This is an initial draft written in mere minutes. I will add to it, providing further details and insights on how it will impact this season and beyond, later, when I have more time to do so. But it should provide the clarity for which I am being asked.
Pat Riley, in a meeting with reporters, said that Chris Bosh’s career “is probably over” and that the team is “not working toward his return.”
Bosh, an 11-time All-Star, failed his preseason physical last week. The Heat had reportedly been prepared to clear him for play, contingent on him passing. During the testing, however, doctors reportedly found more evidence of blood clotting.
In a previous statement, the team said that it and Bosh, “in consultation with team doctors and other physicians, have been working together for many months with the mutual goal of having Chris return to the court as soon as possible,” but said it regretted that “it remains unable to clear Chris to return to basketball activities, and there is no timetable for his return.”
Bosh has done interviews in recent weeks with Uninterrupted, saying that “nothing” would keep him off the court this season and that he was “confident” that he “will play basketball in the NBA,” even though blood clots ended each of his last two seasons at the All-Star break. “I’m ready to play,” Bosh said.
Blood clotting is a normal process that occurs in the body to prevent bleeding and promote healing after an injury. The body forms blood clots when the platelets within the blood encounter a damaged blood vessel, and then breaks them down as the damaged tissue heals.
Clots can form unexpectedly, however, without notice or purpose, and have dangerous consequences. Certain clots, such as those that start in the leg or calf and travel to the lungs, can be fatal. And those who have endured clots in the past are particularly susceptible.
According to the NIH, more than 600,000 people in the U.S. are diagnosed with DVT (a blood clot that originates in the leg or calf) each year and roughly 30 percent of those patients develop a recurrence within 10 years, with the risk being greatest in the first two years.
Recurrence is more likely in those who initially presented with a pulmonary embolism (a blood clot that travels to the lungs), as did Bosh, is more likely to be another pulmonary embolism (as opposed to a DVT alone), leaving Bosh susceptible to a potentially more serious recurrence.
That Bosh has already endured two blood clotting episodes, and that he plays a contact sport (professional basketball), both sharply exacerbate the risk of future recurrences. The risk, for Bosh, is therefore very real.
Blood clots are treated with anticoagulant drugs (blood thinners), which prevent further blood clots from forming as the body’s normal systems work to break up the existing clot(s).
For those who have endured a single clotting episode, blood thinners are typically continued for up to six months. Many professional athletes who have suffered blood clots have been able to successfully resume their careers without incident after their initial blood-thinner regimen.
However, people who suffer multiple blood clots are at sharper risk of a recurrence, and are typically therefore recommended to remain on blood thinners for the rest of their lives.
Blood thinners greatly reduce the likelihood of future blood clots, but they can have a potentially serious side effect: bleeding.
Since blood thinners slow the clotting of blood, unwanted and sometimes dangerous bleeding can occur with the use of these medications. Although infrequent, uncontrolled bleeding caused by blood thinners can be very serious. A blow to the head, for example, can cause bleeding on the brain and kill you!
Doctors and teams are therefore hesitant to allow players on blood thinners to return to contact sports, where a potential trauma could have disastrous consequences.
The issue for Bosh, then, becomes:
If he doesn’t take blood thinning medication, he is at risk of sustaining more, potential fatal, blood clots. Playing professional basketball only exacerbates that risk.
If he takes blood thinning medication to reduce the likelihood a future clot, playing professional basketball puts him at increased risk of sustaining a potentially fatal bleeding event. Read more…