Ok. so a lot so you know my son tore his UCL and there is a discrepancy on what should be done. Rest / Rehab was first recommendation. We are getting second opinion with Dr Kremchek next Monday.
One of the great things about this sight is the knowledge. So I am going to be a sponge. What questions should I go in being prepared to get answered?
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How big is the tear? I'm no doctor, but I think if it's 1%-5% (maybe?) you may be able to rehab it for a while. Ask an expert doc about their experiences. One of son's docs said small tear, and another said >50% and rehab would have wasted an extra year. So get a 2nd opinion.
Chef, first off, let me say I am sorry for your son's injury. I'm not a orthopeadic doc, but I will tell you where I stand, having the ability to look back on my son's situation. My son felt a "pop" during a throw from the outfield when he was 15. We had x-rays, MRI and examination which all revealed a UCL tear. Son had no pain, even during docs exams. Our local ortho referred us to Dr. James Andrews. Son saw Dr. Andrews about a month after the injury. During his examination, I could see the look of confusion on doc's face as he was expecting son to exhibit some pain, but to his surprise, my son complained of zero pain on all the movements. Dr. Andrews was great! He took a LOT of time talking to us and explaining his findings and recommendations. He suggested that we proceed with rehab, but he warned me that surgery may still be required in the future if he didn't respond favorably to the rehab.
Son did the prescribed rehab and followed up with Dr. Andrews 6-8 weeks later. A second MRI was taken and showed his UCL scared over and healing. Dr. Andrews was certain he would make a full recovery and released him to normal playing about 4 months later.
Fast forward 3 years. Son feels a "sensation" in his elbow the morning following a complete game in which he threw only 89 pitches over 7 innings. The team trainer felt like it was just soreness and nothing structurally wrong. After 2 weeks of rest, the issue was still present, so we saw the ortho doc once again. This was a different doctor from our first visit. On examination, he felt certain there was no structural damage. The doc didn't want to do a MRI. I basically demanded it as son was getting a lot of pro interest leading into the 2015 MLB draft. The MRI showed no structural damage, and the ortho told me his ligament looked better than it did on the MRI from 3 years prior. We talked with his HS coach and college pitching coach and all agreed to shut him down as a precaution until he got to campus for summer. Son went through the summer throwing program with no issues while throwing long toss or flat ground. When he threw his first bullpen from the mound, he felt the "sensation" again. The trainer immediately diagnosed it as an ulnar nerve issue and he was referred to the team ortho. On his examination a few days later, he confirmed the trainer's diagnosis and set son up to have a nerve conduction test. The test confirmed the clinical diagnosis, and son had ulnar nerve transposition surgery in August. He rehabbed from the surgery and everything progressed seemingly flawless. Son was again able to throw long toss and flat ground with no pain or issues. His first bullpen from the mound, he felt a "pop" on his 4th pitch. A UCL tear was feared and that was confirmed by MRI a couple days later. Son had UCL reconstruction December 16.
I know this has been a very long post, but I'm trying to lay the groundwork for my opinion. With all the information I have now, I still do not know if I would have done anything different. You can really only go by what the experts recommend. I do think the original tear of son's UCL never completely healed. He does have a slight mechanical flaw where he throws from a slightly closed position. Other than that, I have never had anyone tell me that son had mechanical issues. He has never had a pitching lesson, but he has thrown in front of many, many scouts. I would think that if a major flaw was present, someone would have said something by now.
I think your son is a freshman or sophomore in college, right? My opinion would be to lean toward the more aggressive surgical option at this point I think. Maybe being conservative is the right call for a young teenager, but at this point in your son's career, I would rather have the issue solved rather than putting a band aid on it, per se. Again, I'm not an ortho doc, but I am in the medical field and have a fair amount of knowledge and understanding of anatomy. Everyone is different and each has his own opinion. I'm just giving you my opinion as my son is 2 months post-op. I'm not saying we or he would have done anything different. It is very difficult and I really feel for you and your son.
