Kimmo being treated for blood clots

[DaGreatGazoo]

Per the Twitter: 

 

Comcast SportsNet ‏@CSNPhilly  25m

Kimmo Timonen is undergoing treatment in Finland for blood clots. His return to hockey is yet to be determined

 

Anthony Mingioni ‏@AnthonyMingioni  22m

With Timonen's uncertain status, there's a decent chance Robert Hagg or Shayne Gostisbehere might be up sooner than #Flyers would like.

 

Dan Rosen ‏@drosennhl  36m

Flyers say Kimmo Timonen has been diagnosed with blood clots in right leg and both lungs. Being treated in Finland. No timetable on return.

 

[pilldoc]

http://www.csnphilly.com/hockey-philadelphia-flyers/flyers-timonen-under-treatment-blood-clots

 

Ok folks this is serious.  This changes the dimension of the Flyers defense this year.  Time for this team to move forward.  I know there was alot of discussion whether he should have been resigned or not.  Thank You for your service Kimmo, but time to get well and put your family and health first.

 

I know Gaz (from the shoutbox) sent an e-mail to Capgeek to see if Kimmo's contract can be nullified.

 

Time to bring of the most ready younger d-men.  Calling Mr. Ghost.......????

 

Thoughts....

 

 

My prayers go out to Kimmo and his family...Get Well Soon.

 

 

[flyercanuck]

@pilldoc

 

 No way do I want to throw Gostisbehere into the fire, he'd likely have his confidence destroyed. See how he is in the A first. 

 

 Get well Kimmo. Even if you don't play.

[BobbyClarkeFan16]

No to Gostisbehere, Hagg or Morin on the big club at this point. Let them play 20+ minutes a night in the A and Q respectively. It's probably best if the Flyers use Mark Alt and then look at a free agent like Del Zotto, Diaz or even a guy like Derek Morris to help temporarily fill the void while the young defenders are getting much needed grooming time.

[pilldoc]

@flyercanuck

@BobbyClarkeFan16

 

ok..see your POV...who do give the shot to?  Lauridsen? Alt?

 

FYI...this is Kimmo's 2nd clot.  He had one back during the 2008 playoffs.

[flyercanuck]

@pilldoc

 

 I'd rather take my chances with Alt. For one, he's more "experienced". And for two, I won't cry and mope if they destroy his will to play.

[The Quigster]

I say let anybody who wants to, take a crack the position. These young guys are chompin' at the bit,lets take a look. Every time you acquire a player outside the team,it discourages the up and coming players in the pipeline.

[Irishjim]

from orange and black   Philadelphia Flyers defenseman Kimmo Timonen has sustained blood clots and is being treated in Finland, the team announced today.

Flyers general manager Ron Hextall issued a statement regarding the 39-year-old's condition:

"Flyers defenseman Kimmo Timonen has been diagnosed with blood clots in his lower right leg and in both lungs," Hextall said. "Kimmo is currently being treated for this disorder back in his home country of Finland. His return to play is yet to be determined."

‪#‎PrayforKT‬- Dean

[murraycraven]

Do not rush the youngins!!!!

 

Anway, now that this is out of the way I hope Kimmo recovers and takes care of himself.   The man is a true Warrior...   One of my favorite Flyers ever and really hope eveything works out...

[pilldoc]

Before everyone asks...here is the updated treatment for a DVT (deep vein thrombosis aka blood clod)

 

I apologize in advance for the techinical writing of this post.  This is from our hospital guidelines.......

 

The following recommendations for the treatment of acute venous thromboembolic disease are in general accord with recommendations from the following sources: the 2008 and 2012 American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [3,100], the 2012 guidance document from the International Society on Thrombosis and Haemostasis [131], the British Committee for Standards in Haematology [220], the joint guidelines of the American College of Physicians and the American Academy of Family Physicians [109,221], and the American Heart Association/American College of Cardiology [222].

 

Initial anticoagulation regimen — We recommend that all patients with proximal DVT be initially treated with anticoagulation. The treatment options for initial anticoagulation include the following: unfractionated heparin (UFH), low molecular weight (LMW) heparin, the factor Xa inhibitor (fondaparinux - brand name Arixtra), and the newer oral anticoagulants (factor Xa inhibitors, direct thrombin inhibitors)

 

As an integral part of the initial treatment of VTE, we recommend that oral anticoagulation with warfarin should prolong the INR to a target of 2.5 (INR range: 2.0 to 3.0) (Grade 1A). We recommend against high-intensity therapy (INR range: 3.1 to 4.0) as well as against low-intensity therapy (INR range: 1.5 to 1.9), compared with an INR range of 2.0 to 3.0 (Grade 1A) Warfarin cannot be administered without other anticoagulation for the initial treatment of patients with DVT

