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Red Sox Medical Use of Toradol


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#1 Sampo Gida

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Posted 11 February 2013 - 03:29 AM

A story on ESPN about Papelbons claim he used Toradol for pain.  The Phillies have a policy that does not allow the use due to side effects.

 

http://espn.go.com/b...-boston-red-sox

 

Clay Buchholz supposedly acknowledged that this caused his problems last year with his esophagitis.

 

It's a legal drug but Papelbon claims he was never advised of the side effects and he seems to describe a use, along with Buchholz, of usage that seems to be against it recommended use for short term treatment of acute issues as opposed to treatment of chronic pain

 

http://en.wikipedia.org/wiki/Ketorolac

 

The Red Sox replied

 

A Red Sox official, speaking on background Saturday, described Toradol
as a legal drug with clear pain-management benefits, and acknowledged
its widespread use in baseball, including by Red Sox pitchers before
their starts. But he added that the club is in the midst of reviewing
its policy to ensure players' safety.

 

In light of issues with the medical staff in recent years, this may be an issue worthy of discussing, especially in light of Buchholz's problems last year and Schillings allegation a staffer suggested HGH,  although it is important to emphasize the drug is legal and the Red Sox are by no means alone in using it.

 

 



#2 Van Everyman


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Posted 11 February 2013 - 06:56 AM

Tho I think they finally banned it, the NFL basically wouldn't have existed for about the last five years without Toradol.

#3 Lose Remerswaal


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Posted 11 February 2013 - 07:18 AM

I've had great results with Toradol for back spasms, but I'd have to think twice before going that route again



#4 threecy

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Posted 11 February 2013 - 07:35 AM

Interesting to hear it was the cause of Buchholz's throat problem.

 

This, plus what Schilling said the other day, plus what many have suspected for years, makes one wonder even more about the Red Sox medical team.



#5 Orange Julia


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Posted 11 February 2013 - 08:45 AM

Toradol drip is the go-to for when you end up in the ER or urgent care with a migraine. I assumed that taking it orally caused more GI bleeding problems than a shot, or IV, but I guess it is just bad all around.



#6 JimD

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Posted 11 February 2013 - 09:09 AM

It's disturbing how out of control the team's medical and training staff seem to have been in recent years.



#7 luckysox


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Posted 11 February 2013 - 09:44 AM

I don't get the surprise here - I think many teams probably use Toradol injections for pain management. It freaking works (like OJ, I[ve had it for migraines in the hospital).  And I don't buy the "wasn't advised of side effects" stuff. Grown men can ask questions, and should, about side effects for any substance they take (and if they don't it's their issue, not the team's), and can then say NO if they want to. Most of them would not say no; the risk of bleeding is likely one most would take to be able to play, possibly play well, and earn the $$ they earn.  I honestly don't see this as a story unless Toradol were banned. If it becomes banned and they keep using it, well, that's a story. I don't think this particular issue points to the medical staff being out of control.



#8 DLew On Roids


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Posted 11 February 2013 - 10:06 AM

I'm not sure why this is in Radomski's Lounge.  Toradol is not considered a PED in any sport.  The risk/reward related to its use is the subject of disagreement, but that doesn't mean it's irresponsible to administer it.  

 

The feeding frenzy around the topic of pharmaceuticals and specifically the Red Sox' use of them is officially out of control.  The headline and tone of the Edes story make it appear that something untoward was going on with the club, but there's no evidence or claim that Toradol was used irresponsibly, unless you buy into the idea that its use is irresponsible by definition.  I'm not saying the Red Sox' hands are clean (absence of evidence, yadda yadda), but this is half a story until someone comes forward with information that the Sox doctors were using Toradol excessively, off label, or in some other manner that would suggest recklessness.

 

I guess someone might say that Papelbon saying that he wasn't told about the side effects is evidence of the club behaving irresponsibly, but: 

 

Papelbon said he couldn't recall who introduced him to Toradol, and wasn't sure when he first began receiving injections, but believes it was in 2007, when he was the closer on the team that won the World Series title.

"It was kind of a word-of-mouth thing," he said. "You got in the clubhouse and said, 'Man, I feel like crap,' and somebody would say, 'Oh, you should get a Toradol shot.' All players talk about what gets you through a 162-game season."

