medical

Welcome back to The Times’ Lakers newsletter, where life comes at you fast.

Only a week ago, the Lakers were winning games and flying high. Quite literally. Remember when Luka Doncic dunked?

Happier times.

Now Doncic and Austin Reaves are both sidelined at least for the rest of the regular season and likely through the first round of the playoffs. The injury updates that came on consecutive days following Thursday’s 43-point loss to Oklahoma City felt like a devastating series of gut punches. Coach JJ Redick often talks about “not letting go of the rope.” The Lakers will have to white-knuckle their way through the next few weeks without their two stars.

Why is Luka Doncic in Europe?

Lakers star Luka Doncic reacts after sustaining a hamstring injury against the Oklahoma City Thunder on April 2.

(Cooper Neill / Getty Images)

He knows magic. Now Luka Doncic needs medicine to help pull off his next stunning trick.

With the playoffs approaching, Doncic traveled to Europe to seek treatment for his strained left hamstring, his agent, Bill Duffy, confirmed to The Times’ Broderick Turner. The hope is that with specialized treatments, Doncic can speed up what is typically a four- to six-week recovery process and get back in time for at least part of the Lakers postseason, which begins April 18.

Ultrasound-guided platelet-rich plasma (PRP) injections and stem cell injections are the most common treatments for injuries of this nature, said Kenton Fibel, a primary care sports medicine specialist at Cedars-Sinai Orthopaedics.

The biologic injections can speed up healing of injured tissue. PRP injections use the natural growth and anti-inflammatory factors in platelets to promote healing while stem cells harvested from a patient’s bone marrow or adipose tissue similarly help with the regeneration and turnover of the healing tissue into normal muscle tendon tissue, Fibel said.

Top U.S. athletes have gone to Europe to seek the treatments for decades. Kobe Bryant, former Colts quarterback Andrew Luck and San Francisco 49ers running back Christian McCaffrey are among those who’ve crossed the pond for solutions to chronic injuries. But similar treatments are also available in the United States.

In the U.S., only PRP and stem cell injections coming from a patient’s own body are allowed and the cells are not allowed to be manipulated, Fibel said. With looser regulations in Europe, doctors can attempt to increase the concentration of anti-inflammatory factors in a single PRP sample or culture stem cells over days to increase the number of them with hopes of speeding up healing even more.

Whether there is a significant increase in efficacy between the cutting-edge European treatments compared to the U.S. methods is unclear, Fibel said, but an athlete’s decision to pursue treatment often comes down to individual comfort level or prior experiences.

Lakers star Luka Doncic shoots over Brooklyn Nets guard Drake Powell during a Lakers win on March 27.

(Allen J. Schaben / Los Angeles Times)

The ubiquity of degenerative conditions or recurring soft tissue injuries in sports have turned European countries, including Germany and Switzerland, into hot spots for top athletes searching for help.

“These are injuries that are not always that easy to completely prevent, and it’s also not the easiest to always prevent reaggravation,” Fibel said. “And so I think [the new treatments] also comes from a frustration of doing a lot of the treatments and modalities that were used in prior injuries and still having an issue afterwards [so] that they’re searching for something new and different.”

Doncic knows the routine when it comes to hamstring injuries. As a player who thrives on his shifty change of pace, Doncic’s quick start and stop motions put extra load on his hamstrings and put him at risk of reinjury. Another left hamstring strain sidelined him for four games earlier this season.

Now with a Grade 2 injury, Doncic’s timeline for recovery would typically be four to six weeks. A Grade 2 injury shows “true disruption” that involves about 50% of the tissue, Fibel said. The most severe Grade 3 is used to describe a more significant, if not complete, tear of the muscle or tendon. The Lakers have suffered several Grade 2 injuries this season, including Austin Reaves’ latest left oblique strain.