 

Ambulation and compression stockings — For patients with acute DVT who are fully anticoagulated, are hemodynamically stable, and whose symptoms (eg, pain, swelling) are under control, we suggest early ambulation in preference to bed rest (Grade 2C). For the prevention of post thrombotic syndrome in patients with symptoms, we suggest elastic graduated compression stockings (GCS) with a pressure of 30 to 40 mmHg at the ankle rather than no compression stockings (Grade 2C). GCS may be applied within two weeks and continued for two years. (See 'Ambulation and compression stockings' above.)  

 

First episode of idiopathic VTE

●For a patient with a first episode of idiopathic (unprovoked) proximal DVT, we recommend anticoagulation for three to six months, rather than for a shorter period of time (Grade 1A). We suggest indefinite treatment (eg, >12 months) over treatment for three to six months for those with a low bleeding risk (Grade 2B). For patients with a moderate or high bleeding risk the benefits of indefinite anticoagulation are less certain, and depend heavily on patient-specific bleeding and thrombotic risks as well as the patient’s values and preferences. (See 'Issues to consider' above.)

 

●Following the initial three to six months of anticoagulation, and periodically thereafter, all patients should be evaluated for the risk/benefit ratios of continuation of anticoagulation, discontinuation of anticoagulation, or the use of low-dose aspirin. Patient values and preferences, the ability to achieve good anticoagulation monitoring, and the estimated risk of bleeding and VTE recurrence for that patient will factor heavily into this decision. (See 'Length of treatment' above and 'Use of aspirin' above and 'Estimation of individual risk' above.)

 

Recurrent VTE and antiphospholipid syndrome

●For patients with a low bleeding risk and either a second episode of unprovoked VTE or the antiphospholipid syndrome and VTE, we recommend indefinite anticoagulation over three months of anticoagulation (Grade 1B). (See "Treatment of the antiphospholipid syndrome", section on 'Duration of warfarin use'.)

 

●For patients with a moderate or high bleeding risk and either a second episode of unprovoked VTE or the antiphospholipid syndrome and VTE, the benefits of indefinite anticoagulation are less certain, and depend heavily on patient-specific risks as well as the patient’s values and preferences. (See 'Recurrent VTE' above.)

 

Distal (calf vein) thrombosis — (see 'Isolated calf vein (distal, below the knee) thrombosis' above)

●For patients with unprovoked symptomatic isolated calf vein (ie, distal or below the knee) thrombosis, we suggest anticoagulation for three months, rather than indefinite therapy (Grade 2C). (See "Diagnosis of suspected deep vein thrombosis of the lower extremity", section on 'Calf vein thrombosis'.)

 

●There are few studies that offer guidance on the appropriate length of treatment of patients with provoked symptomatic isolated calf vein (ie, distal) thrombosis. If anticoagulation is not administered, serial noninvasive studies of the lower extremity should be performed over the next 10 to 14 days to assess for proximal extension of the thrombus.

 

●Guidelines for the treatment of isolated symptomatic thrombosis involving the deep veins draining the gastrocnemius and soleus muscles in the calf do not exist. Available studies do not suggest that anticoagulation is superior to either no therapy or use of compression therapy

 

Since this is Kimno's second episode (thought the last one was 6 years ago, in my professional opinion they will go witha longer treatment option)

[pilldoc]

 

from orange and black   Philadelphia Flyers defenseman Kimmo Timonen has sustained blood clots and is being treated in Finland, the team announced today.

Flyers general manager Ron Hextall issued a statement regarding the 39-year-old's condition:

"Flyers defenseman Kimmo Timonen has been diagnosed with blood clots in his lower right leg and in both lungs," Hextall said. "Kimmo is currently being treated for this disorder back in his home country of Finland. His return to play is yet to be determined."

‪#‎PrayforKT‬- Dean

 

 

 

I am very concerned with the clots in his lungs.  They are known at PE's (pulmonary emboli).  This needs to be treated as an emergent situation.  To prevent the clots from his legs from entering the lugns, they can place what is known as an IVC Filter in his legs to help prevent the clots from hislegs from breaking off and being transprted to his lungs.

 

Folks..this is serious.

[murraycraven]

Before everyone asks...here is the updated treatment for a DVT (deep vein thrombosis aka blood clod)

 

I apologize in advance for the techinical writing of this post.  This is from our hospital guidelines.......

