CHICAGO -- Chad Fox has already had three surgeries on his right elbow, so when he threw a slider Monday night and felt the "pop," he knew it was bad.
"As soon as it happened, a million things go through your head, from 'What in the world just happened' and 'Is this it?'" Fox said on Tuesday. "We'll see. It's a waiting game right now."
This could be it for Fox, who was placed on the disabled list Tuesday for the seventh time in his career. And the Chicago Cubs reliever knows it.
In the ninth inning on Monday against Cincinnati on a 2-1 pitch to Jason LaRue, Fox felt the pop and walked off the mound in obvious pain. He underwent an MRI on Tuesday and was waiting for results. He will see orthopedic specialist Dr. James Andrews, who performed the other operations on Fox's elbow, this week.
"I felt a pop," Fox said Tuesday. "I'm not very comfortable right now. It's one of those deals I've dealt with, unfortunately, a lot in my career. I try to stay as positive as I can. Regardless of what the outcome is, I'll get through it. I know I've probably got a trip to Dr. Andrews to let him get his hands on it. He's put it back together three times. If it takes a fourth ..."
And Fox's voice trailed off. Would he consider a fourth operation?
"I don't know. That's a hard question," Fox said. "My gut instinct tells me no. I've been through such an emotional roller-coaster last night and right now still, I'm not going to make any decisions on what these X-rays or MRIs show."
There was no indication that the elbow was weak.
"The whole inning, I never felt tight or anything building up," Fox said. "Last year, when the nerve issue came up, it was kind of building up and building up. I tried to throw a slider and felt something pop and I knew it wasn't something good, especially after three surgeries in one elbow."
Fox, 34, appeared in just 12 games last season with Florida because of ulnar neuritis. The right-hander has a career 10-11 record, six saves and a 3.57 ERA in 214 games. He earned a World Series ring in 2003 with the Marlins, going 2-1 with a 2.13 ERA in 21 games in Florida.
The Cubs called up lefty Will Ohman to take Fox's place on the roster.
Fox was named the Cubs' closer on Sunday, and picked up his first save almost two years to the day on that day. Monday's game was his first back-to-back outing of the year. But the right-hander didn't want anyone to blame anyone for overuse.
"That's one thing -- I don't want anyone to say they pitched me too much," he said. "I'm a grown man. I could've walked in there and said,' Dusty [Baker, manager], I need a night off.' This organization has been incredible to me from top to bottom. That should never be an issue. This was going to happen regardless, whether it was last night, tonight, tomorrow."
Chad Fox / P
Weight: 210 lbs
Bats: R / Throws: R
Even though the Cubs had a 10-3 lead over the Reds starting the ninth inning, Baker wanted Fox in the ninth. That lead shrunk to 10-6 after Adam Dunn's three-run homer off Fox.
"We only had a four-run lead with their big hitters up and the wind blowing out, and that's really nothing at Wrigley Field," Baker said. "That's just like one run, especially with the guys they have. We didn't want to let them back in the ballgame.
"Neifi [Perez] hit a three-run homer, which nobody anticipated, and the next two guys made outs on three pitches, and there wasn't time to get anybody loose," Baker said.
Baker didn't want Fox to throw three days in a row, but was comfortable with two straight days.
"He hasn't pitched that much," Baker said. "We were trying to monitor him the best we could, but any time a guy's had a number of operations and two or three screws in his arm, you never know when a guy can go."
Was it inevitable this was going to happen?
"It's always in the back of your mind and you have to prepare yourself," Fox said.
Almost 24 hours later, Fox had yet to come to grips with the injury.
"I still feel numb," he said. "I feel I should be putting that uniform on to go out and get ready. My wife and my kids have been phenomenal. I'll try to stay as positive as I can."
This is Fox's first season with the Cubs, and he was a non-roster invitee this spring. Yet his teammates were affected by seeing Fox hurt.
"I'll tell you why -- the response my wife got last night from players, from Mark [O'Neal, the Cubs athletic trainer], from this organization. It lets me know I've done something," he said. "We'll see where it takes us."
And Fox had to pause to compose himself as his eyes filled with tears.
After two Tommy John surgeries and an operation to repair a fractured elbow, Fox is ready for anything. He's got three screws in his elbow to support it. And he's got three children to think about.
"I've got three amazing kids and I want to be able to enjoy them," he said. "How many surgeries can you put your body through? That beats me down more than anything. The way my arm's been repaired, I'm not worried about effects long term, or playing golf or going fishing.
"If it calls for another surgery, you have to look yourself in the mirror and say, 'This is what I want.'"
Carrie Muskat is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.