Things happen for a reason and I fully believe that God is in control. My faith is the one thing that I can hold on to. I can tell you it is very difficult to see my son sitting in the dugout watching his teammates perform and knowing he can't. This is the first time he has missed any sport due to injury. I have to believe God is teaching him something. Hopefully we are able to look back in a few years and see the lessons.
Sorry to hear that, Chef. My advice would be to go to ASMI site (asmi.org) and ask Dr. Fleisig for a referral to an Andrews-trained doctor in your area, but after Googling Dr. Kremchek, it looks like he fits that bill. Still, couldn't hurt to ask.
Good luck to your boy! Hoping for the best.
Kremchek is absolutely a great choice. There is a poster here whose son had TJ surgery performed by Kremchek in the last 4 months. Maybe he will read this post and chime in.
Thanks Younggun (and everyone else). I agree with you about being aggressive in treatment. He did hear a pop, but said his arm got really hot at end of third inning, then we had a long at bat. he said his forearm was tight when eh went back out, felt something on first pitch but tried to work thru it. threw about 10-15 more pitches, got worse and coaches kept asking if he was ok and he said yes. They came out and out immediately after he buried a fastball 10 feet in front of plate and he was done.
I am with you on Gods plan. He said to me this morning that he has been praying about it a lot since last night and whatever God decides for him he is ok with. that he is at peace with whatever happens. Makes me proud of who he is as a man 
sultan, that is the question and Dr did not say. I saw MRI (I had to ask, he wasn't going to show it to us), but really didn't know what I was looking at. He just said a tear. Said there were long strands still connected from bone to bone. Coaches were asking grade1,2,3. Not sure they ever got an answer from Dr. I think that is why they were pushing for a 2nd opinion. They did not have to push much for me to agree
chefmike - really sorry to read this. Your son will be in my thoughts and prayers.
Couple of things from our older son's UCL experience:
All the best - let us know how it goes. Hopefully just rehab, but others have given you good experiences and advice on that scenario - that I've heard from many others too.
The ASMI sports medicine forum is good. Lots of physician and trainer responses. Also ask about platelet rich plasma therapy.
I had my surgery done in August 2014 by Dr. Kremchek. He was the third doctor I saw and the only one who was able to fully diagnose the tear (mine was a partial tear). Before Dr. K, I had done two stints of rehab (each 5 weeks long). I did not find improvement and ended up having the surgery which could have been done 8 months prior, in reality.
With that said, if your son ends up opting for surgery, I would absolutely go with Kremchek. He is one of the best there is. Also keep in mind that the road back from TJ is not the end of the world. Stick to the process and it will heal as it is supposed to. I wish your son the best! Feel free to give me a PM if you have any questions.
Chef, So sorry to hear, while I have no answers for you, you and your son willbe in my thoughts and prayers.
Got final news about son. Tommy John surgery with Dr Kremchek this Friday. Said original MRI was "terrible". Did X-ray, ultrasound, and a contrast MRI with fluid. Showed a significant tear across the middle of muscle. Holding on a one end by a couple threads.
The difference in the whole process of diagnosis was like mid day at the equator on the longest day of year vs midnight in anartica on shortest day of year.
He is ok with outcome. He has been saying surgery since it happened. thanks everyone for the information. It was very helpful in asking questions and then understanding what the Doc and everyone was talking about.
I'll keep you posted
Good luck to your son. Let us know if there is anything we can do?
Thanks Bishop. At this point just like what I will be doing for next few days. Hitting my knees and asking for him to be ok to the man I charge of it all
Unless we want to have the donate for yearly out of pocket money. Like I have $4000 laying around . That's what payment plans are made for. It does frost my buns a bit that because we got such bad advice by college docs we felt the need to go outside, which means instead of college picking up all the costs after our insurance pays, I have to. Will and would do it in a second for any of my kids but is a bit frustrating. The 4K would be the same whether I went thru school docs (not specifically affiliated with school but an agreement of some sort) or where he ended up. The politics of insurance- ugh!
I will be praying for your son. A kid I know had TJ and came back the end of last spring, played through the summer. Pitched a perfect game to start off his spring season!
