Blood Clots: A Not So Brief Baseball History

Blood clots are serious business and they have ruined pitchers’ seasons and careers.

In terms of symptoms, Gee had tingling/numbness in his right hand Sunday. This is not Gee’s first issue with his right shoulder. A damaged labrum, which was diagnosed publicly first as a “strain” ended his season on May 25, 2009 after just nine starts with Buffalo. He opted against surgery. In nearly every other case I found where a pitcher dealt with blood clots, another injury, or a history of damage to the arm and shoulder was involved. (Of course, pitching is damaging to the human arm and shoulder.)

Count Terry Collins is concerned. “There is some type of blockage and I am very, very worried about it,” Collins told the Post this morning in Kansas City, where he is an NL coach for the All-Star Game. “He is scheduled for more tests today…”

Collins again, as quoted by the Post: “We once had a player in Houston, who had a problem with his ribs causing a blockage of blood flow and that player was the never the same after that,” said Collins, who managed the Astros from 1994-’96.”

It seems awfully unlikely that Dillon Gee will be pitching again for the Mets soon.

We’re going to go through a history of pitchers with blood clots in their shoulders to try to figure out what’s next for Gee.

 

RECENT METS SCENARIOS  – Not Similar
Tom Glavine, 2006 – Time Missed: 14 days (2 starts). Pitched on August 16 and again on September 1
Similarities: numbness in fingers/hand
Diagnosis: Glavine did not want to use the words blood clot according to the AP story: “He said doctors told him it was a “freckling effect,” where something broke loose in his system.” However, the Mets’ official statement at the time indicated that Glavine did have clotting, but it was in his hand, not his shoulder: “The scar tissue from that old injury occasionally causes blood clots to form in Tom’s finger.”
Treatment: NO SURGICAL PROCEDURE REQUIRED. 
Glavine treated his blood clot with medication, including baby aspirin that acted as a blood thinner.

 

Bobby Parnell, 2011
Parnell missed 12 42 days (April 19-May 31) in 2011, with a case rather dissimilar to Dillon Gee’s. Parnell’s shoulder was not involved, and, like Glavine, there was no surgical procedure.
Diagnosis: From the Star-Ledger: “Parnell underwent an angiogram earlier today, and doctors diagnosed a local clot which was causing the numbness in his right middle finger. There was no sign of an aneurysm.”
Treatment: Parnell was “treated with aspirin.”

 

SEASON ENDERS
Jeremy Bonderman, 2008
Bonderman did not pitch again after June 1, 2008. He appeared in just eight games in 2009. He returned as a starter for Detroit in 2010, but was ineffective, posting a 76 OPS+ where 100 is league average.
1. DiagnosisThe blood clot was caused by thoracic outlet compression syndrome.
2. Treatment: “He underwent a procedure to break up the clot that night before having an angioplasty..”

 

Aaron Cook, 2004
Cook, then 25 years old,  was diagnosed with a blood clot in August of 2004. The clots, like Gee’s had begun in his shoulder, but had migrated to his lungs. Cook had surgery in September 2004, and did not return until July 30, 2005. He was an above-average starting pitcher in 2004, and from 2005-2009.

1. Diagnosis: shortness of breath induced by blood clots “that doctors say started in his throwing shoulder, probably because of pitching, and floated until lodging dangerously into each lung.”
2. Treatment: Cook, “Tom Probst and Keith Dugger [the Rockies' head trainer and assistant trainer, respectively] made a great decision which I think saved my life, to send me to the hospital…” Wikipedia: On September 10, Cook underwent extensive surgery at a St. Louis hospital during which the first rib on his right side was removed to relieve compression on a major blood vein.[3] 

 

Kenny Rogers, 2007
At age 42, Rogers was diagnosed with a blood clot at the end of spring training in 2007. He did not pitch in a Major League game until June 22. When he returned, he pitched well, making 11 starts with a ERA+ of 104. The subsequent season, 2008, was his last as he put up a 78 ERA+ and a 5.70 ERA in 30 starts with the Tigers.
Diagnosis: The “original diagnosis was a blood clot”
Treatment:  “Rogers underwent surgery to remove a blood clot and repair two arteries in his left shoulder” … “The operation removed a clot and repaired both the axillary and brachial arteries. The brachial artery runs down the arm before splitting into two arteries. The axillary artery is located in the upper chest and runs blood to the head and arms.” Rogers, like Bonderman, had been diagnosed with thoracic outlet syndrome, and had surgery to clear an artery in 2001.

