https://twitter.com/Lefty_Leif/status/779386045544730624/photo/1?ref_src=twsrc^tfw So we would have 42 million in cap space next summer should Heat waive his contract at February 9. And could be higher if Josh McRoberts opts out. Top free agents next summer: Steph Curry (unlikely to leave GS, 1% chance he leaves) Kevin Durant (player option) (I can see him leaving if GS does not win the championship/chemistry goes bad) Blake Griffin (player option) Chris Paul (highly doubt he comes to Miami with LeBron on his ear about evil Pat Riley) All in all, free agency does not look good next year, nor in 2018. Build through the draft, possibly trade multiple players for elite talent.
Vit K would do nothing for Bosh if he had an undetected clot.. It's like suggesting Vit C to someone with emphysema.
What blood thinner are you suggesting that has a half life less than 6hr that could be compounded with Vit K and why do you think Vit K is like Narcan for thin blood? That's fine for a life diet with the condition he has but there's no rapid acting pharmaceutical that could reverse his symptoms or they'd be qualified for potential fast track FDA approval which is a lucrative patent. Billions potentially. There's plenty of biotech companies looking to that cure but nothing that's passed Phase II trial as far as I know. Hence our situation.
I could see Griffin. It sucks that Greek Freak signed a new deal. I would have liked to take a shot on him.
I'm suggesting he take coumadin or heparin, and in a situation where he actually wound up bleeding he could take vitamin K, which is a well established reversal for both. He would need IV Vit K and Prothrombin complex, both of which could be easily provided in an emergency situation, to completely reverse the effects of Coumadin in 15 minutes. This is well documented. Obviously the drawback of warfarin is that it requires weekly monitoring and blood draws. I don't see why the half life would be important. I am not a sports dr, I just work in a medical laboratory, so I am not sure if he would be able to play while on heparin. It seems to me the main issue to playing while on Xarelto is the lack of a reversal.
Vit K isn't what I'm suggesting. I'm suggesting he maintain a routine of warfarin which is a Vit K antagonist(hence Vit K being the reversal for warfarin's anticoagulant effects), or heparin. like most people with clots, or with reoccurring clotting issues. Other thinners have medical reversals unlike Xarelto. Edit:there are also things like Low Molecular weight heparin based drugs, such as Lovanox, which may work in this case.
Bosh says this is just a little setback and will continue to attempt a comeback.. Okay, but dont expect it to be on the Heat..
That's not exactly what he said, although it could be interpreted in that way possibly. If you watch the whole video, though, he's talking about his series, and it could mean that he still plans on continuing his series. [video]https://twitter.com/uninterrupted/status/779517002775801856[/video]
Ok, and you work in a medical laboratory doing what? Pharm.D? Tech? Biologist? Reception? That's a pretty broad qualifier for an extremely nuanced medical issue. If all it was going to take is Warfarin and IV medication on standby that takes 15 minutes to reverse a fatal clot you don't think he'd be cleared by now? The Heat have some of the best doctors on the planet in their Rolodex. We've known extensively about those BT for a long time and it is conclusively not a cure or even a properly effective treatment for someone with a rare condition like Bosh is going through. Around 1/4 people die from PE and each person will respond differently to whatever thinner you throw at them. Clearly Bosh hasn't responded to the new blood thinners and a hyper tailored regimen and there's nothing really coming down the pipeline unfortunately that looks better than Xarelto. If he wants a shot he has to take a year or two off and get himself on some experimental meds. He's going to have to hang them up. Unfortunately there is not a lot of incentive to invest an already dwindling R&D budget on such a small piece of pie for Big Pharma and small bio takes 10 years or so and $2.5 billion on average to successfully push a drug past Phase IV. Xarelto was it for Bosh and that didn't work. It's over.
I'm a phlebotomist, and I work in a hospital setting with patients who are on blood thinners daily. I am not claiming to be an expert, but I do have some knowledge of treatment and management of patients who have issues with recurring clots. What is your experience on the topic? I was posing a question, rather than suggesting a methodology of treatment, so I am confused as to why you are acting like I've suggested that the Heat's medical staff is incompetent and all they have to do is listen to me and prescribe Warfarin. As far as I understand it, they don't want him to play while he is taking a blood thinner, as his risk of complications from bleeding will be greater and basketball is obviously a contact sport. The biggest issue to contact with Xarelto is the lack of reversal - All you can do is give FFP, and hope that prevents the patient from bleeding out until the level of Xarelto in the blood is reduced enough to allow normal clotting tor resume. My question was - Why not get him on an anticoagulant with a reversal? As far as I understood things, Bosh decided to go with Xarelto not because Warfarin or Coumadin proved ineffective, but because it doesn't require frequent blood testing. It is possible that I have misunderstood, and he is taking Xarelto because it is all that has proven effective. Warfarin is a well established, effective treatment for pulmonary embolisms and other clotting issues. Warfarin is demonstrably effective in patients who adhere to the requirements and guidelines, and while many people respond to anticoagulants differently, for the most part Warfarin and Coumadin are effective so long as the guidelines are followed. Clots are treated by either anticoagulants or thrombolytics, which act to break up the clots. Warfarin is obviously an anticoagulant, which prevents new clots from forming as the body works through the current clot. Warfarin is commonly prescribed to patients who have history of clotting, as it is proven an effective prophylactic. They could also insert a filter into his Vena Cava, which could help prevent clots from reaching his lungs, and filter clots out before they grow sizable enough to prove problematic. I don't want Bosh to play if he is unable to do so safely. I am just a disappointed Heat fan asking for more information.
