Triathlon and doping III

We have previous posts on doping and triathlon:

24 juil. 2013

Tour de France, the Best of the Dopers?

I am not a fun of  Le monde, but I like the article written after the tour:

Les performances en watts-étalons de ceux qui ont essayé de gagner le Tour de France 2013 sur chacun des six radars et leur puissance moyenne …Cher Pat, tu seras d'accord avec moi : on peut regarder le verre à moitié vide et se dire que tout va bien. Celui des performances de nos coureurs Europcar, incapables de mener à bien leurs raids des années antérieures, à 30 % de leur rendement habituel. C'est vrai aussi pour Contador, qui n'est pas chez Movistar : à 399 watts-étalon moyen, l'ex-triple devenu double vainqueur du Tour est très loin de ses 423 watts de 2007, 439 watts de 2009 et 417 watts de 2010. Il lui faut plus de temps que Rui Costa et que Valverde pour se remettre de sa suspension pour dopage apparemment…Movistar, qui ne prône pas la tolérance zéro, est l'ancêtre de la Banesto qui a mis tant d'années le peloton en file indienne derrière le roi Miguel Indurain et ses 80 kilos. Chez Movistar, on est pas "techno" comme Sky, on est plutôt empirique.

2 févr. 2013

COMMUNITY MEETING AND DOPING

As a Psychiatrist and belonging to a very liberal group of psychiatrists, our Community Meetings were very interesting and real life experiences.  I was and wasn´t looking forward for the Community Meetings.  It was like playing “Crucifixion of Jesus.”  The Community Meetings were run by patients and they addressed the problem they were having in the Hospital.  It was the Carnival of Umberto Eco; a necessary procedure to continue working.

“This definition of comic leads us to the idea of carnival. How do we succeed in finding situations in which we are not concerned by the rules? Naturally enough, by establishing an upside-down world in which fish fly and birds swim, rabbits chase hunters and fools are crowned. At this point we feel free, first for sadistic reasons, second by because we are liberated from the fear imposed by the existence of the rule. Comic pleasure means enjoying the murder of the father, provided that others, less human than ourselves, commit the crime.” (1984; p2.)

“We feel relieved from our own sorrow concerning Snow White’s fate precisely because of the laughable pain of the dwarves. Our tension for the tragedy is mitigated by the ridiculization of the majesty of sorrow through the ridiculization of the zoomorphic little men. They are the mask through which we can pass over in laughter the difficulty of living.” (1984; p.2) Similarly, carnival is that mask.”

http://veniceandthecarnival.wordpress.com/2012/04/13/carnival-umberto-eco/

Doping and drug addiction are quite similar.  I had had 14-year-old patients addicted to heroin.  When working at Children´s Hospital, Buffalo, we were called to see a patient who did not respond to treatment for asthma.  The patient was from Puerto Rico and spoke only Spanish, after several hours of talking to him I found out that he was inhaling heroin and his asthma exacerbations were related to heroin use.  I discovered by serendipity the relationship between adrenergic-cholinergic receptors and its relationship to opioids receptors or simply, heroin withdrawal causing the lungs to overflow by secretions. Perhaps this relationship is not even in literature.  Empirically, it exists from my research.  I give a few years to researchers to find out.

On the other hand, we just found out that our cycling “children” are using EPO and testosterone.  The president from the Cycling Federation is from our town, and he knew about it before the scandal broke up.  The cyclist participated in the Junior World Championship last year and was caught at the airport in Spain bringing the drugs to Spain:

Spanish Customs Agents arrested Mexican cyclist Jose Alfredo Aguirre in April as he had both EPO and human growth hormone in his carry-on bag, according to Spanish sports daily AS.
AS reported that the 20-year-old athlete, who is part of the Spanish Mutua Levante elite U23 team, intended to smuggle the prohibited substances from Mexico to Spain. Aguirre supposedly carried the drugs for José Maldonado, who would give them to team director José Vicente Peidro, who was not available for comment, according to the report.
Aguirre told AS that he believed he was doing Maldonado a favor and did not know that he was carrying any prohibited substances.
"I did not know I was involved in a mess," he said. "I threw the bag in the suitcase without covering it. It was mixed with clothing. I didn't know I was doing anything forbidden, just a favour. However, I assume the consequences of my behaviour and any sanctions assigned to me because of this stupidity."
There have been no sanctions as of yet but an enquiry is now underway by the Mexican Cycling Federation.
"(The Mexican federation) has already met with Aguirre to determine if he will be punished on the basis of different factors and also to try and determine who assisted him apart from Maldonado, where they got the substances and what, if any, is the team's involvement," according to the report.
http://www.cyclingquotes.com/news/spanish_customs_agents_arrest_mexican_rider/

Are we going to do something about it? I doubt it, unless the International Cycling Union wants to do something, but this kid and the Mexican Federation are not important at all for the world.  This is the beginning and fortunately, we do not have the discipline to dope as Ferrari demands to be effective.  If we have the discipline to dope well we do not need any enhancing drug.  We have discussed this issue in previous posts.  Enhancing drugs are used mainly to cover up our out of order life; if we do not rest well because partying and not resting, testosterone is available to quicken recovery.  EPO is available if we do not train well; but at the end, if you do not have the proper technique and training we are going to be behind even with the so called enhancing drugs.