 

 

He doesn't know when he started, he doesn't know who told him to take it, and he all but says he went to the doctors and asked for it.  Given what he doesn't remember, it wouldn't be at all surprising if he were told and forgot.  Or if he received that standard prescription paperwork and tossed it in the trash, the way 90% of people do.


Edited by DLew On Roids, 11 February 2013 - 10:13 AM.


#9 Stanley Steamer

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Posted 11 February 2013 - 11:10 AM

I was surprised to see this story given headline status on ESPN, but find it interesting nonetheless. I'm a family doc who has worked a lot in ER over the years. I agree with those who note Toradol works like a hot damn. I had a friend who had kidney stones who told me it worked much better for his pain than did morphine. But I'll never forget learning about NSAIDs from an experienced old pharmacist. They all carry a risk of GI bleeding, but none more than Toradol. As such, I've always used it in short durations- usually one or two shots, never more than 48hrs. For ongoing use, Ibuprofen and Naproxen are the safest, so that's what I primarily prescribe.
I dont know the details of Buchholz's bleed-- it certainly is alarming, and raises the question of how much and how often he used NSAIDs. Beyond that, I don't think it's inappropriate for athletes to use Toradol. I hope it is done judiciously and with some degree of informed consent.

#10 lexrageorge

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Posted 11 February 2013 - 11:15 AM

Toradol is a pain killer that has side affects.  So does aspirin, Tylenol, and ibuprofen.  Some teams don't use it anymore; some do.   Seems like everyone's been overdosing on their hysteria pills lately.



#11 Dogman2


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Posted 11 February 2013 - 11:28 AM

Toradol is a pain killer that has side affects.  So does aspirin, Tylenol, and ibuprofen.  Some teams don't use it anymore; some do.   Seems like everyone's been overdosing on their hysteria pills lately.

The hysteria relates to the side effects produced by use of the drug. Buchholz's hospitalization and the issues surrounding the medical teams use of the drug, with all know side effects, leads to the concern here. 



#12 terrynever


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Posted 11 February 2013 - 11:40 AM

Piazza's book gives a pretty good rundown on how many types of legal supplements and meds he was taking to keep his body going. According to an excerpt published in Sunday's Post, here's what he admitted to taking:

Andro, until 1998 when it was found in McGwire's locker. Piazza "phased it out." He bought it legally, of course, at nutrition stores in a "Monster Pak" that also included creatine and amino acids.

He also used Vioxx for anti-inflam reasons.

He took "greenies" in his coffee. But they made him too jittery so he preferred Dymentradine, a light asthma med that sends more oxygen to the brain.

He also used ephedra, before it was banned.

 

Piazza did all of this stuff legally. Maybe his example is the reality.



#13 RedOctober3829


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Posted 11 February 2013 - 11:41 AM

Every single college and pro football team uses Toradol.  You see players lining up for shots before every game.  Otherwise, they couldn't play.  It's the same thing in baseball.  Some players need it to play.  It's a common drug to numb pain.  Players have the choice of not playing or taking it.  No one makes them take it.



#14 DaveRoberts'Shoes


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Posted 11 February 2013 - 11:45 AM

Tho I think they finally banned it, the NFL basically wouldn't have existed for about the last five years without Toradol.

 

It's not banned in the NFL.  

 

Interesting to hear it was the cause of Buchholz's throat problem.

 

This, plus what Schilling said the other day, plus what many have suspected for years, makes one wonder even more about the Red Sox medical team.

 

Buchholz speculated that it might have caused his throat problem - it was no doubt multifactorial, as oral NSAIDs and alcohol intake can also contribute to esophagitis, and I think we can all agree that Buchholz used the latter and almost definitely the former.

 

It's disturbing how out of control the team's medical and training staff seem to have been in recent years.

 

Congratulations on your hysteria-mongering.  You make it sound like the medical and training staffs have been strapping players to gurneys and injecting them with testosterone against their will.  Toradol is a very potent, LEGAL medication that can, like any medication, have side effects.  Quite honestly, I'm more concerned with the way trainers use corticosteroids - when I was working with the Padres players would get medrol Dos-Paks all the time for tendonitis, inflammation, etc.  Given that that even ONE dose of corticosteroids can cause AVN (hello, Mike Napoli and your one-year, 3M dollar contract), I'd say that's at least as concerning.  But since toradol is injected, it makes for a much sexier story, I guess.



