Palmer - Botched Surgery

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On a general note, I just hope they take as long as needed for Rhys' recovery.

Far too many times do we see players brought back too soon which hinders their recovery and their form, and ultimately, their careers.

I'd much rather see someone play, say, 200 games over 12 years instead of 190 over 10.

I remain convinced that many players' careers are ending prematurely (29 or 30yo) because they play whilst injured, or they play too soon after injury.

Who here would be happy to see Pav/Rhys/Hasleby/Hill miss a few games here and there with the benefit of enjoying an extra 2 years at the end of their career? All of us.
 

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Hope he is all right.

Where did he get this done? Privately?

NiGHTFuRY said:
What ever happened to patient confidentiality....
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Chops_a_must said:
I think you really need to step back into line sunshine.

For 1) The person I heard this from is not medical, and I did not hear any diagnosis.
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Whoever gave you any details has broken confidence and if employed by the hospital in any capacity would be fired and also is open to civil action by Rhys, Freo or the Hospital in question.

Boith Nightfury and I work in this area, I'd be a little nervous especially if I was this person, especially if your personal details are available Chops and there is a direct link to this person.

I know of 2 people directly fired from hospitals for leaking AFL footballers details and one of em was a lot more minor than you have revealed.
 
Moo said:
Whoever gave you any details has broken confidence and if employed by the hospital in any capacity would be fired and also is open to civil action by Rhys, Freo or the Hospital in question.
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Like I said, wasn't in any way medically employed, or working in the hospital.

And once again, would not have been mentioned if it wasn't going to be on channel 9. They had way more information than I had.
 
Hey thinking all are right but that is not possible you can watch and think are you right. Please as soon as chose right decision for your surgery. Don't wait. I think this is right option for you.
 
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Yea geez.... he needs lipo by the look of that picture.
 
Chops_a_must said:
I think you really need to step back into line sunshine.

For 1) The person I heard this from is not medical, and I did not hear any diagnosis. Hence my guess in the OP.

Secondly, I only posted this after I knew it was going to be reported on channel 9. I wouldn't have even bothered starting a thread otherwise. You honestly think someone else wouldn't have anyway?

And thirdly, I really fail to see how it is unnecessary to talk about the potential ramifications of what has happened. You know, if you want to float around in ignorant bliss for another 3 months, and perhaps sickened and potentially blindsided by the results that's fine by me. But a lot of people here don't seem to realise the significance, and simply do not know. So what harm is there in talking about it?

If you want to go back to my original commentary on the 9 news report, I said, "It's potentially life threatening." There is absolutely nothing incorrect in that statement.


I just hope he gets out healthily, and is not given permanent damage because of it. His football is pretty secondary at the moment, and will likely be for a while.
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This is like talking to a journalist? your not at all interested in what people are saying, your merely trying to push forward what you want them to say.

Read my posts, never have i mentioned that these heresy ramifications are not life threatening. I am merely questioning your need to word everything you have said like Rhys is in a life threatening situation.

Now that you have sprouted your apparent source isn't even a medical practitioner nor hospital employee further makes what you have written dubious.

The harm from you writing comes from the fact that you simply do not know what you are talking about, because you do not know what the real situation is!. Now to simplify it further for you, :thumbsu:

A) You are not his GP/Surgeon
B) You are not a surgeon
C) You are not a Fremantle Fc Representative

Notice how none of what i am writing is directed towards the ramifications of any complication with surgery?

Me float in ignorant bliss? Just because you can quote wikipedia and a mystery source doesn't make you one for reality and the truth

Thankyou for seeing my point Moo.
 

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Chops_a_must said:
Blood clots in the groin.

Pretty ****ing serious. Potentially life threatening as far as I understand.


Whoever made the call not to put a drain in the knee should potentially think about not doing whatever it is job they do, ever again.
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Chops, a drain in the knee will only affect local swelling... I do not believe that it will have had a major affect on "blood clots" in the groin. Bit of a bugger tho, as that will require blood thinners for some time, however, he will not be participating in contact sports at the time. :(
 
SupersonicDocker said:
Read my posts, never have i mentioned that these heresy ramifications are not life threatening. I am merely questioning your need to word everything you have said like Rhys is in a life threatening situation.
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I said it was potentially life threatening chump.

Wiki links are easy to follow without having to reach for the medicine dictionary.

Freodoc said:
Chops, a drain in the knee will only affect local swelling... I do not believe that it will have had a major affect on "blood clots" in the groin. Bit of a bugger tho, as that will require blood thinners for some time, however, he will not be participating in contact sports at the time. :(
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Cheers, thanks for that.

When I had a drain in my shoulder, it was basically just blood. I would have thought it would have had a similar affect. I guess if there is any chance of it blowing up, they do it anyway.
 
