Racers fail doping tests for EWS

[Captain Fastbastard Mayhem]

My first reaction as well ...

 

 

MANY of us had to get up, dust ourselves off, and cycle home with worse scrapes .....

Doesn't mean we should, or shouldn't take proper care of it. Plus, if the event doc gives you something and says the danger of NOT taking it is losing your limb due to bacterial infection (that had already taken hold) then you bloody well listen to him and take it. 

 

BTW - 5cm laceration, deep tissue damage. Requiring stitches, heavy cleaning due to conditions, anti-bacterial treatment and so on. Yeah, that can be fixed by HTFU. 

[Jewbacca]

Doesn't mean we should, or shouldn't take proper care of it. Plus, if the event doc gives you something and says the danger of NOT taking it is losing your limb due to bacterial infection (that had already taken hold) then you bloody well listen to him and take it. 

 

BTW - 5cm laceration, deep tissue damage. Requiring stitches, heavy cleaning due to conditions, anti-bacterial treatment and so on. Yeah, that can be fixed by HTFU. 

Or stop racing, go to hospital and get it sorted out in a controlled environment.

 

Also, this is believing the story dished out by someone caught taking what is a known masking agent..... I mean, why that specific drug?

 

I have heard many a story from someone claiming their innocence, especially those with a lot to lose.

[ChrisF]

Doesn't mean we should, or shouldn't take proper care of it. Plus, if the event doc gives you something and says the danger of NOT taking it is losing your limb due to bacterial infection (that had already taken hold) then you bloody well listen to him and take it. 

 

BTW - 5cm laceration, deep tissue damage. Requiring stitches, heavy cleaning due to conditions, anti-bacterial treatment and so on. Yeah, that can be fixed by HTFU. 

 

The question was IF the photo shows the ACTUAL accident  ....

 

The "damage" shown in that pic truly APPEARS to be minimal.  And my previous reply is based purely on "the photo"

 

 

 

Reading the Dr's report it would appear the damage was substantially more than what the photo shows.  For a "normal person" - YES, do what the Dr says !  For a "racer" earning his life from sport .... sadly it would appear the Dr's at these events are either scape goats, or not up to date with the medicine they have in their bags .... SURELY a Dr intending to administer medical help to professional athletes dont start asking questions AFTER treatment ... he SHOULD be asking those questions when he stocks his bags for the event ....

[Odinson]

Or stop racing, go to hospital and get it sorted out in a controlled environment.

 

Also, this is believing the story dished out by someone caught taking what is a known masking agent..... I mean, why that specific drug?

 

I have heard many a story from someone claiming their innocence, especially those with a lot to lose.

 

Thing is, Probenecid has to taken in large quantities to actually mask other drugs, which will return a positive result, thereby negating the actual doping. That's why it's not actually being used as a masking agent anymore. 

 

 

Because the original use of Probenecid by athletes was in amounts that far exceed therapeutic doses (normally 1 gm per day), it was extremely easy to detect. Because of ease of detection due to the unusually large size of doses, Probenecid is no longer used by dishonest athletes. Probenecid no longer can be used as a weapon for cheating. As soon as it became a substance on the banned drug list (believed to have been in 1987) it ceased to be used by athletes for cheating because of its very ease of detection.

 

Most laboratories test for Probenecid itself, rather than metabolites, for it is the large amount that indicates illicit use. Small amounts, such as therapeutic doses, are of no interest to sport-drug testers because they would be ineffective for cheating purposes. Detected small amounts indicate only therapeutic use. However, even a small trace of Probenecid requires the posting of a positive banned-drug result but in all reality the amount would be useless for cheating. This is a problem that has not been addressed by the IOC Medical Committee. The size of the amount detected and the absence of any other banned substance is the way to determine between cheating and therapeutic purposes.

 

https://coachsci.sdsu.edu/csa/vol56/rushall5.htm

[Captain Fastbastard Mayhem]

Or stop racing, go to hospital and get it sorted out in a controlled environment.

 

Also, this is believing the story dished out by someone caught taking what is a known masking agent..... I mean, why that specific drug?

 

I have heard many a story from someone claiming their innocence, especially those with a lot to lose.

That was dealt with quite succinctly by the doc, in the original article. Something about ensuring more absorption of the antibiotics into the system, which this drug is quite widely used for. 

[Captain Fastbastard Mayhem]

Here we go. Rather use teh source. Added bolding for easy reference. 

 

I am a Specialist Emergency Physician, and have been practising Emergency Medicine for over 15 years. On March 8th -10th 2019, I was acting in a voluntary role as a event doctor on the New Zealand Enduro, a backcountry mountain bike race in Marlborough, New Zealand. 