#15 Smiling Joe Hesketh


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Posted 11 February 2013 - 11:55 AM

US10dollarbill-Series_2004A.jpg

 

Informative as always doc! Thanks!



#16 Ed Hillel


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Posted 11 February 2013 - 12:20 PM

What about Whey Protein? I demand to know which Red Sox players are on that shit. Send out investigative journalist Mike Fish, ESPN.

#17 Average Reds


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Posted 11 February 2013 - 12:29 PM

Agree with DRS that this is much ado about nothing.  And of course we now know that the Schilling PED stuff was quite literally nothing all along.

 

Having said that, there is a part of me that considers the unethical leaks to the press about Francona's use of painkillers after the 2011 season and smiles at the thought that turnabout is fair play.



#18 sachilles


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Posted 11 February 2013 - 12:46 PM

DRS, any concern for Torredol use or other pain meds, masking pain as a warning sign? If it hurts bad enough to warrant Torredol, might they be in a situation where they could injure themselves further or slow the recovery process? I understand that every injury that is causing severe pain, doesn't necessarily mean that injury can get worse.

Seems to be a damned if you do, damned if you don't situation.



#19 5050HindSight

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Posted 11 February 2013 - 01:58 PM

So the most likely take away from the Schilling story, and the Papelbon story is that a member of the medical/training staff offered Schilling Toradol, which he thought was a steroid. Right?



#20 CPT Neuron


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Posted 11 February 2013 - 02:02 PM

US10dollarbill-Series_2004A.jpg

 

Informative as always doc! Thanks!

 

 

You owe both DRS and I $20.00 more for the co-pay.....we are specialists, you know!



#21 Larry Gardner

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Posted 11 February 2013 - 02:11 PM

I'm a lurker and don't post much, but I'm also a pharmacist working for the State of Tennessee--

 

Ketorolac tromethamine (the drug itself-- Toradol is a trade for the brand name drug) is simply an NSAID.  But, it's the best NSAID out there for pain relief, and with this product, the pain relief is similar to morphine.  We would see a lot more of it used, everywhere, but the main problem with this product is kidney toxicity, and because of this, it isn't used much, except in the ER or post-surgery.

 

None of the NSAIDs, including aspirin, has better pain relief than the others, but each user has individual responses, so one NSAID may help you, but not the next person.  That is, except ketorolac, because this product is better for pain-- for moderately severe acute pain (other NSAIDs are mild to moderate pain)

 

Yes, it can cause bleeding, and yes, it can cause cardiovascular side effects, but these are class effects-- ALL NSAIDs can cause these problems.  Ketorolac has a limit of 5 days use, because of the kidney problems that it causes.

 

It's used best in the ER or post-surgery, for non-opiate pain relief-- really great in the ER, when the patient is drug-seeking.

 

Problem would be constant exposure-- I'd be a lot more worried about long term renal toxicity with this one, than I would with the GI bleed-- which again can and does happen with all NSAIDs.  So if Clay's issue with his bleed last year was NSAID-related, that could've happened with any NSAID.  Constant exposure to ketorolac, you're just asking for kidney problems down the road.

 

Hope this is helpful--  Ray



#22 sachilles


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Posted 11 February 2013 - 02:20 PM

I'm a lurker and don't post much, but I'm also a pharmacist working for the State of Tennessee--

 

Ketorolac tromethamine (the drug itself-- Toradol is a trade for the brand name drug) is simply an NSAID.  But, it's the best NSAID out there for pain relief, and with this product, the pain relief is similar to morphine.  We would see a lot more of it used, everywhere, but the main problem with this product is kidney toxicity, and because of this, it isn't used much, except in the ER or post-surgery.

 

None of the NSAIDs, including aspirin, has better pain relief than the others, but each user has individual responses, so one NSAID may help you, but not the next person.  That is, except ketorolac, because this product is better for pain-- for moderately severe acute pain (other NSAIDs are mild to moderate pain)

 

Yes, it can cause bleeding, and yes, it can cause cardiovascular side effects, but these are class effects-- ALL NSAIDs can cause these problems.  Ketorolac has a limit of 5 days use, because of the kidney problems that it causes.

