Steroid Nation

Reports suggest soccer star Ronaldo's early steroid use led to current knee injuries

A Brazilian physician sounded off, opining that international soccer star Ronaldo's pattern of knee injuries appear consistent with early use of anabolic steroids.  The Brazilian Football Conference (CBF) subsequently threw the doc under the soccer-bus, firing him following the Renaldo remarks.

Dr Bernando Santi suggested that Ronaldo's knee injuries resulted from doping that began when the soccer star came under the tutelage of a European professional team -- PSV Eindhoven.  Story at Goal.com.  (full name = Ronaldo Luis Nazário de Limarecent)

El Fenomeno’s career could be over after he ruptured the tendon in his left knee on Wednesday night. This is the third time that the player has suffered such an injury, and his career has been ravaged by similar physical problems over the past decade.

Ronaldo Was Doped

Bernando Santi says that the reason why Ronaldo has suffered so many injuries is because when he signed for PSV Eindhoven in 1994 as a 17-year-old, he was regularly pumped full of anabolic steroids in order to build up the player physically and help him grow.

As a result Ronaldo then developed muscles that were unable to co-exist with his knee’s bone structure, leading to devastating problems in later years.

"I spoke to colleagues in Holland who know people at PSV,” Santi told the daily Folha de Sao Paulo.  “I did not get to talk to PSV doctors. They gave supplements to Ronaldo, who was very thin, and among those supplements they included some anabolic substances which could make him grow a bit more.”

Santi is in no doubt that it was these drugs that have caused the injuries.  "It is a consequence of having grown beyond what his muscles were prepared to grow," he insisted.
"He gained muscle mass very fast, when he still had not reached maturity. The bill for the use of steroids shows up long term, 10, 15 or 20 years later."

Dr Santi isn't the only physician who believes Ronaldo blew out his knee:

Brazilian legend, Socrates, who is actually a fully qualified doctor in medicine, says that Ronaldo’s problems are as a result of the “abuse” he was subjected to earlier in his career.

"This was a pre-announced injury," the ex-Corinthians and Fiorentina star said.

"There is a difference between Ronaldo's muscle mass and the tendons on his knee. We have all seen Ronaldo grow too fast at the start of his career. That destroyed his knees forever.”

Interesting take on the soccer star's knee injuries.  Almost impossible to prove without a long term epidemiological study, the relationship between over-developed muscles of an athlete due to steroid use, and later-life tendon and ligament injuries remains intriguing.

 

Did MLB physician -- Cornell's Millman -- warn Rocker, I-Rod, A-Rod, and Palmeiro about steroids?

Former pitching flake John Rocker claimed yesterday that (NY Daily News) lectured 4 Texas Rangers, including A-Rod, I-Rod, Raffy Palmeiro, and Rocker himself on steroids use.

The loudmouth former reliever said he and then-Rangers teammate Alex Rodriguez, among others, were advised in spring training of 2002 by management and players' union doctors on how to use steroids in a way that is "not going to hurt you."

Rocker said a doctor hired by the Players' Association pulled aside himself, A-Rod, Ivan Rodriguez and Rafael Palmeiro following a spring training lecture and candidly told them how to use steroids.

"Look guys, if you take one kind of steroid, you don't triple stack them and take them 10 months out of the year like Lyle Alzado did," the doctor told him, Rocker said yesterday during an interview on the Buck and Kincade Show on WCNN-680 The Fan in Atlanta. "If you do it responsibly, it's not going to hurt you."

Alzado, a former Oakland Raider, died of brain cancer in 1992.

Interesting that the Mitchell Report named a couple physicians who lectured baseball too.  Mitchell was not kind in relating their story.  One is substance abuse expert Robert Millman who teaches at Cornell Medical Center.

During baseball’s winter meetings in Nashville in December 1998, baseball executives and team physicians heard a presentation from Dr. Millman and Dr. Solomon on baseball’s drug policy. One attendee, Dr. William Wilder, was then the team doctor for the Cleveland Indians. In a memorandum to then Indians general manager John Hart that he wrote after the meeting, Dr. Wilder reported that the presentation focused on the benefits that could be obtained from testosterone. He was disturbed by the presentation, observing in the memorandum that whether or not testosterone increased muscle strength and endurance “begs the question of whether it should be used in athletics.” He believed there was “no reason that some preliminary literature can’t be sent out to the players concerning the known and unknown data about performance enhancing substances,” and recalled that Houston Astros’ team physician Bill Bryan presented a good overview of these issues with respect to supplements at meetings the previous year.   Dr. Wilder reiterated these observations and views in our interview with him.

Bill Stoneman, who retired in 2007 as the general manager of the Los Angeles Angels, had a similar recollection of a presentation by Drs. Millman and Solomon. He remembered wondering at the time why Major League Baseball had permitted the presentation, which to his recollection included the assertion that there was no evidence that anabolic steroids with the message of leniency that was being conveyed.

Huge new blood doping scandal simmering in Europe?

Reports tricking out of Germany may be the cusp of an emerging blood doping scandal. The Velo News presents the issues:

The new year is just days old and cycling is already looking head-on at another potentially explosive doping story.

The German public television station ARD reported Tuesday that Michael Rasmussen as well as his former Rabobank teammates Denis Menchov and the now-retired Michael Boogerd were among 30 elite athletes said to have used an Austrian-based laboratory for banned blood-doping practices.

ARD also alleged that biathletes and Nordic skiers used the Humanplasma lab, which has facilities in Vienna.

Officials from that office refused to comment when contacted by VeloNews late Tuesday and said a lawyer would be addressing questions Wednesday. However, German biathlon officials were quick to deny the allegations, as were Boogerd, retired Austrian pro George Totschnig and interim Rabobank manager Henri van der Aat.

There is a follow-up account here at AFP.

The Tour de France pulled the plug on Rasmussen last year, despite his race lead for suspected doping.

More steroids for the stars: Internet pharmacies putting some juice in those entertainment acts

As long as we are calling out for George Mitchell to investigate doping, he might as well hit up Hollywood too.  The Albany Times-Union reports on roods for the raunchy.  Recent stories here include Sly Stallone and recording piano artist Tzimon Barto.  (Stallone was busted for anabolic steroids and HGH last year in Australia)

The Times-Union names entertainment luminaries:

The names of R&B music star Mary J. Blige, along with rap artists 50 Cent, Timbaland and Wyclef Jean, and award-winning author and producer Tyler Perry, have emerged in an Albany-based investigation of steroids trafficking that has already rocked the professional sports world, according to confidential sources.

The entertainment stars must be using the drugs for appearance, and anti-aging.

...medical experts say that use of steroids and human growth hormone -- an estimated $10 billion-a-year operation worldwide -- reaching into the entertainment industry illustrates how pervasive steroids use in the United States has become. It is not unique to athletics, where performance-enhancing drug use has marred many sports. For many celebrities, the lure of hormonal drugs is their supposed, unproven anti-aging effects.

Just like the MLB players who shipped juice to the ballpark, the stars ship the gear to the gym or the studio or the hotel:

Records shared with the Times Union and information from several cooperating witnesses on Long Island indicate Blige and other stars were shipped prescribed human growth hormone or steroids -- sometimes under fictitious names -- at hotels, production studios, private residences, an upscale Manhattan fitness club and through the Long Island office of Michael Diamond, a chiropractor affiliated with the celebrities, sources said.

Diamond, who has not been identified as a target in the case or accused of breaking any laws, helps run an anti-aging program at Clay Gym in Manhattan, according to the company's Web site.

The Albany investigation became a nationwide spectacle last February when authorities raided a Palm Beach County wellness center and the offices of Signature Compounding Pharmacy in downtown Orlando. The wellness center's owners and the pharmacy's operators are awaiting trial in Albany on charges related to the sale of millions of dollars worth of prescription drugs, mostly steroids, through a suspected criminal enterprise involving allegedly corrupt physicians and a series of anti-aging "clinics" that advertised predominantly through the Internet.

The gym in New York is run by a chiropractor -- Michael Diamond, who must be known to more than a couple stars:

Still, it appears evident Diamond caters to famous clients as evidenced by the many stars, including Steven Seagal, whose photographs -- some autographed to Diamond -- adorn his office's walls.

"Because of this recent development as far as what I found out was going on with (Signature) pharmacy I was approached and I was ... told not to discuss anything right now ... because there's investigations going on," Diamond said, not elaborating.

The Times-Union goes on to discuss the corrupt professionals -- physicians and apparently chiropractors -- who dispense these drugs on bogus grounds.  This could use some cleaning up, and New York Senator Charles Schumer plans on pushing a bill to qualify HGH as a controlled substance, like anabolic steroids.

The report contains a delightful quote from our little friend, the Albany DA:

"They're living the lifestyle of the Tony Montanas of the '70s and '80s because they're drug dealers," Soares said, referring to the character made famous by Al Pacino in the movie Scarface. "Our purpose here is more regulation. We want consistency state-to-state and we want tougher regulation over this cyber-economy that right now pretty much anyone with a computer can go out and obtain ... things that shouldn't be obtained without the control or observation of a treating physician."

Ex-Senator Mitchell probably doesn't want any more problems after all the MLB brouhaha.  Too bad; he is needed everywhere it seems.

Mind doping: The next generation of enhancement

Several news article focus on 'mind doping' or maybe we should call them "Cognition Enhancing Drugs (CEDs)'.

Nature calls the drugs 'Professor's Little Helper'.  Stories also in The London Times, and the Atlantic.  Nature states:

Today there are several drugs on the market that improve memory, concentration, planning and reduce impulsive behaviour and risky decision-making, and many more are being developed. Doctors already prescribe these drugs to treat cognitive disabilities and improve quality of life for patients with neuropsychiatric disorders and brain injury. The prescription use of such drugs is being extended to other conditions, including shift-workers. Meanwhile, off-label and non-prescription use by the general public is becoming increasingly commonplace.

Although the appeal of pharmaceutical cognitive enhancers — to help one study longer, work more effectively or better manage everyday stresses — is understandable, potential users, both healthy and diseased, must consider the pros and cons of their choices. To enable this, scientists, doctors and policy-makers should provide easy access to information about the advantages and dangers of using cognitive-enhancing drugs and set out clear guidelines for their future use. To trigger broader discussion of these issues we offer the following questions, to which readers can respond in an online forum. Now, on to the questions.

Mind Hacks describes things this way:

These are the same drugs that have caused concern about their level of use among students, chiefly modafinil (Provigil) and methylphenidate (Ritalin), although other drugs such as Alzheimer's medication donepezil (Aricept), non-amphetamine ADHD drug atomoxetine (Strattera) are also candidates.

The issues are delineated:

Many of the ethical concerns centre around a potential future where brain enhancing interventions are largely available to the wealthy, leading to a 'brain gap' where the less well off will have relatively poorer mental functioning because they can't access the same cognitive benefits.

Not to mention cheating.  As with HGH, only the relatively wealthy can benefit from this sophisticated cheating.

So there is something to 'think' about this year at holiday time.

Here's wishing everyone very happy and much enhanced holidays.

