The Toradol Thread

[Mr. WEO]

totally understand - the machine must keep moving. players have to suit up, docs have to do what they can to suit them up because theres always someone standing behind that wants that high paying gig.

 

problem starts to happen when accusations of not disclosing the risks, or actually lying about the risks start to come out. I only take joe horn so serious, but when he alleges that the doctors flat out told him what amounts to "just keep doing it, theres no risk." It makes you cringe. Now that very well could be joe hearing what he wants to hear, or saying what he thinks will get him paid - i dont want it to come across like im blindly following the players on this - but it does cause some worry about their medical care

 

Most "team physcians" are orthopedic surgeons (the Bills have 3 docs listed: 2 ortho, 1 spine) and as such, a very small fraction of their income is likely going to come from being the a team doctor. It's more the prestige, the free games and access to the NFL scene that draws them.

 

They all make their money in the operating room so the less time they spend there, the less they make. They aren't financially dependent on the team so I doubt they are worried about pressure to get a guy back on the field, especially if they think the guy really isn't ready.

 

I guarantee that all of these docs are far more concerned about the liability implications of sending an injured player back out to get reinjured than they are about the team owner/GM/HC giving them sh**t.

[Saint Doug]

Most "team physcians" are orthopedic surgeons (the Bills have 3 docs listed: 2 ortho, 1 spine) and as such, a very small fraction of their income is likely going to come from being the a team doctor. It's more the prestige, the free games and access to the NFL scene that draws them.

 

And this is what makes it a physician's dream job. I don't think there's any ortho docs out there that would turn this gig down, regardless of the lack of pay. It pays in many other ways. Also, orthopods are just frustrated jocks who went to med school instead of devoting all their time to playing competitive sports. They love this stuff.

 

There's also mid-level providers too. Remember, nurse practitioners and physician assistants can prescribe medication, as well as podiatrists. NFL teams need full-time providers 24/7, I doubt they are employing physicians full-time, so mid-levels would work out well here.

[NoSaint]

 

 

Most "team physcians" are orthopedic surgeons (the Bills have 3 docs listed: 2 ortho, 1 spine) and as such, a very small fraction of their income is likely going to come from being the a team doctor. It's more the prestige, the free games and access to the NFL scene that draws them.

 

They all make their money in the operating room so the less time they spend there, the less they make. They aren't financially dependent on the team so I doubt they are worried about pressure to get a guy back on the field, especially if they think the guy really isn't ready.

 

I guarantee that all of these docs are far more concerned about the liability implications of sending an injured player back out to get reinjured than they are about the team owner/GM/HC giving them sh**t.

 

By grouping the two perhaps I should've used the phrase "highly sought after job"

 

Don't fool yourself into thinking that there's no pressure on nfl medical personnel to stretch the limits of what they'd be willing to normally do. I'm not saying they are all a bunch of hacks, but that the very nature of their job with the teams has a conflict between best for the patient vs best for Sunday - and those aren't always the same goals.

Edited April 16, 2013 by NoSaint

[26CornerBlitz]

The Toradol segment on HBO Real Sports was certainly eye opening. I'd never heard of Toradol or the reliance on it by NFL players prior to the HBO piece.

 

Pretty serious issue that gives me some additional perspective on the price for "success" that NFL players must pay.

Edited April 16, 2013 by 26CornerBlitz

[Mr. WEO]

And this is what makes it a physician's dream job. I don't think there's any ortho docs out there that would turn this gig down, regardless of the lack of pay. It pays in many other ways. Also, orthopods are just frustrated jocks who went to med school instead of devoting all their time to playing competitive sports. They love this stuff.

 

There's also mid-level providers too. Remember, nurse practitioners and physician assistants can prescribe medication, as well as podiatrists. NFL teams need full-time providers 24/7, I doubt they are employing physicians full-time, so mid-levels would work out well here.

 

Huh?

 

By grouping the two perhaps I should've used the phrase "highly sought after job"

 

Don't fool yourself into thinking that there's no pressure on nfl medical personnel to stretch the limits of what they'd be willing to normally do. I'm not saying they are all a bunch of hacks, but that the very nature of their job with the teams has a conflict between best for the patient vs best for Sunday - and those aren't always the same goals.

