Tag: Carl Pavano

Doctors: Carl Pavano Nearly Died from Ruptured Spleen

On Jan. 12, pitcher Carl Pavano—currently a free agent—slipped while shoveling snow and suffered a ruptured spleen. According to Joe Christensen of the Minneapolis Star-Tribune, the seemingly minor tumble almost proved fatal.

As Christensen states, Pavano didn’t think much of the fall at the time.

‘It knocked the wind out of me,’ (Pavano) said. ‘I didn’t think anything of it that weekend. We were out on snowmobiles and sleds with the kids. We were building snowmen.’

Two days later, (he) went through a full workout.

However, Pavano’s condition took a drastic turn for the worse four days after the fall. Christensen continued:

On Jan. 16, Pavano went for another workout in Westchester. Riding to the facility, he felt a sudden wave of abdominal pain and nausea.

‘My body just went into shock,’ (Pavano) said. ‘I turned white. It was one of the worst feelings I’ve probably ever had.’

Three days, three hospitals, a collapsed lung and one emergent surgery later, Pavano narrowly survived what anyone in the medical field would deem a close call—he nearly died.

Thankfully, it appears he is now out of the woods and focused on recovery—the best possible outcome of the frightening sequence of events.

Wait a second, what? He slipped while shoveling snow and nearly died as a result? How can that be possible?

Believe it or not, upon examination of the reported mechanism of injury, it actually makes sense. That said, it should be emphasized that the following merely represents educated speculation, as exact medical details are—as always—unavailable.

With that in mind, let the anatomy lesson begin.

According to Christensen, Pavano did not slip and fall down. Rather, he partially lost his balance and fell onto the upright handle of the shovel he was using. As he is certainly much taller than the shovel, he likely jammed the shovel upward into the left side of his abdomen and under his left rib cage.

That’s the spleen’s territory.

One of the spleen’s primary functions is to help the body fight infections. It is especially important in fighting certain bacterial infections. That said, it is not necessarily for survival, and countless people live entirely normal lives after having it surgically removed for one of any number of reasons.

Usually, the lowest three left ribs protect the spleen from direct hits. Nevertheless, an upward-angled blow to the left side of the abdomen can sidestep that protection by going under those ribs. In other words, nothing but soft tissue sat between Pavano’s spleen and the shovel handle, resulting in direct trauma to the organ.

However, that is only the beginning of the story.

Via the splenic artery—one of the largest arteries in the human body—the spleen receives approximately 10-15 percent of the body’s blood supply all by itself. If any of the blood vessels within the spleen are broken for any reason, that massive blood supply turns into internal bleeding.

Bleeding from splenic injury can range from slow and smoldering due to a small laceration—like the case of the NFL’s Jason Witten—to immediately life-threatening following frank organ rupture. As Pavano now knows, one can turn into the other, as well.

Due to the important—though not vital—immune function of the spleen, doctors usually try to allow it to heal on its own following less-serious injuries. As Christensen reports, that was the case with Pavano—even after things first started to look concerning:

‘I was in good shape, so my vitals were strong,’ Pavano said. ‘They didn’t feel the bleeding was proficient enough where we needed to rush into surgery. I got into the hospital on a Wednesday, and I was just deteriorating every day, little by little.’

Unfortunately, the spleen—an already fragile organ—is even more vulnerable when it is injured, and the progression of a smaller injury to a life-threatening one is very possible.

A ruptured spleen represents as big of a medical emergency as they come. Though it can sometimes be repaired, the injury usually requires either a splenic artery embolization—surgically blocking the blood vessel—or a total splenectomy.

It also requires it now.

Policy differs from hospital to hospital, but usually an on-call general surgery or trauma surgery team is assembled, and the operating room is prepared as the patient is being transported to it.

Luckily, doctors identified the gravity of Pavano’s situation in time—a difficult task in and of itself. CT scans and ultrasounds are only so good at identifying severe internal bleeding, and the abdominal compartment can silently hold an amazingly large volume of blood.

