Ferritin and Triathlon II

http://www.cmaj.ca/content/early/2012/07/09/cmaj.110950.full.pdf

Reading the article helps to understand even more Ferritin as a marker for many purposes.  I do not see why Ferritin is not used to unmask doping.  It is not possible to have a high level of Ferritin, above 100, if it is not obtained by transfusions or IV iron.  In 1999, over 45% of riders displayed ferritin values above 300 ng/ml and one fourth levels over 500 ng/ml. http://bjsm.bmj.com/content/38/6/704.full  After being tested for the first time in 1999, the Ferritin level in the peloton decreased a year later but the decrement was not significant.  The older the rider, the greater the quantity of iron, most likely related to transfusions from what we know now.  Ferritin can be elevated for medical reason, in the case of an inflammatory process but it will never reach values above 200; unless somebody is really sick or receiving Total Parental Nutrition (TPN).

The graphic below shows the year the cyclist is born and the average of the Ferritin level for the specific group.

The study done and published:  Br J Sports Med 2004;38:704-708 doi:10.1136/bjsm.2003.006635.  The authors timidly mentioned the fact that transfusions were taking place already among the members of the peloton.  It takes years to increase Ferritin with oral iron and IV iron is necessary at least three times a year to keep Ferritin close to 100 when having a well-educated athlete.  If we need to give IV iron every two months, it means that the triathlete needs a better education.  It means that there are problems with nutrition in general and many people doped in these conditions (give transfusions).  At the same time, we need the proper nutrition to increase red blood cells and hemoglobin.  Eufemiano Fuentes says that he was “treating anemia” when he was in front of the judge for “La Operación Puerto.”  Education is the solution to our problems!

PSYCHOLOGY OF THE TRIATHLON WINNER

 I specifically mentioned triathlon winner because we need different psychological profile for what we do.  We can be good at many things but we need a psychological profile for a specific thing.  Winning in triathlon needs a head able to learn constantly, reflecting upon experience.  My cousin, who was a boxer, told me once: “You should look for a hole between the arms and throw your punch without thinking.  That is the way to win.”  Triathlon is a different story and is becoming more sophisticated.

“Learning is experience. Everything else is just information.”

― Albert Einstein

At the same time, as Albert Einstein mentioned about standards and work:

"One should not pursue goals that are easily achieved. One must develop an instinct for what one can just barely achieve through one's greatest efforts."

--quote to Walter Daellenbach, May 31, 1915.

http://www.asl-associates.com/einsteinquotes.htm

Working every minute for what we need; an educational training at home and school.

"The value of a college education is not the learning of many facts but the training of the mind to think."

--New York Times, May 18, 1921; Frank 1947, 185; Brian 1966, 129, Illy, 25-32. Frank, P. 1947. Einstein: A Centenary Volume. Cambridge, Mass.; Harvard University Press.; Brian, D. 1996. Einstein: A Life. Hoboken, N.J.: Wiley.; Illy, J., ed. 2005, February. "Einstein Due Today." Manuscript. (Courtesy of the Einstein Papers Project, Pasadena.)

The following quotes say much about what is needed to succeed.

 "Example isn't another way to teach, it is the only way to teach." - Albert Einstein

"Education is what remains after one has forgotten everything he learned in school." - Albert Einstein

http://www.alberteinsteinsite.com/quotes/einsteinquotes.html#education

I always tell athletes: “Forget about earning your living practicing triathlon.  Practice to perfect your sport and success will come naturally and at the same time your way of living.”

"Work is the only thing that gives substance to life."

--quote to son Hans Albert, January 4, 1937.

"Science is a wonderful thing if one does not have to earn one's living at it. One should earn one's living by work of which one is sure one is capable. Only when we do not have to be accountable to anybody can we find joy in scientific endeavor."

--Letter to an admirer, March 24, 1951; quoted in Dukas and Hoffmann, Albert Einstein, the Human Side, p.57.

"A society's competitive advantage will come not from how well its schools teach the multiplication and periodic table, but from how well they stimulate imagination and creativity."

--Einstein to Vivienne Anderson, May 12, 1953, AEA 60-716.

I will end up the Psychology of the winner in triathlon with the following quote:

“The only thing that interferes with my learning is my education.”

http://thinkexist.com/quotation/the_only_thing_that_interferes_with_my_learning/15596.html

Champions need special education and not special psychology! But even then, Einstein says:

"After a certain high level of technical skill is achieved, science and art tend to coalesce in esthetics, plasticity, and form. The greatest scientists are always artists as well."

--Remark made in 1923; recalled by Archibald Henderson, Durham Morning Herald, August 21, 1955; Einstein Archive 33-257.

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/

Since I started with the Community Meetings I understood the reason of their existence.  It was also a way of evaluating how to proceed to have some work done; meaning how to make patients to take responsibility for themselves.  Sometimes, it was the only way to start a communication with patients by having this Community Carnival.  Everybody from staff was “attacked” by patients at certain point.  We needed to “play safe” in an out of the hospital to avoid being “attacked” by patients.  We avoided by all means to be crucified by the Community Meeting.  I SEE THE CARNIVAL IN THIS DOPING SCANDAL.

Now it is the turn for Rasmussen.  He wants to continue being involved in cycling.  What else could he do?

http://www.guardian.co.uk/sport/2013/jan/31/danish-michael-rasmussen-doping-years

Maître Fous is a good documentary.  Related to the subject of Carnival.