 

I just don't think there is much pressure to do so. Certainly not in the NFL today. There is just no way a very busy doc today is going to risk his livelihood to keep "NFL team physician" on his CV. By the way, this is exactly why teams should not have specialist physicians employed full time.

[Saint Doug]

 

 

Huh?

 

It's true. If you knew any ortho docs, you would agree. And the ones that don't match in ortho, which is fairly competitive, become sports medicine docs.

[NoSaint]

 

 

Huh?

 

 

 

I just don't think there is much pressure to do so. Certainly not in the NFL today. There is just no way a very busy doc today is going to risk his livelihood to keep "NFL team physician" on his CV. By the way, this is exactly why teams should not have specialist physicians employed full time.

 

with the attention on player safety i think its certainly less and less likely to slide by. thats not to say that i dont think it was a very real issue in the past, and atleast a minor issue still. read the jason taylor piece and tell me that he had any business in a large number of games that he certainly played in.... now how did he get on the field if it werent for a doctor patching him up as best they could and sending him on his way. look at the colt mccoy, or kris dielman incidents even after concussion issues were already a concern nationally. the equation used for an nfl player is far different than the one used for an average patient. thats not to say they should always be exactly the same but... they have the best doctors around, but i am not confident that they always are A)invited to evaluate a player, B)free to sit a guy short of limbs being totally detached. That can vary team to team, doctor to doctor, player to player and time period to time period.

Edited April 16, 2013 by NoSaint

[Hapless Bills Fan]

And this is what makes it a physician's dream job. I don't think there's any ortho docs out there that would turn this gig down, regardless of the lack of pay. It pays in many other ways. Also, orthopods are just frustrated jocks who went to med school instead of devoting all their time to playing competitive sports. They love this stuff.

 

Huh?

 

There's a saying, to be an anesthesiologist you have to graduate last in your med school class.

To be an orthopedist, you have to graduate last and play football

 

(not true of course, but it captures the spirit)

[NickelCity]

"Marijuana, in its natural form, is one of the safest therapeutically active substances known to man." - Judge Francis Young

[Hapless Bills Fan]

Ketorolac is an excellent analgesic. It has been shown to be as effective as opiods in trials, but has zero abuse potential. Let's not give this drug a bad name.

 

However, this drug has restrictions as do most medications. Due to renal issues, it shouldn't be used for more than 72 hours. It's the team's physicians we should be pointing our fingers at. This medication cannot be dispensed without a prescription. But, let's no drag a perfectly good medication through the mud.

 

I don't think that's the intent at all. But Toradol was never intended for chronic use. If a medication is misused (over-prescribed, used every Sunday), it's not the fault of the medication.

[The Poojer]

Holy crap!

 

For perspective I'd say read this - its worth the time

 

http://www.miamihera...ylors-pain.html

 

I don't know that there's a safe alternative pain killer for THAT.

[Mr. WEO]

There's a saying, to be an anesthesiologist you have to graduate last in your med school class.

To be an orthopedist, you have to graduate last and play football

 

(not true of course, but it captures the spirit)

 

Med students who graduate last will never get into an ortho residency program. The bottom of the class is typically Family Medicine and maybe rehab or internal med.

 

It's true. If you knew any ortho docs, you would agree. And the ones that don't match in ortho, which is fairly competitive, become sports medicine docs.

 

I know many and I don't agree. I'm assuming you actually know few or none.

 

with the attention on player safety i think its certainly less and less likely to slide by. thats not to say that i dont think it was a very real issue in the past, and atleast a minor issue still. read the jason taylor piece and tell me that he had any business in a large number of games that he certainly played in.... now how did he get on the field if it werent for a doctor patching him up as best they could and sending him on his way. look at the colt mccoy, or kris dielman incidents even after concussion issues were already a concern nationally. the equation used for an nfl player is far different than the one used for an average patient. thats not to say they should always be exactly the same but... they have the best doctors around, but i am not confident that they always are A)invited to evaluate a player, B)free to sit a guy short of limbs being totally detached. That can vary team to team, doctor to doctor, player to player and time period to time period.

 

The Colt McCoy story is an outlier now. The times Taylor were describing I don't think exist anymore. My guess is that these guys are getting ijected by the trainers anyway, not doctors.

 

Anyway, it's good to see they were able to get Taylor back in there week after week....for Dancing with the Stars, which he nearly won.