In Pavano’s case, the blood may have gone somewhere else, as well. He may have also had a partially ruptured diaphragm.

The left half of the diaphragm—a thin, flat muscle that somewhat resembles a horizontal piece of paper lying on top of the abdomen—sits immediately above the spleen.

If the shovel handle forced itself far enough into the abdomen to rupture Pavano’s spleen, it is reasonable to guess that it also tore part of the left half of his diaphragm, creating a connection between the normally separate abdominal and chest cavities. As the diaphragm is essential for breathing, an injured diaphragm also explains Pavano’s feeling of getting “the wind knocked out of (him).”

If his diaphragm did, indeed, rupture, Pavano’s spleen could bleed not only into the abdominal cavity, but through the tear and into the chest cavity, as well. As blood accumulates within the chest, it can force a lung to collapse—called a “hemothorax”—as it did with Pavano. Christensen mentions that doctors needed to remove over six liters of blood from the chest cavity before performing a splenic artery embolization to stop the bleeding.

In short, it appears likely that the shovel handle not only caused a medium-sized cut in Pavano’s spleen, but also partially tore his diaphragm. His body then compensated for the bleeding—slow at first—as the blood accumulated in his abdomen and chest over the next few days. Then, when the amount of blood lost became large enough to cause a hemothorax and shock, his condition began to spiral downhill—fast.

According to Christensen, at one point doctors warned Pavano how bad it had gotten. “I was hours away from going into cardiac arrest and probably wouldn’t even be here,” Pavano told Christensen.

Fortunately, it appears doctors intervened just in time. By evacuating the blood from Pavano’s chest, doctors allowed his collapsed lung to re-expand, and by performing a splenic artery embolization, they stopped the source of the bleeding. After then removing the spleen entirely, his medical team ensured this would never happen again.

They also saved his life.

Consequences of hemorrhagic shock range from the minor and reversible to the permanent and debilitating, and details regarding his recovery will likely continue to surface over the coming weeks and months.

Though Christensen reports that he wants to pitch again, Pavano is going to defer figuring that out until a later date.

“Right now, that’s the last thing I’m worried about,” he said. “It’s been a crazy few weeks.”


Dave Siebert is a medical/injury Featured Columnist for Bleacher Report who will graduate from medical school in June. He plans to specialize in both Family Medicine and Primary Care (non-operative) Sports Medicine. Injury and anatomical information discussed above is based on his own knowledge.

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Could Fresh N.L. Start with Mets Save Carl Pavano’s Fading Career?

Fresh off a trade that sent reigning NL Cy Young Award-winner R.A. Dickey to the Toronto Blue Jays, the New York Mets are pursuing replacement options that can help them get back on track in the NL East.

There was a certain amount of interest in signing Francisco Liriano, but that was put to bed on Friday when the Pittsburgh Pirates inked the lefty to a two-year deal.

Liriano may not be the only pitcher on the Mets radar, however, as former New York Yankee and Minnesota Twin Carl Pavano could possibly find his way back into the Big Apple.

Pavano pitched for the Yankees from 2005-2008, though he sat out the entire 2006 season and left a bad mark on NYC after making only 26 starts in the pinstripes while still taking home $38 million.

It was in Minnesota that Pavano was able to resurrect his career somewhat, going 17-11 in his first full season with the Twins (2010), earning a two-year contract worth $15 million.

He battled injuries throughout 2012 and would make only 11 starts for, and with the Twins shuffling their rotation this offseason, it’s becoming clear that Target Field will no longer be Pavano’s home.

Depending on what the Mets plans are in the NL East in 2013, a deal for Pavano could make sense.

As Phil Mackey of ESPN1500 tweeted earlier this month, MLB execs believe that the only contract Pavano will get would include a low base salary with performance incentives.

This would bode well for the Mets, as their handling of contract negotiations with Dickey is a clear sign that they’re reluctant to hand out big dollars even to a pitcher that’s proven to be at the top of his game, let alone one who’s had a career hampered by injuries and subpar performances.

