Former Boston Red Sox closer Jonathan Papelbon, who was with the team from 2005-11, said Saturday that he and numerous other Red Sox players were regularly injected with Toradol, a legal anti-inflammatory drug whose use has become increasingly controversial in sports.
Toradol is the nonsteroidal drug that Red Sox pitcher Clay Buchholz acknowledged last season might have contributed to the esophagitis that sidelined him for 20 games. Buchholz was hospitalized in intensive care and lost three or four pints of blood while dealing with the condition, which is a known side effect of the painkiller.
Papelbon said that when he was administered a physical by the Philadelphia Phillies prior to signing as a free agent after the 2011 season, doctors asked him if he used Toradol. When he answered in the affirmative, he was told that he would have to stop.
“They told me, ‘We don’t do that here.’ That kind of surprised me,” Papelbon said Saturday, speaking by phone from Phillies camp in Clearwater, Fla. “I haven’t had a single Toradol shot since.
“But here’s the thing you have to understand. There are so many organizations that do it. Not only baseball, but every sport. Football, basketball, hockey. It’s not just the Red Sox.”
Repoz
Posted: February 11, 2013 at 06:33 AM |
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1. Austin Posted: February 11, 2013 at 07:16 AM (#4366895)Of course, any anti inflammatory can be misused in treatment of injury. To get esophagitis from Toradol, you would have to be taking some ridiculous doses. You know how an advil overdose can inflame your stomach? Same thing.
So, the guess of the doctor in the house is that Toradol itself is not controversial. Perhaps team doctors are prescribing large and repeated dosage of Toradol which exceed by a significant amount best practices / recommended doses - if Buchholz was taking enough to get esophagitis - then that would be the problem.
Playoff beards don't boost testosterone, they reveal it.
"Playoff beards don't boost testosterone, they reveal it. "
Only if you're Chuck Norris...
It seems this particular anti-inflammatory is going to become a controversial issue in sports.
If athletes are suffering because of Toradol, it's because doctors are letting them take far more than everyone knows a person should take.
The real issue is, if it is being taken like this is, turning mild inflammatory issues which should be rested into bigger ones. Pain is the body's smoke detector. We can listen to it and check if there is a fire, or pull the batteries out and move along and hope for the best.
Not to mention infecting the rest of the office.
Ah, #### those guys!
Naw, I kid. My situation now is I could just stay home and no one cares. I've worked in other situations where they assume you're malingering if you call in sick, so it gets tricky.
With modern technology, you can work from home and have access to your work PC and all your files. It's not either-or.
I rarely actually "call-in sick" anymore. I just work from home, unless I'm literally sick in bed. I worked from home for a full month-and-a-half before my last surgery.
Sure. Office drones like us have it made now. There's actually no reason our firm needs an office at all, really. The actual office and the commuting seem like a waste of time and money to me.
I'm wondering if not getting rest is a cause of later neurological issues, or if both the behavior pattern that leads to not getting rest AND later neurological issues are symptoms of something else.
My company doesn't allow this. For intellectual property reasons we cannot dial in from outside the office so if I don't come in it's a sick day or a vacation day. Working from home is not allowed.
EDIT: I hope Mrs. Idiom is OK.
The IT dept in my company is up to 60-80% WFH now. They have hotelling space or shared cubes in the office. They've cut their real estate needs by 2/3.
I think that is the future. Be in the office with your team 2 days a week, and WFH the rest. Another team shares your space, and is in a different 2 days.
My wild-ass, I AM NOT A SCIENTIST guess would be the immune system might be involved, that not allowing yourself to heal may wear it down over time. Also, recent studies have shown that intense mental activity involves a lot more energy that we previous thought, so maybe there's a connection there, too.
edit: I also hope your better half is ok and getting better. I know something happening to Mrs. Shooty fills me with terror.
Did you get married, or are you just being colloquial?