 

The following recommendations for the treatment of acute venous thromboembolic disease are in general accord with recommendations from the following sources: the 2008 and 2012 American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [3,100], the 2012 guidance document from the International Society on Thrombosis and Haemostasis [131], the British Committee for Standards in Haematology [220], the joint guidelines of the American College of Physicians and the American Academy of Family Physicians [109,221], and the American Heart Association/American College of Cardiology [222].

 

Initial anticoagulation regimen — We recommend that all patients with proximal DVT be initially treated with anticoagulation. The treatment options for initial anticoagulation include the following: unfractionated heparin (UFH), low molecular weight (LMW) heparin, the factor Xa inhibitor (fondaparinux - brand name Arixtra), and the newer oral anticoagulants (factor Xa inhibitors, direct thrombin inhibitors)

 

As an integral part of the initial treatment of VTE, we recommend that oral anticoagulation with warfarin should prolong the INR to a target of 2.5 (INR range: 2.0 to 3.0) (Grade 1A). We recommend against high-intensity therapy (INR range: 3.1 to 4.0) as well as against low-intensity therapy (INR range: 1.5 to 1.9), compared with an INR range of 2.0 to 3.0 (Grade 1A) Warfarin cannot be administered without other anticoagulation for the initial treatment of patients with DVT

 

Ambulation and compression stockings — For patients with acute DVT who are fully anticoagulated, are hemodynamically stable, and whose symptoms (eg, pain, swelling) are under control, we suggest early ambulation in preference to bed rest (Grade 2C). For the prevention of post thrombotic syndrome in patients with symptoms, we suggest elastic graduated compression stockings (GCS) with a pressure of 30 to 40 mmHg at the ankle rather than no compression stockings (Grade 2C). GCS may be applied within two weeks and continued for two years. (See 'Ambulation and compression stockings' above.)  

 

First episode of idiopathic VTE

●For a patient with a first episode of idiopathic (unprovoked) proximal DVT, we recommend anticoagulation for three to six months, rather than for a shorter period of time (Grade 1A). We suggest indefinite treatment (eg, >12 months) over treatment for three to six months for those with a low bleeding risk (Grade 2B). For patients with a moderate or high bleeding risk the benefits of indefinite anticoagulation are less certain, and depend heavily on patient-specific bleeding and thrombotic risks as well as the patient’s values and preferences. (See 'Issues to consider' above.)

 

●Following the initial three to six months of anticoagulation, and periodically thereafter, all patients should be evaluated for the risk/benefit ratios of continuation of anticoagulation, discontinuation of anticoagulation, or the use of low-dose aspirin. Patient values and preferences, the ability to achieve good anticoagulation monitoring, and the estimated risk of bleeding and VTE recurrence for that patient will factor heavily into this decision. (See 'Length of treatment' above and 'Use of aspirin' above and 'Estimation of individual risk' above.)

 

Recurrent VTE and antiphospholipid syndrome

●For patients with a low bleeding risk and either a second episode of unprovoked VTE or the antiphospholipid syndrome and VTE, we recommend indefinite anticoagulation over three months of anticoagulation (Grade 1B). (See "Treatment of the antiphospholipid syndrome", section on 'Duration of warfarin use'.)

 

●For patients with a moderate or high bleeding risk and either a second episode of unprovoked VTE or the antiphospholipid syndrome and VTE, the benefits of indefinite anticoagulation are less certain, and depend heavily on patient-specific risks as well as the patient’s values and preferences. (See 'Recurrent VTE' above.)

 

Distal (calf vein) thrombosis — (see 'Isolated calf vein (distal, below the knee) thrombosis' above)

●For patients with unprovoked symptomatic isolated calf vein (ie, distal or below the knee) thrombosis, we suggest anticoagulation for three months, rather than indefinite therapy (Grade 2C). (See "Diagnosis of suspected deep vein thrombosis of the lower extremity", section on 'Calf vein thrombosis'.)

 

●There are few studies that offer guidance on the appropriate length of treatment of patients with provoked symptomatic isolated calf vein (ie, distal) thrombosis. If anticoagulation is not administered, serial noninvasive studies of the lower extremity should be performed over the next 10 to 14 days to assess for proximal extension of the thrombus.

 

●Guidelines for the treatment of isolated symptomatic thrombosis involving the deep veins draining the gastrocnemius and soleus muscles in the calf do not exist. Available studies do not suggest that anticoagulation is superior to either no therapy or use of compression therapy

 

Since this is Kimno's second episode (thought the last one was 6 years ago, in my professional opinion they will go witha longer treatment option)

 

 

So what you are saying Doc is this is bad right?  I just went into  my neighboring office and to ask a MD I work with- he said it "was not good" and he would suspect this will put him on the shelf"...