Pavano started his career in the National League as a member of the Montreal Expos. After enjoying his best days as a major leaguer with the Florida Marlins, Pavano moved to the American League in 2005 and has been in the AL ever since.

Age is another factor the Mets need to take into consideration. Pavano will turn 37 before spring training gets underway, further diminishing his chances of signing a multi-year deal.

Beyond Johan Santana and Jonathon Niese, the Mets have plenty of room for improvement in their starting rotation, and while Pavano may prove to be a budget-friendly move, there really aren’t many benefits to committing salary to a pitcher that hasn’t done anything worthwhile in nearly three years.

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Bronx Bombs: Ten Years of Yankees Pitching Duds

Quacky curmudgeon Scrooge McDuck had a giant silo of gold coins to swim in.  Eccentric pop icon Michael Jackson owned the Elephant Man’s dirty old bones.  “Big Pants” MC Hammer bought a $12 million mansion that housed nearly 20 racehorses. 

Just because you have loads of cash doesn’t mean you always spend it wisely.

Theatrical New York Yankees radio announcer John Sterling has often chuckled and stated, “You can’t predict baseball”.  To be fair, Sterling churns out a lot of goofy jibber-jabber on a daily basis, but ol’ John really hit the pinstriped nail on the head with that one.

You can be certain any lifelong Yankees fan has heard many a naysayer spin yarns about the team winning numerous World Championships by buying All-Star caliber teams.  The team’s General Manager is named “Cashman” after all. 

The hole in that theory is that play on the field and deep pockets don’t naturally go hand in hand.  Sure, piles of dough can assure that a team can be competitive, but money doesn’t account for injury, team chemistry, or that all-important Rudy-ish “fight in the dog” spirit. 

Simply stated:  Loads of dollars do not a championship make.  Need further proof?  Go count the number of rings on Jason Giambi’s fingers.

For all its success, superstars, and timeless tradition, the so-called “Evil Empire” hasn’t been free from bad signings, especially when it comes to the mound on East 161st Street in the Bronx.  In the blink of an eye, good intentions go sour like milk in the summer sun and what may seem like a wise investment can go flat in a season’s time. 

60 feet, six inches.  Sometimes that short distance can be quite the journey.

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Minnesota Twins: Are the Twins This Terrible or Is This Just a Sophomore Slump?

The Minnesota Twins have the worst record in baseball. No surprise, at 10.5 games back of the division-leading Cleveland Indians, this also gives the greatest deficit of any team.

Can the Twins really be this bad? Sure, they have had several players out of the lineup.

Former MVP and All-Star catcher Joe Mauer, left fielder Delmon Young and slugger Jim Thome are all on the disabled list and have not been able to contribute like they did last year.

Yet the Twins’ starting rotation is pretty much in intact from last season, and while they lost Jon Rauch, Jesse Crain and Matt Guerrier, the end of the bullpen still has closer Matt Capps and the return of Joe Nathan.

Perhaps this is just one big sophomore jinx as the Minnesota Twins, in only their third homestand of the season, are playing in their second season at Target Field.

I looked over the Twins roster and found several “sophomores” who are playing their second season with Minnesota. 

In all cases, it would appear this is a double-sophomore jinx.

Here are seven “sophomores” that are not performing to their 2010 levels.

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Minnesota Twins vs Toronto Blue Jays: Woeful Twins Rocked on Opening Day

Don’t hand the Twins the AL Central title just yet. The kinks made themselves visible Friday on Opening Day for the Twins.

The Twins ace, the man who is supposed to be the rock in the Twins rotation, got mauled in the first inning for four runs. Carl Pavano only lasted four innings and ended up allowing eight runs, seven of which were earned. But the beatdown didn’t end there.

The Twins basically got out-hit, out-pitched, out-everythinged.

Minnesota batters mustered up just eight hits and three runs to the Jays hitters who pounded the Twins meek pitching staff for 12 hits and 13 runs.

Blue Jays pitcher Rickey Romano silenced Twins bats, ending his first night of the year in impressive fashion, boasting an ERA of just 1.42 and fanning seven Twins batters.

