Wednesday, October 5, 2005

By Nick Wagoner
Senior Writer

Less than a week after missing practice because of a sinus infection, Rams’ coach Mike Martz missed another workout for something that could potentially be more serious.

Martz did not attend Wednesday’s practice and won’t be at Thursday’s either because of what might be endocarditis, a heart condition involving an infection of the heart’s valves or its inner lining.

As of now, it is unclear exactly what Martz’s condition is, but team physician Dr. Douglas Pogue said there will be plenty of testing done on Martz this week to determine what is wrong.

“An extensive medical workup has been done and is ongoing through me and other consulting physicians,” Pogue said. “A definitive diagnosis has not yet been established, but we are continuing to pursue this aggressively and will do everything we can to restore coach Martz to normal medical health.”

Included in that medical workup are a number of tests that will likely include blood cultures which will help identify bacteria in the blood. Other tests generally used for this type of issue are an echocardiogram, which uses a pair of tests that use high-pitched sound waves to produce an image of the heart.

An electrocardiogram is another test commonly associated with endocarditis, but it is used to determine abnormal heartbeats. Receiver Isaac Bruce underwent this kind of test when an irregular pattern was detected in his heartbeat during the team’s June mini-camp.

Martz issued a statement of his own after a 12:45 conference call with the Seattle media. In that statement, Martz revealed what could be the problem.

“I have been ill for four or five weeks,” Martz said. “Our medical staff is in the process of evaluating a number of diagnostic tests to determine the cause. Dr. Pogue suspects a bacterial infection of a heart valve called endocarditis. This can’t be confirmed for a number of days until a series of blood tests are concluded. Diagnosed early, this can be treated through a lengthy series of antibiotics with full recovery.”

Martz looked weary after Sunday’s game against the Giants, but appeared to be in good spirits Monday. After the Seattle conference call, Martz returned home to get rest before continuing with testing. He said the illness makes him tired more than anything.

“This infection causes a great deal of fatigue and is somewhat debilitating,” Martz said. “Consequently, I will limit my work day as much as possible until I can start to recover. I will not be at practice Wednesday or Thursday.

“I can't explain to you the fatigue. You feel really good and then in the course of a couple hours you hit rock bottom.''

Endocarditis can be caused by bacteria or fungi, with fungi being rare and often more dangerous. In Martz’s case, it is suspected to be a bacterial issue. According to medical sources, the bacteria will enter the bloodstream and settle on the heart, usually the valves.

There are a number of ways for that bacteria to enter the body, but one of the most commonly mentioned ways is through dental and surgical procedures. The cure for endocarditis usually involves a series of antibiotics to be taken over a period of time that can last anywhere from four to eight weeks.

Until it is determined that Martz actually does have endocarditis it will be difficult to trace the origin of how he acquired it. Martz did have back surgery in March in a fairly new procedure, but it seems unlikely that this would be a reaction to something so far removed.

Nonetheless, Martz has dealt with some of the symptoms of endocarditis including the fatigue and weight loss.

“This is something that if you let it go, it could become a real issue,” Martz said. “They feel very confident that's what it is, but they have to confirm it.”

Assistant head coach Joe Vitt will act in place of Martz until his return. Vitt is running the team’s practices this week and said that Martz’s absence won’t cause a problem in that regard.

“He has Scripted every play,” Vitt said. “He has Scripted the practice. He has set the practice format, we just get it going. He is going to see it on film; he is going to critique it on film.

“We are professionals. We are going to get paid no matter who the heck coaches and we have to go out and perform. At the end of the day nobody wants to hear our sad story. There are no excuses for losing so we are out here practicing to win.”