On the afternoon of March 8th 2019, I was reviewing and treating a number of riders who had been injured in the day’s racing. Mark Maurissen approached me, and asked me to review Martin Maes, who had sustained a significant laceration to his right pretibial area (lower leg) during the day’s racing. Martin had sustained an approximately 5 centimeter long vertically orientated burst type laceration to his lower leg. There was significant soft tissue damage, and the wound was grossly contaminated (conditions were particularly muddy that day) I irrigated and debrided the wound extensively, applied a topical antiseptic solution, and sutured the skin using 4 x interrupted sutures. I was concered about a significant risk of infection given the wound location, tissue damage, and initial contamination. At that point I dispensed a course of flucloxacillin (an antibiotic) in a standard dose (500 milligrams 4 times a day for 3 days with a goal of preventing infection). I gave Martin standard wound care advice, and planned to follow him up in 2 days 

On March 10th 2019 at around 10 am, I reviewed Martin’s wound. At that point, he had a clearly established serious infection surrounding the wound, despite the prophylactic antibiotics. This infection had developed over the last 24 hours. I removed 2 of the sutures, draining a small amount of pus, and irrigated and further debrided the wound. A higher dose of antibiotic was clearly indicated, as the infection was significant enough be life or limb threating if left unchecked. My standard practice in a case like this is to give a higher dose of flucloxacillin in combination with a medicine called probenicid. In this case, probenicid acts to reduce the excretion of penicillin type antibiotics from the kidneys, thus boosting the blood levels of antibiotic. These higher levels of antibiotic are particularly important for treating serious infection, and I do not believe Martins infection would have resolved without them. The only other option would have been hospitalisation for intravenous antibiotics, which carries its own set of risks and costs, and would not necessarily be more effective than adding probenicid. 

I provided Martin with a prescription for 2 grams of flucloxacillin 3 times a day for the next 2 days (dropping to 1 gram 3 times a day for a further 5 days), and probenicid 500 milligrams 3 times a day for 7 days. I discussed all of this with Dr Julian Balance, an Orthopaedic Surgeon also volunteering as a race doctor. He agreed with the management plan as above. 

Both Martin and Mark asked if the medications I were permissible for racing. I informed them that probenicid has no performance enhancing effects, and as far as I was aware was not a prohibited substance for racing. I checked this with Dr Balance, as well as Dr Sam Grummitt (another of the race doctors), neither of whom were aware that probenicid was a prohibited substance. There was no cellular data coverage at the event to enable us to check this. Martin began vomiting that afternoon, likely as a result of the higher doses of flucloxacillin, which often cause significant gastrointestinal upset. At that point we discussed referring him to hospital, and elected to give him a trial of an anti-vomiting drug prior to this. I dispensed 4 milligrans of ondansetron, which settled his vomiting, and enabled him to take the prescribed antibiotics. 

I understand Martin made a good recovery, and was able to race 2 weeks later. I also understand that Martin returned a positive urine drug test for probenicid at that event. I have subsequently learned that probenicid is on the UCI prohibited substances list, and has previously been used as a masking agent, although it has no performance enhancing effects. 

The probenicid I prescribed Martin was clearly medically indicated and I would do so again given the same clinical scenario. I believe he would have experienced a significant impairment to health had I not prescribed it, with the potantial for life threatening spread of infection. Had I known it was a prohibited substance, I would have been happy to fill in a therapeutic exemption form. I am confident that there was no performance enhancing benefit from the prescription, and in fact the severity of the infection was likely to have been detrimental to his performance in the next few weeks—Dr Tom Jerram

[DieselnDust]

The question was IF the photo shows the ACTUAL accident  ....

 

The "damage" shown in that pic truly APPEARS to be minimal.  And my previous reply is based purely on "the photo"

 

 

 

Reading the Dr's report it would appear the damage was substantially more than what the photo shows.  For a "normal person" - YES, do what the Dr says !  For a "racer" earning his life from sport .... sadly it would appear the Dr's at these events are either scape goats, or not up to date with the medicine they have in their bags .... SURELY a Dr intending to administer medical help to professional athletes dont start asking questions AFTER treatment ... he SHOULD be asking those questions when he stocks his bags for the event ....

 

Spoke to My GP about this. The response was that doctors act in your best interest not in terms of witch hunting organizations like wada.

[MORNE]

GP's aren't real doctors IMHO offcourse lol

 

edit: no offence intended to any GP's that mght be lurking on here. I'm not the kind of guy that ever goes to the doctor. But I have had my own near death experience about 15y ago and it changed my opinion on GP's forever....I just go straight to the guys who went all the way now when i suspect i might be dying again lol....the specialists.

[ChrisF]

..... My standard practice in a case like this is to give a higher dose of flucloxacillin in combination with a medicine called probenicid. In this case, probenicid acts to reduce the excretion of penicillin type antibiotics from the kidneys, thus boosting the blood levels of antibiotic. These higher levels of antibiotic are particularly important for treating serious infection, and I do not believe Martins infection would have resolved without them. The only other option would have been hospitalisation for intravenous antibiotics, which carries its own set of risks and costs, and would not necessarily be more effective than adding probenicid. 

