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Tiger Woods involved in rollover crash. suffered compound fractures in both legs


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1 hour ago, Sawbonz said:

I should have clarified if he has  comminuted tibia fractures that are open and required fasciotomy, given the frontal impact his vehicle sustained he likely has mangled extremity (ies). I would bet his MESS was at least 5 without even knowing his hemodynamic status in the field

 

 

of course without examining you can’t say, but tibial fracture from MVAs with that kind of axial load are very high energy and I would expect there to be significant soft tissue injury. I just saw he was in surgery for 10 hours which could mean vascular injury requiring repair, so I would think 3C is definitely possible if not likely. IM rods are quick, and periarticular fracture extending into shaft would likely get external fixation to let soft tissue envelope recover. Even definitive ORIF of multiple fractures wouldn’t take that long. I really feel for him 

 

tldr distal 1/3 open tibia fractures, which are likely here given mechanism of injury, are bad news

 

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17 hours ago, Sawbonz said:

I should have clarified if he has  comminuted tibia fractures that are open and required fasciotomy, given the frontal impact his vehicle sustained he likely has mangled extremity (ies). I would bet his MESS was at least 5 without even knowing his hemodynamic status in the field

 

 

of course without examining you can’t say, but tibial fracture from MVAs with that kind of axial load are very high energy and I would expect there to be significant soft tissue injury. I just saw he was in surgery for 10 hours which could mean vascular injury requiring repair, so I would think 3C is definitely possible if not likely. IM rods are quick, and periarticular fracture extending into shaft would likely get external fixation to let soft tissue envelope recover. Even definitive ORIF of multiple fractures wouldn’t take that long. I really feel for him 

 

tldr distal 1/3 open tibia fractures, which are likely here given mechanism of injury, are bad news

Can we get somebody that knows what they're talking about?

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On 2/25/2021 at 6:44 PM, Sawbonz said:

I should have clarified if he has  comminuted tibia fractures that are open and required fasciotomy, given the frontal impact his vehicle sustained he likely has mangled extremity (ies). I would bet his MESS was at least 5 without even knowing his hemodynamic status in the field

 

 

of course without examining you can’t say, but tibial fracture from MVAs with that kind of axial load are very high energy and I would expect there to be significant soft tissue injury. I just saw he was in surgery for 10 hours which could mean vascular injury requiring repair, so I would think 3C is definitely possible if not likely. IM rods are quick, and periarticular fracture extending into shaft would likely get external fixation to let soft tissue envelope recover. Even definitive ORIF of multiple fractures wouldn’t take that long. I really feel for him 

 

tldr distal 1/3 open tibia fractures, which are likely here given mechanism of injury, are bad news

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12 minutes ago, Lurch said:

 


Fairly certain that exact statement has been made two or three other times in his career.

 

Well, he's a 45-year old guy with what appear to be pain-killer abuse issues, he's won one major tournament in going on 13 years now and, he just had his legs bent at close to 90-degree angles.

 

This is much bigger than what he has ever had to deal with.

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10 minutes ago, PittsburghTiger said:

Well, he's a 45-year old guy with what appear to be pain-killer abuse issues, he's won one major tournament in going on 13 years now and, he just had his legs bent at close to 90-degree angles.

 

This is much bigger than what he has ever had to deal with.

Exactly. The last 13 years and 1 major but if you hear any sports pundit (tv or radio) they would act like Tiger’s Back! He’s gonna be like old Tiger! Even with the last 5 years of back surgeries—Tiger’s Back! He’s gonna win another 10 majors. I get it! I know how much he has meant to the sport and for many watchers he was the only reason to watch golf. A lot of people feel the same about Serena. (But she doesn’t have the likely substance abuse issues/nor current medical/ health crisis). I get he’s competitive and wants to be great. But damn ever since his life unraveled 13 years ago it’s like people don’t want to accept it. Shit. Dude looked beyond fucked up in his interview with Jim Nantz the day before the crash. I guess he doesn’t have people around him that are willing to push him to get help. If he was addicted to pain killers before can’t imagine that changing with these new gruesome injuries. 
 

