PHILADELPHIA -- Phillies ace Zack Wheeler underwent a successful thrombolysis procedure to remove a blood clot in his right upper extremity on Monday morning at Thomas Jefferson University Hospital in Philadelphia.
The procedure, performed by Dr. Paul DiMuzio, came just two days after Wheeler was placed on the 15-day injured list on Saturday night due to the blood clot. The next steps and any timeline for Wheeler's potential return this season are still to be determined.
"We don't know," Phillies manager Rob Thomson said prior to the club's series opener against the Mariners at Citizens Bank Park. "We don't know until we get further information."
For now, the focus is solely on Wheeler's health and well-being.
"A lot of people ask me about the pitching staff and the team, but right now, my thoughts are just about him," Thomson said. "Like I said the other day, this isn't like a hamstring or a calf. This is real. This is life.
"So my thoughts are constantly on him and his family. Hopefully everything works out -- and so far, so good."
It's been a whirlwind few weeks for Wheeler.
The veteran right-hander was locked in a tight battle for the National League Cy Young Award for much of the season. The chances of Wheeler winning his first Cy Young honor seemed better than ever following his July 6 start against the Reds in which he threw a complete-game one-hitter with 12 strikeouts.
But Wheeler hadn't been quite the same since that outing. He put up a 4.54 ERA over his next six starts, a stretch that included having one of his starts pushed back two days after he felt a little extra shoulder soreness following his Aug. 2 start against the Tigers.
Wheeler made two more starts after that -- one on Aug. 10 in Arlington and another on Friday in D.C. Though he said he felt better physically in those appearances, his velocity was down significantly against the Rangers. It improved against the Nationals, but it was still below his season average.
"Zack had been feeling better after his right shoulder soreness,” Phillies head athletic trainer Paul Buchheit said on Saturday when Wheeler was placed on the IL. “But [Friday], some symptoms had changed. Doctors were great in helping to diagnose and expedite that diagnosis [Saturday] morning."
Wheeler was sent for more testing on Monday, when he ultimately underwent the procedure in which "the clot was cleared out of there," per Thomson.
"He's the heart of this team, the heart of this staff," said Matt Strahm, whose locker in the home clubhouse is directly next to Wheeler's. "You never want to see it."
Again, though, the focus is largely on the non-baseball aspect.
Wheeler spent a few days on the paternity list in early June after his wife, Dominique, gave birth to their fourth child.
"That's what we're thinking of first and foremost -- he's a dad and his family comes first," Strahm said. "So that's what we're worried about mostly."
As for the baseball side of things, Wheeler's outlook remains unclear for the time being.
Thomson said on Monday the team will proceed with a five-man rotation of Cristopher Sánchez, Ranger Suárez, Jesús Luzardo, Aaron Nola and Taijuan Walker for now.
"Yeah, for the time being," Thomson said. "For the time being, I think we're pretty good."
The most obvious alternative would be promoting Andrew Painter -- the club's top prospect and the No. 2 pitching prospect in all of baseball, per MLB Pipeline. Painter has a 5.31 ERA in 17 starts with Triple-A Lehigh Valley this season.
Seemingly a given to be called up by this point earlier in the year, Painter's unexpected struggles have made that far less of a guarantee in recent weeks. Now without Wheeler, the Phillies could be tempted to at least give Painter a look at the big league level, if for nothing else than to utilize a six-man rotation.
That would allow the team's other starters to get some much-needed extra rest. Nola just returned on Sunday after missing three months with a right ankle sprain. Suárez has struggled of late entering Monday night's start. Sánchez is on pace for a career-high innings total for the second straight season and Luzardo has already pitched more than twice as many innings as he did last year.
That's why the Phillies were planning to roll with a six-man rotation upon Nola's return.
Wheeler's absence has changed that plan, but Thomson doesn't want it to change anything else.
"As I told everybody, 'Just be yourselves. That's all we can do. Don't try to be anybody else,'" Thomson said. "Because they're good enough just the way they are."