Polly said:
I think its pretty common for patients to have low dose of blood clotting agents before surgery to minimise blood loss. Some people react differently, sounds like Rhys has a thrombosis caused by these clotting agents, the subsequent restriction in the groin area is probably hindering the natural post op drainage of the knee.
As far as I know a thrombosis below the knee isn't considered particularly dangerous, however above the knee needs to be taken seriously and Im sure the medicos are doing that.
He will probably be on an anti coagulant such as Clexane for 6 months, this shouldn't hinder his rehab, the only concern is it is bloody tricky getting the coagulating properties of your blood stable when you are on such medications. You need blood tests weekly and dosage variations.
Saying its a botched operation with no real basis is a bit of a stretch. The hospitals and surgeons in Perth, whilst we complain about the system, are pretty good. Im sure they've done plenty of knee recos before.
Rhys is a fit young man, I would say he has a better chance than most of recovering fully!
Good luck young fella, he probably thought he'd be home by now sitting on the couch with his playstation.:thumbsdown:
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Sorry, disagree entirely with this, apart from the last two lines.
Blood thinners eg Clexane are often/always used post-operatively in lower limb surgery to prevent clots. As this is given as an injection form usually into the abdominal wall twice daily, it is usually ceased within days of being mobile.
IF Palmer has developed blood clots anywhere in his leg, then the treatment changes from preventive to active and he will need Warfarin for 3 - 6 months depending on recovery. It is only Warfarin treatment that requires blood tests, and not necessarily weekly once his 'level' is stable.
Sorry to appear pedantic but I have a dislike of misinformation...:)
 
Wow this is bad news for an outstanding young player. I hope that he gets better soon and is carving up the midfield again in 2010.
 
Freodoc said:
Sorry, disagree entirely with this, apart from the last two lines.
Blood thinners eg Clexane are often/always used post-operatively in lower limb surgery to prevent clots. As this is given as an injection form usually into the abdominal wall twice daily, it is usually ceased within days of being mobile.
IF Palmer has developed blood clots anywhere in his leg, then the treatment changes from preventive to active and he will need Warfarin for 3 - 6 months depending on recovery. It is only Warfarin treatment that requires blood tests, and not necessarily weekly once his 'level' is stable.
Sorry to appear pedantic but I have a dislike of misinformation...:)
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Well said. Let it never be said that Freo supporters aren't a smart lot.

I was going to say something, but the only sure way I know of to prevent clotting is to keep picking the scabs off your sores.:p

But clearly it's not my line of speciality.

People have information sources that they may or may not wish to reveal, that is their prerogative. If the source is wrong Chops, slap him for us, but if they're right, thanks. If they are a good source then we'll keep getting updates that the club clearly won't pass on through any of the media channels. If the source is identified, we'd get nothing.

Anyway, not to trivialise this situation, let's wait for some info to be released before we start calling for a priest. P.s. Get well soon Rhys.
 
Freodoc said:
Sorry, disagree entirely with this, apart from the last two lines.
Blood thinners eg Clexane are often/always used post-operatively in lower limb surgery to prevent clots. As this is given as an injection form usually into the abdominal wall twice daily, it is usually ceased within days of being mobile.
IF Palmer has developed blood clots anywhere in his leg, then the treatment changes from preventive to active and he will need Warfarin for 3 - 6 months depending on recovery. It is only Warfarin treatment that requires blood tests, and not necessarily weekly once his 'level' is stable.
Sorry to appear pedantic but I have a dislike of misinformation...:)
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Beat me to the punch.

Your absolutely correct. Blood thinners (anticoagulants) are used around the time of surgery to prevent blood clots (thrombosis). Even so, patients can still develop blood clots regardless.

There was some truth to the first posters original post. Blood clots below the knee aren't treated, above the knee (including into the groin) are treated.

Treatment is Clexane (injections) often twice daily. Also Warfarin (tablet) is used concurrently until it achieves a therapeutic dose. Then once the Warfarin is at the desired level, Clexane can be stopped. The regular blood tests a patient needs is to check the blood is appropriately thinned and the Warfarin dose gets adjusted.

Side note - Warfarin is rat poison. :)

If you had thrombosis in the groin treatment would be for approximately 6 months. During which you can't play contact sport.

On the topic of life threatening, it is absolutely POSSIBLY life threatening. If the clots in the veins of the leg/groin break, they travel to the heart and can eventually lodge in the lungs. If they are big enough they can prevent blood flow to the lungs resulting in death.

BUT.....its all heresay. Nobody has proof that Rhys has deep vein thrombosis to the level of the groin.
 
Thanks for the last two posts guys... nice to hear some well informed facts!

Being someone who regularly gets their hands dirty on ACL reconstructions in my line of work I'd like to add the following:

1. Virtually none of the orthopaedic surgeons I work with routinely use drains for ACLs. Knees don't really bleed all that much unless you're doing a lateral release which I'm guessing Palmer wouldn't have, or a major operation such as a knee replacement, which Palmer definitely woundn't have. As mentioned before by someone, drains are becoming out of fashion. In fact, there is a review by a widely accepted medical database called the Cochrane Database of Systematic Reviews which looks at best medical evidence on a wide variety of topic and concludes in one review that there is "no evidence to support routine drain insertion in orthopaedic surgery". Many surgeons I work with don't even put drains in for total knee joint replacements.