 

It's used best in the ER or post-surgery, for non-opiate pain relief-- really great in the ER, when the patient is drug-seeking.

 

Problem would be constant exposure-- I'd be a lot more worried about long term renal toxicity with this one, than I would with the GI bleed-- which again can and does happen with all NSAIDs.  So if Clay's issue with his bleed last year was NSAID-related, that could've happened with any NSAID.  Constant exposure to ketorolac, you're just asking for kidney problems down the road.

 

Hope this is helpful--  Ray

Thanks, that answers a lot of questions for me. Any sort of habit forming issues known to exist with it? Seems its availability is pretty limited.



#23 absintheofmalaise


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Posted 11 February 2013 - 02:56 PM

I moved the What is a PEDs posts over to Radomskis Lounge.



#24 Larry Gardner

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Posted 11 February 2013 - 02:57 PM

Thanks, that answers a lot of questions for me. Any sort of habit forming issues known to exist with it? Seems its availability is pretty limited.

 

No habit-forming issues of any kind with NSAIDs, no euphoria, and no way to abuse NSAIDs, or they would be classified as "Controlled Substances", which all have some euphoriant effects, tolerance, and abuse potential.

 

I see someone mentioned Vioxx in an earlier post in this topic-- it was removed from the market due to the cardiovascular side effects, and there was also another product that was removed in the past 6-8 years or so-- Bextra.  Bextra was similar to ketorolac in a way-- it also had some better pain relief properties, but it was also responsible for killing some folks with an allergy issue....bad drug...

 

When used properly, ketorolac is a great drug.  If it weren't for the kidney toxicity, we'd all be using it for arthritis some day, because it's a great pain reliever without the abuse and tolerance issues of opiates.

 

Hope this helps, Ray



#25 seantoo


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Posted 11 February 2013 - 03:34 PM

The hysteria relates to the side effects produced by use of the drug. Buchholz's hospitalization and the issues surrounding the medical teams use of the drug, with all know side effects, leads to the concern here. 

All drugs administered by Doctors have side affects, it's legel and used by most teams so there is no story in this case, move along now there is nothing to see here.

Our team's frequent injuries the past 2 seasons is an issue, but this is not. 



#26 The Gray Eagle


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Posted 11 February 2013 - 04:13 PM

Piazza's book gives a pretty good rundown on how many types of legal supplements and meds he was taking to keep his body going. According to an excerpt published in Sunday's Post, here's what he admitted to taking:

Andro, until 1998 when it was found in McGwire's locker. Piazza "phased it out." He bought it legally, of course, at nutrition stores in a "Monster Pak" that also included creatine and amino acids.

He also used Vioxx for anti-inflam reasons.

He took "greenies" in his coffee. But they made him too jittery so he preferred Dymentradine, a light asthma med that sends more oxygen to the brain.

He also used ephedra, before it was banned.

 

Piazza did all of this stuff legally. Maybe his example is the reality.

 

This is what the "clean" players do, along with other stuff, like injections of B12.

 

The idea that the players who don't take illegal PEDs are powered only by milk and American red meat is pretty silly. The only difference between the cheaters and the clean players is that the stuff the clean players are injecting themselves with isn't yet illegal. That is definitely a significant distinction, but it seems like a lot of people are shocked that "clean" players use all these substances, drugs and injections. That's what it's like when there are tens of millions of dollars at stake in sports. Pretty much everyone is getting injections and taking substances. The only question is if the substances are banned yet or not.



#27 Harry Hooper


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Posted 11 February 2013 - 07:03 PM


It's used best in the ER or post-surgery, for non-opiate pain relief-- really great in the ER, when the patient is drug-seeking.

 

Problem would be constant exposure-- I'd be a lot more worried about long term renal toxicity with this one, than I would with the GI bleed-- which again can and does happen with all NSAIDs.  So if Clay's issue with his bleed last year was NSAID-related, that could've happened with any NSAID.  Constant exposure to ketorolac, you're just asking for kidney problems down the road.

 

Hope this is helpful--  Ray

 

 

 

Isn't the word around baseball the last few seasons that starting pitchers started getting Toradol routinely administered on game days not for pain relief but to prophylactically mute inflammation?