Speaking of Twins batters, Justin Morneau made his return to the lineup and his performance was merely worthy of a footnote on the highlight reels. Morneau was silent in his first game back since sustaining a concussion in Toronto nearly nine months ago, going 0-for-4 on the night.

“Spring training was about how I felt. Hopefully we’re past that and now it just matters if we win or lose,” Morneau said.

But the bats weren’t the only thing to fault in the loss, the pitching of the Twins really let the club down. After Pavano went just four innings, the Twins cycled through a pitcher an inning, with inning-long appearances by Jeff Manship, Glenn Perkins, Kevin Slowey and Dusty Hughes respectively.

The best nights of relief were had by Perkins and Slowey, two guys who have starting pitching potential. Both didn’t allow a run and allowed only one hit each. That about summed up the bright spots of the Twins’ Opening Day bout.

The home runs were very present, just on the wrong side of the ball for Twins fans. The Jays cranked four homers Friday. It was the J.P. Arencibia show with the Jays’ young budding superstar going 3-for-4 with two homers and five RBI.

Those are stats the Twins wish they could have come close to matching.

“We didn’t follow the plan very well pitching,” Minnesota manager Ron Gardenhire said. “They swing the bats and, if you keep throwing the ball out over the plate, they’re going to kill you. We didn’t do a very good job of that tonight. We didn’t play good defense. It was just a bad night all the way around.”

Tsuyoshi Nishioka was less than stellar in his season debut for the Twins, going just 1-for-4 and even committing an error. The bright side on him, though, is that he does look comfortable in his new environment with the Twins and should settle into the lineup nicely.

The first loss can be attributed to jitters, but the Twins honestly looked no different than where they left off last year in New York. They were sloppy, didn’t seem in sync and the pitching was putrid. The go-to ace man failed miserably and the bats that were supposed to be powerful this year were whimsical. 

The fear that Morneau won’t be himself were confirmed. It is very evident that he will have to shake off a considerable amount of rust before he is the Home Run Derby champion he was prior to the concussion.

The pitching staff may need some more time to stabilize, but that’s not new news. The fear is that the Twins will get off to a slow start and will be forced to make a trade to acquire pitching, and this means dealing Liriano.

That’s a worst-case scenario for the Twins, but the first game out of the gates didn’t do much to calm those fears.

It’s safe to say the Twins’ first few games will be chaotic.

Then again, the Twins have never been fast starters. If there is one thing they are known for it’s late season surges where the written off Twins powerhouse the the front of the Central and steal away the title from a White Sox or Tigers team that has been there the whole second half.

So perhaps all the first day jitters and panic attacks are for naught.

However, the fact the Twins gave up 13 runs and the White Sox scored 15 isn’t comforting. Then again, the fact the Sox did give up 10 to the Indians is.

But if there is another thing the Twins are known for, it’s raising the blood pressure of their fans.

So Twins fans, bust out the blood pressure machines, it’s going to be a long 161-game haul ahead.

Next Three Up

Saturday: at Toronto (Liriano vs. Drabek)

Sunday: at Toronto (Blackburn vs. Cecil)

Monday: at New York Yankees (Baker vs. Nova)

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New York Yankees Tried Sign-and-Trade with DBacks for Carl Pavano

Via Joel Sherman of the NY Post:

There has been previous reporting done that when the Yankees were looking into reuniting with Carl Pavano this offseason that they would involve a third team as a way to avoid losing their first-round draft choice (this was prior to signing Soriano, which did cost that pick).

I have learned that the team was going to be the Diamondbacks, who essentially would have signed Pavano and then traded him to the Yankees for prospects. And that makes sense because the new Arizona GM, Kevin Towers, worked as a special assistant to Yankees GM Brian Cashman last year. One of Towers’ jobs was to assess the Yankees farm system, so he spent a lot of time watching Yankees prospects.

So there you have it. The Yankees were a lot closer to having signed Pavano than most people would be happy with. The truth is, that as much as people would have hated it, it might have been the best thing the Yankees could have done to improve their rotation this offseason (short of sending Jesus Montero and a bunch of other prospects to Kansas City for Zack Greinke, that is).