The 'Roid Report debuts on Epic Carnival

The huge news today included a devastating day on the college football gridiron as #1 Mizzou and #2 West Virginia lose, a nasty ice storm pounds the Midwest, and our weekly report on PEDs debut at Epic Carnival -- The 'Roid Report.

As we noted in a post last week, sports stories consist of 4 items now:

• Action on the field
• Contracts, free agents, and trades
• Legal troubles
• Steroids and PEDs

We should add these issues:

• Injuries
• and the BCS

The 'Roid Report will document the week in PEDs.  Performance Enhancing Drugs appear here to stay, and here to cause scandal after scandal.  We feel that the failure of society and leadership to come to grips with the ethics of scientific advances, and the limits of medical technology has led to the problems with PED use.

Rather than discuss how the managers in the front office of the teams, the athletes who play the games, the fans who watch the games, and the medical professionals who treat the athletes all think about performance enhancement, 'we' treat the issue like an exercise in forensics: bad boys and bad girls cheat.

There is an element of cheating in current PED use as the code of ethics is currently constructed.  However, the use of PEDs should be discussed in terms of results, side effects, long term consequences, ethics, and economic feasibility.   We hope we can advance this discussion.

Whithered testicles: Brits say boys as young as 11 use 'roids to impress the ladies

In a shocking expected (of course kids emulate their idols) new study, The British Council on the Misuse of Drugs announced that boys as young as 11 use steroids to get that slugger's physique, to impress the girls and win friends.  Worse yet, some emulate boy band members. From the Daily Mail:

The Advisory Council on the Misuse of Drugs said there was increasing evidence of youngsters injecting the bodybuilding drug, which can lead to rapid muscle growth. It came as they confirmed they are reviewing the legal status of ecstasy as well as cannabis.

A survey found one in every 200 11-to-16 year olds had tried steroids.

Committee member Lord Adebowale: "These are being used not just by athletes but by people who want to be in boy bands and get girls."

 

The British Govt expresses extreme consternation about the most serious of all steroid effects:  acne, breasts, and whithered testicles"

The advisory council will write to Home Secretary Jacqui Smith to warn about the trend, which can lead to long-term health problems for children – including sterility, acne, liver tumours and the growth of breasts in boys.

"It can also make the testicles wither – which is probably not what the users want," said Professor Sir Michael Rawlins, the chairman of the committee.

"Even more worrying, there is emerging evidence that anabolic steroids cause aggression.

"I am really very worried about that. I shall write to the Home Secretary explaining our very grave concerns about this."

If the current state of bullocks weren't bad enough, think of all the potential shrinkage in the years leading to the 2012 Olympics in London:

 

They also fear a boom in use of the drug by athletes in the run-up to the 2012 Olympics. The figures revealed that 200,000 people in Britain have tried anabolic steroids, with 42,000 saying they had used them in the last year.

 

London Bridge ain't the only thing  falling down across the pond.

German pole vaulter Buschbaum admits to testosterone use: for sex change procedure

German pole vaulter Yvonne Buschbaum, a medalist at the Sydney Olympics, announced yesterday she will forgo her life as female, and vault over to the other side of the aisle.  Bloomburg with the story:

German pole-vaulter Yvonne Buschbaum, the ninth-best jumper on the all-time list, is quitting the sport to become a man, Saarbruecker Zeitung reported.

Buschbaum, who was sixth at the 2000 Olympics in Sydney, will undergo a gender-change operation involving hormone treatment, she told the western German newspaper.

"For the most part my decision is the result of my psychological imbalance,'' Buschbaum told the newspaper. "For many years I've felt a sense of being in the wrong body.''

'Hormone treatment' means testosterone injections for Ms. Buschbaum. Those would be legal testosterone injections, not the kind Greg Anderson ascertained from AIDS patients in the streets of San Francisco.

More details surface in swimmer Rebeca Gusmoa scandal: the old urine switch trick

Did Brazilian swimmer Rebeca Gusmoa use a little extra testosterone on her morning Wheaties?  Or does she have polycystic ovary disease producing high testosterone?  Does urine produced in her kidneys match the urine sent in the test tube?  Tune in tomorrow as this episode is swimming with intrigue.

Thus far, the international governing body for swimming (FINA) suspended Pan Am gold-winning swimmer Rebeca Gusmao when she tested positive for high testosterone -- not to mention huge muscles and burgeoning acne.  Gusmao countered by saying she has PCOS that she told FINA about 4 years ago.

New information says that some of the urine samples Gusmao produced were not even from her own bladder.  Her Brazilian swimming doctor accompanied her to each doping test, thus raising suspicions about the doctor's honesty...and more.

SwimNews.com carries this story:

Alexandre Pussieldi at bestswimming.com.br is the man on top of the Rebeca Gusmão case - and it seems he may have unearthed a scandal that will rock not only Brazilian swimming but may require the intervention of FINA under rules that hold doctors, coaches and others responsible in doping cases where darkness is found to lurk.

1. The LADETEC agency announced that four of the tests of the swimmer at the Pan Am Games were negative. That is not strictly the case - nor is is for a laboratory to provide such detail. Only positive results are announced, first internally and then beyond when the case is made public.

2. Dr. Eduardo De Rose, President of the Games Medical Commission, has concluded that the samples said to have been provided by Gusmão are not from the same person, according to the differing DNA uncovered by analysis

3 - and here's the real wrap: Dra. Renata Castro, the medical director of the Brazilian federation who accompanied the swimmer to all tests except the one that produced a positive result at the Pan Ams, has resigned.

And hints of a more sinister nature; a nice doctor-athlete intimate relationship scandal:

Speculation from good sources in Brazil talks of a 'strong' relationship between the swimmer and the doctor, one that has atrtracted negative comment from team swimmers and coaches. but not, so far, from the federation.

Ex-MLB player David Segui details his steroid / PED use

In an incongruous interview with ESPN's Mike Fish, former MLB player (the Orioles and other teams) David Segui details his PED use. Segui meanders around with logical fallacies falling like split fingered fastballs.

Segui says that HGH and PEDs should only be taken under a doctor's supervision, yet he admittedly took these drugs covertly.  Furthermore, an ethical sports medicine specialist, orthopedic surgeon, or team doctor is not going to risk a federal offense by dispensing HGH, a controlled drug, for a suspect off-label use.

David Segui, taking a break on a recent morning from a cardio workout in the large gym and fitness center situated on his country estate, isn't mincing words.

Yes, he used performance-enhancing drugs late in his 15-year career in Major League Baseball. And he doesn't feel guilty about it.

"Obviously, I've done 'growth,'" says Segui. "I'm not going to tell you I never took a 'greenie' [amphetamine]. I'm not going to tell you I never tried steroids before.

Segui admits to illegal use of HGH.  [Using HGH for performance enhancement is clearly illegal.  Ask Dr. James Shortt, physician to the Carolina Panthers, who went to jail for illegal PED prescriptions including HGH. (Mark Zeigler's fine review here)]

Segui first disclosed his use of human growth hormone to ESPN last year. He acknowledges that he has had a doctor's prescription for HGH One of sport's most controversial and undetectable substances -- since 2001, when he was diagnosed with low levels of the hormone. But he also admits now that he used it before then to speed up his recovery from a hand injury.

Thus, Segui admits he violated federal controlled substances acts, on multiple occasions by illegally using HGH and anabolic steroids. How do these guys get away with blatant flaunting of narcotics and controlled substances laws?  Imagine David Letterman announcing he uses meth to get motivated for his show.  Or Rudy Guillini saying he buys Adderall on the street to control his weight.

Segiu continues to use HGH.  He claims HGH deficiency. Maybe those years of steroid and HGH abuse caused his 'HGH deficiency. Or maybe he frequents 'anti-aging clinics'.

Segui, now 41 and in his third year of retirement from the game, no longer worries about his next contract or how to stay on the field. But he says he continues to follow a doctor's orders in dealing with a hormone deficiency. He keeps the prescribed synthetic growth hormone in his refrigerator. First thing in the morning or last thing at night, he grabs some loose flesh around his stomach and injects himself.

Years more of HGH use might mean cardiac problems, diabetes, carpel tunnel syndrome, myopathy, and even may increase the rate of a malignancy growth (cancer).  Just saying...

The article does contains this canard:

Major League Baseball didn't ban human growth hormone until early in 2005, though the drug had been around the game for at least a decade prior to that. Segui told ESPN.com he first used it during the 1998 season when he was with the Mariners, without the knowledge of Seattle's training and medical staff.

Look, it is irrelevant if 'baseball banned' HGH in 2003.  The substance is a controlled drug which is illegal without an ethical physician's prescription for treating a real disease.

 

Swimmer Gusmoa says ovarian problem caused elevated testosterone

Rebeca Gusmoa, the Brazilian Pan Am swimming champ suspended for high testosterone, say her hormonal abnormality stems from an ovarian disease.  That could be a possibility.  Story at Swimnews.com.

Polycystic ovary syndrome (PCOS) does produce high testosterone in women.  PCOS occurs when the ovaries produce too much androgen (testosterone).  The symptoms include menstrual irregularity, infertility,  hirsuteness, acme,  weight gain (obesity),  baldness,  high cholesterol and high blood pressure, and type 2 diabetes.  Some researchers believe PCOS might be caused by insulin.

Note the weight gain is in the waist, producing obesity rather than muscular definition.  What does syndrome looks like in a world class swimmer? Female swimmers develop broad shoulders and strong backs.  Might the physiology be different in a top athlete?  Shouldn't the other symptoms be present: too much body hair, acne, baldness, etc.

We have seen PCOS produced by drugs.  Could PCOS be caused by use of testosterone, as in doping?  Gusmoa shows the acne in the close up photo.  Her physique appears radically altered; she looks twice as large as her competitors.  Gusmoa claims doctors diagnosed PCOS in 2003; she says she wasn't treated.  (treatment consists of progesterone, and other measures if the blood sugar becomes uncontrolled; oral hypoglycemics for blood sugar, and other medicines for hypertension, acne, fertility, excess body hair).

An important finding would be is the testosterone in Gusmoa's sample shows synthetic qualities.  Since PCOS would produce natural T, the proof is in the lab.

Of Gusmoa does have PCOS, then she should have alerted FINA to the max.  She says she did; did FINA listen?  This could be interesting.  (more on Gusmoa and PCOS after the jump)

The myth of growth hormone -- HGH -- in sports medicine

(Update, we found this Swedish report on HGH and postive effects with tendons)

You heard this excuse in the past, and you may hear this excuse in the future.  And we can see no legitimate scientific evidence to indicate that this statement carries clinical meaning. (Jeff Pearlman -- ESPN -- is tired of excuses too)

"A doctor prescribed HGH for my _________ injury" (fill in the blank with shoulder, elbow, knee, hip, ankle).

We work a floor above a world renown orthopedics clinic, which we and family visit on a regular basis with ________ (fill in the blank with shoulder, elbow, hip, knee, ankle, groin) injuries.  Family members have competed for years at the highest level in college and high school and recreational sports including Drake Relays, state championship games and tournaments in basketball, track, and football, experiencing those common injuries, in spades.  Not once in those plethora of injuries have the words 'growth hormone' and 'treatment' been uttered in the same paragraph.

