of arteries and clots

illustration by Samara Pearlstein

So. SO. Mr. Rogers has a blood clot in his shoulder.

There’s a good Q & A in the Freep about thoracic outlet syndrome, which is what they maybe possibly perhaps think this could be. As usual, the team does not see fit to release a ton of information on exactly what’s going on, but it seems like they’ve said more than usual this time ’round… in the official site article they say that:

Instead of a minor procedure, doctors had to do some artery replacement. 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.

MLB.com article

WOW! Actual information! We pretty much never get that. Usually it’s “Ballplayer A felt something in his arm. It felt like a kitten digging its tiny little needle claws into his muscle. Team doctors think it’s maybe a thing, you know, in his arm. Or with his arm. Not necessarily in. Just, you know, involving the arm in some way. Oh and he’ll be out for 12 weeks.”

I’m curious about the fact that they repaired both the axillary and brachial arteries, however. The passage up there doesn’t make it entirely clear, but the brachial artery is actually a continuation of the axillary artery, like so:

illustration exclusive to Roar of the Tigers

Artery repairs generally involve taking part of a bit of some other blood vessel (usually from the leg; I went into that in a lot more detail when I wrote about Dingman’s surgery). So Rogers needed to have this done in two separate stretches of the same artery, basically? What the heck kind of clot WAS this? UBERCLOT? CLOTZILLA??

Thoracic outlet syndrome occurs when muscles over- or mis-develop in the shoulder, or a mis-angled bone (or an extra one, I guess) is present– basically anything to compress the part of the shoulder called, durrr, the thoracic outlet, which is kinda like the space between your collarbone and ribs and bony shoulder. Like so:

Illustration exclusive to Roar of the Tigers

As you can see in the image there, the axillary artery feeds through the thoracic outlet. Compression of the outlet therefore compresses the artery. If it’s compressed a bit you have blood cells bumping up against the walls more often and are more likely to get a clot there (like how people with high cholesterol get plaque in their blood vessels, which makes them more narrow, and more likely to host a clot). If it’s compressed even more, the artery itself might be damaged by it, possibly torn.

(now that I think about it, is that what intially happened to ol’ Dinger?)

Apparently, Kenny’s PREVIOUS shoulder injury most definitely WAS thoracic outlet syndrome, and he had surgery to remove a (I guess extraneous, or at least non-essential) rib which was compressing the area. The MLB article previously linked says that there was “surgery to clear an artery,” but there’s no indication of whether this means the artery was ‘cleared’ just by having the rib-created pressure on it eased, or if they actually had to go in there and remove a clot.

I have a hard time believing that his only issue this time ’round is the same thoracic outlet syndrome, I guess because the brachial artery is outside of the thoracic outlet, and as I said before, it’s reported that he had repairs in that artery as well. I hope it wasn’t an embolism (a blood clot that breaks loose of its forming site and travels throughout the bloodstream, looking for more harmful places to lodge, like in the lungs or brain); those buggers are freakin’ scary.

In fact the whole concept of a blood clot in the shoulder is pretty scary for a pitcher, if only because it can probably go undiagnosed for quite some time. The symptoms include some things like numb or tingling sensations in the fingers and a general tired or heavy sensation in the arm that, well…. they sound an awful lot like regular ‘tired arm’ pitching symptoms. It’s a little worrying to think that a guy who doesn’t know his arm very well yet (think last year’s Verlander, asking Bondo and Kenny time and again if his arm fatigue was normal) might just assume that it’s regular pitching pain and not get it looked at until it’s become legitimately dangerous.

Eeeek.

Usual disclaimer on all that: me no surgun, me on’y dum lil’ art stoodent, no know big doctor wurdz.

In other When It Rains, It Pours, And Then You Realize You’re Wearing A White Tshirt news, Vance Wilson ALSO managed to get himself DLed with mysterious arm pain that (he claims) is not tendonitis and is more nerve-related. He describes the pain as a “pinching sensation”, and it’s distracting enough that he can’t throw, which is a rather important part of that whole catching job thing.

In his place we get…. Mike Rabelo.

So saith Jim Leyland, on the topic of Rabes:

“He’s got talent,” Leyland said. “and he’s wound up tighter than a clock. I think once he gets around our atmosphere and everything, I think he’ll relax and I think he’s got a lot of ability. I like him. He’s one of those guys, just watching him, that wants to do good so bad that sometimes it works against him.”

MLB.com article

Sounds like he’s an eager beaver, but the kind of eager beaver that gnaws on the tree too fast, so that the tree comes crashing down on his eager beaver skull. Woo.

Since we don’t have nearly the same amount of information about Vance’s injury as we do about Kenny’s, I can’t exactly whip up some psuedo-scientific illustrations for it. He did describe it as a pinching sensation in his nerves, though, so I offer you this appropriately pinched nerve.

4 responses to “of arteries and clots

  1. ivantopumpyouup

    I just spent like five minutes giggling at the illustration of the pinched nerve. Thanks for that :P

  2. so happy to be following along with you again this year! Those illustrations about killed me. With their awesomeness.

  3. Hey man, never left! :) Glad you’re along for the ride.

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