 

And his final comment is why the class action suit against the NFL will be hard for the players to win:

 

“Would I do it all again? I would,” Taylor says. “If I had to sleep on the steps standing up for 15 years, I would do it.”

[Saint Doug]

I know many and I don't agree. I'm assuming you actually know few or none.

 

Ha. If you only knew. Sure dude.

[Mr. WEO]

Ha. If you only knew. Sure dude.

 

Well, dude, why don't you enlighten me. Tell me all about your experience with these "frustrated jocks who went to med school instead of devoting all their time to playing competitive sports."

[JohnC]

WEO, Would orthopedics be involved in amputations or is that strictly a trauma doctors domain? I was thinking about the mounting casualties that needed to be treated in Boston. Are those intertwined fields or are they trained separately?

[Turbosrrgood]

I found most of post thread informative, as I had never even heard of Toradol...But I found the very last paragraph to be disturbing...

 

I have smoked plenty in my day (I left that phase long ago), and I am actually for legalizing marijuana. However suggesting that allowing pot will in any way help players, or the sport is ridiculous IMO. Pot, which is most certainly addicting (first hand experience), has to be the worst possible "medication" for relieving sports pain for several reasons. Pot is considered to have detrimental effects on concentration and learning abilities, as well as physical effects (lungs). I can't imagine that this would in any way help players do anything except support a drug habit.

 

You could start a whole other conversation about the "role model" aspect of such a thing. What about middle school and high school athletes? Should they also be taking drugs to help them play sports?

 

I also think that in general, theses guys are using their status as athletes as an excuse to continue abusing prescription drugs without necessarily having a medical need. Granted I can't possibly know exactly what they are feeling, but they have much more access and justification for using these drugs than your average person...I'd guess their decision to use these drugs is rarely questioned so long as they can still play. They basically have a blank prescription pad for whatever they want (just my completely unproven assumption).

Edited April 18, 2013 by Turbosrrgood

[Mr. WEO]

WEO, Would orthopedics be involved in amputations or is that strictly a trauma doctors domain? I was thinking about the mounting casualties that needed to be treated in Boston. Are those intertwined fields or are they trained separately?

 

An isolated leg trauma patient would likely have their amputation done acutely by an orthopedic surgeon if it was essentially a "completion" amputation (completing the job done partially by the explosion/gunshot/etc). Trauma surgeons likely wouldn't even be in the OR on for such a patient with an isolated injury.

 

For patients with chronic vasculr disease requiring elective or semi-elective amputation, often it is done by a vascular surgeon. Sometimes a general surgeon.

[KeisterHollow]

I was actually prescribed toradol 17 years ago. I was 15, and had suffered a broken back (4th, 5th, and 6th thoracic vertebrae) in a checking-from-behind incident while playing high school hockey.

 

The stuff is absolute magic. My back literally felt like it was being split in two, consistently, and a single dose of toradol made it really quite manageable. I will say, however, that over time, I began to miss the numbing affect of it once the doctors deemed that I no longer needed it.

 

For me, it's a double-edged sword. These guys get paid so much money, and the vast majority of them feel like they need to be on the field to earn it. Compounding the issue is that there's a brotherhood mentality to any team, and most players don't want to leave their team without their services, so they're often willing to do whatever's necessary to get on the field. Fans, media, and coaches all foster this approach, whether we mean to or not, by the attention we pay to the game and, especially, individual players.

 

I'd like to think that advances in science and technology will result in better, safer pain management practices, but that's no guarantee. I also believe that, if it's not toradol, it'll be some other wonder-drug for pain management that players cling to...and who am I to tell them that they shouldn't do so?

 

My personal opinion is that the NFL would be going too far in banning toradol; I think the responsibility of the NFL is to inform players of the risk(s) associated with both short-term and long-term usage of the drug, and allow players to make their own decisions.

 

The NFL, as hard as it may be, needs to find a way to walk a fine line between being proactive with regard to player safety without unnecessarily limiting the choices players get to make with respect to their personal well-being.

 

Just my 1 cent.

 

I agree with you. Many of us seem to forget, what we really want is a violent, dangerous sport to watch. How many of us would want to watch flag football? I, for one, have already begun to second guess the NFL and my following of it since they've changed the rules these past 5 years or so. I'm honest - I like that it is violent. Now, I don't want to see death, or severe injury - but, I do want to see hard hits, and caused fumbles, and OLD SCHOOL FOOTBALL.

