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ST. LOUIS -- Cardinals left-hander Jaime Garcia will undergo thoracic outlet surgery Friday to relieve nerve issues in his pitching arm, shoulder and hand. Garcia and doctors believe the injury has dogged him for several years.
Garcia referred to the procedure, which involved the removal of the first rib, as the "most logical and only option I have." He made the announcement on his 28th birthday and wryly noted, "I think I've had about 27 birthdays better than this."
The recovery period is three to four months, and the oft-injured Garcia is confident he will be back next season for the final year of a $27 million, four-year contract.
"Obviously, this is a really tough surgery and it's not easy to come back," Garcia said Tuesday. "They're taking a piece of bone out of my body and I don't think anybody wants to go through it.
"I'm already thinking about being for sure ready to go."
General manager John Mozeliak said the team would likely have a better handle on Garcia's future in two months.
Mozeliak said earlier in the week he believes the defending National League champions have enough pitching even though Michael Wacha also is on the 15-day disabled list with a stress fracture in his pitching shoulder. Joe Kelly (hamstring) is expected to rejoin the rotation on Friday.
The Cardinals, who already had ruled Garcia out for the year, were initially surprised by the pitcher's decision to have the procedure done by an outside specialist and rejecting other treatment options, and then revealing plans before informing the team. Garcia is having the surgery done by Dr. Robert Thompson of St. Louis.
Garcia first discussed his symptoms with Dr. George Paletta, the former Cardinals team physician who operated on his shoulder last year, who recommended he see a specialist. He also consulted with Gregory Pearl, who did the same surgery on former teammate Chris Carpenter and had the same diagnosis of thoracic outlet syndrome, a disorder when the nerves in the space between the collarbone and first rib become compressed.
"Obviously, when you think about this type of surgery there's certain risks involved," Mozeliak said. "But based on how he's feeling and his past history he feels like this is a last resort."
Before this season, Garcia said, "I had no idea the syndrome even existed."
Now, he believes it's the cause for some of his starts that began so well but ended badly. On June 21, for instance, he opened with four scoreless innings against the Phillies, and then gave up two runs in the fifth and three in the sixth as nerve issues intensified, resulting in stabbing pain in the hand along with numbness and tingling.
"I think every single start, things would just get worse and worse as the game went on," Garcia said.
Garcia was a 13-game winner each of his first two seasons in 2010 and 2011. He has totaled 15 wins since then and made just nine starts last season before undergoing a season-ending procedure for tears in the rotator cuff and labrum.
This year he was 3-1 with a 4.12 ERA in seven starts after beginning the year on the 15-day disabled list while rehabbing from shoulder surgery.
He had a 1.29 ERA in the first inning, 2.57 in the second, 0.00 in the third and 1.29 in the fourth. In the fifth and sixth innings, the ERA spiked to 12.86 and 11.57.
Skipping his bullpen session and weight training gave Garcia a brief spike of productivity. He threw seven scoreless innings at Toronto in early June and allowed a run in seven innings in a victory over the Nationals the next time out.
In his last start against the Phillies on June 20, he opened with four scoreless innings and struggled to get three more outs, surrendering four runs on four doubles and a home run. He was placed on the DL the next day.
The surgery wasn't a long-term success from a baseball standpoint for Carpenter, who retired at age 38 after pitching just six more games.
"I don't want to get into details about Carp, if he waited too long," Garcia said. "Guys come back and guys don't."
Garcia contacted several players who have had the procedure and come back strong, naming pitchers Josh Beckett of the Dodgers and Chris Young of the Mariners, both in their mid-30s. Beckett threw a no-hitter this season.
Garcia said he didn't tell the team about the nerve issues until recently, believing it was part of the recovery from shoulder surgery.