Not quite yet. Mrs. pre-Shooty is clunky to type, though.
or is it that the players should just play with pain? seeing as how they make all that $$$
teams are not gonna let their good/expensive players just rest - i've watched more elbows and shoulders destroyed because when they first started hurting, the players were either afraid to say anything - seeJD "nancy boy" drew and turning into - or the team said - like - rub some dirt on it - or even worse, injected the STEROID cortisone into the joint
and now they are treating papelbon like he's using illegal drugs?
this is such BULLSTUFF
this screeching is how religious fanatic groups like puritans (etc) get starated
No, they should be allowed to rest and recover.
teams are not gonna let their good/expensive players just rest - i've watched more elbows and shoulders destroyed because when they first started hurting, the players were either afraid to say anything - seeJD "nancy boy" drew and turning into - or the team said - like - rub some dirt on it - or even worse, injected the STEROID cortisone into the joint
It's long past time that stopped.
They've certainly given some heart attacks.
TBF, some of that was probably just excessive angina.
It's just that it hasn't been pronounced an evil one by our overlords...yet.
The main problem for me working from is that while I can view and edit files on my work PC, I can't print them at home for data security reasons (I can't connect a home printer to the office network, effectively). I guess I could get a fax machine and have someone fax documents to me at home but that seems excessive given how close I live to the office.
I rarely get sick anyway. I did have some medical issues that landed me in the emergency room last year, and stupidly went to work the next morning, just a few hours late. I didn't have any follow-up problems as a result, but it was stupid and drove (still drives) my wife crazy. I definitely would not do that again today -- work just isn't that important.
Can't you down load them onto a secure thumb drive and then print?
Non-synthetic opiates are remarkably safe. Even hardcore addicts take decades to die from high morphine consumption. Heck, they put codeine in OTC cough medicine well into the 1970's.
Advil can ruin your liver in as little as a year with overuse.
Inflammation (a very common source of pain, hence why most painkillers are actually anti-inflammatories) can also cause injuries, or prevent healing, due to the inflamed tissue rubbing against things it wouldn't normally rub against if it weren't inflamed.
So there are real legitimate reasons to use anti-inflammatories to treat injuries.
Edit: Its too bad Vioxx kills people; it was high-leverage in my recovery from a pulled hamstring, and not just from a make-the-pain-go-away point of view.
Of course not, Babe Ruth was able to take aspirin. Any drugs in common use by Ruth or Mantle era players are fine.
Any new drugs created since their times open avenues of performance enhancement denied our heros and taints their magnificent records.
If Ty Cobb were alive today he'd be disgusted that such a huge PED cheat like Bonds holds the records he does. Not because of steroids mind you, Cobb would have taken more than Bonds given the chance, his disgust would at baseball allowing players with such high melatonin levels to play at all.
Definitely not from my home PC, and even in the office thumb drives have been disabled. Very concerned about data security.
You also could print the file to a PDF, then email the PDF to yourself. Same basic idea as faxing, only the paper is digital.
Even better.
Emailing a work document to my home email account in any format is expressly prohibited. Although I have occasionally done it when there was no other alternative, it's something we can be terminated for and we are frequently reminded of that fact.
This is going to be a really tough issue, because most high level pro athletes DON'T WANT to rest. Most of them want to take that painkiller and get right back out there, primarily because they're terrified of losing their job to the next guy down the line, and in this day and age that can potentially cost them their lifetime financial security.
Now why in the hell would Ty Cobb have ever cared if his opponents were dozing off between pitches?
Does this mean I should not be popping 3-4 advil a day to help the hangover from excessive intake of alcohol?
this is one reason I still keep my blackberry. I negotiate contracts, and if on the road (or even golfing), the Blackberry is still the most dependable device to read/edit/compare two docs. (w/ tracking changes) contracts when the use of a laptop isn't practical at a particular moment in time. Plus it is still 'corporate approved'
Joey makes a good point here that didn't get any response. Sports teams, and I'm sure the NFL is by far the worst offender, regularly utilize legal but almost certainly reckless and unhealthy drugs to keep their players on the field and playing well. Toradol may be a perfectly safe drug when used in proper moderation but who believes that teams are actually exercising proper moderation in its use? So far it gets ignored or swept under the rug but at some point, like head trauma in football, it's going to blow up and everybody is going to get the details of how badly teams/athletes abuse legal means of performance enhancement/recovery/pain blocking and how it can affect their bodies over time.