He certainly has a great PR team. The narrative is that he wasn’t incapacitated (drugs or alcohol) and hardly a mention that the cops didn’t do a blood test. Just said it was an accident. Drove too fast on dangerous road. Which could all be true...but to say he wasn’t on substances when they don’t have a fucking clue is bullshit. I don’t have a clue but given his 2017 DUI and substances involved and the fact that he has never been to rehab that any of us knows I doubt he just kicked the habit. Dudes been on ambien and dialudid for like 13 years. And had like 5 back surgeries the past 5 years. No way he’s not doing a buttload of pills to manage pain. Maybe this accident saved his life? He looked so bloated and fried in that Nantz interview. 

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On 2/25/2021 at 5:44 PM, Sawbonz said:

tldr distal 1/3 open tibia fractures, which are likely here given mechanism of injury, are bad news

Doesn’t he have both a proximal and distal open fracture of the right lower leg?  Are you ignoring the proximal break as more easily recoverable, or have I incorrectly read the previous statements about his injuries?

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Exactly. The last 13 years and 1 major but if you hear any sports pundit (tv or radio) they would act like Tiger’s Back! He’s gonna be like old Tiger! Even with the last 5 years of back surgeries—Tiger’s Back! He’s gonna win another 10 majors. I get it! I know how much he has meant to the sport and for many watchers he was the only reason to watch golf. A lot of people feel the same about Serena. (But she doesn’t have the likely substance abuse issues/nor current medical/ health crisis). I get he’s competitive and wants to be great. But damn ever since his life unraveled 13 years ago it’s like people don’t want to accept it. Shit. Dude looked beyond fucked up in his interview with Jim Nantz the day before the crash. I guess he doesn’t have people around him that are willing to push him to get help. If he was addicted to pain killers before can’t imagine that changing with these new gruesome injuries. 
 
He certainly has a great PR team. The narrative is that he wasn’t incapacitated (drugs or alcohol) and hardly a mention that the cops didn’t do a blood test. Just said it was an accident. Drove too fast on dangerous road. Which could all be true...but to say he wasn’t on substances when they don’t have a fucking clue is bullshit. I don’t have a clue but given his 2017 DUI and substances involved and the fact that he has never been to rehab that any of us knows I doubt he just kicked the habit. Dudes been on ambien and dialudid for like 13 years. And had like 5 back surgeries the past 5 years. No way he’s not doing a buttload of pills to manage pain. Maybe this accident saved his life? He looked so bloated and fried in that Nantz interview. 


Pre-crash:
He won the 2019 Masters. You don’t win THE FUCKING MASTERS if you’re not “back”.

Post-crash: too early to tell.
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3 hours ago, Nicole44 said:

Exactly. The last 13 years and 1 major but if you hear any sports pundit (tv or radio) they would act like Tiger’s Back! He’s gonna be like old Tiger! Even with the last 5 years of back surgeries—Tiger’s Back! He’s gonna win another 10 majors. I get it! I know how much he has meant to the sport and for many watchers he was the only reason to watch golf. A lot of people feel the same about Serena. (But she doesn’t have the likely substance abuse issues/nor current medical/ health crisis). I get he’s competitive and wants to be great. But damn ever since his life unraveled 13 years ago it’s like people don’t want to accept it. Shit. Dude looked beyond fucked up in his interview with Jim Nantz the day before the crash. I guess he doesn’t have people around him that are willing to push him to get help. If he was addicted to pain killers before can’t imagine that changing with these new gruesome injuries. 
 

He certainly has a great PR team. The narrative is that he wasn’t incapacitated (drugs or alcohol) and hardly a mention that the cops didn’t do a blood test. Just said it was an accident. Drove too fast on dangerous road. Which could all be true...but to say he wasn’t on substances when they don’t have a fucking clue is bullshit. I don’t have a clue but given his 2017 DUI and substances involved and the fact that he has never been to rehab that any of us knows I doubt he just kicked the habit. Dudes been on ambien and dialudid for like 13 years. And had like 5 back surgeries the past 5 years. No way he’s not doing a buttload of pills to manage pain. Maybe this accident saved his life? He looked so bloated and fried in that Nantz interview. 

He absolutely still uses/abuses pain pills and mixes that liberally with alcohol. That’s as of 3 weeks ago. 

Whether that contributed or not to his accident is unclear. 

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3 hours ago, Lurch said:

 


Pre-crash:
He won the 2019 Masters. You don’t win THE FUCKING MASTERS if you’re not “back”.

Post-crash: too early to tell.