The timing of the injuries couldn’t be worse for the Lakers. Not only do the playoffs begin in less than two weeks, but the Lakers were playing their best basketball of the season before the injuries to Doncic and Reaves. They appeared to be legitimate contenders in the playoffs. Now they must wait to see if Doncic’s super serum turns him into a superhero capable of saving their postseason.

“[Doncic is] going to go through all the necessary things to be back at some point,” Redick said, “and it’s our job again to extend the season so both those guys can get back.”

Scoreboard watching

Lakers star LeBron James reacts during a game against the Sacramento Kings on Dec. 28.

(Eric Thayer / Los Angeles Times)

It’s true what they say: No lead is safe in the NBA.

Just when it looked like the Lakers were likely to finish third in the West, the Nuggets found a rhythm, the Lakers got bitten by the injury bug and the Rockets refused to relent.

Reeling from the loss of their two leading scorers, the Lakers have fallen to fourth in the West with Denver surging on a nine-game winning streak. After an overtime win against the Portland Trail Blazers on Monday, the Nuggets (51-28) have a half-game advantage over the Lakers for the No. 3 seed.

The good news: The Lakers can’t drop below the fifth seed, thanks to Minnesota’s recent slide. They also have an additional cushion from their exceptional March, which gave them head-to-head tiebreakers against Denver and Houston.

I won’t repeat the obvious injury-related bad news.

To drop to fifth, the Lakers have to be 2-2 (or worse) in their last four games, while the Nuggets, who have the head-to-head tiebreaker against Houston, go at least 2-1 and the Rockets (49-29) run the table. The Nuggets have the tougher schedule between the three teams, though, playing both Oklahoma City and San Antonio in the final three games.

Here’s a look at the remaining games for the teams fighting for third, fourth and fifth in the West:

(Thuc Nhi Nguyen / Los Angeles Times)

On tap

Tuesday vs. Thunder (62-16) 7:30 p.m. PDT

The Lakers won’t be able to undo last week’s 43-point loss in Oklahoma City, but a competitive showing in the rematch could at least offer a much-needed confidence boost entering the postseason.

Thursday at Warriors (36-42), 7 p.m.

The Warriors are in position to eke into the play-in tournament as the 10th seed. Believe it or not, this could be the last meeting between LeBron James and Stephen Curry in their illustrious careers as the 41-year-old James enters unrestricted free agency this summer.

Friday vs. Suns (43-35), 7:30 p.m.

Phoenix is currently seventh in the West with a chance to chase down sixth-place Minnesota for a playoff berth. Dillon Brooks recently returned from a fractured left hand that kept him out for about six weeks. The Suns went 9-9 during his absence.

Sunday vs. Jazz (21-58), 5:30 p.m.

The Jazz and the Kings are in a heated race to the bottom of the conference. Losers of nine straight, the Jazz are primarily hoping to keep their top-eight protected draft pick, which was at risk of conveying to Oklahoma City.

Status report

Luka Doncic: left hamstring strain

The Lakers have ruled Doncic out for at least the remainder of the regular season. Doncic previously missed four games with another left hamstring strain, but that same timeline won’t apply because the absence rolled into All-Star weekend, when he made a token appearance in the All-Star Game.

Austin Reaves: left oblique strain

Reaves played through the injury he suffered in the first quarter against the Thunder last week, but was ruled out for the rest of the regular season and he likely will miss the first round of the playoffs. He was injured while reaching for a loose ball.

Marcus Smart: right ankle contusion

Smart will miss his eighth consecutive game Tuesday against the Thunder as his ankle injury has lingered for more than two weeks since he got tangled up with Orlando’s Goga Bitadze. While Smart has worked out with staff members on the court before games, he is still day-to-day for his return.

Favorite thing I ate this week

(Thuc Nhi Nguyen / Los Angeles Times)

When in doubt, consult the L.A. Times. For all the news you need to know, yes, but also about your local food needs. This dinner was brought to you by the L.A. Times’ best 101 restaurants list, which recommended Lalibela on Fairfax for an Ethiopian feast. We started with the lentil sambusa (not pictured), which came with a perfectly spiced herb sauce, and shared the veggie utopia, which hits every note with the restaurant’s most popular vegetarian dishes.