Davis Romero, 2008
At age 25, Davis was diagnosed with blood clots in 2008 while working as a minor leaguer with the Syracuse Chiefs. In 2008, he ran a 3.71 ERA in 106.2 innings over 23 starts and two relief appearances in the International League before his season ended on August 14. He was ready to go by April 26, 2009, but has not appeared again in the big leagues.
Diagnosis: From the Las Vegas Sun, “Romero missed all of 2007 after having surgery on his pitching shoulder to repair and torn labrum, and he couldn’t finish last year because a blood clot in the same shoulder.”
Treatment: ??

 

Tom Lemke (Nebraska), 2011
Nebraska’s Friday night starter, could not throw from June 2011 until “late fall.” He faced batters in “live scrimmaging” in October.
Diagnosis: From the Sioux City Journal: Lemke was in the hospital for shoulder surgery last year when doctors discovered blood clots.
Treatment: “”I had some bones removed in my shoulder, so I had to learn to pitch all over again,” said Lemke….” … “Lemke had adjusted his pitching motion – taking the ball straight back and a “quick-arm” windup and delivery – to adjust to his new shoulder and all the time he spent recovering from the blood clots.”

 

Kevin Rogers, 1994
Diagnosis:
 From the AP story in May, 1994: “Kevin Rogers, San Francisco Giants pitcher who has been on the disabled list since May 2, has been diagnosed with a blood clot in his pitching shoulder.” He was 25. The New York Times story on Cone also indicates that Rogers had suffered a similar aneurysm.
Treatment: He never pitched in the big leagues again, but returned in the middle of the 2005 season making rehab appearances for San Jose and Pheonix. After missing all of the 1996 season, he pitched in the minors in 1997 and 1998.

 

MULTI-MONTH ABSENCES
David Cone, 1996
Cone missed four months with the complications from a duel aneurysm/blood clot diagnosis in 1996. He did not pitch from May 2 through September 2. Cone returned as a terrific pitcher with an ERA+ over 125 every year from 1997 through 1999. He was an all-star twice in that late-career surge, and finished in the top six in the Cy Young Award voting twice after his aneurysm/blood clot issue.
Diagnosis: From the New York Times, May 1996: “Blood clots that formed in the aneurysm near the shoulder apparently broke off and blocked blood flow, causing tingling and pain in his fingers and making his ring finger turn white.”
Treatment:  “Treatment has apparently alleviated the potentially dangerous problem in Cone’s fingers. But the prime problem — the aneurysm in his arm — remains and might require surgery.”

Kip Wells20062008
Wells’ blood clots kept him out of action for nearly three months in 2008; he did not pitch between April 28 and July 21. He also had problems with blood clots in 2006 and after surgery on March 6, returned June 19 per Wikipedia.
By ERA+, Wells was a below pitcher every single season after 2003. Somehow, he kept appearing in big league games all the way through the 2012 season.  Diagnosis ’08: The  AP story: “They’re going to take a look at where the clots are coming from,” Rockies trainer Keith Dugger said. “More than likely, the clots are coming from the shoulder.”
Treatment ’08: Surgery

CAREER-ENDING
JR Richard, 1980

From Wikipedia: On July 30, 1980, Richard suffered a stroke and collapsed while playing a game of catch before an Astros game, and was rushed to the hospital for emergency surgery to remove a life-threateningblood clot in his neck. His condition brought a sudden end to his major league career at the age of 30.
Oil Can Boyd, multiple
From Wikipedia: “He pitched 10 years in the majors before blood clots in his right arm ended his career.”
Diagnosis: August 1988 from the Sun-Sentinel: Boyd was “diagnosed as having a blood clot about two centimeters long in the main artery into the arm and area in front of the right shoulder.”
The problem came back: “In 1994 [with the independent Sioux City Explorers (Northern League)], Boyd was 4-1 with a 1.89 ERA before his season was stopped prematurely by a blood clot in his right shoulder.”

 

Conclusion
The medical history on blood clots and pitchers looks ominous for Dillon Gee’s 2012 season. It’s not just the clots. The pattern seems to be that pitchers’ blood clots are associated with further shoulder or vascular damage.

Please use the comment section to point out blood clot stories I missed, so I can add them in.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s