Perhaps only the professional athletes get the goodies?  We searched PubMed, the National Institutes of Health online database of a zillion medical articles over a million years...essentially the online Index Medicus for those old enough to remember that humble 1000 pound series of medical and scientific reference volumes.

A search on growth hormone brings up about 56,000 reference articles.  Ankle injury reveals 5600 reports.  Combining the two search terms brings up 0.  That's right no medical reports on HGH and ankle injuries.

'Orthopedic' unearths 48,000 hits.  HGH and 'orthopedic' pairs this down to 48.  These 48 contain research on the use of HGH in children with cerebral palsy, Turner Syndrome, McCune-Albright Syndrome, and...well you get it, not much on the use of HGH in sports medicine.

Studies mentioned problems with HGH, more than orthopedic healing solutions:  carpel tunnel syndrome, scoliosis, and other 'side effects'.  Oh yeah, level of HGH did not predict clinical outcome of total knee replacement in older men, but you already knew that.

There was a 1963 report on HGH and thyroid hormone in bone fracture healing, however that citation is so old, no abstract was given.

Thus, either the use of HGH in sports medicine, orthopedics, and rehab medicine is either a huge secret that is withheld from other physicians, or the reports of same are a scam.

Any physician using HGH for healing (unless it would be related to burn injuries, AIDS, and children with short stature) is practicing myth, heresy, chicanery, or quackery.   Could those 'doctors' be would-be trainers, strength coaches, practitioners of 'anti-aging clinics', or hallucinations?

Borrowing a paragraph from a sports medicine physician:

Unfortunately, there is an absence of well-designed clinical trials that support the use of HGH as a supplement.  An article written in 2003 addressed the misuse and potential side effects of HGH.  A large clinical trial that included 131 men and women showed some changes such as an increase in blood glucose levels and an increase in blood pressure.  There were also some musculoskeletal complaints such as swollen joints and carpal tunnel syndrome.  All of these changes stopped when the medications were stopped.

German researcher documents tragic effects of steroids on German athletes and their children

Faust's Gold documented the former East German doping machine that produced an incredible number of world records, and Olympic gold medals including the women's 400M world mark held my Marita Koch.  The doping regime culminated in 13 women's swimming gold medals at the 1986 Montreal Olympics.  The systematic doping also produced birth defects in their children, and emotional problems in the former GDR athletes.

The doping machine isolated gifted German Democratic Republic athletes for intense training, surreptitious administration of anabolic steroids, and biological testing done to beat the anti-doping tests.  The doping machine included trainers, physicians, coaches, government officials, the Stasi (GDR secret police), and politicians to the highest level.  Now it appears that the doped athletes continue to suffer heinous consequences from the covert anabolic steroids they ingested or injected.

German research physician Giselher Spitzer, presented evidence to the Play the Game conference in Iceland, that documents the horrific results of anabolic steroids given to teenage women.  The Sydney Morning Herald carries the report.  Most striking was the high rate of birth defects suffered by these athlete's children:

THEY are the 69 children of a small part of the drugged generation of sporting stars. But instead of inheriting their parent's athletic ability, the children have been shown to have serious medical issues at rates much higher than that of the general population. Seven have physical deformities and four are mentally handicapped.

Frightening damage from East Germany's systematic doping of two decades of elite and promising sports stars in the 1970s and '80s has emerged in the next generation, according to the German researcher Giselher Spitzer.

A recently published two-year study of 52 Olympic and elite-level former East German athletes, now aged between 40 and 60, conducted by the Germany University, Humboldt, has revealed shocking medical consequences of the forced consumption of anabolic steroids.

Dr Spitzer said in addition to the high rate of physical and mental handicaps in the offspring of the 52 athletes, more than a quarter of the children have allergies and 23 per cent have asthma.

He said the risk of miscarriage and stillbirth in the athletes was a staggering 32 times higher than in the normal German population.

The athletes themselves suffer consequences from the past steroid abuse:

...38 per cent had severe depression with suicidal tendencies and 32 of the 52 had had therapy for psychiatric issues. Dr Spitzer said the study revealed a quarter of those studied had suffered some form of cancer.

As Robin Parisotto states in Sportigo:

It seems that for some athletes the rewards totally outweigh the risks. This drug is the one that was force-fed to thousands of East German athletes as part of its state-sponsored doping program; anabolic steroid. These anabolic steroids are still producing unintended consequences further compounded by the fact that off-spring of athletes involved in the massive doping program are now suffering as well. Dr Giselher Spitzer from the Humboldt University in Germany has just released the frightening numbers above, ones which echo many previous stories.

For the protagonists of legalized doping, take a good hard look at Dr Spitzer's report and try and convince the public that legal doping would overcome the current problems. In any case why should the rights of the cheats trample over the rights of athletes who do not want to take drugs which may cause real medical problems later in life? Have the cheats lost sight of the fact that sport is in this bloody mess because of their actions, not the actions of clean athletes. When the ‘corporates’ invaded sport and waved the cheque books in front of them they could have said no to doping.

Remember, Victor Conte designed BALCO along the lines of the East German doping machine.

Curve balls from steroid and HGH apologists

The revelation that Cleveland Indian Paul Byrd used HGH for several years hit the press the evening of the Tribe's huge game against Boston.  Conspiracy theorists immediately pointed to the timing of the San Francisco Examiner's release of the story and the time frame of the playoffs.

While it is true that George Mitchell is a Boston Red Sox executive, we would suspect that former Senator Mitchell's sense of fair play and his integrity were not compromised by leaking the material to the Chronicle to sabotage the Tribe.

Often when discussing PEDs, the facts become harder to find than a knuckle ball in a rainstorm.  Example: The Baseball Prospectus distorts the facts on HGH and PED use in sports.  This report says Byrd used HGH to treat a HGH deficiency.

Byrd was using hGH under doctor’s orders after the discovery of a small, non-secreting pituitary tumor that may have resulted in lower-than-normal levels of hGH.

The majority of pituitary tumors secret excess hormones.  A minority (called 'clinically nonfunctioning pituitary adenoma') do not secrete excess hormones, but rather impede the secretion of hormones because of the LARGE size of the tumor.  These 'tumors' become invasive to surrounding tissue, presenting with symptoms such as severe headache, visual field cuts, and hormonal problems.  After a complete medical workup these tumors should be removed - which then may also cause hormone deficiencies.

The 'Prospectus goes on:"

Was Byrd’s use illegal?

First, we must note the difference between the terms “illegal” and “banned.” Illegal denotes a use contrary h governmental laws or regulations. Byrd’s use, by prescription and for an FDA-approved condition, was not illegal.

Sigh.  There is no 'FDA-approved condition'.  First the FDA approves 'indications for marketing', and does not mandate medical practice.  Second the FDA does not 'approve conditions (diseases)'.

There is little evidence for 'Adult Growth Hormone Deficiency', beyond what we outlined above.  Any other definition borders on fad, used as marketing by Anti-Aging Clinics.

The Prospectus piece contains other errors: a misunderstanding of Internet pharmacies, and a misunderstanding of controlled substances.   It is not legitimate to prescribe a drug based on a phone contact or a questionnaire, without a face to face meeting.  (note the smoke coming from our computer at this point)

----------------------------------------------------

The practice of medicine does not adhere to the principles delineated in press reports, press conference, and excuses contrived by athletes who use banned substances.  Thus, we are incredulous that by virtue of the excuses athletes use, some writers/fans accept that standard treatment of a sore elbow requires HGH.

Standard treatment of tendon or ligament injuries does not consist of HGH.  Medical practice does not mandate HGH for the recovery of athletic injuries.  A strong statement of the uses and abuses of HGH can be found from the British Medical Journal.

An athlete may be prescribed a banned drug with the recommendation of a physician,  If that is the case, the physician and athlete fill out a TUE -- Therapeutic Use Exemption.  Drugs banned by the sports administrations -- WADA, MLB, NFL, NCAA -- may be legitimately used if the athlete files a TUE.  For instance an athlete with ADHD could file a TUE for dextroamphetamine use.

If the athlete does not file a TUE while taking the banned drug, he is in violation of the rules, and in fact engaging in drug abuse, with regard to the sport.

Furthermore, another curve ball thrown out to the public is the 'Banned in 2005'.  The fact of the matter is that MLB banned PEDs in 1991, and reiterated the ban 1997 well before 2005.  Furthermore, it is CLEARLY illegal for any physician to prescribe HGH or anabolic steroids, or amphetamines for the purpose of athletic enhancement.  In the case of anabolic steroids and amphetamine, both of which can enhance performance, medical tradition has determined that the nonmedical use of these drugs to enhance athletic performance is unethical.  (In the case of HGH, there is little evidence that the drug enhances healing of sports-related injuries such as tendon injuries)

Feds say Benoit given excess steroids by local doctor

The Atlanta Journal-Constitution reports the federal attorneys looking into Chris Benoit's doctor, Phil Astin, say the physician prescribed excessive anabolic steroids.  We say 'not so fast our friends'.

Our position for some time has been that Benoit's behavior was affected by anabolic steroids, however that the sad homi-suicide of his family resulted from a multifactorial situation of chronic brain trauma, anabolic steroids, benzos, narcotics, and stress.

Federal prosecutors say the amount of testosterone prescribed to professional wrestler Chris Benoit by his doctor was "excessive" and want the judge to dismiss motions to suppress evidence seized in the case.

U.S. District Attorney David Nahmias has asked Judge Russell G. Vineyard to proceed in the case against Phil Astin III, the Carrollton doctor indicted on seven federal counts of over-prescribing to two unnamed patients. Officials have said that Benoit, who killed his wife and child in June before taking his own life, was not one of those patients.

Astin is currently suspended from practicing medicine, and essentially on house arrest.  The Gov't says the followed (from the AJC):

Officials cited records from Jones Pharmacy in Fayetteville showing seven testosterone prescriptions Astin wrote for Benoit from May 2006 to May 2007, calling them "an excessive amount of testosterone cypionate."

"Each prescription dispensed a 10-month supply of the drug," authorities charged, "yet the pharmacy filled seven of these prescriptions in a 12-month period."

That is weird prescribing frequency.  The math sounds funny...'dispensed a 10 month supply, seven times in 12 months'. Usually physicians work in multiples of months, such as 5 refills of a one month supply.

However, when examined closely this isn't so weird.  Testosterone cypionate is 100 mg per 1 cc.  The drug can be dispensed in a 1ml or a 10 ml vial.  The usual dose (reference to follow) is 50 mg to 200 mg every 2-3 weeks.  The Feds must be thinking that a typical dose is 50 mg every 2 weeks or 100 mg per month.  Thus a 10 ml bottle, which has 1000 mg would be 10 months supply as mentioned above.

That is very arbitrary.  A doctor could prescribe 200 mg every 2 weeks, or 400 mg per month.  A 10 ml vial would then last 2 1/2 months.  The dose could be higher too.