In case you missed it

Injury-riddled Lakers lose to Dallas; Luka Doncic to have medical treatment in Europe

Lakers’ Austin Reaves out for rest of regular season with oblique strain

Luka Doncic’s hamstring strain will keep him out for remainder of the regular season

Lakers star Luka Doncic suffers hamstring injury in reality-check loss to Thunder

After a sizzling March, Lakers face a big playoff test against equally hot Oklahoma City

Luka Doncic matches Michael Jordan for the most magical March in NBA history

LeBron James achieves his 125th career triple-double in Lakers’ win over Wizards

Until next time…

As always, pass along your thoughts to me at thucnhi.nguyen@latimes.com, and please consider subscribing if you like our work!

SACRAMENTO — Attempting to force a state budget agreement, California Controller Kathleen Connell said Monday she is considering withholding lawmakers’ salaries, and cannot pay 35,000 state employees if the Legislature and Gov. Pete Wilson fail to approve a budget by Saturday’s constitutional deadline.

Without a budget, Connell said, she also will have no choice but to delay payments of some Medi-Cal bills, such as prescriptions, for elderly people–a step that would add pressure on lawmakers to approve a spending plan.

Under the state Constitution, California must have a new budget by the July 1 start of the 1995-1996 fiscal year. But Wilson and the Legislature remain far apart and seem to be in no rush to approve a budget.

In recent years, it has become common for the deadline to pass without a budget. In 1992, the state went more than 60 days without a budget, leading state government to pay its employees and vendors with IOUs.

Connell, who is in her first year in office and who issues the checks for the state, said California has the cash to pay its bills. However, without agreement on a budget measure authorizing state spending in the new fiscal year, Connell said she will have no choice but to delay paying vendors, some medical bills for the elderly, the blind and the disabled, and as many as 35,000 state employees, including management officials.

“I don’t think any taxpayer is going to be sympathetic to the idea that we have the cash but are not paying our bills,” said Connell, a Democrat.

Connell last week suggested that she would withhold lawmakers’ pay starting July 1 if they had not approved a budget by the deadline. But she softened her position after concluding that there may be a constitutional requirement that she issue their checks. However, Connell said she is still studying the question.

“I’m raising a moral issue here,” Connell said after a speech in Sacramento. “If there are [state] employees who are not going to be paid because we have partisan politics dominating the Legislature, then there has to be a question of who else should accept responsibility.”

In the Legislature, the Senate-Assembly budget conference committee met Monday afternoon. But Wilson and top legislative leaders have not scheduled budget talks to resolve differences.

Wilson has proposed a $56-billion budget that includes deep welfare cuts and requires 10% increases in state college and university tuition. Wilson also is pushing for a 15% income tax cut over three years–an idea opposed by many Democrats.

“We fully expect to have a budget in the month of July,” Wilson spokesman Paul Kranhold said. “We are hopeful that the Legislature will forward us a budget by Saturday, or soon afterward.”

The amount separating Democrats and Republicans is relatively small–$1.8 billion–compared to other years of the Wilson Administration, when the gap between Wilson’s proposals and what the Legislature proposed ranged from $5 billion to $14 billion. But rancor is so dividing the Assembly this year that partisans in the budget fight have yet to take the first steps toward a solution.

“It can happen by Saturday,” said Assembly Republican Leader Jim Brulte. “There is no reason that it couldn’t or shouldn’t happen by Saturday. But I don’t know if it will.”

Past court orders require that, even without a budget, the state pay to keep schools open and issue checks to welfare recipients. The state also will continue to meet its bond debt and pension payments, Connell said.

But starting Saturday, Connell said, the state will not pay vendors who perform various services for the state, or deliver goods to state prisons and state hospitals. Without a budget, she said, state agencies that lease space will be unable to pay rent and cannot pay utility bills. Payments for services such as nursing home care or food deliveries to prisons would be delayed until a budget is approved.