2. Drains are more likely to introduce infection because they provide a communication from the outside world into the body.

3. The fact that Palmer may or may not have a DVT gives no indication of whether it's serious or not. Half of the people on any average airplane or hospital ward can have a DVT without any symptoms or adverse effects. Therefore, unless someone here is medically trained and has seen the Palmer to assess the severity of his DVT (if it exists) then we are all really guessing about what all this means for him and for us.

4. DVTs are recognised complications after surgery and are not indications of technical errors or "botched surgery". They can happen just because of bad luck or because of a genetic predisposition to blood clotting. The presence or absence of drains does not affect the development of DVTs. If having a drain in prevents you from mobilising after the surgery this can INCREASE your chance of getting a DVT.

5. Other potentially life threatening medical conditions include the flu, an infected sore, an allergic reaction or a punch in the head.

Has anyone actually heard any reliable information about what's happening to Palmer?
 
martorius said:
Thanks for the last two posts guys... nice to hear some well informed facts!

Being someone who regularly gets their hands dirty on ACL reconstructions in my line of work I'd like to add the following:

1. Virtually none of the orthopaedic surgeons I work with routinely use drains for ACLs. Knees don't really bleed all that much unless you're doing a lateral release which I'm guessing Palmer wouldn't have, or a major operation such as a knee replacement, which Palmer definitely woundn't have. As mentioned before by someone, drains are becoming out of fashion. In fact, there is a review by a widely accepted medical database called the Cochrane Database of Systematic Reviews which looks at best medical evidence on a wide variety of topic and concludes in one review that there is "no evidence to support routine drain insertion in orthopaedic surgery". Many surgeons I work with don't even put drains in for total knee joint replacements.

2. Drains are more likely to introduce infection because they provide a communication from the outside world into the body.

3. The fact that Palmer may or may not have a DVT gives no indication of whether it's serious or not. Half of the people on any average airplane or hospital ward can have a DVT without any symptoms or adverse effects. Therefore, unless someone here is medically trained and has seen the Palmer to assess the severity of his DVT (if it exists) then we are all really guessing about what all this means for him and for us.

4. Other potentially life threatening medical conditions include the flu, an infected sore, an allergic reaction or a punch in the head.

Has anyone actually heard any reliable information about what's happening to Palmer?
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Cheers, what do you do martorius?
 
Frequent reader very infrequent poster but felt compelled to post!

Claims of 'botched" surgery are a nonsense.

Claims proclaiming that the surgeron and health care team erred significantly by not inserting an intra-articular drain are also nonsense.

The use of such devices after ACL reconstruction s not universal and certainly not accepted as best practice. The purpose of such drains when inserted is NOT to prevent the formation of thrombosis but rather to minimise pain and stiffness in the knee. There is no good evidence to support the use of such devices in ACL reconconstruction. Furthermore the use of postop drains in knee replacemnt which is associated with significant bleeding is also decreasing as evidence emerges that such devices may actually increase bleeding.

It is usual practice to give a prophylactic dose of anticoagulant preoperatively and this is usually a subcutaneous injection of enoxaparin or heparin. However even with every precaution patients sometimes develop deep vein thrombosis or infection.

It is a nonsense to suggest that deep vein thrombosis (DVT) that occur in the veins distal to the knee aren't treated - all DVTs are treated as all such patients are at risk of thromboembolism - this occurs when part or all of the clot breaks away from the blood vessel wall.

This is where it becomes life-threatening as the clot is then an embolus - that "travels" in the blood and can cause major problems - for example pulmonary embolus. An embolus can result in stroke, myocardial infarction as it "blocks" the supply of oxygen to the tissues and muscles of where it lodges so to speak.

Further anticoagulant therapy such as warfarin which acts by blocking the livers ability to produce Vit K dependant clotting factors may be needed to ensure no further clots are produced. The dose and length of time such therapy is required depends on the intial diagnosis e.g. DVT v PE and ranges from 3 to 6 months, depending on non-transient risk factors.

There is absolutely nothing wrong with the quality of the medical and health services in metro WA - patients here at even the best facilities with renowned surgeons get DVTs and suffer post-op infections.

There is also no evidence to suggest that such adverse events associated with ACL reconstruction significantly impact on graft , recovery and associated ROM (range of movement). SO IF AND IF IS THE KEY WORD that is the case here the prognosis is not all doom and gloom bring out the knives stuff!!!

So after a long rant - don't be so quick to bag your own :p

And here's to a good and full recovery
 
Yeah,bloody brilliant posts:thumbsu:

But geez I wish that these posts would have been available to me last semester. Would have taken care of a big portion of my last assignment for me. :mad:
 

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Palmer - Botched Surgery

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