I'm not an expert but it seems every time I hear that an MLB pitcher gets treated conservatively he needs surgery anyway a couple months later.
But I would trust the doctor, maybe a very small tear can heal itself.
Dominik85 posted:I'm not an expert but it seems every time I hear that an MLB pitcher gets treated conservatively he needs surgery anyway a couple months later.
But I would trust the doctor, maybe a very small tear can heal itself.
got second opinion from an expert in this surgery yesterday. Surgery it is. On Friday
Good luck. Son is 18 months post TJ with Kremchek and doing well. Have him follow the program religiously and all will work out. Oddly I believe the adversity my son has experienced and the dedication to coming back has made him both mentally and physically stronger. Rooting for a very healthy future for your son!
Fairly new to this forum but as a parent of a student-athlete my heart goes out to your son. Best wishes to him on a full and speedy recovery.
Tomorrow is the day. Have to report to doc at 6:15am. 45 minute drive. So early to bed. Early to rise. Thanks for all the guidance. Advise. And prayers. I'll keep you all up to date.
Chef, I have followed your posts for years since our guys are the same year. Prayers for your son, and for the surgeon(s).
Good luck tomorrow. Let us know how it goes!
Surgery went great. I watched and they had a nurse sitting with me explaining as they went. Doc came out said it was obviously a total rupture. He is in recovery.
They cut thru a lot of layers of muscle to get to ligament. He is gonna be SORE!
Road to back on the mound has begun
Again, best wishes on a full and speedy recovery!
Best wishes, on his road to recovery. Glad you got a second opinion.
Glad surgery went well, he is well on his way to recovery!
Unfortunately we will have an opportunity to compare notes my college soph has surgery scheduled March 16th. Man this has been tough mentally for everyone as there was no indication, he had felt great. Best of luck in recovery for your son !
2014 Dad posted:Unfortunately we will have an opportunity to compare notes my college soph has surgery scheduled March 16th. Man this has been tough mentally for everyone as there was no indication, he had felt great. Best of luck in recovery for your son !
I hate hearing about these injuries. Best wishes for your son and family, as well.
2014 dad. Answered your pm. Same about no indication. Jeremy handling it well so far.
Although lots of negatives, a few positives.
1. School -potentially if he wants- for 5th year with scholarship. So can either finish degree or work on grad degree.
2. For first time in life, will learn to deal with true adversity. And though I never ever want my kids to deal with adversity. Reality is they will and this one can be in a controlled environment where his family and team has his back.
3. For first time in his life, he will learn how to not be "the man". He has always been a great teammate but now he will learn how to be one even more.
4. I get to spend quality time with my son. He gets to realize even more that I love him not for son the ball player but just Son the man.
I am going to look at this as a positive experience in his growth as a man. To date, so is he.
Right this second, he has his girlfriend and 3 HS friends at our house with him. They are laughing in other room about who knows what.
Keep making it a positive experience! My own son went though two different surgeries over his 4 year college career, cutting short one year and summer ball and preventing him from pitching another (he was a 2-way player). Overcoming and having success after adversity is a life lesson, no matter what he ends up doing. Learning how to deal with it will make him a better person. My prayers are with you and your son for a speedy recovery and I'm looking forward to following his future successes on the mound and in "life."
Chef, we went through the same with our son and you are spot on about loving the man he has become. It made T1 put a lot of things in perspective.
As far as the out of pocket goes, we did the same with ours because school doc's really mis diagnosed everything. We went out on our own and kept our ins company informed every step of the way and they contacted the school to get second party payment info for the doc we went with. It wouldn't have mattered because like you we would have paid whatever it would have cost, well been on the payment plan like you, but regardless would have done whatever it took.
Maybe talk to your rep and see what your options are. The only out of pocket we had was $100 for the anistegiologist. Everything else has been covered between our ins and the schools. He even choose not to go back to that school and had follow ups for 3 months after and not any bills.
Good luck! He will be dying to hold a baseball in a week.