[murraycraven]

I am very concerned with the clots in his lungs.  They are known at PE's (pulmonary emboli).  This needs to be treated as an emergent situation.  To prevent the clots from his legs from entering the lugns, they can place what is known as an IVC Filter in his legs to help prevent the clots from hislegs from breaking off and being transprted to his lungs.

 

Folks..this is serious.

 

 

Very dangerous!   In fact, this is how my father died after battling cancer for 2 years.   Really hope eveything is okay and he gets well.  Hockey is just a sport and he is still a young man with a family...

[pilldoc]

So what you are saying Doc is this is bad right?  I just went into  my neighboring office and to ask a MD I work with- he said it "was not good" and he would suspect this will put him on the shelf"...

 

 

That is correct...this is NOT good... in essence also factoring in his age.... his career IMO is over

[pilldoc]

Very dangerous!   In fact, this is how my father died after battling cancer for 2 years.   Really hope eveything is okay and he gets well.  Hockey is just a sport and he is still a young man with a family...

 

My grandmother died several years ago due to throwing multiple PE's in her lungs.  (Granted she was 92 at the time and was post-op from having GI surgery, which in itself is a risk for having clots)

[Irishjim]

from O&B....Okay, so if my knowledge serves me right, and basing the following on a couple assumptions, this is what our cap situation looks like. Pronger & Timonen's combined cap hit is $6,941,429. We're currently $3,061,429 over the upper limit. Assuming Hextall places both players on LTIR on the last day of Training Camp, then theoretically the Flyers have $3.88M in LTI Relief to maximize. We're currently at 45 total contracts (50 is the max) between the NHL & AHL, so adding one or two more players equal to $3.88M is doable. MD

[pilldoc]

@Irishjim

 

Thanks!

[ruxpin]

I am very concerned with the clots in his lungs.  They are known at PE's (pulmonary emboli).  This needs to be treated as an emergent situation.  To prevent the clots from his legs from entering the lugns, they can place what is known as an IVC Filter in his legs to help prevent the clots from hislegs from breaking off and being transprted to his lungs.

 

Folks..this is serious.

 

My mother had clots in the lungs stemming from phlebitis in the legs (sounds very similar to KT).  She was actually a bit younger than Kimmo at the time and it was life-threatening and touch-and-go for quite awhile.

 

She was never really healthy afterward.

 

Yes, it is very serious.

[pilldoc]

My mother had clots in the lungs stemming from phlebitis in the legs (sounds very similar to KT).  She was actually a bit younger than Kimmo at the time and it was life-threatening and touch-and-go for quite awhile.

 

She was never really healthy afterward.

 

Yes, it is very serious.

 

so sorry to hear that Rux.  How is she doing today if I may ask?  Like I mentioned above, my grandmother died of having multiple PE's in her lungs so I totally understand your feelings.

[Lindbergh31]

@BobbyClarkeFan16

 

DelZotto on a minimum level contract or Morris (who is a right-handed shot) on a minimum contract would be better than Alt but we'll wait and see. I wonder if we have seen the last of Timonen in a Flyer's uniform. 

[JackStraw]

All I hope for right now is for Kimmo to be alright. One of my all time favorites.

 

Fwiw, Eklund says the Flyers have MDZ in their sights.

 

http://www.hockeybuzz.com/blog/Eklund/Timonen-Future-Uncertain-Flyers-Closing-In-On-Del-Zotto-Signing/1/61656

 

(I can't believe I just posted something from Eklund)

[pilldoc]

Here is a thread on MDZ..... come to your own conclusions if you want him on this team. (if they move forward and sign him...I say 1 yr only)

 

http://www.hockeyforums.net/index.php/topic/62802-michael-del-zotto/

[ruxpin]

so sorry to hear that Rux.  How is she doing today if I may ask?  Like I mentioned above, my grandmother died of having multiple PE's in her lungs so I totally understand your feelings.

 

Thanks for asking.  She lost her battle with triple negative breast cancer and advanced alzheimers in 2012 (she was 69).

[pilldoc]

Thanks for asking.  She lost her battle with triple negative breast cancer and advanced alzheimers in 2012 (she was 69).

 

wow rux that is tough.  again I am so sorry for your loss.  Again I understand your feelings, my wife lost her father about 8 yrs ago due to Stage 4 male breast cancer (yeah it exists), although he did not die of the cancer, we believe he had a massive MI due to a clot. 

[DaGreatGazoo]

DOC-since it's off season and he's not seeing team people every day. What would be the symptoms or how would this be diagnosed?

Curious what led to the discovery....