Why doping is recurrent? Because it is addictive in itself.

https://www.youtube.com/watch?v=sDW6vkuqGLg

Triathlon and Speed II

I am not a fan of Eisenhower but there are things related to our task that should be taken into consideration:

“Don't join the book burners. Don't think you are going to conceal faults by concealing evidence that they ever existed. Don't be afraid to go in your library and read every book…”

When we see evidence, we should not hide it if we want to improve.  There is a limit to generalize evidence, and it will depend on the stage of our knowledge.  We have to know better in order to improve.

There is research regarding neurons under low oxygen pressure.  We have an electronic device called oximetry which can measure oxygen saturation in blood indirectly, and it is non-invasive.  Normal people can tolerate 95% of oxygen saturation pressure measured by oximetry without getting short of breath. Below 93%, it precipitates shortness of breath indirectly because it corresponds to high CO2 in blood.  When working at the VA hospital we had Vets having 60% of oxigen saturation at rest without using oxygen at home; 55% was needed for the insurance to give oxygen at home.  By walking 50 meters and taking the blood gas sample standing, the Vets were able to score below 55%.  What is happening to our neurons when we do not have enough oxygen pressure?  There are studies done on animal (reptiles) and mammals to understand this phenomenon in order to help patients with strokes.  We are generalizing evidence because this kind of studies are related to speed training.

Is Exercise-Induced Arterial Hypoxemia in Triathletes Dependent on Exercise Modality?

We concluded that Exercise Induce Arterial Hypoxemia was greater during running than cycling for a similar metabolic rate corresponding to training intensity and that EIAH could thus be considered dependent on exercise modality.

https://hal.inria.fr/file/index/docid/720806/filename/sm290.pdf

There are generalizations in the above statement that needs to be addressed:

1)   The VO2 max is not the same for the different disciplines in these athletes; the CO2 drive and O2 drive would be trigger differently.  In other words, the metabolic rate is the same but the training fitness is not the same for the two disciplines; lactate threshold is not the same.

2)   The hypoxic drive is not that important; breathing drive:

Normal respiration is driven mostly by the levels of carbon dioxide in the arteries, which are detected indirectly by central chemoreceptors when carbon dioxide crosses the blood brain barrier, forming detectable Hydrogen ions, and directly by peripheral chemoreceptors, and very little by the oxygen levels. An increase in carbon dioxide will cause chemoreceptor reflexes to trigger an increase in ventilation. Hypoxic drive accounts normally for 10% of the total drive to breathe. This increases as the PaO₂ goes to 70 torr and below, while hypoxic drive is no longer active when PaO2 exceeds 170 torr.

http://en.wikipedia.org/wiki/Hypoxic_drive

Please read the article written by French researchers to follow me. 

 

3)   Are the French training more and more efficiently cycling than running?  As a coach, this would be my guess.  The CO2 diffusion is 20 time faster than the O2 diffusion, breathing more rapidly helps to lose CO2 instead of increasing O2 to the same degree.

4)   What we see is that hypoxemia is present when we are expecting the oxygen saturation not to drop more than 4% from baseline.

5)   Hypoxemia installs even when changing from running to cycling and stays there until the end of the exercise period.

6)   Transitioning appears to be necessary as training to improve our ability to cope with low oxygen pressure.  Swimmers sometimes train 400 meters running (all out) before sprinting swimming.

Let’s go back to our subject of how the neurons adapt to hypoxemia.  The subject of neurons adapting to low oxygen pressure is what gives SPEED.  Studies were done and sponsored to help patients with strokes when the O2 saturation decreases significantly.

http://jeb.biologists.org/content/205/23/3579.full.pdf

First, oxygen signaling is well developed in hypoxia-tolerant neurons, making them ideal models for studying signal transduction processes during adaptations to hypoxia. Second, hypoxia-tolerant neurons are useful models for distinguishing between injury and adaptation induced by hypoxia. This is of obvious interest in determining the relevance of proposed therapeutic interventions for patients with hypoxic or ischemic diseases. Third, these neurons may help in the identification of entirely new targets for treating diseases that involve hypoxia

This makes fartlek the training of choice.  Without the hypoxic episodes, short in duration and recovery al 60% with high cadence, the neurological changes to go fast does not exist:

Hypoxia Boosts Walking Ability in Spinal Cord Patients

Experimental models demonstrating that hypoxia therapy induces cellular and physiological changes in the nervous system that translate into beneficial plasticity and strength laid the groundwork for this new work, said Dr. Trumbower.
www.medscape.org