This is very sad news can't believe some people were making a joke of this in earlier posts. I'm praying for a speedy recovery.
<blockquote class="twitter-tweet" lang="en"><p><a href="https://twitter.com/chrisbosh">@chrisbosh</a> thinking about you brother...I'm ready when you get back...speedy recovery</p>— Goran Dragic (@Goran_Dragic) <a href="https://twitter.com/Goran_Dragic/status/568869790476972032">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>Praying for you and your family <a href="https://twitter.com/chrisbosh">@chrisbosh</a></p>— Kobe Bryant (@kobebryant) <a href="https://twitter.com/kobebryant/status/568862012039565312">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>Prayers for the bro <a href="https://twitter.com/chrisbosh">@chrisbosh</a> God has your back!!! <a href="https://twitter.com/hashtag/SpeedyRecovery?src=hash">#SpeedyRecovery</a></p>— James Ennis (@JamesDa_Truth) <a href="https://twitter.com/JamesDa_Truth/status/568856567044550656">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>I'm praying for a speedy recovery for <a href="https://twitter.com/chrisbosh">@ChrisBosh</a>!</p>— Earvin Magic Johnson (@MagicJohnson) <a href="https://twitter.com/MagicJohnson/status/568845942415355905">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>Prayers up for my big dog <a href="https://twitter.com/chrisbosh">@chrisbosh</a>. Everything gonna b fine.</p>— Mario Chalmers (@mchalmers15) <a href="https://twitter.com/mchalmers15/status/568816005746704384">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>Man my heart real heavy right now thinking about <a href="https://twitter.com/chrisbosh">@chrisbosh</a> health! Especially after hearing about Kersey the other day. My prayers are....</p>— LeBron James (@KingJames) <a href="https://twitter.com/KingJames/status/568805784672460800">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> <blockquote class="twitter-tweet" lang="en"><p>Best of luck to <a href="https://twitter.com/chrisbosh">@chrisbosh</a> - hope he comes out of this OK.</p>— Bill Simmons (@BillSimmons) <a href="https://twitter.com/BillSimmons/status/568801250935844864">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>
Are you a physician? I am not, but I have worked in the radiology dept at a major hospitals for over 10 years, mostly at a HCA facility. Obviously I have not followed every pt who has been diagnosed with PE, but in those 10 years, I still have too see a positive PE diagnosis PT who was told that they didn't admission for their condition. It is just standard protocol in our facilities all over America. If you are pulmologist, or a physician working for another medical organization, I would like to know what protocols you guys follow. Thanks.
<blockquote class="twitter-tweet" lang="en"><p>Heat expected to announce Chris Bosh's season is over.</p>— Joseph Goodman (@JoeGoodmanJr) <a href="https://twitter.com/JoeGoodmanJr/status/568907029361725440">February 20, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>
I am a physician. Given the correct clinical context, outpatient treatment of pulmonary embolism can be instituted safely and effectively. The importance of "correct clinical context" should be highlighted, however. The patients that would be amenable to outpatient treatment should have low risk of death based on the PE severity index, not be hypoxemic, not require IV pain control, hemodynamically stable, no bleeding risk. There are also other factors to consider. There are studies that have compared outpatient and inpatient therapy for patients that fit these criteria, and it did not demonstrate statistically significant difference in recurrence of thromboembolism or other complication.
Thanks for the response. I have seen those studies, but our e.d. physicians are timed constraint to assess a pt who has p.e., so therefore they get admitted and it is then the hospitalist's job to determine the proper course of action according to the degree of severity. In 2012, my hospital was rated by consumer reports as the safest hospital in Nevada (I believe they used the Joint Commission on safety) and an educated guess would indicate that proper treatment protocols for a number of conditiond was a big factor in the selection. Lastly, I want to make sure we are talking about ACUTE P.E. and not after hospitalization treatment. As a physician, I am quite sure you would have recommended Chris Bosh to be admitted, would you not? After all, he has a bilateral P.E. Appreciate the comments. Medicine fascinates me and I wish I had gone to med school as opposed to law school. Oh well. . .
Is someone predisposed to developing this condition or does it just happen? Just wondering for all the people saying the Rockets 'dodged a bullet'. I mean, I'd understand the 'dodging a bullet' angle if the Rockets passed on signing someone that's been a huge p***y and clown his entire career and has never won anything...
I would absolutely admit Chris Bosh if I saw him in the ED. We have to keep in mind that studies and guidelines are not medical "law." And even within guidelines, there are factors that are up to "clinical judgment." The interesting thing is WHERE you see the patient would affect HOW you treat the patient. When you see a patient in the emergency department, you wear ED colored glasses, and anyone that even smells like an inpatient admission gets admitted. On the flip side, if you see a patient in clinic, your perspective is entirely different, and you begin to weigh the pros and cons of inpatient admission. I would be far less inclined to send someone who is borderline for hospitalization to the hospital if I saw them in clinic for numerous reasons. But, absolutely - bilateral PEs are not the same animal as unilateral PEs, which are not the same as saddle PE, which are also not the same as subsegmental PEs. The clot burden matters a lot, as does numerous other factors. I don't think there's a physician in the world that would not admit Chris Bosh in this clinical setting (assuming large clot burden), especially when you factor in his celebrity.
There are MANY reasons for people to be predisposed to thromboembolic events, including hypercoagulable states, malignancy, immobilization, nephrotic syndrome, use of certain medications, pregnancy, etc. When there is an obvious reason for why you had a clot, then it is called a "provoked DVT/PE," and the treatment is pretty clear cut. You get put on anticoagulation (blood thinners) for a period of time, given the removal of said risk factor. When you DON'T find a reason for a clot, then you get into muddy territory. There is still great debate within the medical community for what to do in these situations, but it ultimately comes down to what the bleeding risk is for the patient. Data shows that indefinite anticoagulation in these patients decreased the recurrence of clots, however, it also increased the risk of bleeding. How this applies to Chris Bosh would depend on what kind of bleeding risk is imposed by a career playing in the NBA. No one knows the answer. If he was an NFL player, then there would be a strong push from his physician to end his career, and he'd be insane to go against medical advice. However, the NBA isn't nearly as violent, and Bosh would likely finish out his career without sustaining an injury significant enough to cause a life threatening bleed. At the end of the day, it may be up to Bosh. I certainly wouldn't hold it against him to call it a career and live out the rest of his life with his 9 figure bank account...
Damn, scary. Take care of yourself Bosh! What are the symptoms for this? Just fatigue? Chest pain due to heart working harder or not getting enough oxygen? curious if Team Doctors would consider a medical history of a p.e. to be enough to veto a trade/signing? Not to say Miami would do that, but just curious in general...like the way Cuttino got treated by NYK for heart murmur.
Chest pain, shortness of breath. HP, my man, your rep to me gave me the last green bar. Thanks and have a great Saturday!
You are Dwight Howard now! I was going to call my brother (an MD) to ask about Bosh/Kersey, but figured all I had to do was wait around cfnet for guys like you to show up with the explanations. cheers!
As expected, out for the season. [rQUOTEr]MIAMI, February 21 – The Miami HEAT announced today that Chris Bosh will miss the remainder of the 2014-15 Season, while being treated for blood clots on his lung. Bosh, who is receiving care under the guidance of Miami HEAT team physicians at a Baptist Health System Hospital, is currently resting comfortably. Chris is OK and his prognosis is good.[/rQUOTEr]