#28 radsoxfan


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Posted 11 February 2013 - 07:13 PM

It's sort of embarrassing for ESPN that they put this story on the front page of their website (and that Edes wrote the thing at all). Could this be more of a non-story? 

 

Thinking that this somehow means the Red Sox medical staff is out of control.... Yikes.



#29 JimD

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Posted 12 February 2013 - 09:10 AM

All drugs administered by Doctors have side affects, it's legel and used by most teams so there is no story in this case, move along now there is nothing to see here.

Our team's frequent injuries the past 2 seasons is an issue, but this is not. 

 

Can we dispense with the flip dismissal of this subject?  If the truth of the matter is that the team staff periodically administered Toradol when it felt that doing so was safe and beneficial and did it's best to educate the players, then I agree that it's a non-issue.  But If it comes out that, for example, the Sox medical staff was not only giving game-day injections of Toradol to pitchers on a regular basis but actually recommending it, then there very well may be 'something to see here'.



#30 OttoC


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Posted 12 February 2013 - 09:26 AM

If it is common proactive, then maybe it should be addressed on a league-wide basis. However, players should be told that they should not drink or smoke when under a regimen of Toradol (and incidentally that alcohol and aspirin pills is not a good combination).



#31 Dogman2


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Posted 12 February 2013 - 10:09 AM

All drugs administered by Doctors have side affects, it's legel and used by most teams so there is no story in this case, move along now there is nothing to see here.

Our team's frequent injuries the past 2 seasons is an issue, but this is not. 

Your dismissal of the subject is laughable given the nature of Bucchholz's injury.  This is not an indictment of the team's medical staff as it is not illegal and use is widespread.  However, the known side effects are an issue if Bucchholz and his hospitalization is a direct result of this drug administered by the team and his subsequent use of alcohol.  There is evidence that supports this.

 

If you don't want to discuss it, you don't have to be in the thread.


Edited by Dogman2, 12 February 2013 - 10:10 AM.


#32 lexrageorge

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Posted 12 February 2013 - 12:53 PM

Your dismissal of the subject is laughable given the nature of Bucchholz's injury.  This is not an indictment of the team's medical staff as it is not illegal and use is widespread.  However, the known side effects are an issue if Bucchholz and his hospitalization is a direct result of this drug administered by the team and his subsequent use of alcohol.  There is evidence that supports this.

 

If you don't want to discuss it, you don't have to be in the thread.

 

The problem is that it is being portrayed as a potential scandal, and being linked to Schilling's PED story.  Even if Buchholz's problems were a result of Toradol plus alcohol, that does not mean the team was at fault for prescribing Toradol.  It's use appears to be fairly widespread; side affects can happen from any drug or drug/alcohol combination.  

 

As stated, there's mostly likely nothing to see here other than ESPN making something out of nothing to get some clicks during a slow sports cycle.



#33 wade boggs chicken dinner


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Posted 12 February 2013 - 01:58 PM

The problem is that it is being portrayed as a potential scandal, and being linked to Schilling's PED story.  Even if Buchholz's problems were a result of Toradol plus alcohol, that does not mean the team was at fault for prescribing Toradol.  It's use appears to be fairly widespread; side affects can happen from any drug or drug/alcohol combination.

 

I wonder how much education the players are really getting?  For example, given all of the NSAIDs that are taken on a daily basis, I wonder how much information they are given about possible effects of drinking with NSAIDs? 

 

I have no doubt that professional athletes will take anything and everything that it not illegal to give them any kind of performance boost (whether real or placebo).  No wonder the life expectancy of an athlete isn't great.



#34 Dogman2


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Posted 12 February 2013 - 02:13 PM

The problem is that it is being portrayed as a potential scandal, and being linked to Schilling's PED story.  Even if Buchholz's problems were a result of Toradol plus alcohol, that does not mean the team was at fault for prescribing Toradol.  It's use appears to be fairly widespread; side affects can happen from any drug or drug/alcohol combination.  

 

As stated, there's mostly likely nothing to see here other than ESPN making something out of nothing to get some clicks during a slow sports cycle.

I'm aware of this portrayal problem.  The point is that people want to talk about potential problems that exist as a result of Toradol use.  As WBCD lays out and despite the legality of use, there are still health side effect related issues associated. So, set aside the legality portion and ESPN's clickmongering conversation and understand that we aren't even talking about that stuff. 