 

Being back means winning 7 tournaments and a major or 2 every year. Winning the 2019 Masters means he’s a good player and can compete on the biggest stage. 

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I think he’s done as a competitive golfer on the pga tour. He may heal well enough to play Friday and Saturday at tournaments that he has an exemption for, but I’ll go ahead and doubt that he will do better than maybe barely make a cut here and there. 
Maybe he can compete on the senior tour in a few years. 
 

would be cool if he proved me wrong though and even got back to where he was in 2019. 

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2 hours ago, Enchubben said:

How/where does he get the dilaudid? Asking for a friend.

You don't want dilaudid. Unless you're trying to get into heroin for whatever reason. Oxycodone is the sweet spot (or so I've heard).

(good chance heroin is in your future either way, unfortunately)

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8 minutes ago, ztejas said:

You don't want dilaudid. Unless you're trying to get into heroin for whatever reason. Oxycodone is the sweet spot (or so I've heard).

(good chance heroin is in your future either way, unfortunately)

The vitamin D I had in the hospital was the tits. Wayyyyy too addictive though; I was craving that shit by the time I left.   

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4 minutes ago, Enchubben said:

The vitamin D I had in the hospital was the tits. Wayyyyy too addictive though; I was craving that shit by the time I left.   

Yeah. I'm not sure how much they even prescribe it outside of hospital settings. It basically is heroin. Tiger might have been on it since after a certain amount of pills you might need it I guess. I'm not entirely sure that's how opiates work in regards to pain (then again, his pill use may have passed the "pain management" stage a long time ago).

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11 hours ago, ztejas said:

Yeah. I'm not sure how much they even prescribe it outside of hospital settings. It basically is heroin. Tiger might have been on it since after a certain amount of pills you might need it I guess. I'm not entirely sure that's how opiates work in regards to pain (then again, his pill use may have passed the "pain management" stage a long time ago).

I got a scrip for 1 pill when I had oral surgery. Knocked my ass out.

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I’m fortunate enough to have never had chronic pain, so I can’t understand what those people are going through. That being said, I hate pain killers. I rarely take them even when prescribed. I can’t stand the way they make me feel. Maybe I just haven’t been given the right ones?

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1 hour ago, Hate said:

I’m fortunate enough to have never had chronic pain, so I can’t understand what those people are going through. That being said, I hate pain killers. I rarely take them even when prescribed. I can’t stand the way they make me feel. Maybe I just haven’t been given the right ones?

You don't like constipation?  Who doesn't like constipation?

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1 hour ago, Hate said:

I’m fortunate enough to have never had chronic pain, so I can’t understand what those people are going through. That being said, I hate pain killers. I rarely take them even when prescribed. I can’t stand the way they make me feel. Maybe I just haven’t been given the right ones?

 

I've never gotten any sort of high or relaxing feeling from Hydrocodone or Tylenol 2. I don't have any bad side effects either, they just do nothing.

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2 hours ago, Hate said:

I’m fortunate enough to have never had chronic pain, so I can’t understand what those people are going through. That being said, I hate pain killers. I rarely take them even when prescribed. I can’t stand the way they make me feel. Maybe I just haven’t been given the right ones?

 

28 minutes ago, BradInATX said:

 

I've never gotten any sort of high or relaxing feeling from Hydrocodone or Tylenol 2. I don't have any bad side effects either, they just do nothing.

I think there can be a few things at play. First - taking something as prescribed and intentionally abusing something to get high is different. Especially if it's a lower strength opitate like Tramadol or Tylenol 2 (which has a very small amount of codeine). Even hydrocodone won't produce much euphoria until you take 3 or 4 of them. 

Not only can the amount ingested be different, I think there is definitely some psychosematicism with the surrounding mentality and awareness of how it's making you feel. With some lower strength painkillers or psych meds like Valium or clonazepam (brand name escaping me) it's almost like you consciously have to try and feel high. If you aren't used to or consciously trying to "access" that you might just shrug it off or not notice. 

Second, people have different chemistries and different things make them feel... different. Just like some folks aren't into pot or don't like the way they feel after a shot of tequila - some folks aren't going to like the feeling produced by opiates (to a degree - which is my next point).

