive blood clot that spread in his arm from the spot where McBride was kicked.

"This was a freak thing, but he's come through it with flying colors," said Edwards, who examined McBride upon his return from England and referred him to Dr. Tom Davis, an interventional radiologist at Riverside Hospital in Columbus.

"The danger was the clot would break free, pass through the heart and into the blood vessels in the lung. He would get a pulmonary embolus, which is potentially life-threatening."

A ROUGH DEBUT. Playing his first game on loan for English club Preston North End, an opponent kicked McBride in the right biceps just minutes into the Sept. 16 match.

"It was a 75-25 ball I knew I wasn't going to get, but I wanted to make sure the fans and teammates knew I wasn't afraid to get involved in a little collision," said McBride of the encounter at Deepdale, Preston's home field.

"I took a good shot to the arm, but we were right back up. I got a foul called on me, and that was that."

There was no melee, no pushing, no jawing. McBride played the full 90 minutes and drew praise from Manager David Moyes for his work in the 1-1 tie.

"At the end of the game, I felt like I had a dead arm, a muscle bruise," said McBride. "The next day, I lifted and tried to loosen it up. It didn't loosen up, it became a little more stiff.

"The next day at training was OK. After the second day, it started to get a little more stiff, and I had some swelling.

"The trainer said [it was] probably nothing, [to] keep an eye on it."

He played the next match, three days after he'd been kicked, and continued training. Not until he'd played another game did anyone realize the severity of his condition.

"I came in to the locker room and took off my shirt," said McBride. "One of the guys said, 'Holy s-, look at your arm.' I looked down at my arm, and it was twice the size of this one."

The Preston team doctors examined him with an ultrasound scan. They were shocked at what they saw. The clot was more than a foot long, having grown from a point near the bottom of his right bicep up to and through his armpit.

McBride called Dr. Edwards.

"He told me hop on a plane as soon as I can, get my butt home," McBride said.

THE PROCEDURE. Blood clots can be removed passively or aggressively. Medication is suitable treatment for smaller clots, but the doctors decided patience could be detrimental to McBride's health.

"We could put him on blood-thinners and hope his body could eat through the clot over time itself," said Edwards. "That's acceptable, but in a big clot to hope things work out OK rather than being aggressive is not as good an alternative."

Davis performed a procedure that is a combination of enzymatic and mechanical thrombectomy. Enzymes are injected to attack and consume the clot. Pieces of it are removed with surgical tools. McBride was taken back and forth between stations for injections and extractions.

After more than eight hours, they injected dye into McBride's arm to detect any remnants of the clot.

As the dye flowed through his bloodstream, radiological scans showed no traces of the clot. Yet some risk remained.

"There is some danger the clot can come back, because the clot can damage the vein and cause it to re-clot," said Edwards.

"This was a quite extensive, unusual case. It's a big blood vessel, but it has very thin walls, so it's a significant risk to do this."

McBride found some humor in the sterile, daunting atmosphere. At his first look at the long, flexible tube that would be used to inject the dye, he said, "That's a long way to go, Doc!" in belief the tube would be inserted in his mouth or nose, or someplace else.

"He said, 'No, no, we're putting it up through your arm.'"

THE RECOVERY. "Normally, you're out six months, you're on blood-thinners six months," said McBride. "The doctors were understanding to my age and thought my body would heal quicker, because most of the studies aren't of people my age.

"I was able to start training and lifting about seven days after the procedure, and I was able to start kicking a ball about seven days after that."

As to whether he rushed his return to activity a bit, he replies with a smile. "Maybe, maybe."

He lived in his hometown of Arlington Heights, near Chicago, for about two months. McBride took care of the exercise, and his family took care of the rest.

"I didn't think it was any big deal," he said. "I've been in hospitals enough the past few years. I have a great family. My mom's always there, so is my brother and sister. We're all very tight."

He went back to Preston in late December and played four games before rejoining the U.S. team. He scored against China Jan. 27, and got a league goal for Preston Feb. 10.

His clot was removed two weeks before the United States tied Costa Rica, 0-0, in Columbus last October. He watched that one from the stands - and also missed the 1999 inaugural game at Crew Stadium with one of those broken cheekbones.

The Crew forward has been called in for the Feb. 28 Mexico match in the Ohio capital.

"It's been an exciting time since they announced it," he said. "I'm looking forward to it. I know our fans, and I know the support in and around the Midwest is great. Playing against Mexico in general is a great time, because it's just a battle.

"Now I feel like I am part of this team, but I also know I have to perform every time. And yes, it's great to be healthy again."

by Soccer America senior editor Ridge Mahoney

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