 

There are still problems with Toradol's use.


Edited by Dogman2, 12 February 2013 - 02:15 PM.


#35 Pearl Wilson


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Posted 12 February 2013 - 07:37 PM

This is kind of beside the point, but isn't Papelbon known to be a migraine sufferer? 



#36 lexrageorge

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Posted 12 February 2013 - 07:44 PM

I'm aware of this portrayal problem.  The point is that people want to talk about potential problems that exist as a result of Toradol use.  As WBCD lays out and despite the legality of use, there are still health side effect related issues associated. So, set aside the legality portion and ESPN's clickmongering conversation and understand that we aren't even talking about that stuff. 

 

There are still problems with Toradol's use.

 

The bolded is conjecture, not fact.  The fact that there are potential side affects does not mean it's use is a problem. Seems like if anything some further investigation is required.  



#37 DannyHeep


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Posted 12 February 2013 - 07:51 PM

It's not banned in the NFL.  

 

 

Buchholz speculated that it might have caused his throat problem - it was no doubt multifactorial, as oral NSAIDs and alcohol intake can also contribute to esophagitis, and I think we can all agree that Buchholz used the latter and almost definitely the former.

 

 

Congratulations on your hysteria-mongering.  You make it sound like the medical and training staffs have been strapping players to gurneys and injecting them with testosterone against their will.  Toradol is a very potent, LEGAL medication that can, like any medication, have side effects.  Quite honestly, I'm more concerned with the way trainers use corticosteroids - when I was working with the Padres players would get medrol Dos-Paks all the time for tendonitis, inflammation, etc.  Given that that even ONE dose of corticosteroids can cause AVN (hello, Mike Napoli and your one-year, 3M dollar contract), I'd say that's at least as concerning.  But since toradol is injected, it makes for a much sexier story, I guess.

I think the biggest part around this is the potency of this drug. Toradol is prescribed for kidney stones. I've had it a bunch of times. I went from the world's worst pain to nothing in about 2 minutes. I can't even imagine playing baseball on the stuff. I'm not sure how they even did that.

 

If players are taking this for injuries, there is serious risk to making that injury worse, this drug knocks out all pain for a solid amount of time. Playing 2 hours on an injury (which will be masked by this drug) without pain, isn't a good idea.



#38 radsoxfan


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Posted 12 February 2013 - 07:56 PM

There are still problems with Toradol's use.

 

Should we start talking about the risk of liver failure from tylenol overdose?  The risks of cancer from smoking cigarrettes and chewing tobacco?   The side effects of excess caffeine? The litany of problems with drinking alcohol?

 

The list of drugs with side effects and risks could go on for awhile.  Unless it came out that the Sox team doctors are forcing this stuff on the players without their consent, or illegally manipulating them into taking it.... I honestly don't see how this story has anything to do with the Red Sox.  

 

People take NSAIDs for pain relief.  NSAIDS cause some side effects in some people.  The side effects can be found easily on the bottle or by looking it up online. The drug is legal.

 

Should ESPN write an article about how occasionally Red Sox players take NyQuil before going to bed also?



#39 radsoxfan


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Posted 12 February 2013 - 08:04 PM

I think the biggest part around this is the potency of this drug. Toradol is prescribed for kidney stones. I've had it a bunch of times. I went from the world's worst pain to nothing in about 2 minutes. I can't even imagine playing baseball on the stuff. I'm not sure how they even did that.

 

You sure they didn't give you morphine?  Or did you get high on Toradol?

 

Toradol will relieve pain, yes.  I'm not sure why this would prevent playing baseball.  


Edited by radsoxfan, 12 February 2013 - 08:04 PM.


#40 DannyHeep


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Posted 12 February 2013 - 08:29 PM

I asked the doctor specifically because the pain went away so fast I couldn't believe it. I definitely didn't feel comfortable driving immediately after. I've taken it a few times and each time I was definitely not ready to do anything that required thought or motor skills.