 

All that is involved with that dangerous activity - just like any dangerous activity - is questionable, and there is someone who can come in and say, "WE SHOULDN'T ALLOW THIS", or "WE SHOULDN'T BE DOING THIS". You name it, military, policing, recreational drug use - anything that has a negative to it, someone will defend not doing it.

 

My problem has always been - I see a world free of danger as a VERY BORING WORLD. We're animals. We live and die. We take risks. We enjoy many of them. I say let them play, but also take steps to allow them to heal if they so choose, and to allow them to play through it if they so choose. It is their bodies. I also say LET THEM SMOKE if they want to - who are we kidding? Probably 85 percent of them do anyway, and probably 65 percent or more of the public does. It's a joke to have something like that illegal. That's my two cents.

[San Jose Bills Fan]

I found most of post thread informative, as I had never even heard of Toradol...But I found the very last paragraph to be disturbing...

 

I have smoked plenty in my day (I left that phase long ago), and I am actually for legalizing marijuana. However suggesting that allowing pot will in any way help players, or the sport is ridiculous IMO. Pot, which is most certainly addicting (first hand experience), has to be the worst possible "medication" for relieving sports pain for several reasons. Pot is considered to have detrimental effects on concentration and learning abilities, as well as physical effects (lungs). I can't imagine that this would in any way help players do anything except support a drug habit.

 

You could start a whole other conversation about the "role model" aspect of such a thing. What about middle school and high school athletes? Should they also be taking drugs to help them play sports?

 

Two counterpoints for you:

 

1) Medicinal marijuana can be prescribed as a topical cream, it can be ingested, it can be administered in numerous different ways. As such it is not necessarily a detriment to lung function nor does it have to affect cognitive ability.

 

2) The "Role Model" thing is silly and outdated. Firstly there used to be a huge taboo on marijuana use. That seems to be going away as more states pass laws allowing its medical use.

 

Secondly, there are numerous prescription drugs which if used illegally are taboo. The very fact of them being prescribed medically should eliminate that stigma.

 

Finally we can continue to tell our young people that it's alright to drink alcohol but there's something wrong with being prescribed medical marijuana?

[Turbosrrgood]

Two counterpoints for you:

 

1) Medicinal marijuana can be prescribed as a topical cream, it can be ingested, it can be administered in numerous different ways. As such it is not necessarily a detriment to lung function nor does it have to affect cognitive ability.

 

2) The "Role Model" thing is silly and outdated. Firstly there used to be a huge taboo on marijuana use. That seems to be going away as more states pass laws allowing its medical use.

 

Secondly, there are numerous prescription drugs which if used illegally are taboo. The very fact of them being prescribed medically should eliminate that stigma.

 

Finally we can continue to tell our young people that it's alright to drink alcohol but there's something wrong with being prescribed medical marijuana?

 

Like I said, I'm for legalizing Marijuana (which has already been done in Colorado and Washington as mentioned in your original post). I don't have any problem with drinking OR smoking. However I've always thought it was ridiculous to compare the two as equals, they are not the same. Alcohol is generally described as a depressant, while marijuana is generally described as either a narcotic or hallucinogen depending on the source. As someone who has used marijuana extensively, and enjoyed it...I've always thought the "medical" aspect of it was always a little bogus, and more of a type of propaganda for legalization. Opiates are used medically, that doesn't mean we should allow our athletes to abuse mophine (legal) or heroin to deal with their pain...

 

Whether it is legal or not is irrelevant when determining whether it is a banned substance for athletes. There are many substances legal and otherwise, that are on the banned substances list. Despite it's "medical benefits", pot is still overwhelmingly a recreational drug, and an addicting one. Suggesting that we should allow/encourage athletes to use pain management as an excuse to use recreational drugs seems counter productive to me.

 

As far as the "role model" argument goes, I hate taking this stance because I usually hate that argument...However the fact is many young athletes look up to professional athletes and emulate their behavior. If Peyton Manning starts advocating how he loves sparking up a joint after a tough game, it isn't going to go over well with schools and parents when they start citing that as their reason for doing it.

 

As a side note, I'm skeptical that a majority of states will ever legalize pot. That creates another issue, of this treatment only being legal in certain areas. That creates inequalities for teams trying to sign players, and for players seeking treatment.

Edited April 18, 2013 by Turbosrrgood