Even still, I’m happy the Yankees didn’t sign Pavano. Not because he spent four years in the Bronx and didn’t do much at all, but because it is doubtful I could have been able to handle the amount of vitriol that fans would have expressed toward him. It would have made angry Yankees fans even angrier. I’d rather see washed up guys try for one more season of glory while we wait for the prospects.

What do you think? Did the Yankees make a mistake not trying harder to sign Pavano? Or was it the smartest move they’ve made all offseason?

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Brian Cashman: Sports’ Most Overrated General Manager?

This winter has exposed cracks in the New York Yankees’ organization.  What was once the proudest and most cohesive unit in baseball has reverted to the days of factions between the New York front office, headed by GM Brian Cashman, and the Tampa brain trust, led by the Brothers Steinbrenner.

The winter was mostly inactive, until the Steinbrenners overruled Cashman in signing Rafael Soriano, a free agent Cashman didn’t want because he wanted to protect the Yankees’ first round draft pick.  Recently, Cashman allowed himself to go on the record suggesting Yankee captain Derek Jeter move to the outfield by the end of Jeter’s contract, igniting a media frenzy in the New York papers.

Numerous sources indicate that Cashman may leave the Yankees organization for a smaller market club when his contract ends after the season.  And to that, Yankee fans should say good riddance.  Brian Cashman has been the most overrated general manager in all of sports for the last ten years.  

While Cashman has made some good moves over the course of his tenure (trading for Scott Brosius and Chuck Knoblauch in 1998, getting major contributions from Shawn and Aaron Small in 2005), most have been relegated to obscurity (Chili Davis anyone?).

The only reason Cashman has been able to survive for so long was that he was able to win multiple World Series Championships with teams that Gene Michael built.  

His mistakes are further covered up by the Yankees’ huge payroll, which allows the team to eat bad contracts without problems, like Carl Pavano’s in 2004 (who Cashman greatly considered bringing back this offseason) or AJ Burnett’s in 2008, contracts that would devastate other teams.

So, to Brian Cashman I say, “Be careful what you wish for.”  Leaving a great gig like the Yankees will be a day you rue for years to come.  Sure, you may get more power with a mid-market club, but you’ll miss the ability to sign any free agent you want, as well as the pomp and circumstance of New York.

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MLB Breaking News: Carl Pavano To Remain With Minnesota Twins

It’s official: Carl Pavano will remain with the Minnesota Twins for now after tonight signing a two-year contract worth $16.5 million.

This move was crucial for the Twins. The Twins, winners of the American League Central in 2010, would have had their playoff hopes significantly decreased had Pavano signed elsewhere for 2011. In 2010, the Twins ranked 16th overall in ERA of starting pitchers with a 4.17 ERA. Pavano was very successful in 2010, posting a 17-11 record to go along with a 3.75 ERA.

It was speculated that the Twins fifth starter in 2011 assuming Pavano would not return would be either Nick Blackburn or Kevin Slowey. In 2010, Blackburn had a 5.42 ERA, while Slowey’s was 4.45. Now that Pavano’s return is official, the Twins will be able to remove one of these starters from their rotation, eliminating a weakness.

With Pavano, the Twins rotation has to be considered among the deepest in the American League. As of now, it looks to be composed of Francisco Liriano, Carl Pavano, Scott Baker, Brian Duensing and either Kevin Slowey or Nick Blackburn. Liriano is a legitimate ace, and every one of the Twins starters is strong relative to his spot in the rotation. 

In one and a half seasons with the Twins, Pavano has a 22-15 record with a 3.97 ERA. He has helped the Twins reach the playoffs now two seasons in a row, though their success has been limited in October. The Twins’ decision to go out and re-sign Pavano shows that the Twins are still the head of the American League Central. Now that Pavano is officially back, coupled with the return of Justin Morneau, the Twins have to be considered legitimate threats to reach the World Series in 2011.

