They didn't mention it at all: Jon Lester, cancer survivor

The second game of the World Series is on as I write this, and the Red Sox aren't in it. Jon Lester pitched very well in game seven, but was out-duelled by Tampa Bay’s pitchers.

The announcers talked a lot during the game about the power and mix of Jon's pitches. They didn't mention at all that he was a cancer survivor.

Early in the season in Jon's first few victories on the baseball diamond, the headlines and the stories focused on the marvel that Jon could have returned, after cancer, to the top of his game. Now, it is a mark of how far he has come in his recovery that they don't mention it at all.

Advice: Understand that your cancer survivor friends may prefer not to talk about their cancer, that they don't want to be defined by it.

Read another story about Jon Lester.

Thrilled to be a pitcher and not a patient: Carl Pavano's shoulder misdiagnosis

The scar still looks fresh, 15 months later, on the inside of Carl Pavano's right elbow. Usually, after Tommy John surgery, it settles into a flesh-colored zipper, visible but not so obvious. Carl is actually progressing quite well.

As he comes to the end of his four-year, $40 million contract, Carl is thrilled to be a pitcher and not a patient. But he also has wounds from a bitter comeback trail that are hard for him to forget.

Carl said he was bruised by the belief among fans, reporters and some teammates that he was not dedicated to his craft. When he reflects on four lost seasons, he said he thought it could have been different if the Yankees' team doctor had recommended reconstructive elbow surgery sooner.

Carl shares some of the blame. He said he should have reported his back problems early in the 2005 season, when he made 17 starts through the end of June. Those issues brought about everything else, he says.

"I wish I had been smart enough to just get it right," Carl said. "Say something, make sure something was taken care of, instead of just keeping pitching and thinking it was going to get better."

A daily massage at his apartment helped for a while, Carl said, but pitching with back pain affected his arm. He went on the disabled list that July, and the Yankees announced that he had right shoulder tendonitis.

He made two rehabilitation starts after a month of rest and was re-evaluated by the team physician and a doctor whom Carl had known and trusted for years. The new diagnosis was rotator cuff tendonitis and associated pain in the humerus.

"When they reported I had rotator cuff tendonitis, I actually had a stress fracture in my humerus bone," Carl said. "It wasn't rotator cuff tendonitis. It was just misdiagnosed."

By May, Carl was back on a minor league pitching mound, but he left a start for Class AA Trenton with elbow discomfort. This, Carl said, was a pivotal point.

Six years earlier, when Carl pitched for Montreal, a doctor had removed bone chips from his elbow. He did it again in May 2006, removing a chip the size of a marble. (Carl kept is as a souvenir, he said, until it turned to mold and dust.) The procedure was a temporary fix. It helped for a while, but when Carl broke his ribs in a car accident that August, he aggravated the elbow by trying to keep pitching without telling the Yankees about the injury. In hindsight, Carl said, he could have had Tommy John surgery that summer, but the Yankees did not recommend it.

"I think I could have, but we'll never know," Carl said. The doctor "was told not to. He was told to take the bone chips out and rehab it."

Two starts into the 2007 season, the elbow pain returned, and Carl insisted on major surgery as the only way to heal everything. It took four doctors to find one who agreed definitively. That was the Mets team doctor.

"They had to go through all that red tape; that's why I had to go get all these opinions," Carl said. "It was crazy. And I had to walk around with my heart in my throat: 'Are you serious? You're messing with my career here.' You think I wanted to have Tommy John surgery? But I knew I needed it and I knew I could come back from it. That's why I was all for it."

The Mets team physician told Carl he had done everything he could to come back from the 2006 operation. His only choice was Tommy John surgery, in which a tendon from Carl's knee was used to replace an elbow ligament.

It took place June 5, 2007, nearly two months after he had last pitched a game. Carl said he wished he had the operation sooner.

"I would have been back seven weeks earlier this year," Carl said. "That would have been a considerable amount of time to help the team."

Advice: If you don't agree with a doctor's diagnosis, ask what else it could be. If the answer and the recommended treatment are still unsatisfactory, consider getting another doctor's opinion.

Read another Yankee pitcher's misdiagnosis story.

Thanks to Tyler Kepner for the source article in yesterday's New York Times.

He lost a $25,000 bet: Chewing tobacco addiction

Red Sox Manager Terry Francona was seen in last night's World Series baseball game spitting five times and what clearly looked like brown tobacco juice emerged three times. He knows he has a problem: he lost a $25,000 bet that he could kick his habit by the end of the season. Francona appeared to switch to gum last night.

Watching Francona's toxic brown spit should spur Major League Baseball into a vigorous campaign against chewing tobacco. Joe Garagiola, who has spoken to major leaguers and amateur players about the risks of chewing tobacco, said yesterday that Francona's parents had asked him to talk to their son about his addiction. Garagiola said his message is that chewing tobacco is addictive, causes oral cancer and can cost you your life. "If I were to talk to Terry, I'd tell him to think seriously after the World Series about getting help," he said. "I know a good place, like the Mayo Clinic in Rochester, Minnesota."

Advice to nervous members of Red Sox Nation: Chew sugarless gum for the tension, and warn your tobacco-chewing friends about the dangers.

Read another of our baseball stories, or read Richard Sandomir’s source story in today’s New York Times.

His diagnosis was a Sports section headline: A delayed diagnosis story

It’s the first day of spring, so we think of baseball. A few short years ago, David Wells helped the Boston Red Sox win their first World Series in 86 years. The lefty pitcher was known for his great curve ball, great girth, and great thirst.

Now with the San Diego Padres, the 43-year old pitcher has been diagnosed in the last two weeks with adult onset diabetes, according to yesterday’s Boston Herald. Last year, his manager had had to cancel a pitching start for him last fall because of gout in his right foot. Gout, which can be temporarily excruciating and disabling, is common among people with diabetes. With more prompt diagnosis and treatment, Wells would have had better blood circulation to his feet, which may have prevented uric acid from building up there, which caused his gout and missed start. And if the Boston Red Sox had kept him...Woulda Coulda Shoulda.

Advice for Red Sox fans: Believe! And watch out for diabetes, now growing at an epidemic pace. Make sure your off-season exercise is more than hoisting beer bottles!

Read another diabetes story .