Maybe I wasn't paying much attention when he was dealing with it but this is the first I've heard about Buchholz's condition being the result of Toradol use, it certainly didn't get any significant attention before.
Does this mean I should not be popping 3-4 advil a day to help the hangover from excessive intake of alcohol?
Yes.
Take aspirin if you must take something every day. At least you'll only get an ulcer.
And kidneys. NSAIDs are a huge no-no for most kidney patients as are quite a number of OTC medications like antihistamines.
if you'be been hit/hurt during a game and you can't continue without a shot of something, you should not be playing, period.
I'm guessing your doctorate is not a medical one, dr. scott? If that is your real name....
To the extent that helps performance or that many people believe it does, yes. So is caffeine.
I'm not sure how facetious this is. But no, no one should be taking 3-4 advil a day. Especially not if they're heavy drinkers.
Dr. Google suggests there's no real risk to occasional advil use to treat occasional hangovers.
'Teams' aren't using it at all. Players are. Even if the teams are encouraging their use to get more value out of their player contracts, a crackdown on that would simply lead to lots of contracts with playing time incentives and then the players wouldn't need any encouragement to take them.
Players take these measures because they want to. Now maybe that's often a poor decision by them and they haven't factored in everything involved, but then that's the situation that needs to be addressed. Cracking down on every pharmaceutical known to man in professional sports leads to nowhere good for the sport.
Maybe instead of banning PEDs we should ban the root of the problem: self interest. I suspect we'd have the same amount of success in achieving what we wanted to.
i'd just like to point out the obvious flaw with that line of thinking, which is that the phillies didn't have anyone else to put in the games. for the first 2/3 of the last season, the bullpen was in shambles and if they tried to use papelbon every time there was a high-leverage situation late in games, he'd have had to come in from the bullpen 2 or 3 or 4 or 5 times per game because everyone else who was out there was a ####### gascan.
there are strong arguments for using your best reliever in the highest leverage situations, but in the case of papelbon last year, it would have been whack-a-mole because those high-leverage situations were created by the fact that noone else in the bullpen could throw a clean inning.
Cmon, Papelbon had plenty of appearances in non-save situations last year, a lot of them in games with 4+ run leads. But Manuel was unwilling to use him in tie games on the road even when available, and last year they happened to lose a bunch of these games with inferior pitchers on the mound while Papelbon rotted on the bench solely because of the save statistic.
E.G. The Phillies head into the bottom of the 9th in Toronto on June 16th in a tie game. Papelbon hasn't pitched since the 13th and is available, but instead Scwimer comes in to pitch the 9th, and then Savery starts the 10th before losing the game. On the following day, Papelbon pitches the bottom of the 8th in a game in which the Phillies are down 6-2.
These types of sequences happened several times last year.
Manual's usage of Papelbon absolutely lowers his value.
To challenge the argument that it's one of the worst deals, however, the Phils are precisely the kind of team that can get away with this usage given that they have three starters who can go 8 or 9.
Players take these measures because they want to. Now maybe that's often a poor decision by them and they haven't factored in everything involved, but then that's the situation that needs to be addressed. Cracking down on every pharmaceutical known to man in professional sports leads to nowhere good for the sport.
If a drug isn't over the counter, how is it proper terminology to say that "players take these measures"? Doctors are supposed to be there to keep patients healthy, not keep them available.
Not only that, but not too long ago at OTM, we *generally* came to conclusion that the Sox would have been better off (money and wins) keeping Papelbon. It would have taken a crystal ball to see that and all...but still...
edit: And as for the 'If he were used properly' argument. I absolutely believe that some players cannot handle being used outside the role they've been told they will have. You have to weigh the immediate benefits vs. problems down the line.
Ehhh...doctors are there to help their patients live a certain lifestyle, within fairly broad (some broader than others) safety thresholds.
1. Papelbon claims he was not informed of the side effects so could not make an informed decision. Also, he would not have known to stay away from other OTC NASID’s which could exacerbate the side effecs.
2. The other issue, more important, is the use is not in accordance with the manufacturers or FDA guidelines to use short term only for acute pain. Buchholz was getting an injection every 5 days to treat chronic pain typical among pitchers, Papelbon also seemed to use it quite frequently. The safety of such usage is not known since it has never been studied.