The Feds point to the PDR, which gives 'guidelines' for prescriptions;  however the PDR or the FDA guidelines are not the practice of medicine.  If anything those documents are aimed at the marketing of the drugs.

A physician might prescribe as much testosterone as it takes to place the patients measure serum testosterone in the normal range.  Thus a 10 ml vial of T cypionate might cover only a couple months or less.  Seven refills over 12 months might not be excessive at all.

We are not advocating that Benoit's doc was exactly right on; in fact it sounds like some of his practices were shoddy.  However, the statement from the Feds is some prosecutorial hyperbole that would not be borne out my medical practice.

The government said it also recovered other pertinent files showing that Astin had provided "take-home syringes" of Demerol to one of his staff members.

Authorities also allege Astin violated federal law by issuing multiple undated prescriptions for controlled substances to unnamed patients. Federal law mandates that such prescriptions be dated and signed on the date they are issued.

Illegal performance enhancing drugs -- anabolic steroids and HGH -- banned by MLB as early as 1991

In the discussion of HGH use by the Cardinals' Rick Ankiel, media and baseball pundits say that performance enhancing drugs were not banned before 2003/4.  If that statement is accurate, then MLB allowed illegal drug use.  Professional sports, although not following through with a comprehensive anti-doping testing program, long ago prohibited the use of anabolic illegal drugs in players and other personnel.

Also heard frequently, and just as inaccurate, is 'HGH is used for injury rehab'.

Baseball clearly banned illegal drugs (logic tells you illegal drugs are 'a priori' banned anyway) in 1991 (see image of memo) when Fay Vincent reigned as commissioner.  Commissioner Vincent stated "the use of illegal drugs by players, office personal, trainers or anyone else involved in the game cannot be condoned or tolerated" (see image to the left; reference here).  That means any black market drugs, such as cocaine or anabolic steroids are prohibited.  That includes illegal use of unethically prescribed drugs like HGH for faddish 'recovery' indications.  The Vincent memo says violators are subject to unspecified discipline.

In 1997, Commissioner Bud Selig, essentially  copied Vincent's memo reiterating that illegal drugs are prohibited in the pro baseball.  The memo specifies the policy, testing, and possible punishment (to the right, and above reference).

HGH is not approved for any PED use, nor for injury recovery.  (Reference here; see below)  A doctor's prescription for an adult athlete raises serious issues, and may lead to criminal prosecution (as with Dr Shortt who prescribed HGH to the Carolina Panthers' players)

Internet pharmacies also violate current FDA prescription rules (References here, and here.  There is no legitimate doctor-patient relationship in this prescriptions.

Signature used a quasi-prescribing scheme, noted here:

The document charges two people with conspiracy, illegal distribution of human-growth hormone and other steroids as well as health-care fraud. It also states Daniel McGlone of American Pharmaceutical Group in New Jersey peddled the drugs to bodybuilders and used Signature to fill prescriptions written by unlicensed or retired physicians.

"McGlone would forward these prescriptions via facsimile or mail to various large compounding pharmacies, including primarily Signature Pharmacy . . . to deliver human growth hormone, anabolic steroids and other prescription medications to customers all over the United States," the indictment reads.

We will develop a longer post on the prescribing practices and logic behind these drugs.  Suffice it to say that there has never been adequate research, nor an FDA indication, for using HGH as an aid when rehabbing athletic injuries.  The anti-aging clinic scams do not legitimize, nor legalize the use of HGH or anabolic steroids to rehab sports injuries (reference here).

The anti-doping milestone of 2003 (or 2004 when testing began), oft referred to in media reports, is simply the year that MLB decided to implement a more serious PED testing program.  The current anti-doping program is not perfect: As Victor Conte of BALCO fame says "You can drive a Mack truck through the current anti-doping program loopholes".  To say that HGH or anabolic steroids were allowed in Major League Baseball before 2004 is both inaccurate and misleading.

Here is an excellent reference on debunking the anti-aging effect of HGH.

Congressional hearings on pro wrestling

With all the pressing serious problems facing this country, and the world, one must register surprise that the US Congress apparently will hold hearings on the use of PEDs in professional wrestling.  The New York Daily News says it will happen:

A congressional panel that grilled Bud Selig, Paul Tagliabue and David Stern about performance-enhancing drugs in sports two years ago will hold a hearing next month on steroids and professional wrestling.

The House Subcommittee on Commerce, Trade and Consumer Protection will hold the hearing in late September, three months after World Wrestling Entertainment star Chris Benoit allegedly strangled his wife and suffocated his 7-year-old son before hanging himself with a weight-machine pulley in his suburban Atlanta home.

"I am extremely concerned about the possible illegal and destructive practices by professional entertainment athletes that negatively influence the younger generation," said Rep. Bobby Rush, the Illinois Democrat who is the chairman of the committee. "We must make sure that today's wrestling sports heroes are not using illegal performance-enhancing drugs that, unfortunately, can and have led to their untimely deaths."

So there you go.  We all complained and whined about the steroid use in pro wrestling;  Congress picks up on a topic and runs with the publicity ball.

The Congressional committee should find a more proper investigatory mission than 'protect the kids' (unless you're a pro wrestler's kid).   The superficial statement above by the great representative of Illinois doesn't impress us.   The homi-suicide of the Benoit family, and the numerous steroid-related (possibly not directly caused) deaths of relatively young wrestlers however does concern public-health minded citizens.

We suspect an investigation will find a sport-wide mess of WWE pressure for revenue and attendance, and use of steroids, HGH, stimulants, pain killers and narcotics, benzodiazepines, alcohol, and anti-depressants that adds up to killer cocktails.

Tim Couch: taking a plant steroid for menopause? (laxogenin)

As reported in Yahoo, Deadspin, and here at Steroid Nation, former Jaguar QB Tim Couch, consulted with a Florida nutritionist for his NFL rehab comeback, who promotes the plant steroid laxogenin as anabolic for his company called Maxim Rejuvenation.  (The write-up from the Maxim Website will be found after the jump).  The claims are nonsense. The supplement Couch took might be weakly helpful for menopausal women.  Likely any benefit Couch received at the clinic was from real steroids and HGH.

Yahoo has a video with Couch promoting Laxogen (go to Part 6).  Good for strength, pumping up the metabolism, and hot flushes.

The Maxim website says this compound was discovered by an American scientist in 1996.  Interesting because all publication are from Japan and China, the first in 1963: [Laxogenin, a new steroidal sapogenin isolated from Smilax sieboldi Miq.] Jpn J Pharmacol. 1963 May;83:557-8. Japanese.  No abstract available. PMID: 14041495 [PubMed - indexed for MEDLINE].

There are 7 medically indexed publications on the compound.  None look at the compound's anabolic use (Maxim claims found after the jump).  You would think that the National Institutes of Health has a full bore research program on this compound for use in the Olympic Games. Not true. The last official paper on it was from the 'Shanghai Institute of Organic Chemistry' and discussed the synthesis of laxogenin from diosgenin.

This compound appears to be a plant steroid.  Plant sterols might be interesting, but certainly untested for all the medical uses the Maxim website claims.  There are some naturalists, with little scientific training, who make overblown claims for these plant steroid products.

The actual compound in this drug labeled Laxogenin, as analyzed by Dr. Don Catlin's lab at UCLA, was diosgenin (so much for truth in labeling).  'Disgenin' pulls up 347 references.  This compound is called a sapogenin, and is found in yams.  The molecule is being researched for a number of uses, however ALMOST NONE in human clinical trials.

Here is one clinical trial: Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women.  Climacteric. 2001 Jun;4(2):144-50.

Menopausal women?  Couch was taking a plant sterol for menopause?  Hope it helps his hot flashes.

The other paper was looking at a sports drink called SPORT.  There was no effect on performance parameters (reference found at the bottom)

This scheme sounds so Victor Conte and BALCO.

• Invent some bogus supplement as a covering ruse. 
• Use anabolic steroids, anti-estrogens, and HGH to deliver real results. 
• Market your snake-oil.
• Promote the product with athletes who obtained results from real anabolic drugs (Bonds, Romo, Marion Jones)

Fraud.  The FDA. the FBI, and Gov't fraud agencies need to hunt down these renegades.

---------------------------

Can J Appl Physiol. 2000 Feb;25(1):55-67. Links The efficacy of SPORT as a dietary supplement on performance and recovery in trained athletes. Timmons BW, Newhouse IJ, Thayer RE, McAuliffe JE, McIllwaine S.

 

Steroids aren't the only problem in public health

We blog about steroids as a public health problem here.  However, there is far more wrong in the USA public health domain than just steroids.  Recent reports show that health care in the US is #42 (by one measure) and falling. The New York Times editorial is found here:

Here's a wrenching fact: If the U.S. had an infant mortality rate as good as Cuba's, we would save an additional 2,212 American babies a year.

Yes, Cuba's. Babies are less likely to survive in America, with a health care system that we think is the best in the world, than in impoverished and autocratic Cuba. According to the latest C.I.A. World Factbook, Cuba is one of 41 countries that have better infant mortality rates than the U.S.

Since 1958, the infant mortality rate fell in the US.  However in 2002, the trend reversed.  Infant mortality rose.  It appears infant mortality is higher in New York than in Beijing China.  That's progress,  huh?

"America's children are at greater risk than they've been in for at least a decade," said Dr. Irwin Redlener, associate dean at the Mailman School of Public Health at Columbia University and president of the Children's Health Fund. "The rising rate of infant mortality is an early warning that we're headed in the wrong direction, with no relief in sight."

The bad news continues with life expectancy.  New York Times again:

Americans are living longer than ever, but not as long as people in 41 other countries.

For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands...

A baby born in the United States in 2004 will live an average of 77.9 years. That life expectancy ranks 42nd, down from 11th two decades earlier, according to international numbers provided by the Census Bureau and domestic numbers from the National Center for Health Statistics.

We talk about the racial issue with regard to Barry Bonds.  Here is a worse situation: the mortality for black males in the country lags behind other groups...by almost 9 years.

Black American males have a life expectancy of 69.8 years, slightly longer than the averages for Iran and Syria and slightly shorter than in Nicaragua and Morocco.

This is about more than national health service, but about obesity and poverty, and a shift of money to the wealthy.  Clearly over 40 million Americans who don't have health insurance coverage (and thus receive less than optimal health care) is a factor, however there are other factors:

-- Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.

''The U.S. has the resources that allow people to get fat and lazy,'' said Paul Terry, an assistant professor of epidemiology at Emory University in Atlanta. ''We have the luxury of choosing a bad lifestyle as opposed to having one imposed on us by hard times.''

-- Racial disparities. Black Americans have an average life expectancy of 73.3 years, five years shorter than white Americans.

-- A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.

Steroid and PED use is a public health problem.  Steroid abusers contribute to morbidity (high blood pressure, severe heat problems, hepatitis, infections, psychiatric conditions) mortality (pro wrestlers and pro cyclists who dope show a propensity to die young), and legal problems.  However, this is just a small part of the overall public health decline in the USA.

(Note: someone loves us: Thanks Slav!)