Update on UCL and TJ for son. Brace came off a week ago. He is so excited. He has full range of motion. He can now do lower body workouts. He is a little ahead of schedule but really that is not a concern of mine. Truly doesn't matter if he is ready to pitch in early January vs. in Mid February since the first game isn't until mid February . The trainer said the nice thing about being ahead at moment is 2 fold. 1, if he has a set back, he could still be ready for opening weekend. 2, if he does stay ahead, then he can build endurance for first outing.
As far as the insurance goes, College picked up the doctor who did his surgery as their team guy from now on. He had done the last 4 surgeries of team after not great advice by who they had previously used (who we saw first). Because of that, nothing out of pocket for me
Great news- sounds like progress is going well!
LHP son recently found out he will be redshirted....20 months post TJ finishing freshman year of college. Arm doing great and touched 91 for first time. Came into fall season at 80-82 (was 86-87 prior to TJ).
True test of persistence and staying the course.
Keep us posted on all his future milestones!
Another update. Shoulder strengthening going very well. Yesterday he was allowed to throw a baseball for first time. 10 throws at 15 feet- soft. He was SOOOOO excited
Sounds great ChefMike! Still remember watching him go head to head in the tournament against our ace pitcher (who also just had TJ) Good luck and hopefully his team can show the big dogs what is up this weekend!
TroyBaseballKid22 posted:Sounds great ChefMike! Still remember watching him go head to head in the tournament against our ace pitcher (who also just had TJ) Good luck and hopefully his team can show the big dogs what is up this weekend!
wait -ZK who plays for BG had TJ surgery? Wow that is a lot of letters!!! ZK and Jeremy played on same summer team (Raptors / MV Prospects) summer before senior year and summer after. They are good friends and I love his parents. Actually had some excellent parents / players from Troy that were his teammates those 2 years.
Yep - 2pm today is battle of Ohio, Then hopefully take out the #2 Louisville Cardinals. WSU have the ability, but baseball is a game that can go either way on any given day. Such as that playoff game between Troy and Miamisburg. Classic 1-0 tournament game. Both pitchers pitched great that day.
chefmike7777 posted:TroyBaseballKid22 posted:Sounds great ChefMike! Still remember watching him go head to head in the tournament against our ace pitcher (who also just had TJ) Good luck and hopefully his team can show the big dogs what is up this weekend!
wait -ZK who plays for BG had TJ surgery? Wow that is a lot of letters!!! ZK and Jeremy played on same summer team (Raptors / MV Prospects) summer before senior year and summer after. They are good friends and I love his parents. Actually had some excellent parents / players from Troy that were his teammates those 2 years.
Yep - 2pm today is battle of Ohio, Then hopefully take out the #2 Louisville Cardinals. WSU have the ability, but baseball is a game that can go either way on any given day. Such as that playoff game between Troy and Miamisburg. Classic 1-0 tournament game. Both pitchers pitched great that day.
Yes, he did. My family and his are very good friends as well! Our mothers worked together, my brother helped his dad coach a team and I played with ZK for a year back in the day. Came out when pitching against a B1G team, didn't feel good, got an MRI and then had TJ (by Kremchek) in the middle of May.
For sure. I'd love to see Wright State or even OSU pull one out in that regional (no offense to UL)
ChefMike:
Sending you a PM. Look like my son is going to have TJ with Kremchek in a few weeks.
Just replied Bucsfan. So sorry.
Update on the rehab since I am here. It is going very well. Jeremy started throwing in first week of July on flat ground. No pain to date. Says arm feels very strong. He has had 3 checkups (I think) since June including one today. Ultrasound today and cleared to continue the plan. Plan at moment is to continue with long toss daily . Throwing on a line as increased distance by 20 feet weekly. This is until he reaches 200 feet. Today he is at 120, with clearance for 140 as of tomorrow. The idea is this will increase velocity and strength without over extending. He said yesterday 120 is very easy for him but he is being watched closely (thank goodness) so he is not trying to increase velocity within a shorter distance.
After he reaches 200 feet on line then he will get on the mound (basically beginning of November). Not sure how mound work will be done but I know there is a specific plan. The goal to get him on the mound opening day of 2017 season and what they think as of moment is he will be with a pitch count of between 70-80 pitches.