Third - and this is somewhat analogous to the first point - there is absolutely what you might call a point of no return. i.e. unless you have some really wacky chemistry or some disorder - getting hit with morphine in the ER is going to feel pretty damn great - because it's fucking morphine. The difference between popping a few vicodin and having IV morphine administered is huuuuge. Dilaudid - or hydromorphone - is around 5 times stronger than morphine. That's why Enchubben loved it so much to where it left a lasting impression. That's why people get addicted to heroin - and why no one that does heroin doesn't like it. I guess it's possible someone could get Dilaudid in the hospital and not enjoy it but it seems pretty far fetched. Really strong opiates are pretty universally euphoric for humans. 

Basically - different strokes up until a certain point. Someone is welcome to chime in with some harder science - I'm mostly speaking on the social/psychological aspect.

 

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So my previous job was lab testing for a pharma company that made schedule 2 drugs. Mainly opioids. I forget how much hydromorphone is in dilauded, but our samples were around 5 grams per batch and 99.x% pure.  Probably close to 100g in our lab safe at any given time.    
frequent DEA visits along with cameras everywhere were a good deterrent against what they call diversion (stealing it to sell).

My understanding is that it’s really for post surgical pain only. 

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The dilaudid i had was for extreme case of pancreatitis. it was bad.  They gave me morphine first and it did absolutely nothing. I remember the doctor saying something like some people don't respond well to natural pain killers and need synthetics. (Porbbaly was @ztejas mentioned above)  Mentioned that if i ever need pain meds in this kind of situation again to mention that my body chemistry doesn't respond well to natural painkillers. 

Admittedly, if I was a doctor or nurse, and the patient said I need synthetic pain killers, I would assume it's because they're some sort of addict.

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Yep -- my daughter needed morphine when she had a horribad internal bone infection, put her in the hospital for a week.  She was in so much pain she could barely communicate....the morphine hit, and she felt great.

She explained later "I understand why they restrict the hell out of morphine....because it's freaking AWESOME."

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1 hour ago, gurt said:

I got an IV of Fentanyl when I dislocated my knee and it took the pain from like a 9 to maybe a 3.  It was like I didn't even care that I was hurt.  That stuff is insane.

My dad was given Fentanyl when he was in the hospital for his heart surgery. It made him hallucinate badly. He said he never wanted that shit again.

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7 minutes ago, Enchubben said:

I remember the doctor saying something like some people don't respond well to natural pain killers and need synthetics.

That's interesting and I didn't know that. I tend to use "opiates" as an umbrella term - but there is a difference between opiates (natural) and opioids (synthetic). I still think you'd be high as a kite if you did enough of either. 

But yeah - I guess I alluded to that in commenting that different people have different chemistry. 

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1 hour ago, ztejas said:

 

I think there can be a few things at play. First - taking something as prescribed and intentionally abusing something to get high is different. Especially if it's a lower strength opitate like Tramadol or Tylenol 2 (which has a very small amount of codeine). Even hydrocodone won't produce much euphoria until you take 3 or 4 of them. 

Not only can the amount ingested be different, I think there is definitely some psychosematicism with the surrounding mentality and awareness of how it's making you feel. With some lower strength painkillers or psych meds like Valium or clonazepam (brand name escaping me) it's almost like you consciously have to try and feel high. If you aren't used to or consciously trying to "access" that you might just shrug it off or not notice. 

Second, people have different chemistries and different things make them feel... different. Just like some folks aren't into pot or don't like the way they feel after a shot of tequila - some folks aren't going to like the feeling produced by opiates (to a degree - which is my next point).

Third - and this is somewhat analogous to the first point - there is absolutely what you might call a point of no return. i.e. unless you have some really wacky chemistry or some disorder - getting hit with morphine in the ER is going to feel pretty damn great - because it's fucking morphine. The difference between popping a few vicodin and having IV morphine administered is huuuuge. Dilaudid - or hydromorphone - is around 5 times stronger than morphine. That's why Enchubben loved it so much to where it left a lasting impression. That's why people get addicted to heroin - and why no one that does heroin doesn't like it. I guess it's possible someone could get Dilaudid in the hospital and not enjoy it but it seems pretty far fetched. Really strong opiates are pretty universally euphoric for humans. 

Basically - different strokes up until a certain point. Someone is welcome to chime in with some harder science - I'm mostly speaking on the social/psychological aspect.

 


Found our surly #PillGuy

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