By Dave Sheinin
Washington Post Staff Writer
Sunday, March 5, 2006
PORT ST. LUCIE, Fla., March 4 -- The Washington Nationals' camp received a morale boost Saturday with the news that right fielder and cleanup hitter Jose Guillen would not require surgery after all for his injured left wrist. Instead, he will rest for seven to 10 days and still might be ready to play by Opening Day.
The drastic change in direction -- the result of second and third medical opinions -- came less than 24 hours after the team said Guillen likely would need surgery that would have kept him out for about three months.
"This is very good news," Nationals Manager Frank Robinson said. "That's why you want more than one opinion."
Timothy Kremchek, a Cincinnati Reds team physician who also does medical consulting for the Nationals, reviewed Guillen's MRI exam results on Friday night and determined the injury did not need surgery. Guillen also was examined Saturday in Baltimore by hand specialist Thomas Graham, who agreed with Kremchek.
The original recommendation of surgery had been made Friday morning by Edward St. Mary, a hand specialist based near the Nationals' spring training headquarters in Viera, Fla. St. Mary's diagnosis was of tenosynovitis, or inflammation, of the extensor tendon in the wrist.
"When I got the description of what was going on with [Guillen], it just didn't add up," Kremchek said in a telephone interview Saturday. "It didn't seem right. If you know baseball players . . . it made more sense that this was an overuse injury, and this was not a surgical problem. I looked at the MRI, and indeed that was the case."
Guillen, who has said the wrist began bothering him two weeks ago, did not return a voice message left on his cell phone Saturday, but he was expected to rejoin the team this weekend. He was treated by Graham with a cortisone shot and anti-inflammatory drugs, and also will wear a split for the next seven to 10 days. Guillen also is rehabilitating his right shoulder after surgery in October.
"There is no structural damage," Kremchek said. "All of his tendons and ligaments were normal. He had some fluid and inflammation in the top part of his wrist. That's just from hitting the ball hard and overdoing it, trying to get in shape for the season. I just think he did too much too soon and aggravated it."
Asked if Guillen might be ready to play by the April 3 season opener, given the injuries to his shoulder and wrist, Kremchek said, "Absolutely, I think he'll be there by the beginning of the season, barring any kind of setback once he comes out of his splint."
Nationals officials chalked up the difference in diagnoses to the fact Kremchek and Graham have more experience treating athletes.
"Dr. Kremchek and Dr. Graham have a lot of history with athletes and sports teams and these types of injuries," General Manager Jim Bowden said. "And certainly, a lot of times how you treat an injury with a professional athlete, versus how you treat it with someone else, is different."
However, St. Mary is no stranger to professional athletes in general, nor to the Montreal/Washington franchise specifically. In June 2004, he performed surgery to repair the fractured forearm of Montreal Expos pitcher Tomo Ohka, and at the time the team's Web site referred to St. Mary as the Expos' "team hand specialist."
A call to St. Mary's answering service on Saturday was not returned.
The team recently initiated preliminary talks with Guillen regarding a contract extension, and Bowden said the decision to avoid surgery should not be viewed as a willingness to take a risk with Guillen's long-term health.
"If there was risk involved, we would not go this route," Bowden said. "We care about Jose Guillen long-term, not just short-term."
The news that Guillen will avoid surgery came at a time went camp morale was at an all-time low, after season-ending shoulder surgery to right-hander Brian Lawrence and the unresolved standoff between the team and second baseman Alfonso Soriano, who has resisted the team's efforts to move him to left field.
Before Saturday's news, team officials had been forced to imagine an Opening Day lineup without Guillen, one featuring younger players such as Brandon Watson and Ryan Church in more prominent roles. Budget restraints likely would have prevented the Nationals from going outside the organization for an established player to fill in for Guillen.
Now, thanks to a fortuitous turn of events, the question is moot again.
Asked if the team will seek any additional medical opinions regarding Guillen, Bowden said: "We like the opinion we got [Saturday] from both doctors. We'll stick with that one."