#41 VORP Speed

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Posted 12 February 2013 - 08:37 PM

Toradol is a very effective NSAID. It's particularly useful because it does not need to be given orally. It is not a wonder pain drug or an anesthetic. I cannot count how many times I got woken up in the middle of the night during residency, phoned in an order of Toradol and then got woken up half an hour later to give something stronger. If you tear your rotator cuff or have a Dave Dravecky episode on Toradol you are still going to feel it. It could blunt some soreness and maybe let you stay in a game a little longer if your manager is abusing your arm, or perhaps contribute to chronic overuse if this is repeated over time, but this idea that it's going to mask acute injuries is just incorrect. Go take 800mg of Advil and then close a car door on your finger and you will see what I mean.

#42 Dogman2


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Posted 12 February 2013 - 09:27 PM

Should we start talking about the risk of liver failure from tylenol overdose?  The risks of cancer from smoking cigarrettes and chewing tobacco?   The side effects of excess caffeine? The litany of problems with drinking alcohol?

 

The list of drugs with side effects and risks could go on for awhile.  Unless it came out that the Sox team doctors are forcing this stuff on the players without their consent, or illegally manipulating them into taking it.... I honestly don't see how this story has anything to do with the Red Sox.  

 

People take NSAIDs for pain relief.  NSAIDS cause some side effects in some people.  The side effects can be found easily on the bottle or by looking it up online. The drug is legal.

 

Should ESPN write an article about how occasionally Red Sox players take NyQuil before going to bed also?

 

 

For crying out loud.   Go back and read what I have said.  Then, try to follow the conversation.

 

I haven't knocked the medical staff once and, really, you don't work for the team so no need for all the snark.  I haven't put out any conjecture.  I haven't said anything other than Buchholz landed in the hospital as a result of mixing this drug with alcohol and those side effects. I then said, as WBCD also did, this conversation has neither to do with any legality issue nor any ESPN clickmongering and that is what people are focusing on. Those issues relate to why Buchholz landed in the hospital.  Any time a player ends in the hospital, it's an problem.  WBCD laid out the potential issue with the amount of information that is shared with those on this drug.  Heep then moved that part of the conversation forward when he spoke about dosage.  

 

Are we all up to speed?  


Edited by Dogman2, 12 February 2013 - 10:02 PM.


#43 radsoxfan


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Posted 12 February 2013 - 10:12 PM

The point is that there is no reason to focus on Toradol.  Or pretend that Edes/ESPN are breaking some story here.  Like DRS mentioned, if you had to pick a drug, corticosteroids are probably more worrisome. But the list could go on and on.  

 

Buchholz' esophagitis may or may not have been related to Toradol.  The drug is much more likely  to cause kidney and stomach issues, so lets not pretend the link in his case is absolute.

 

I have no idea what you mean by saying Heep "moved that part of the conversation forward when he spoke about dosage".  He said it helped with his pain for kidney stones in the ER. When did he talk about dosage?


Edited by radsoxfan, 12 February 2013 - 10:21 PM.


#44 DaveRoberts'Shoes


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Posted 12 February 2013 - 10:41 PM

I asked the doctor specifically because the pain went away so fast I couldn't believe it. I definitely didn't feel comfortable driving immediately after. I've taken it a few times and each time I was definitely not ready to do anything that required thought or motor skills.


For what it's worth, Toradol, like all NSAIDs, has no effect on your cognition or sensorium, so you either got something else or it was the placebo effect.

And to the point that Rad brought up, alcohol intake is more likely to cause esophagitis than any NSAID. But to be completely fair, we really have no idea what was being put into Buchhlolz' body before he got hospitalized last year, either by himself or the medical staff.

#45 wade boggs chicken dinner


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Posted 12 February 2013 - 11:06 PM

The point is that there is no reason to focus on Toradol.  Or pretend that Edes/ESPN are breaking some story here.  Like DRS mentioned, if you had to pick a drug, corticosteroids are probably more worrisome. But the list could go on and on.  

 

I wasn't focusing solely on Toradol, and I think the reference to corticosteroids is a good one.  Players want to play, and clubs want them to play too (though for different reasons).  If that takes some, well, "help," then for most players, so be it.

 

It would be a really interesting question for players - and their agents, who should be more up on this stuff - and medical staff to see how much information players are getting on possible negative reactions of some of the things they are using.  For example, would they be as willing to take NSAIDs if they knew the risks of NSAIDs and alcohol?  Would they be as willing to okay corticosteroids if they knew the consequences of going down that route?