 

Neifi Perez not paying attention to TUEs about Adderall use

As soon as we published our bit on Neifi Perez testing positive again for amphetamine, Neifi came out to say that he suffers from ADHD;  he added that he takes Adderall (a mix of amphetamine salts) for ADHD.  (ESPN story here) (Foul balls line here)

However, there are several issues in his statements.

• Neifi said a psychologist diagnosed him with ADHD and then gave him Adderall.  Psychologists cannot prescribe medications;
• 'The team' gave him the medication.  Oops.  Adderall is a Schedule 2 controlled substance, which can only be prescribed by a physician with a DEA number.  If 'the team' gave it to him (presumably the trainer) that is a violation of federal narcotics law;
• Neifi says someone from the team told him to use amphetamine.  Another oops.  It is not recommended to look to baseball players for advice on drugs, and therapeutic doses.

Perez needed to pay attention to team meetings about Therapeutic Use Exceptions.  These are exceptions to drug policies when an athlete takes a banned PED but for a diagnosed medical condition.

For a TUE an athlete needs an official diagnosis of the condition, a legal prescription, and for the doctor to fill out the TUE form.

Either Neifi or his doctor (if he had one) wasn't paying attention.

We have treated professional athletes before.  It is amazing how many obtain drugs form trainers, who have no business giving out medicines to athletes.

"It's not fair," said Perez in a conversation with ESPNdeportes.com from his home in Detroit.

"They called three different positives on a 20-day-period. I was using a medicine that was supposedly authorized by the doctors due to a personal condition."

Benefits of a gastric bypass: better absorption of alcohol

The Wizard of Odds reigns as the news leader for the Charlie Weis Gastric Bypass Trial of the Century, Part Deux  The Wiz covered the Weis Mistrial of the Century, and is now back at it in the second rendition.

We will again be supplying the world class substantially below medical standards commentary over there.

Although testimony today appeared to be uninspired in Boston, we do present interesting new benefits of a gastric bypass.  Not only will the patient lose weight, but, the patient can imbibe far less alcohol to catch a buzz ease tension.

As reported by The Clarion Ledger Healthscene, those bad boys at Standford performed a study that showed bypass patients need to be very careful with drinking.  Their blood levels were much higher after 5 ounces of red wine than non-bypass patients.  Bypass patients absorbed alcohol quicker than than the control group.   Furthermore, it took the bypass patients longer to sober up; seems alcohol is less metabolized in the bypass patients too.

The research team gave 36 men and women - 19 who had obesity surgery and 17 who did not - five ounces of red wine each to drink in 15 minutes. Using a Breathalyzer, their alcohol levels were measured every five minutes until it returned to zero.

More than 70 percent of the surgery patients hit a blood-alcohol level of 0.08 percent, which qualifies as legally intoxicated in California as well as Mississippi, and two reached levels above 0.15, Morton said.

By contrast, most of the control group had levels below 0.05 percent, the study reported.

Researchers also found obesity patients took longer to sober up. After matching the control group with the patient group for age, gender and weight, they found the patients took 108 minutes on average to return to a zero blood-alcohol level versus 72 minutes for the control group.

Morton said the obesity surgery patients don't produce as much of an enzyme that breaks down alcohol because their stomachs are smaller. Also, the alcohol passes to their small intestine faster, speeding up absorption, he said.

Here's to you Charlie Weis.

Easy to cheat at the Tour de France?

ABC Australia News carries a syndicated piece on the eve of the Tour de France focusing on the extent of doping, and on the difficulty of catching the dopers.  Gone may be the days of simply infusing stored blood products, but drug-cheats now use sophisticated methods of doping.  Like ACTH.

French doping expert Professor Jean-Pierre de Mondenard feels the UCI's new anti-doping charter, which all teams must sign prior to the start, is a ploy to paper over the cracks.

And while he applauds the increase in the number of random doping controls being carried out by the governing body, he says the UCI are powerless to stop those who want to cheat because many of the substances used are undetectable.

"More random tests are the way forward. But even going looking for suspect cheats can be a waste of time," he said.

"There are too many undetectable products around for the doping controls to be efficient. It's a masquerade.

"Everyone knows it's easy to get around the controls."

De Mondenard can speak with authority:  he is a physician and a cycling enthusiast.

As well as being a passionate amateur cyclist, Professor De Mondenard is a world authority on doping in sport.

Recently he published the respected "Dictionnaire du Dopage"; a 1200-page who's who of doping substances and who has been caught using them.

One drug he cited and which he claims is used on a widespread basis in sport is Synacthen, also known as ACTH.  According to one one definition, the drug, made synthetically, "promotes the synthesis and release of the other adrenal steroids, namely aldosterone and the adrenal androgens".

Professor De Mondenard said it is only one example of a product which has befuddled the controller.  "In his allegations (Jorg) Jaskche talked about Synacthen, in the Operation Puerto affair there was Synacthen found in a cool box," he said  "Synacthen has been commercialised since 1969 in France, it is forbidden since 1999 - and it is still undetectable.  How can we realistically talk about a fight against doping? It's a joke. You can't fight against something that has been around for over 30 years, and which you can't still detect."

De Mondenard sums up the situation well.  As anabolic substances become detectable by anti-doping authorities, they are not useful.  Newly developed drugs then enter into the drug-cheat's equation.  Having taken an anabolic, a doping athlete appears to be hooked on cheating, always looking for the new dope.

"Because scientists can now detect homologous blood transfusions, it's no longer of any use.  It's the professionalisation of dopers. Every time the fight against doping moves ahead, the dopers move along too."

He added: "There are also a whole range of 'borderline' substances being used which are efficient, can be used to dope, but which are not banned and so not targeted during the controls.

"All the doping controllers look for are the substances they are capable of finding."

'Mark Doctors' -- Physicians who juice the dopers

An interesting picture continues to emerge of the shadowy world of doping, entertainment, and sports.  A report from the LA Times looks at Chris Benoit's doctor, whom Benoit visited immediately prior to his homisuicide rampage.  The Times speculates that Benoit's doctor may face legal charges.

As noted yesterday, local and federal agents raided Dr. Phil Astin's office Wednesday night and into the Thursday morning hours:

Benoit's Carrollton, Ga.-based physician, Phil Astin, told the Associated Press on Wednesday that he met with the World Wrestling Entertainment star last Friday and previously had prescribed him testosterone to boost levels of the hormone that were in decline — probably caused by prior steroid use.

Less than 24 hours later, the Drug Enforcement Administration raided Astin's office, focusing on whether Benoit's medical records showed he was prescribed steroids, and if so, whether the prescription was necessary, a law enforcement source told the AP. A DEA spokesman said no arrests were made. Calls to Astin's office went unanswered, and Fayette County Dist. Atty. Scott Ballard could not be reached for comment.

Astin has been noted to run a shady medical operation in the past.  Also interesting are the comments on the sick relationship between the pro wrestlers and enabling physicians:

Bryan Alvarez, an independent wrestler and friend of Benoit's, said it's no secret in the pro wrestling community that some performers work with doctors known in the industry as "mark doctors," who prescribe steroids, painkillers or other performance-enhancing drugs without proper cause.

"Some steroids can't be legally prescribed for injuries," Alvarez said. "I don't know if [Astin's] name showed up on the bottles inside Chris' house, or if he didn't give them for legitimate reasons, but the fact he got raided shows he did something wrong."

That is a remark and a trail worth following.

Benoit story morphs into bizarro world

The Nation's interest in the Benoit homisuicide stems from the involvement of anabolic steroids, and other PEDs.  However, the entire spectre of weirdness in this story appears on the verge of some dark  mystery.  The latest developments:

1.  ABC News (and other outlets) now report that someone altered the wrestler's Wiki-entry to state that Benoit's wife died; this alteration came a full 14 hours before the bodies were discovered.  Further -- the alteration came from a computer whose IP address can be traced to Stamford CT, the home of Mr. McMahon and the WWE, Benoit's employer.

On June 28, FOXNews.com reported that news of Nancy Daus' death was posted on Wikipedia half a day before the police discovered the bodies. The posting reads: “Chris Benoit was replaced by Johnny Nitro for the ECW Championship match at Vengeance, as Benoit was not there due to personal issues, stemming from the death of his wife Nancy.” The phrase "stemming from the death of his wife Nancy" was added to the English Wikipedia's "Chris Benoit" article at 12:01 a.m. EDT on June 25,^[104] whereas the Fayette County police reportedly discovered the bodies of the Benoit family at 2:30 p.m. EDT (14 hours, 29 minutes later). The IP address of the editor was traced to Stamford, Connecticut, which is also the location of WWE headquarters.^[105]

3.  It is reported by a TMC.com that Dr. Astin, whose name can be found on Benoit's prescriptions, including the testosterone one, has a checked past:

TMZ has learned that the personal physician who saw Chris Benoit just hours before the wrestler killed his wife and son once had his medical license suspended for "repeatedly prescribing several controlled substances to patients in excessive quantities or for excessive periods of time and prescribing for other than legitimate purposes."

According to records from the Georgia State Board of Medical Examiners, Phil Carroll Astin was found guilty of engaging in "unprofessional conduct" in 1992 by over-prescribing a plethora of pills including amphetamines, antidepressants, tranquilizers and narcotics to various patients. Chris Benoit was not among those mentioned in the case.

As a result, the medical board suspended Astin's license for 30 days, put him on 5 years probation and fined him $2000. Astin was reinstated in 1997, following the completion of his sentence...

TMZ has also obtained Medical Board records which show that Dr. Astin was suspended again in 2001 for "reasons related to competence or character."

4.  A wrestling fan took Benoit's photo, in the physician's office, just hours before he went on the rampage in his house.  An Atlanta TV station has the photo to the left.

What is going on here? 

 

Law officers raid Benoit's doctor's office

The Benoit story changes course almost by the hour. It is now reported nationally that local law enforcement and the DEA raided a Dr. Astin's office near Atlanta.  Astin's name was found on prescriptions at the Benoit's home following the homisuicide.

FOX 5 News has learned that drug agents have raided the office of the personal physician of wrestler Chris Benoit.

The office of Dr. Phil Astin was raided overnight with agents confiscating computers. Dr. Astin has told the Associated Press that he had prescribed testoserone for the wrestler in the past and had seen him on Friday.

Drug agents tell FOX 5 News the investigation of Dr. Astin stems from prescription drugs found in the Benoit home after Benoit killed his wife, son and himself.

FOX 5 News was at the doctor's office overnight as agents with the Fayette County sheriff's drug task force as well as federal DEA agents and Carroll County investigators served a search warrant on Dr. Astin at his office in Carrollton. FOX 5's Doug Evans was there as agents brought out what appeared to be evidence and loaded it in police SUV's.

During the raid of the doctor's office, investigators told FOX 5 News that Dr. Astin's name was on prescription bottles found in Benoit's home.

Pro wrestling cleverly distracting attention in Benoit case

The pro wrestling establishment (WWE) is feeding the media a story about stress in the Benoit family, with the suggestion caring for a child with Fragile X leads to murder-suicide.