“The effect of having no budget begins immediately. It begins on July 1, and the damage will grow with each day,” Connell said.

If the state goes without a budget through July, the missed payments would total at least $360 million for Medi-Cal and state assistance to counties to operate trial courts. The total for employees was not known.

Unlike 1992, the last time there was a lengthy budget deadlock, the state cannot use IOUs to pay its workers who fall under the Fair Labor Standards Act.

A federal judge, acting on a lawsuit brought by state employees, ruled last year that the state acted illegally in 1992 by issuing the IOUs, and that roughly 120,000 workers covered by the Fair Labor Standards Act must be paid even if there is no budget.

But between 33,000 and 35,000 state workers are not covered by the act, raising the possibility that they will not be paid on time for work done after July 1.

The employees whose pay is in jeopardy include Wilson’s political appointees, and heads of departments and middle-level managers. Professionals such as deputy attorneys general and state physicians and dentists also may have their paychecks delayed. An aide to Connell said the controller’s office is reviewing the law to determine whether judges and other judicial officials can be paid.

The first state employees to miss a paycheck would be in the Department of Transportation, where 50 management employees would miss July 15 paychecks for work done after July 1.

Gov. Pete Wilson has criticized the commission’s findings, and Sens. Barbara Boxer (D-Calif.) and Feinstein have urged the President to throw out the panel’s work entirely. Rep. Vic Fazio (D-West Sacramento), whose district includes the threatened Air Force base, wants Clinton to send the report back and ask the commission to redraft it without the McClellan closure recommendation.

Mexican President Claudia Sheinbaum praises services from Cuban doctors, who often work in underserved rural areas.

Mexican President Claudia Sheinbaum has confirmed that her country will continue receiving Cuban medical workers, as part of a longstanding programme meant to build goodwill between the island and other Latin American countries.

Her remarks on Wednesday come as the United States pressures Latin American countries to sever their ties to Cuba’s medical programme.

Sheinbaum, however, told reporters during a news conference that the agreement was a benefit to Mexico. Thousands of Cuban medical workers have deployed there since 2022 to work largely in poor, rural areas.

“We have a very good agreement that’s also been a great help to us. It’s a bilateral agreement that’s been very beneficial for Mexico,” said Sheinbaum.

“It’s hard to get Mexican doctors and specialists to go out to many rural areas where we need medical specialists, and the Cubans are willing to work there.”

In February, the US passed a law that opens the door to sanctions on countries that continue to participate in the programme.

It called for the US secretary of state to issue a report within 90 days about which countries continue to pay the government of Cuba for the “coerced and trafficked labour of Cuban medical professionals”.

The move comes amid a wider push to further isolate Cuba and topple the government in Havana, a longtime target of US ire. So far, countries including the Bahamas, Honduras, Guatemala, Jamaica and Guyana have ended their participation in the Cuban medical exchange programme.

Cuba has long depicted the decades-old programme as a means of signalling solidarity with other countries. It has also become an important source of foreign revenue for the island nation, which has been under a restrictive US economic embargo since 1960.

The administration of US President Donald Trump, however, has depicted the programme as akin to forced labour.

“Basically, it’s human trafficking,” Secretary of State Marco Rubio told reporters in February.

“I mean, they’re barely even being paid. Their freedom of movement is tightly restricted. And we want these countries to understand that’s what they’re participating in.”

Experts at the United Nations have also raised similar concerns, including about the confiscation of passports, which the Cuban government justifies as a means of preventing trained doctors from fleeing the country after their state-sponsored studies.

The pressure on the Cuban medical missions is part of a broader push under Trump’s second term to seek regime change on the island.

By threatening tariffs on Cuba’s trading partners, Trump has largely cut the island off from accessing the foreign oil necessary to power its electrical grid.

Trump has also said that he hopes to “take” Cuba and install a new government that will be more pliant to US demands.