#46 McBride11

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Posted 14 February 2013 - 11:18 PM

If Tek had been crushing Nyquil to beat insomnia Im sure so ESPN person would be after it as well.

What I havent heard a good report on the dosing they are using. 60 mg IM was older dosing. Newer standards are 30mg IM = 15 mg IV = 800 mg Oral ibuprofen. Roughly. It seems they were only using it every 5 days as prophylactic as he pitched? Which doesnt seem often enough to have dramatic side effects. Unless they are hitting mega doses. The growing concern in college football seems a far bigger issue with those kids getting it likely daily.

#47 OttoC


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Posted 14 February 2013 - 11:24 PM

Some of these people have an on-line reputation as partiers. What if they are also using NSAIDs the morning after?



#48 SoxScout


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Posted 15 February 2013 - 02:34 AM

Passan: Red Sox's use of Toradol could put ex-trainer at odds with state law, industry guidelines

 

A former Boston Red Sox athletic trainer regularly injected players with the powerful and controversial painkiller Toradol for six seasons, former Sox pitcher Curt Schilling and two other sources who independently witnessed the injections told Yahoo! Sports, possibly flouting state laws intended to prohibit trainers from administering such treatments.

 

Mike Reinold, an athletic trainer and physical therapist for the Red Sox who was fired after last season, used Toradol to treat players, mostly Boston's pitchers, Schilling and three other sources said. Toradol is a legal substance and isn't banned by Major League Baseball. The Massachusetts board of Allied Health Professionals, which regulates trainers in the state, has disciplined multiple trainers in recent years for injecting patients, regardless of the drug administered.

 

"It is the board's position that athletic trainers are prohibited from using injectables," said Amie Breton, director of communications for the Massachusetts' Office of Consumer Affairs and Business Regulations.

 

Witnesses and the findings of a 2012 MLB investigation into Reinold concur that the 35-year-old injected players at home and road stadiums from 2006-11. MLB sent a league-wide memo March 8, 2012, strictly prohibiting trainers from injecting Toradol. While MLB's investigation focused on Reinold, sources said he was far from the only trainer administering Toradol.

Reinold ingratiated himself with some players, particularly younger pitchers. Following the 2009 season, the Red Sox let go of head trainer Paul Lessard, a 12-year veteran who immediately joined the Cincinnati Reds, and then promoted Reinold. Over the next two seasons, his relationship with a number of veteran players worsened to the point they refused treatment from Reinold, three sources said, and the quality of Red Sox's conditioning came into question following the 2011 implosion.

 

By then, Red Sox pitchers were taking Toradol shots before a majority of starts, two sources said. Jon Lester admitted to reporters Monday that he frequently used it, as did starter Josh Beckett. Phillies closer Jonathan Papelbon told ESPNBoston.com he used it for years with the Red Sox.

The risks are abundant, according to doctors. Toradol use can cause excessive internal bleeding as well as damage to the kidneys and liver, and by allowing a trainer to inject players, the Red Sox may have opened themselves up to potential litigation in the future.


Edited by SoxScout, 15 February 2013 - 02:41 AM.


#49 terrynever


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Posted 15 February 2013 - 06:18 PM

Passan: Red Sox's use of Toradol could put ex-trainer at odds with state law, industry guidelines

I liked this part of Passan's story:

 

More than 300 Toradol shots over his career taught Schilling their vitality. He said he experimented with different times of injection before settling on the optimal one: 5:25 p.m., exactly 100 minutes before a 7:05 start. Even though it's neither considered nor classified as a performance-enhancing drug, its ability to help pitchers perform isn't in doubt. Schilling remembers one particular game, a 2002 Sunday getaway day in Milwaukee with the Arizona Diamondbacks.

"I slept on a pillow wrong," he said. "I woke up at 5:30 [a.m.]. I couldn't move my head. I went to the ballpark at 6:30 for a 1:30 [p.m.] game. Worked for four hours on it. I literally couldn't move my head. I went to the bullpen and started throwing and I didn't think there was any way I could pitch.

"Then the Toradol kicked in. I threw a one-hitter and struck out 17."



#50 joyofsox


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Posted 15 February 2013 - 07:45 PM

"Then the Toradol kicked in. I threw a one-hitter and struck out 17."

 

April 7, 2002

http://www.baseball-...200204070.shtml






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