Triathlon and Anemia

Listening to Laura Esserman is necessary for somebody dedicated to taking care of patients:

https://www.youtube.com/watch?v=pqm9yoOAVjU

How can we protect ourselves from the human errors made by lack of judgment when analyzing data?  This is the daily work of most of us clinicians that help patients, reason why we should get pay or not.  Analyzing data should be for everybody but most of us are already involved in the system and we have difficulties to see what is best for patients. Or simply, we become psychopaths when not looking at this data.  Triathlon and sports (see the Olympics) are full of coaches unable to see mediocrity or poor training.  In Mexico people would say: “do not worry, nobody is going to die.”  Mexico is closing the Olympics with no medals sending 126 athletes to compete.  The cost of training for each one of the athletes is as high as any developed country or perhaps higher. How the above is related to the name of the post: triathlon and anemia?

I looked at the data of African nations regarding hemoglobin (hg), hematocrit (htc) and related measures.  It is the most efficient and economical way of looking at nutrition and recovery in athletes.  Anemia comes when nutrition and recovery are not adequate for the physical activity done by the subject.  The hg, htc and related measures suffer when we are not meeting the nutritional and recovery requirements according to the physical activity.  How are the Ethiopians and Kenyans meeting the requirements now when we see the African general population suffering from low hemoglobin?

 

Bekele had a hematocrit of 49 when competing which locates him above the 95^th percentile of the African population; that hematocrit does not come from African nutrition from what we know.  Gebrsellasie has a hematocrit more in accordance to African nutrition.  

We wrote an article related to the subject:

13 juin 2012

Ferritin and triathlon

I read that Kenenisa Bekele has had a hematocrit of 49, compared to the 42 of Haile Gebrselassie.  We do not have the conditions of how they took the blood sample to have a better context in order to say something about it.  In the same article, they also mentioned that Bekele has 250 of Ferritin and Gebrselassie 150.  

http://www.independent.co.uk/sport/general/athletics-bekele-ready-to-shred-the-record-books-6167676.html

I have not seen a Ferritin of 250 in natural conditions; a level that high is only attained by IV iron.  The majority of the Tour de France cyclists carry values above 500 because we know that transfusions and regular IV infusions take place.  Our athletes have the blood taken first thing in the morning during the recovery week.

Our ability to practice triathlon will depend on the hemoglobin/hematocrit values one is carrying according to the table below.  Great disadvantage takes place before even competing if our hemoglobin is below 15 for females or 16 for males.  The Africans have learned it well and now they make sure the hemoglobin/hematocrit is as high as possible.  We now have the African doping scandal.

But going back to the title of this post.  We are afraid of calling anemia when looking at the Hg values in Mexico and in Africa, but even changing the name as Laura Esserman suggested for “idle” cancer.  A treatment should be instituted if we want to compete at our maximum capacity, but negligence is present in the whole process as is the case of Mexico.  Education is the way but when it does not exist, doping becomes the only option to treat anemia and related problems (lesions, chronic fatigue, etc.).  Eufemiano Fuentes defended himself for the doping of cyclists saying that “he was curing them with blood transfusion and related substances.”  We will continue educating athletes which is our main goal.

30 janv. 2013

Operación Puerto and Triathlon

I will paraphrase what Eufemiano Fuentes mentioned during his interrogatory in court for the English speaking readers.  I copy from the newspaper Marca.  There are videos related to the interrogatory in the same newspaper. 

Fuentes is questioning the way doping is considered because he believes that he was treating anemia.  It is interesting because the dilution of blood when training is well known and could mimic anemia.  He mentioned that he was giving the amount of blood needed to get to the normal level, always using the same subject’s blood.  This does not sound incorrect from the point of view of a medical doctor except for the fact that the problem can be solved differently by administering the right amount of nutrients at the right time; instead of the blood itself. Fuentes says that time was the limiting factor; he needed to have ready the competitor in a few days or perhaps weeks.  But he knew also that the administration of blood was doping for the UCI rules.  Fuentes questions that there is a hematocrit value of 50 as an upper limit; but there is no low value accepted by the UCI to be treated.  He took care of his athletes because there is a danger in practicing cycling at a profesional level with a low hematocrit.

Fuentes also mentioned that who opened up the persecution by the police and the Operación Puerto, Jesús Manzano, was using cocaine, and Fuentes did not want to follow him up as a cyclist because of that reason.