The problem is that if he plays for another team, Miami doesnt get the cap relief of a medical retirement IIRC. Sent from my SAMSUNG-SM-G920A using Tapatalk
I dont think any team will chance it anyways. Its not just Heat doctors, NBA physicians in NY failed his physical. Thats alarming for any team in the Nba
No malice in my previous post, I love debating this stuff FYI.. So I don't see it getting ugly. Long post does not = ugly. Regardless of what pharmaceutical he goes with, he has shown a chronic problem with clotting issues over the last two years and no matter the drug he takes (assuming nothing sneaks by the Fed before December). He is absolutely going to be looking at everything you talked about in your post and that is what a normal, civilian in that situation would be advised to do. We're talking about a frail, 6'11 guy with very serious health issues at 32 (?) years of age. People that size already run higher risks as far as cardiovascular health goes as I'm sure you're aware of as a phlebotomist. Add that to the fact he has a super rare illness and on top of that, one that is directly affected by contact. 15 minutes to reverse a blood thinner after dude gets tackled to the ground on a breakaway slam with an undetected clot and he's dead in minutes. 15 minutes is a lifetime when you're blood can't clot. Most people aren't banging around with 7 foot tall 250lb athletic freaks that are taking the more common BT so they aren't at major risk 100 days out of the year. Had it been the one incident I would understand where you're coming from but after the 2nd incident and virtually every Dr on the planet telling him to go home to his kids, I think it's best for both parties to accept the fate and look forward respectively. My background is in Pharmaceutical R&D, biotech investing and financing, compounding, and audiotronics / recording.
True, but A) He's have to play for 25 games before that happens, and B) he won't be playing on another team until after next summer, if he ever does, and Miami would have already probably spent the money. I'm not sure how it would work if that happens, but they'd still have a ton of money to spend next summer. Also, I'm not sure how any doctor is going to clear him to play for their team. If he dies on the court, that is the end of that doctor's career.
I see what you're saying. I misread the tone of your post. I don't really have much knowledge when it comes to contact sports and anticoagulants. I was under the impression that the contact itself is not more dangerous, but any contact that results in a cut, or gash. I also was not aware that PEs are affected by contact. It is definitely true that with the issue being recurring, he will have to be on some form of anticoagulant for the rest of his life. An aspect that I hadn't considered is, even if he is taking coumadin or warfarin, if he winds up in a situation where he suffers a serious gash or, let's say, breaks a bone that subsequently pierces an artery, it would not be taken well by fans. Even if he is given treatment and comes out being fine, I could see that being a situation where the Heat franchise is viewed as putting players at unnecessary risk. Basketball isn't really a sport like Hockey where players who have their necks slit by skates are trying to come back and finish out the game. I do still wonder if a Vena Cava filter might prove an adequate solution, where he is ultimately able to return to contact sports, but I do not believe that venous filters are 100% effective, and I would imagine he would probably still require at least a low molecular weight Heparin drug like Lovanox. I have to imagine that Heat medical staff have consulted with hematologists and pulmonologists to determine whether it was an option, and if it was, they would have suggested it. With the risk factors inherent in playing, as well as the risk factors for clots from frequent travel and the issue being a recurring one, it really does seem like Bosh would be best suited to hang them up. I am just really upset about it, honestly. I think we were title contenders with Bosh in the lineup. Without him, I think we are still a tough team, but I don't think we are contenders.
I'm not going to sit here and pretend I'm more familiar with a Vena Cava filter than I am, definitely have to read into that more. The constant plane rides for away games really puts the risk over the top for me. The thinners would have to be out of his system in time for practices as well. Taking any pharmaceutical that isn't cosmetic on such a varied and grueling schedule is just asking for disaster in my opinion. 5 kids, 2 rings, 1 wife, 1 HOF ceremony, Miami life with $200+mil at 30something. I'll take it.
The only problem with a blood thinner like Coumadin is that hes playing a contact sport and since its a blood thinner, it makes the bleeding, should he get cut, much harder to stop. My dad was on it a decade ago and a paper cut would take a half hour to stop bleeding or some such ridiculousness
Another guy I forgot about that I bet is going to be atop Riley's list is Gordon Heyward. He's the type of player Riley has historically liked, and he will be one of the best players in free agency. He also plays in a crappy market, so the allure of Miami might be an added bonus.
NBA: Heat president Pat Riley says Chris Bosh's "Heat career is probably over" and team is not working toward his returnvia @ESPN App http://es.pn/app Sent from my OnePlus 3
I'm thankful for the Big 3 era but damn I never expected it to end like it did. This sucks. Get well CB.
Landry and Jones are star level players mired in bad team play. Baseball and basketball lend themselves more to individual recognition. Sent from my OnePlus 3
I'd say Landry is pretty close in terms of ability to Welker, if not better. Jones is a top 5 safety. They're a good team away from being stars, I only said they have star talent. Sent from my OnePlus 3
It's got to be tough for Bosh. I'm sure he feels healthy almost all the time. And he knows he can step on any court and be one of the best players on the planet. But reality is that a bump can cause a fatal embolism or aneurysm at any time. I can't picture any team being willing to put him on the court regardless of what waiver he signs.
I agree about those two, but I think Suh is an even bigger star. Sure, he plays a fairly unpopular position, but he's still a star. He's in Nike commercials, and even had his own reoccurring story line in Ballers.
Chris Bosh fired his longtime agent Henry Thomas a few days ago according to Stephen A Smith. Smith said his agency was in shock that Bosh did that.
This one? http://www.espn.com/nba/story/_/id/17650279/nba-melancholy-end-big-three-era-miami-heat What is "not good" about it?