3. The other issue is given it’s effectiveness to kill pain, if using it to play through an injury can cause more serious injuries. Pain is a message sent to the brain that a body part needs rest and is injured. Ignoring that can worsen an injury.
In light of the Red Sox issues with players returning from injury too early and then getting reinjured (Pedroia, Ellsbury, Papi, Daisuke, Hill, etc) one wonders if Toradol is contributing to this.
4. Since the side effects are so serious that some players/teams may avoid using it, it gives a clear competitive advantage to those willing to put their bodies at risk, and younger players may feel compelled to use it though they otherwise would not. This is exactly what happened with steroids. There may be players for example on the Phillies who are injecting themselves with Toradol despite FDA requirements it be administered only by a Doctor (like steroids).
In some countries, the tablets have been banned and you can only get the injection at hospital due to the serious side effects which dwarf OTC NASID's.
To be clear, I have a laptop that I can bring home with me. I can also log into the network from my home PC. But I don't have the ability to print from either device except on a network printer in the office.
this is one reason I still keep my blackberry. I negotiate contracts, and if on the road (or even golfing), the Blackberry is still the most dependable device to read/edit/compare two docs. (w/ tracking changes) contracts when the use of a laptop isn't practical at a particular moment in time. Plus it is still 'corporate approved'
I have found Blackberries are great for typing emails and little else. Trying to read at a document on a Blackberry is usually a complete waste of time for me unless it is a very short document.
But do you think Papelbon (or any closer) considers pitching in tie games in the 9th at home as a different role than pitching in tie games in the 9th on the road?
(I get migraines. Sometimes the doctors give me Toradol, but it hardly does a thing. They hate prescribing good painkillers because this country has ###### up priorities and the government would rather people be in pain than take life-PEDs to manage it.)
I've been called that before, but the Dr. came with the degree, not the birth certificate, the scott did... That being said, Im not a medical Dr, nor do i play one on TV.
Yes, I was being somewhat facetious, but I thought it was an important thing to point out, as I know its a fairly common hangover "remedy", and in my youth I was a bit to free with it in those situations. They dont teach you about that in laser physics classes though.
As is alcohol, which was apparently a Performance Enhancing Drug both on and off the field when you hear all the stories about Babe Ruth and Mickey Mantle.
Taken in large does like Buchholz supposedly did, it is a PED (Performance Eliminating Drug).
Maybe. It's not a save situation, and some pinheads might start carping about with "Why is he using me now?? 3/4ths of the managers in the league wouldn't do this, so they must be onto something."
I know *we* say things like..."The first thing I would tell my bullpen is, 'your role is to get people out, deal with it.'"...but it's just not that simple. Unfortunatly.
Will they really not give you some decent meds? That is ###### up. If you're in pain, you're in pain. I take 1 alleve, and 1 aspirin a day. I have some old meloxicam my physician gave me via the phone, that i use if I'm really sore, but I can't really tell if it works....
Helps me catch the ball
Summer, Spring, and Fall
So I'll gain the Hall
Yes. That's why I won't allow my children to attend school.
A lot of people have been diagnosed with a "gluten allergy", which has nothing to do with celiac disease, and I am skeptical relates to much of anything. Cutting gluten out of your diet can be useful because gluten is found in lots of simple starches, which are generally not good for you, but gluten itself is not actually bad for you if you don't have celiac disease. (Or, maybe, a well-founded gluten allergy.)
EDIT: Apparently there is some evidence of a celiac-migraine link, though a lot of the sources aren't exactly peer-reviewed.
But Manuel doesn't care about the carping when using a closer in tie games at home.
The rebound headache thing is some justification for why they don't like to give out the good painkillers. But having to completely give up on a day every time a minor headache becomes a moderate one because the only way to stop it from becoming a major one is to hide out in a darkened room with an ice pack...I'd be much more functional under the influence of narcotics. And my doctors realize this, but still won't help.
I'm ballparking based on what one doctor told me several years ago, so the figures are probably off, but triptans help in maybe 80% of cases, and every other drug family is a coin flip at best. If you're in that 20%, you'll be searching for a while.