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Carl Pavano Signs With the Minnesota Twins: Two More Years of the ‘Stache

After keeping Twins nation in constant anxiety for the last two weeks, Carl Pavano and his moustache have finally climbed on board for the 2011 and 2012 seasons.

The St. Paul Pioneer Press has reported that Minnesota and Pavano agreed to a two-year, $16.5 million.

In the process of signing, he turned down the likes of the Yankees, whom he serviced for four seasons; the Pirates, who were desperate to get their hands on any pitcher; and the Nationals, the silver medal winners in the Pavano Sign and Dash event in the Olympics.

“I’m excited,” Pavano said after signing Wednesday night. “When you go through free agency, there’s a lot of big decisions that you have. Obviously I couldn’t walk away from the rapport I have with my teammates, the staff and the organization.”

I’ll tell you who else was excited: Twins’ fans everywhere.

And do you know why?

Not only is it because they love Pavano and his facial hair; it’s because he’s has been the X factor in the rotation for the last 18 months.

Since coming over from Cleveland in the summer of ’09, Pavano has paced the Twins with 22 victories, including 17 last season. His 3.75 ERA isn’t too shabby, either.

Oh yeah, I forgot to mention the fact that he is one of the most durable men in the majors, completing seven contests by himself last year. 

Assuming Pavano is the number one starter, the rotation is then completed with the likes of hard-throwing lefty Francisco Liriano, the consistent Scott Baker, the young and ready-to-go Brian Duensing, and the also durable Nick Blackburn.

That isn’t a rotation you want to mess with.

The AL Central is set to be a frenzy come spring training, as the White Sox, Tigers, and of course the Twins look to be ultra competitive, while the Royals and Indians have taken the back seat in recent years and will once more this year.

You have to believe that this signing gives the Twins another reason to boost their confidence and try and snag that third consecutive AL Central crown.

The signing of Pavano is basically a fiesta for the Twins and their fans. Target Field’s party will start when Carl Pavano and his ‘stache walk in for at least two more seasons.

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2011 MLB Offseason: Where Does Carl Pavano Fit in Minnesota’s Rotation?

Carl Pavano and the Minnesota Twins finally came to an agreement today for a two year contract worth $16.5 million.  After rumors about the possibility of Pavano returning to the New York Yankees or that the Washington Nationals were a favorite, he will be returning to the Twins for the next two seasons, where he could perhaps retire.

With the re-signing of Pavano, the Twins are faced with a tough decision as to who will be the official starters for the 2011 season.  Minnesota now has six potential starters to fill five rotation slots.  Besides Pavano, the Twins have Francisco Liriano, Scott Baker, Kevin Slowey, Nick Blackburn and Brian Duensing.  Duensing is the only one of these six potential choices to not have any wins or losses for the 2010 season:

Carl Pavano:  3.75 ERA, 17-11 record, 1.19 WHIP, 117 Ks, 37 Walks in 221 IP

Francisco Liriano:  3.62 ERA, 14-10 Record, 1.26 WHIP, 201 Ks, 58 Walks in 191.2 IP

Scott Baker:  4.49 ERA, 12-9 Record, 1.34 WHIP, 148 Ks, 43 Walks in 170.1 IP

Kevin Slowey:  4.45 ERA, 13-6 Record, 1.29 WHIP, 116 Ks, 29 Walks in 155.2 IP

Nick Blackburn:  5.42 ERA, 10-12 Record, 68 Ks, 40 Walks in 161 IP

Brian Duensing:  2.62 ERA, 10-3 Record, 78 K’s, 35 Walks in 130.2 IP


The Twins now have to decide which of these pitchers is the extra baggage that will not fit into the starting rotation for this coming season. 

Do they rid themselves of the high ERA and sub-.500 record of Blackburn, or cut Duensing? 

Do the Twins trade one of these other pitchers for prospects, or do they move one of the starters to a long relief position? 

My bet would be to move either Blackburn  into the bullpen or deal in a trade, but that is only prognostication.  The only thing I do know for sure is Pavano will be part of the rotation.

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