Gary Kubiak will not coach the Broncos in San Diego on Thursday night as he recovers from a complex migraine, general manager John Elway said Monday.
Special-teams coordinator Joe DeCamillis will serve as Denver’s interim head coach for the game, and offensive coordinator Rick Dennison will take the lead in play-calling duties on offense.
“Joe has worked very closely with Gary in game-management situations, as well as (director of football analytics) Mitch Tanney, so we thought that was the best and the easiest way to handle that situation,” Elway said. “Joe has a tremendous amount of experience, and obviously the coordinators will be involved with that too. We think he’ll do a tremendous job this week.”
Kubiak, 55, was taken to a hospital by ambulance Sunday because of flu symptoms after the Broncos’ 23-16 loss to the Atlanta Falcons at Sports Authority Field at Mile High. He was hospitalized overnight and was diagnosed with “a complex migraine condition that caused extreme fatigue and body weakness,” the Broncos announced, and received medication before being released Monday afternoon.
Elway said Kubiak hadn’t been feeling well before Sunday’s game and became very lethargic after the game.
According to the Broncos, Kubiak had precautionary tests while hospitalized, including a magnetic resonance imaging scan and computerized tomography (CT) scan. Both returned normal results, but he is expected to have further testing to determine the cause of the migraine and any potential triggers.
“(Doctors) thought the prognosis for him was very, very good,” said Elway, who visited Kubiak in the hospital Sunday and spoke with him again Monday. “He’s going to have this week off. He’s going to be back on Monday, but he’s going to take this week and take care of some of those issues and find out if there are some different triggers or what not. But when it comes down to Gary’s health, everyone’s excited about what the prognosis is.”
The Broncos have been cautious with Kubiak’s health in large part because of his history.
In November 2013, while coaching the Houston Texans, Kubiak collapsed on the field during halftime of a game against the Indianapolis Colts and was hospitalized for two nights after suffering a transient ischemic attack (TIA), or mini-stroke. With TIAs, blood flow to the brain is interrupted by a clot, but the symptoms don’t last long and usually cause no permanent damage to the brain, according to the American Stroke Association. TIAs are described as “warning strokes” because patients face a high risk of later suffering strokes.
“A lot of people know about migraines that cause visual changes or flashing lights in the eyes or some loss of vision, like a blind spot. But migraines can also cause symptoms that look more like a stroke,” said Dr. Sharon Poisson, a neurologist at University of Colorado Hospital. “In some cases, they can cause weakness on one side of the body or numbness on one side of the body. Some people will have trouble talking, trouble getting the right words out, which can look a lot like stroke. Since they often present looking very much like stroke, we go through the same process when somebody comes through the emergency room with those symptoms as we would with stroke.”
Among the differences is that a migraine won’t cause damage to the brain. No cells will die, as they can with a stroke, so MRI scans typically appear normal.
Poisson said that while complex migraines and TIA often present similar symptoms, most of the time they are not directly related. But patients with migraines are at a higher risk of strokes and TIAs than people who don’t get migraines.
“Although it can happen, it is very rare that a migraine is directly associated with a stroke or TIA,” she said, adding that most complex migraines are treated with headache medicine and, for some who have recurring migraines, preventative medicine. “Most complex migraines get better quickly over the course of hours and, less commonly, a day or two. They typically get all the way better, without any residual symptoms. There are a lot of possible triggers for migraine, and we tell patients to try to avoid their triggers, but in general, we do not restrict their activity. If a patient is feeling poorly after a migraine, I will instruct them to ease back into things, but they are able to return completely to their usual activities.”
In an August feature for Stroke Smart, Kubiak said he was given a clot-busting thrombolytic drug while hospitalized in 2013 and, after a couple of days, felt normal. Kubiak missed a game after the incident and Phillips took over as interim head coach for the Texans.
But the health scare prompted Kubiak to change his coaching routine to reduce his workload and the stress of the job.
“Kind of ran myself into the ground a little bit,” Kubiak said in February, before Super Bowl 50. “I’ve tried to do things different. … I love the work, so I’m going to be up early in the morning working the hours, but I’ve also tried to go about it a little bit of (a) different way — not try to take on everything myself and understand I’ve got good people with me. I think it has helped me.”
Doctors ordered Kubiak to take a week off from work to recover, and the Broncos plan to stay in touch with his physicians to determine how much interaction he feels comfortable with over the next seven days.
“Gary is going to concentrate on Gary this week, and everybody else will concentrate on figuring out how to get a win in San Diego,” Elway said. “The doctors said a week. They were firm.”