To bring the thread back somewhat, doesn't Papelbon get migraines, too?
Google seems to concur.
Never knew the % of Migraine sufferers who couldn't use triptans was so high. Learn something every day.
I'm assuming you've had an MRI? If you have actual holes in your brain to show them, I'd like to hope that would help getting them to sign off on it.
X_t is your level of performance at time t
X_t+1 is your level of performance at time t+1
A is a treatment active at some point t to t+1 inclusive (this does not rule out administration prior to time t)
Y is the difference between X_t+1 and X_t
X_t+1 = X_t + Y
If Y>0 then A is performance enhancing (or the correlation is spurious).
Simple no?
The debate then is over whether A is "acceptable." Sometimes that is decided based on widespread usage -- e.g. eyeglasses. Aspirin would fall into this category as would caffeine (one of the first things they tried to ban actually). Sometimes that is decided based on whether it would be, well, obvious -- i.e. working with a batting coach presumably enhances performance but practicing one's craft is obviously something we want professionals to do. It would seem logical to also include legality -- if it's illegal it would seem to by definition be unacceptable ... but baseball tolerated greenie usage for decades. Sometimes acceptability is defined based on how large Y is ... or more generally how large Y is believed to be in the absence of any real evidence.
But really acceptability is determined by the same screwed up human process we decide whether much of anything is acceptable -- i.e. irrationally. One minute polygamy is the thing to do, next thing it's a sin, then next thing folks are studying whether primates are wired to be polygamous.
As to "serious" painkillers and/or anti-inflammatories -- they are in reasnably widespread usage but they have a huge impact on performance (taking the field or not, returning from injury sooner or not) and, to the extent they are overused, the legality and/or widespreadedness issues come into play.
I certainly don't object to the safe use of an anti-inflammatory to speed healing. But then, if they are safe and effective, I don't have any objection to the use of roids or HGH to speed healing.
But to the extent painkillers/anti-inflammatories are used heavily to keep a player on the field when it would be better for the player's health to rest ... well, that's morally the same as roids adding HRs to McGwire's total (if that's what they did).
The easiest bright line to draw is that the use of controlled substances to enhance athletic performance is unacceptable. But that's not the line that we've drawn (although that's pretty much where the Olympics tried to start, even including non-controlled stuff like caffeine).
I have, but the MRIs were to rule out other conditions, as they don't show evidence of migraine. My first MRI came while I was in the middle of a headache, actually, and they told me beforehand that it wouldn't manifest itself on the readout. (This is my recollection, anyway, I was ten or eleven at the time.) Anyway, the doctors have no argument about the migraine diagnosis - it's come from probably half a dozen neurologists. They just argue about how to treat them, and they only rarely come up with ideas that will let me keep normal hours and maintain steady attendance at class or work.
Part of what I would like - not ideally, but practically - is an equivalent of the athlete's cortisone shot. I've just about given up hope on fixing the underlying problem, at least until I get decent health insurance again, but I want something to cloud the pain so I'm not constantly on the DL, so to speak. In that respect, I can almost understand why they're reluctant. But I also have a lot of sympathy for the athletes who just want to be on the field.
I'm pretty sure Papplesmear is going to go out and take the ball whenever asked. The Phillies overpaid to get him, and he wants to continue to be overpaid.
But more importantly he wants to win, and seeing game after game blown while he's rested and available cant sit that great with him. The "closer" role no longer matters once you get paid, he can't really worry too much about his next deal 4 years away now.
And it's Manuel's job not just to put players in the best role for the team, but to motivate them to want to do that role. I have a hard time believing that if Manuel had sat Pap down and found the right way to say "this team doesn't need a closer, it needs a fireman, and you are the only guy who can do it and singlehandedly turn around our season", that Pap wouldn't have ran out to the mound breathing fire whenever Manuel brought him in early.
I was prescribed Maxalt for my migraines a couple of years ago, and that has made a huge difference. The only side effect is that they leave me somewhat sleepy, but the migraines make me sleepy as well.
Being wired for it doesn't make it right.
It just makes it oh so dirty hot.
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