While undeniably true that a child with developmental problems can be very stressful, we have never seen a murder-suicide in a family that stressed.  We would suggest the culture of violence within pro wrestling, the use of drugs that cause mental status changes, and other drugs that increase aggressiveness would constitute more important factors than familial stress (which is common) in this crime(photo from the Daily News).

We hope that the American public, along with the press, doesn't buy a superficial explanation forwarded by an organization that continues to be irresponsible and completely mercenary.

The chief crook of pro wrestling, McMahon, faked his own death in a violent episode just a couple weeks prior to the Benoit episode.  McMahon pushes the working schedule to exhaust his employees.  He was also involved in litigation in the 90s when he was charged with trafficking anabolic steroids to his wrestling employees.  Clearly McMahon is CYA from litigation and public castigation.

Despite pro wrestling's heinous record, a shyster like McMahon appears to be a billionaire.  Twenty million American tune in to the entertainment weekly.  However, the entertainment venue doesn't need to lay the foundation for death, then try to pawn off their culpability on the stress of a disabled child.

Hopefully fans see through the spin.  Fans should enjoy the entertainment-sport of pro wrestling without as much of the violence and PED drug use as promoted by the WWE/WWF.

Benoit saw doctor Friday; Family struggled with Fragile X son

More information comes out almost by the hour.  The AP found Chris Benoit's physician who said the pro wrestler stopped in on Friday before the homisuicide.  The doctor also said that he prescribed low doses of testosterone for low endogenous hormones in Benoit.  Wonder if the doctor knew Benoit received Internet PEDs?

Professional wrestler Chris Benoit met with his personal physician hours before he allegedly killed his wife and son and then hanged himself in his basement, the doctor said Wednesday.

"He was in my office on Friday to stop by just to see my staff," said Dr. Phil Astin of metro Atlanta. "He certainly didn't show any signs of any distress or rage or anything."

Authorities say Benoit strangled his wife, suffocated his 7-year-old son Daniel and placed a Bible next to their bodies before hanging himself with a weight-machine pulley over the weekend. No motive was offered for the killings, which were spread out over the weekend and discovered Monday.

Astin, who said he was Benoit's longtime friend and physician, said he had prescribed testosterone to Benoit because he suffered from low amounts of the hormone. He said the condition likely originated from previous steroid use. He would not say what, if any, medications he prescribed the day of the meeting.

An attorney for the WWE tried to deflect attention away from pro wrestling activities and back into domestic issues.

Before the killings, the family was struggling with how to care for the child, who suffered from a rare medical condition called Fragile X Syndrome, an inherited form of mental retardation often accompanied by autism, said Jerry McDevitt, an attorney for World Wrestling Entertainment.

"Him and Nancy were clearly struggling about this whole issue, about how to take care of Daniel," said McDevitt.

"I don't know what he confronted when he went back into the house," he said. "No one really knows that. We'll have to see. Clearly this issue of the son was a stressor on both of their relationships for some time."

Mutiple concussions and psychotic behavior

The New York Times carries a piece on the Benoit homisuicide today.  The Times outlined the usual situation details. However, it is worth reading and noting the thoughts of former pro wrestler -- and author of 'Head Games' -- Christopher Nowinski on Benoit's behavior. 

Nowinski suggests that Chronic Traumatic Encephalopathy may play a role in the wrestler's behavior.  Nowinski also urges the coroner to perform a detailed post-mortem examination on Benoit's central nervous system (CNS):

...Christopher Nowinski, a former professional wrestler who worked with Mr. Benoit, and who was forced to quit because of head injuries, said he believed that repeated, untreated concussions might have caused his friend to snap.

“He was one of the only guys who would take a chair shot to the back of the head,” Mr. Nowinski said, “which is stupid.”

Mr. Nowinski has written a book called “Head Games: Football’s Concussion Crisis” (Drummond Publishing Group, 2006), about chronic traumatic encephalopathy, a condition that can cause memory loss, depression and “bizarre, paranoid behavior.”

Mr. Nowinski said that he had been trying to persuade the coroner examining Mr. Benoit to allow a brain exam to look for the telltale neurofibrillary tangles in the brain’s cortex, but that he had thus far been rebuffed.

“Part of me hopes there was something wrong with his brain,” Mr. Nowinski said. “The Chris Benoit I knew was always more concerned about everybody else’s well-being than his own.”

Often, aberrant behavior results from the culmination of factors.  It may be that a genetic liability combined with the chronic effect of steroids and multiple concussions leads to psychotic behavior.

Byron Houston Exposed

By now fans have heard of the problem Byron Houston got himself into in Oklahoma City:  Arrested for indecent exposure the other night.  This constitutes his fourth arrest on this charge (NewsOK.com).

Troubled former basketball star Byron Houston told police he fears he'll end up in prison because of his arrest for indecent exposure Wednesday in Oklahoma City, according to a police report released Friday.

Houston, 37, was arrested after a woman told police she saw him masturbating in his vehicle during afternoon rush hour traffic. It is the fourth time he's been arrested for indecent exposure.

He pleaded guilty to indecent exposure charges in 2003, but hasn't been charged in connection with Wednesday's arrest.  Judge Ray Elliott sent Houston  to treatment instead of prison for the 2003 conviction, and Houston remains on probation.

Houston's attorney says this is a mental health issue.  This is true:

Houston's attorney said the arrest is the latest in a painful chain of events for he and his family.

"It's a legal issue, but it's also a mental health issue,” attorney RIchar Anderson said.

Andnerson said it is unfortunate that Houston's celebrity status as a basketball player has caused him to be "ridiculed” for his troubles with the law. He said Houston faces serious mental health issues but is a "loving” man surrounded by a "great” family.

Houston, a registered sex offender, is being held in the Oklahoma County jail.

A series of reports in the UK recently dealt with this issue.  Although in this blog we usually talk about the effects of anabolic/androgenic drug, anti-androgen drugs can help people who cannot control urges like exhibitionism control the compulsion.

There are blogs that say Houston is incorrigible.  Not true.  There is effective treatment.

The Pittsburgh Steelers quietly fire testosterone/HGH doc

The Pittsburgh Post-Gazette publishes a story about Steeler doc Dr. Richard Rydze, the physician inplicated in the Florida Internet pharmacy bust.  The Steelers, plagued by past allegations of steroid abuse are obviously distancing themselves from someone implicated in buying anabolic substances.

The Steelers have removed Dr. Richard Rydze from their medical staff roster, an apparent reaction to the revelation in March that he had purchased $150,000 in testosterone and human growth hormone with his own credit card.

Rydze was interviewed by investigators from Albany County, N.Y., in February, but never accused by them of any wrongdoing. Nevertheless, his employers at the University of Pittsburgh Medical Center began their own investigation after his name surfaced in the New York case.

More than three months later, UPMC officials are not ready to comment about their investigation, said Susan Manko of the hospital's news bureau.

Steelers President Art Rooney II declined comment yesterday on the team's dropping Dr. Rydze, an internist, after 21 years of working mostly on game days for them. Previously, Rooney said, "There is no evidence that Dr. Rydze prescribed or provided any hormone treatments to any of our players. Dr. Rydze has assured me that this has never happened and will never happen."

Nevertheless, having a doctor on their staff connected to steroids purchases apparently was not something the Steelers believed they could tolerate.

The NFL bans the use of any kind of steroids or human growth hormone. Dr. Rydze previously told Sports Illustrated he uses the HGH to treat older patients. He is medical director of the Little Sisters of the Poor Nursing Facility, according to his bio on a UPMC Web site.

Rydze's name surfaced during an investigation by an Albany, N.Y., prosecutor into an illicit steroids distribution network that led authorities to raid two facilities in Orlando, Fla., and arrest four company officials in February

Catheter controversy

The controversy continues over the cocaine contaminated catheter of paralympian Jeff Adams.  Adams is the wheelchair racer from Canada who claims a woman spiked  his mouth with cocaine in a bar, and that cocaine ultimately contaminated a catheter he used after the  incident.  He then used the same catheter to draw a urine sample tested for doping tests at a competition.  The positive test brought a 2 year suspension for Adams.

The Globe and Mail says that the Canadian doping control agency, the Canadian Centre for Ethics in Sport,  is considering requiring it's own sterile catheters be used in anti-doping procedures.

Adams acknowledged yesterday the truth about his positive test sounds stranger than fiction, but he's sticking by his story that a stranger in a bar slipped cocaine into his mouth before he failed a drug test last year.

Adam's story contains several very questionable elements:

• That a woman can randomly jam a significant amount of cocaine in a person's mouth (ignoring the cost) to deliver drug into the circulation
• That the small amount of cocaine can contaminate a catheter;  those catheters are made of rubberized material that doesn't adhere substances
• That Adams reuses catheters without cleaning.  Ugh.  One would think he would suffer rip roaring urinary tract infections on a regular basis.

Here is Jeff Adam's story:

"I understand the reaction that people are having to the story that is spinning out of control in the media," the six-time wheelchair racing world champion said in a telephone conversation.

He's not ducking responsibility, he said, but he's not backing down. He says anti-doping officials don't provide the same level of security and sterile equipment for a disabled athlete as for an able-bodied athlete who can urinate directly into a bottle. Adams and lawyer Tim Danson say doping-control officers do not, as standard procedure, offer wheelchair athletes a sterile catheter for urine collection, and as such, they claim the Charter rights of athletes with disabilities are not protected.

Adams said he was sitting in the Toronto goth bar Vatikan "next to a woman who was on cocaine. I had been talking to her, and at some point, I stopped being interested in doing that. I told her that I was really tired, and didn't want to talk to her any more. She got pretty upset about that, and in her head, I think she thought that she would be helping me by giving me cocaine, that I would no longer be tired," Adams said...

The alleged cocaine assault took place one week before the race. Adams said the catheter he had used that night was the same one he had in his wheelchair pouch at the time of the test. He said he'd washed the outside of the appliance where it comes into contact with his body, but the inside was contaminated. Reusing a catheter is common for those who need them, he said.

Update: Please read the comment on this story by Jeff Adams below.    Pretty darned good response.  And we buy it.  If the facts are as Jeff relates below (and we have no reason to doubt) we would now argue that he should not be suspended from competition.  Jeff, just watch out for those UTIs, fella!

In the past we have authored letters of support for athletes we felt wronged.  Jeff any address to whom readers who dispute your suspension, can send off a letter?

We will reproduce Jeff's explanation after the jump.

Univ Toledo football dinged for medication control

As noted in the Wizard of Odds, the Univ of Toledo football team now faces a revamp of it's structure.  One of the issues was control and dispensing of medications.  The Toledo Blade has this to say:

Medication control

The university president ordered that the “inventory, storage, and dispensing of medications” in the department be placed “immediately” under the direction of the university’s director of pharmacy.

Dr. Jacobs also urged Mr. O’Brien to replace current team physician Dr. Roger Kruse with a “full-time university employee physician in an effort to improve the conformity to applicable laws concerning the control of medications.”

Dr. Jacobs told The Blade yesterday that he didn’t think there were any medications distributed to the wrong persons, and there were no athletes harmed. He said because the UT investigation found that rules or laws were violated, he was considering whether to refer the matter to prosecutors.