....

 

Both Martin and Mark asked if the medications I were permissible for racing. I informed them that probenicid has no performance enhancing effects, and as far as I was aware was not a prohibited substance for racing. I checked this with Dr Balance, as well as Dr Sam Grummitt (another of the race doctors), neither of whom were aware that probenicid was a prohibited substance. There was no cellular data coverage at the event to enable us to check this. ....

 

Surely a sports Dr asks these questions when buying his meds ....

 

uhm ja ... 

 

IF it the options are going outside the regs or hospitalisation ... 

 

 

I would expect much better from a specialist "sports Dr" .....

[ChrisF]

Spoke to My GP about this. The response was that doctors act in your best interest not in terms of witch hunting organizations like wada.

 

and thats why you get SPECIALIST sports Dr's.  Many sports have Dr's that travel the globe with a particular sport.  They KNOW their clients, and they KNOW the rules !!

 

 

Think of how they treated Lorenzo when he broke his collarbone during the Thursday practice.  Flew him to a hospital, operation under local anestheatic, flew him back to the track, Saturday he qualified and did well in the race on Sunday.

[NotSoBigBen]

The sceptic in me just says 'there's always a story/excuse' ...

[Captain Fastbastard Mayhem]

and thats why you get SPECIALIST sports Dr's.  Many sports have Dr's that travel the globe with a particular sport OR  TEAM. They KNOW their clients, and they KNOW the rules !!

 

 

Think of how they treated Lorenzo when he broke his collarbone during the Thursday practice.  Flew him to a hospital, operation under local anestheatic, flew him back to the track, Saturday he qualified and did well in the race on Sunday.

Firstly, fixed your post. Not all sporting events have travelling docs, or teams that travel with a dedicated medic / doc. Some sporting codes (like the local DH / Enduro / XC guys) get 3rd party medical services that just cater for looking after the clientele in cases of medical need, and may not have WADA certification / affiliation / whatever. 

 

Secondly - additional cost and complications of going to hospital to get it sorted. These guys don't get paid a lot, and the team budgets are LOW. Comparing Lorenzo's situation to theirs is disingenuous as any team he's in will literally do anything to protect their investment. 

 

In this situ, I'm inclined to take Maes's and the doc's word on things. The guy was treated, got a bacterial infection, was treated accordingly at the lowest possible cost with the best outcome for his health and due to the doc's blind spot on that particular drug, he didn't get a TUE filled out until it was way after the event and he tested positive for a drug that the doc told him wasn't performance enhancing. 

 

YES, he tested positive. Yes, he had the drug in his system and should have got the doc to fill out a TUE anyway, just in case (dunno if it works like that, but IMO it should - if you get treated, doc sends alles to UCI / controlling body and they assess) No, I don't think this is malicious nor do I think he should have been punished for it given the evidence that has been presented to teh interwebs. 

 

Could I be wrong? Yes. 

[Andrew Steer]

The sceptic in me just says 'there's always a story/excuse' ...

As long as being fitter, stronger, sharper etc gets you any advantage over your professional peers and a better shot at money and endorsements, there will be doping. 

 

Enduro, welcome to the professional ranks... three rather high end positives with what looks like threadbare testing in place. Let the games begin

[DieselnDust]

and thats why you get SPECIALIST sports Dr's.  Many sports have Dr's that travel the globe with a particular sport.  They KNOW their clients, and they KNOW the rules !!

 

 

Think of how they treated Lorenzo when he broke his collarbone during the Thursday practice.  Flew him to a hospital, operation under local anestheatic, flew him back to the track, Saturday he qualified and did well in the race on Sunday.

 

 

 

trust me, even Sports doctors dont know what is or isn't on that list. Unless you've got the gys at sports science Inst on short dial

B) how many events can pay for specialists to be in attendance.

c) how many athletes outside of mainstream sports can afford specialists for every question.

d) lets stop looking at the world through rose coloured glasses

[Andrew Steer]

this just reinforces my stance on the athletes being responsible for what they put into their bodies being a little over the top. Where is the WADA guidance on this? I walk into Dischem and buy tub of Whey protein. How the heck do I Know whats in it? I've checked the ingredients lists and just as the story above, how would I actually know what in a tub unless i pay to get the stuff phyically analysed? I do feel for these okes because the manufacturers of these supplements don't always meet the necessary FDA requirements for ensuring there's no cross contamination.

 

We just betaalenkak

Is this post for real? Who would you like to be responsible for what athletes put in their bodies?

Please answer this

 

There are endless guidelines for athletes and info sessions from WADA and locally SAIDS on what athletes can and can't do... it comes with the territory. 

No, as an athlete who makes a living out of professional sport, you can't just walk into Dischem and buy MuscleFreak Superload 5000 and think you will sleep soundly at night. 

 

[DieselnDust]

Ah you're in the red wine and bread camp