Sickle cell trait sidelines Steelers player

Pittsburgh Steelers safety Ryan Clark jokes with teammates as they warmup before practice at the NFL football team's facility on Wednesday, Jan. 4, 2012, in Pittsburgh. AP Photo/Keith Srakocic

PITTSBURGH - Ryan Clark sat down in Mike Tomlin's office and did something a little out of character for the normally verbose Pittsburgh Steelers safety. He listened.

And when Tomlin told Clark he couldn't play in Sunday's wild card game at Denver because of a sickle-cell trait that becomes aggravated when playing at higher elevations, Clark just shrugged his shoulders and nodded.

HealthPop: What is a sickle cell trait?

"I said `OK coach,"' Clark said Wednesday. "It wasn't any fight ... does he seem like a man who changes his mind anyway? I knew there wasn't going to be any changing in that."

And for that, Clark is grateful. If given the choice, Clark would give it a shot even when faced with potentially dire consequences.

"Y'all have seen me play, I run into people all the time, so clearly I'm not that bright," Clark told reporters with a laugh.

He's kidding. Clark knows what's at stake.

He nearly died the last time he played in Denver, when the then-undiagnosed condition flared up and he ended up having his gall bladder and spleen removed in addition to losing 30 pounds.

Just what exactly is a sickle cell trait? People who inherit one sickle cell gene and one normal gene have sickle cell trait. That's compared to people who inherit one sickle cell gene from each parent, who may get sickle cell anemia, the most severe form of sickle cell disease.

People with the trait usually do not have the symptoms of sickle cell disease, but they might experience complications of the disease, such as pain crises, which occur when the sickled cell becomes stuck in the blood vessel, causing painful swelling. In rare cases, people with the trait can face harm when they're dehydrated, in an atmosphere with increased pressure - like when scuba diving - or when they are in areas with high altitude and low oxygen.

Doctors cleared Clark to play this weekend but didn't make any guarantees. That's all Tomlin needed to hear.

"They couldn't tell me 100 percent that `Nothing is going to happen to you, you're going to play and you're going to be fine' and I think that 1 percent chance was enough for coach Tomlin to take it out of my hands," Clark said.

Tomlin told Clark that if Tomlin's son Dino was in the same situation, he wouldn't let him play, the kind of blunt assessment that Clark has grown to appreciate during Tomlin's five years on the job.

"I think either way is a difficult situation," Clark said. "Not to play with your teammates is a tough situation but to have to wonder after every play if you're going to be alright is also a stressful situation."

Instead Clark will watch in street clothes as Ryan Mundy steps in. Mundy has played well when called upon this season, collecting the first interception of his career in a 13-9 win at Kansas City on Nov. 27 and even catching a pass on a fake punt in a victory over Tennessee.

While not as quick as Clark, the 6-foot-1, 209-pound Mundy makes up for it with his size. He's been a special teams ace for most of his career, though Tomlin has called Mundy "starter capable."

So does Clark, just hopefully not until somewhere around 2013 or 2014.

"I tell him all the time I just need two more years to pay off this house in Baton Rouge and he can have the position," Clark said. "He's going to be a guy that's going to play in this league for a very long time."

Mundy made two spot starts for Troy Polamalu in 2010 but understands the stakes will be significantly higher this time around. At 26, the former West Virginia star thinks he's mature enough to handle the pressure.

"It's the playoffs, and it's a big deal," Mundy said. "So, you don't want to overlook that, but at the same time you don't want to get your head up in the clouds too much or lose focus of the task at hand."

The task on Sunday will be making sure not to get suckered by Denver quarterback Tim Tebow. Though Tebow has struggled passing the ball, he's shown an ability to chuck it downfield when defenses get a little too concerned with stopping the run.

The last thing Mundy wants to see is the ball sailing over his head.

"You can get comfortable from them running the ball, and then here they go throwing a deep pass on you," Mundy said.

Few teams have done it successfully against the Steelers this season. Pittsburgh allowed the fewest passing yards (172 a game) and the second-fewest passing touchdowns (15) in the league this season, though those numbers may be skewed by a favorable schedule that included games against the woeful AFC South and the NFC West.

Tebow's numbers aren't much better, though the secondary has a healthy respect for the former Heisman Trophy winner.

"He's tough to plan for," Clark said. "When you think about tackling a quarterback, quarterbacks slide, quarterbacks don't like to be hit. Tim seems to enjoy the physicality of football. He's a football player."

So is Clark, which makes his situation all the more frustrating. He hasn't missed a start when healthy since playing for the Redskins in 2004. In Pittsburgh's biggest game of the year (so far) he'll be forced to watch from the sidelines.

It's why he didn't exactly celebrate when it became clear the defending AFC champions would have to start their bid for a record ninth trip to the Super Bowl in Denver. Clark admitted getting emotional after the playoff pairings became set, knowing it would likely mean he'd have to sit out and hope the Steelers advance.

"You fought 16 weeks, you trained during the offseason to help your team win a Super Bowl and this is part of that mission and part of that journey," Clark said. "I was upset about it, not in the sense of not angry at coach ... but just as a competitor you want to go out there and compete and I knew I probably wouldn't have the opportunity."

Instead, it's Mundy's time. For a week anyway.

"Everybody gets their opportunities in different ways," Clark said. "This is his and he's going to do a good job for us."

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