“One of the things that comes out of [UT’s merger with the Medical University of Ohio last year] is that we have a pharmacy that knows [medication control laws] and practices those practices,” Dr. Jacobs said. “This allows me to put our pharmacist in charge of those issues.”

Anabolic Briefs

1. 'The truth' about champ James Toney. (from Philly.com)

The failed test cost the brash veteran the crown he'd lifted from Ruiz and earned him a one-year ban from WBA title fights, though he quickly got another try with WBC champ Hasim Rahman the following March...Old habits, it seems, die hard...According to the California State Athletic Commission, the ex-champ at 160, 168 and 190 pounds tested positive for both boldenone and stanazol, results that -- without an appeal -- will prompt a one-year ban from the fight's May 24 date.

Even a couple days later, when a post-fight urine sample showed the presence of steroids in Toney's system, I was still in his camp and steadfastly buying the medical excuse he was selling.

 2.  American teens now need surgery for gynecomastia (man-boobs):

In 2006, according to the group, nearly 14,000 boys age 13 to 19 underwent surgery to reduce their breast size. That represents 70 per cent of all the male patients who had such surgery last year, and an increase of 21 per cent over the previous year for that age group...

The foremost reason is the rise in obesity, according to several plastic surgeons who were interviewed. At the same time, there is a new willingness among pediatricians and plastic surgeons to surgically treat enlarged male breasts...

While gynaecomastia in young men is most often associated with hormonal fluctuations or obesity, many surgeons are also beginning to link it with increased abuse of steroids.

3.  Eight Indian athletes caught doping:

NEW DELHI, June 15 (Reuters) - Eight Indian athletes, including a kabaddi player, face punishment after being caught for doping during this year's national games, the Indian Olympic Association (IOA) said on Friday.

Four of them tested positive for the banned anabolic steroid nandrolone and others for the diuretic furosemide, the IOA's medical commission said in a statement after a hearing.

The kabaddi player tested positive for nandrolone, after 257 urine samples from the February games were tested at a World Anti-Doping Agency (WADA) accredited laboratory in Bangkok.

 

Chronic Traumatic Encephalopathy (CTE) is killing ex-NFL players

In the past, Steroid Nation looked at the excess of death in former Pittsburgh Steelers.  Many of the Steelers played on the line where a number of factors could add to morbidity and mortality: cardiac disease, weight gain, steroids, and concussions.  In new autopsy data, physicians are finding tangles of nerve cells in the brain of these players (neurofibulary tangles).  Similar neuropathological findings exist in the brains of patients with Alzheimer Dementia;  however this is a new finding in relatively young ex-pro football players.

An excellent story in the New York Times says the condition -- chronic traumatic encephalopathy -- (CTE) kills ex-NFL players.

The images on the screen were of magnified brain tissue from her son, the former Pittsburgh Steelers offensive lineman Justin Strzelczyk, who was killed in a fiery automobile crash three years ago at age 36. Four red splotches specked an otherwise tranquil sea — early signs of brain damage that experts said was most likely caused by the persistent head trauma of life in football’s trenches.

Strzelczyk (pronounced STRELL-zick) is the fourth former National Football League player to have been found post-mortem to have had a condition similar to that generally found only in boxers with dementia or people in their 80s. The diagnosis was made by Dr. Bennet Omalu, a neuropathologist at the University of Pittsburgh Medical Center. In the past five years, he has found similar damage in the brains of the former N.F.L. players Mike Webster, Terry Long and Andre Waters. The finding will add to the growing evidence that longtime football players, particularly linemen, might endure hidden brain trauma that is only now becoming recognized.

“This is irreversible brain damage,” Omalu said. “It’s most likely caused by concussions sustained on the football field.”

Dr. Ronald Hamilton of the University of Pittsburgh and Dr. Kenneth Fallon of West Virginia University confirmed Omalu’s findings of chronic traumatic encephalopathy, a condition evidenced by neurofibrillary tangles in the brain’s cortex, which can cause memory loss, depression and eventually Alzheimer’s disease-like dementia. “This is extremely abnormal in a 36-year-old,” Hamilton said. “If I didn’t know anything about this case and I looked at the slides, I would have asked, ‘Was this patient a boxer?’

There were other complications with Strzelczyk too, including use of anabolic steroids:

Strzelczyk, 6 feet 6 inches and 300 pounds, was a monstrous presence on the Steelers’ offensive line from 1990-98. He was known for his friendly, banjo-playing spirit and gluttony for combat. He spiraled downward after retirement, however, enduring a divorce and dabbling with steroid-like substances, and soon before his death complained of depression and hearing voices from what he called “the evil ones.” He was experiencing an apparent breakdown the morning of Sept. 30, 2004, when, during a 40-mile high-speed police chase in central New York, his pickup truck collided with a tractor-trailer and exploded, killing him instantly.

The issue should be on the agenda of the NFL meetings next week.  The past few weeks have seen Gene Upshaw spare with Mike Ditka  and other retired NFL players over this issue, in part;  some  retired NFL players cannot pay their medical bills covering injuries suffered during their playing days.  CTE will add fuel to that fire.

Minnesota coach who text-messaged high school players for sex blames Tourette Syndrome

From the Twin Cities (Star-Tribune) comes the story of a high school coach, notorious for  abusive treatment of his players, now finds himself notorious for explicit text messages to minors.  Oh yeah, he blames it on Tourette Syndrome.

With new allegations in Orono and Roseville, Maplewood police are broadening their investigation of a former boys' basketball coach who was charged last week with harassing former players with obscene text messages.

Youth basketball insiders are surprised by the sexual charges against Matthew S. Ricker, who has no criminal history. But out-and-out browbeating, they said, is a familiar story...

Ricker, 31, is charged in Ramsey County District Court with sexually harassing three Hill-Murray high school players whom he had coached last season and with allegedly offering $500 to a 17-year-old boy to engage in oral sex.

Since then, Orono police reported that a boy received a sexually explicit instant message in April from Ricker. And a teenage boy in Roseville has accused Ricker of inappropriate e-mail stalking.

Now he blames Tourette Disorder, a syndrome of motor and vocal tics.  Less than 10% of the patients, suffer from coprolalia, which are obscene vocal tics:

A search of Ricker's Plymouth home last week turned up sexually explicit material, male pornography and an Orono basketball program with some of the boys' pictures cut out, according to a warrant filed in Hennepin County. Ricker was a volunteer assistant coach at Orono High School in the 2005-06 season.

The search warrant cited an Orono police report that said a boy got an instant message from Ricker on April 25 asking how experienced he was with girls and whether he ever masturbated.

In the criminal complaint filed against him, Ricker told police he attributes his problems to Tourette's syndrome and obsessive-compulsive disorder.

We have over 700 outpatients with Tourette, and believe us, none exhibit this kind of antisocial medical symptom.

A child and adolescent psychiatrist who is considered an expert in Tourette's said that it can cause involuntary vocalizations, including profane outbursts.

"But this is not a tic behavior," said Dr. Bart Main, who works in Eagan and has no direct knowledge of the case. "This sounds like very complex, planned, elaborate behavior that does not qualify as a tic at all."

Does Mark Cuban really need to tell everything?

We are doctors here, and even we didn't really need to read all this. Mark Cuban blogging about his colonoscopy.  We (really 'I', but I can't face this alone) thought we had called up our mother for gracious sakes and were listening to the day's proceedings, not reading Cuban. (also linked in Larry Brown Sports)

I usually don't talk about personal issues, but I thought this was important to share.

('Never talks about personal issues'...oh oh here it comes)

I'm getting to that age where it pays to be proactive and start getting tested for the myriad of things that can go wrong with my body. One of the things I wanted to get over with is a check for colon cancer. Although I'm officially younger than the "suggested age" for a colonoscopy, I wanted to get it out of the way. I had read and heard too many stories about people who found polyps and how if "they had only caught them a little sooner" it would be no big deal to remove them. So I set my appointment and went for it.

Like every guy, the thought of being violated by a long tube is at the very bottom of the list of things I want to do on a summer day. I could live with having to take all the laxatives that lead up to the procedure, That's just more time to get my reading done. But the tube up the outdoor, that's scary.

Well this morning was the morning. I had officially lost 4 pounds to the laxative over the past 24 hours and was surprisingly not hungry after going without food for the past 24 hours as I got to the hospital at the prime time of 7am.

I was definitely nervous. Despite doctors and nurses telling me it would be a breeze, I was naturally skeptical.

A breeze was an overstatement. I can honestly say that if it made medical sense to get one done every year, i would have no problem with it. It was easy and breezy :).

Once I got into the Gastro Room where they did these, they told me that they were going to knock me out, and I would get a nap and wake up like nothing happened . They were right. One minute Im talking rugby, the next I'm waking up, picking up the conversation where I left off and being told to "dispell the air in my system".

Please please please NO MORE!

No where else can you rip off some huge farts and have 3 nurses and a doctor, while maintaining a very professional demeanor, tell you that you aren't done yet and demand that you let loose a few more. Then it was up to get dressed and out the door so my wife could give me a ride home.

Now, about an hour latern I'm obviously back at it.

I'm writing this post because I hated the fact that I was afraid of getting a colonoscopy. It honestly scared me. I don't like hospitals. I don't like entries into exit lanes and its scary as shit that they could find something. In other words I was a pussy when I shouldn't have been.

Here comes a great pun, although he doesn't know it:

Bottomline is that your life just might depend on getting tested for colon cancer. There is absolutely nothing to be afraid of. Its truly easy and breezy. Do it.

When The Nation was in medical school, the book ' House of God' about Beth Israel hospital in Boston was popular.  A gastroenterologist in the book called procedures 'bowel runs of the stars', because he did alot of them, and he made alot of money.  We decided not to go into that specialty.  And now we reaffirm our choice.

Teenage track star dies of salicylate toxicity

Fox News reports 17 year-old Arielle Newman of Staten Island who was found dead in her sleep in April died of a methyl salicylate overdose, absorbed from a muscle cream she used chronically.  Apparently the level built up slowly in her body leading to toxicity.

A budding teenage athlete has died after 'overdosing' on a common topical muscle cream.

The medical examiner announced on Thursday that the 17-year-old track star, Arielle Newman of Castleton Corners, N.Y., died from a toxic dose of sports cream, the Staten Island Advance reported.

Ellen Borakove, a spokeswoman for the medical examiner's officer told the Advance that the Notre Dame Academy track star's blood contained lethal amounts of methyl salicylate, the active ingredient found in muscle rubs such as BenGay and Icy Hot.

Borakove said the petite girl used the topical medication excessively, allowing the poisons to accumulate in her body over an undetermined amount of time.

Newman was found dead in her home on April 3. The initial autopsy was inconclusive, which led to speculation her death was linked to a party she had attended the night before.

Salicylate is similar to the active ingredient in aspirin, acetylsalicylic acid, which can also be toxic.  Overdose by cream would be extremely rare but possible.  The salicylates cause any number of nasty effects including gastritis and ulcers, kidney and liver dysfunction, tinnitus, bleeding, metabolic acidosis, cardiac problems, ischemia (lack of blood flow in certain areas), and in high doses stupor and coma.