The Mexican government has tried to balance its friendly relations with Cuba with the US’s demands.

In the absence of energy shipments, Sheinbaum’s government has sent vessels with humanitarian aid to the island.

A deaf 6-year-old boy snatched by immigration agents from Northern California and deported to Colombia this month needs to be returned to the U.S. immediately or he could die, a lawyer representing the child said Wednesday.

Attorney Nikolas De Bremaeker said the boy, Joseph Lodano Rodriguez, was “at risk every day that he is not getting his treatments.” The child has a cochlear implant that requires the same routine maintenance and cleaning he was receiving stateside but may not get in Colombia.

“Joseph is at immense risk for his life if he does not continue the treatment that he was receiving in the United States,” De Bremaeker said at a virtual news conference hosted by California Supt. of Public Instruction Tony Thurmond, a Democratic gubernatorial candidate.

“He is at risk of infection, he is at risk of meningitis, he is at risk of death if he is not given the proper care for his surgical implants.”

Joseph, his 28-year-old mother, Lesly Rodriguez Gutierrez, and another son, 5, were detained by federal agents on March 3 while attending an immigration meeting and deported shortly after.

Rodriguez Gutierrez traveled to the United States in 2022 seeking asylum from domestic violence and lived in Hayward. She was told in the run up to the March 3 meeting that she needed to bring her two children for a routine check-in to update the photos Immigration and Customs Enforcement had of them.

Shortly after arriving, ICE agents “tried to force her to sign a document without explanation, and then pushed the family into a vehicle to be put on a flight to a faraway detention facility, “ De Bremaeker told The Times earlier.

The Department of Homeland Security did not respond to questions sent Wednesday after office hours but has consistently said that Rodriguez Gutierrez was “an illegal alien from Colombia” who “illegally entered the United States in 2022.”

She was issued a removal order on Nov. 25, 2024, according to DHS.

Thurmond, the superintendent, called on the public to lobby Congress and the Trump administration “to return Joseph so he can continue his studies.”

Thurmond showed a 40-second clip of Joseph and his family at a Colombian facility for the deaf.

The child appeared to struggle communicating with his sibling and mother, while his brother repeatedly tried to give directions to him in Spanish with little avail.

Joseph’s only language is American Sign Language, Thurmond said. Joseph was studying at the state-funded Fremont’s California School for the Deaf.

“Joseph is struggling,” Thurmond said. “He does not have the ability to communicate with anyone and in many ways, he can barely communicate with his mom. Like Joseph’s mom, Lesly was just beginning to learn American Sign Language.”

Both California senators — Alex Padilla and Adam Schiff — along with state Democratic congressional members Eric Swalwell, Nanette Barragán, Zoe Lofgren, Kevin Mullin and Lateefah Simon called on the U.S. Department of Homeland Security and the State Department to investigate the deportation.

The group is also calling on both government agencies to return the family to the U.S. through the process of humanitarian parole. That move would allow Joseph to re-enroll in school and receive specialized care.

Celena Ponce, founder of Hands United, a nonprofit organization dedicated to aiding deaf immigrant children and families, said her group was trying to connect the family with the deaf community and services, like interpreters, in Colombia.

She said, however, that Joseph and his family face several challenges. The first hurdle if he ends up staying in Colombia, is that he and his mother will have to learn Colombian sign language, which differs from American sign language.

Ponce added that Joseph also suffered language deprivation, meaning he is delayed in comparison to other 6-year-olds who are hearing.

“Because Colombia does not have residential schools similar to what California has, the ability to be fully immersed in language is not present,” she said.

Whatever gains he made at the California School for the Deaf would likely end, she said.

Times staff writers Clara Harter and Christopher Buchanan contributed to this report.

Afghan officials say a suspected Pakistani air strike hit a drug rehabilitation centre in Kabul, killing hundreds of patients and staff and leaving the facility in ruins. Pakistan denies targeting civilians, as tensions escalate between Islamabad and Afghanistan’s Taliban-led government.