From the above referenced blog:

Newman, 17, died April 3 after her body absorbed lethal levels of methyl salicylate, an ingredient found in sore muscle treatments like BenGay, Icy Hot and Tiger Balm. Newman was using a cream, adhesive pads containing the anti-inflammatory and another product with the chemical, said Ellen Borakove, spokeswoman for the medical examiner.

The methyl salicylate likely caused a seizure after the teen returned home following an April party near her home.

A very sad story.  We aren't sure about the accuracy of the 'seizure' conclusion.  Salicylate toxicity might cause any number of conditions, cardiac arrhythmia even.  How could such high levels build up?  We wonder about the overall accuracy of these reports...

Mike Ditka slaps Gene Upshaw upside of the head over NFL vet's care

Mike Ditka, Gene Upshaw both former NFL Hall of Fame players, both feisty and both full of vinegar.  Upshaw involved in the NFL Players Association;  Ditka involved formerly in coaching, and now in media broadcasting.  Any confrontation between the two reverberates around the NFL and the country.

Confrontation erupted plenty the past few days.  Ditka says he is upset about the sorry condition, physically and mentally, former NFL players find themselves in often without proper finances or insurance to alleviate some of the pain,  Ditka says he is further upset about the ineptness the NFL Players Association shows in getting help to the players.  We looked at the medical problems of former Steelers here.

Gene Upshaw says Ditka is offside.

Ditka added a new blow in Round 17 of the fight last week when he questioned the NFL's intentions to help out the maimed players.  Form the Chicago Tribune:

There was just as much cynicism is Mike Ditka's voice Wednesday when he questioned whether the new NFL measures were little more than a PR stunt.

According to Chicago Sports, Gene Upshaw retaliated against Ditka's remarks, calling the former Bear TE 'dumb':

"It was irresponsible and shows how dumb [Ditka] is," Upshaw said Thursday. "I didn't just come to this rodeo. I've been doing this since 1983. When did he start? Last year? I get upset when people say I turned our back on players. The NFL never turned its back on anybody."

Ditka, who last year started the organization Gridiron Greats with former Green Bay Packer Jerry Kramer to assist retired players, had dismissed the league's announced plan to improve benefits as "a lot of rhetoric." Miffed at the characterization, Upshaw urged everyone to consider the source.

"Look, I was in the Hall of Fame before Mike Ditka got there [in 1988]," said Upshaw, a 1987 inductee. "He just runs his mouth. He doesn't want to know the facts, which are we are already helping people but we just can't talk about everyone we help because these guys have pride."

Ditka not only called Upshaw a fraud, but blitzed Upshaw even more charging improprieties in NFLPA's loans to the former Raider Upshaw:

"They're the people who are irresponsible," Ditka said of Upshaw and his fellow union leaders. "Nobody is less deserving of his position because he has no comprehension of what it means to give back to the game. He's a fraud."

And here from AOL:

[Upshaw is] taking loans from the Players Association which are illegal,'' Ditka said. ''You cannot take any loan which [is] over $4,000 from the union.

  ''He's on the books for over [a] $100,000 loan, which is really a criminal offense.''

''There's going to be a Senate investigation of the National Football League Player's Association, believe me,'' he said, ''... and we'll see what happens, that's all.

  ''They brought it on themselves.''

Former NFL players suffer from a myriad number of health problems including football injuries, dementia possibly involving concussions from playing, consequences of old steroid use, etc.  This is an important issue that needs to be worked out at the highest level, rather than end up as a bicker between two old nemesis.

Mitchell probe focus now on Baltimore Oriole (ex)players

(also see the Steroid Summer of 2007)

The George Mitchell MLB probe took a major step forward tonight, according to the New York Times (registration required).   Mitchell is pursuing several (ex)members of the Baltimore Orioles, asking for more information including medical records.  The names are at once expected and yet surprising.

Mitchell asked for more information on Rafael Palmeiro, Sammy Sosa, David Segui, Jason Grimsley, and Fernando Tatis.  Several of the named players allegedly used HGH (growth hormone) for which there is no lab test; the only evidence of HGH use continues to be documentation of purchase and delivery.  Thus, pursuit of that evidence is paramount for a PED investigation.

Palmeiro played for Baltimore from 1994 to 1998, and again from 2002 to 2004.  Segui from 1990 to 93, and again 2001 to 2004.  Grimsley from 2004 to 2005.  Sammy Sosa paced the Oriole clubhouse in 2005.  Tatis, the surprise player, only played with Baltimore in 2006.

Other Oriole players implicated by media speculation include Miguel Tejada, Jay Gibbons and Brian Roberts appear not to be involved in this leg of the Mitchell investigation.  From the Times:

Investigators into steroid use in baseball are seeking medical records from at least two of baseball’s premier sluggers over the past dozen years, Sammy Sosa and Rafael Palmeiro, along with dozens of other players suspected of using performance-enhancing drugs, a baseball official with direct knowledge of the request says.

The investigators in the inquiry headed by the former Senator George J. Mitchell have also asked the Baltimore Orioles to send medical files relating to Jason Grimsley, David Segui and Fernando Tatis to those players, the official said. The players will then be asked to authorize their release to Mitchell, although they are believed to be unlikely to do so.

Raffy Palmeiro tested positive after histrionically denying to a Congressional Inquiry that he took steroids.  When he tested positive for Winstrol he immediately blamed a B-12 injection from Tejada.

Sosa, a PED suspect since the Civil War, played only briefly for the O's;  the majority of his alleged PED use occurred during his long stint with the Cubs. There are no reports of a positive Sosa PED test.

The IRS and Jeff Novitzky nailed the veteran relief pitcher Jason Grimsley.  However, Grimsley only played with Baltimore for 2 late seasons.  The Grimsley bust netted the feds anabolic steroids, and HGH.

Fernando Tatis seems to be a surprise target of the Mitchell Probe.  Tatis played for the O's in 2006, in which he put up pedestrian numbers.  However, in 1999, as a St. Louis Cardinal, Tatis blew up with 34 home runs, 107 RBI, and a .298 average.  He has never even vaguely approached that level of performance.

Segui admits to use of prescription HGH.

New York Times report fails toxicology final

Murray Chass of the New York Times leads a story on the Sports Page with this bromide:

Alcohol last week killed one more major league baseball player than steroids ever have.

If you didn't get it the first time, he repeats:

I repeat: Alcohol last week killed one more baseball player than steroids ever have.

This story in the big paper in the Big Apple, doesn't get it Big Time.  I repeat, the Times spit the bit.

Alcohol constitutes a major public health problem.  Alcohol use, abuse, tolerance, withdrawal, and delirium all contribute to major morbidity and mortality.  Alcohol inebriation clearly causes fatal results if combined with driving, or boating, or swimming, or other activities requiring mental alertness.  Long term alcohol use causes psychosis, dementia, depression, hormonal problems, cardiac hypertrophy, liver cirrhosis, diabetes, gastritis, fetal alcohol syndrome, and other major problems I haven't mentioned such as job loss, marital strife and on.

Last time any scientist looked, steroid use and abuse can cause emotional changes, psychosis, depression, hormonal problems, cardiac hypertrophy, liver damage, tumors, diabetes, possible fetal defects, azospermia, acne, aggression, and crime.

So why would an author trash one public health campaign to bitch complain about MLB not doing enough about another public health issue and public fraud investigation?  Someone explain the logic. Please. 

More from the Times:

Yet Major League Baseball and George J. Mitchell and Congress and the steroids zealots are in a tizzy over the use of performance-enhancing substances in baseball. At least Mitchell is being paid to care about them, but he is in such a frenzy to get to the core of steroid use that he wants to run roughshod over federal and state laws barring an employer’s release of an employee’s medical records.

When baseball has addressed the issue of drugs of abuse and performance enhancement, it has always ignored alcohol. Alcohol, after all, is legal for most players of major league age...

But if players who use steroids serve as poor role models for children, so do players who drive drunk and kill themselves...

This and the rest that follows simply is silly.  Inane.

The morbidity and mortality from booze, and tobacco (how did that get into this discussion?) are significant.  Does that mean MLB is all wrong for initiating an investigation into steroid and PED use?

Take anabolic steroids.  A person does not inject some Deca then go out and drive inebriated. However, chronic use of 'roids makes one more aggressive.  Ask several experts who are testifying in steroid-tainted murder trials, including steroid expert Harrison Pope.  You don't have the immediate dulling of cognition, however the citizen in Florida shot by a juiced-up aggressive cop is every bit as dead as the next corpse.

Alcohol affects your brain.  Steroids affect your brain.  My friend at a New York research center will likely demonstrate some very interesting brain blood flow studies in the future looking at anabolic steroids affecting brain perfusion.

Alcohol causes cardiac problems.  Steroids are suspected of causing cardiac problems too (although HGH is the biggie in this category).

Alcohol attacks the liver.  Steroids attack the liver.

Alcohol can decrease testicular production of testosterone.  Steroids can decrease the testicular output of testosterone.

Anything alcohol can do, steroids can do better...

Yeah, but alcohol causes fetal alcohol syndrome.  Ask the German female swimmers if anabolic steroids caused the multiple birth defects seen in their children...then watch them weep.

In short, the use of anabolic steroids causes significant, if delayed, public health problems.  Google 'dead pro wrestler and anabolic steroids'.  There are 281,00 hits.  Not trivial.

Clearly alcohol presents a much more prevalent public health problem than anabolic steroids.  That does not mean the investigation into juice should be dismantled leaving all the funds for alcohol education.  Both are important public health issues.

That was the apples and apples, the public health aspect of the issue.

Now the apples and oranges: anabolic steroid use is sports-fraud, and drug-cheating.  Alcohol use is generally more recreational use.   If we discuss the morbidity and mortality from recreational drug use, then alcohol dominates a large part of the discussion; anabolic steroids do not sit at that discussion.  However, steroids partake of the discussion concerning morbidity and mortality of American drugs of abuse, and of America sports fraud.  Steroids and PEDs simply require more time to produce deleterious results.  The sinister deleterious health consequences of PEDs sneak up on a person, which is difficult for the instant gratification or instance annihilation people to understand

Make no mistake using simple-minded short term thinking; there are significant morbidity and mortality issues when discussing the PEDs.  We don't need to rob Peter to pay Paul.  We need to understand fully the issues behind any contemporary drug problem.  Even if those issues demand serious thinking.

Major League Baseball has made television commercials warning against the dangers of steroids, and dangerous though they may be for possible future ill effects, no baseball player is known to have died from using them. Ken Caminiti admitted using steroids, but he died at the age of 41 from a drug overdose that included cocaine but not steroids.

Putting steroids in perspective, since the Balco investigation began four years ago, 1.6 million people have died from smoking-related causes (400,000 a year, the United States surgeon general says) and about 150,000 (nearly half in traffic accidents) have died from alcohol-related causes.

How comforting it is to know that some people care more about baseball’s career home run record than the lives of hundreds of thousands of human beings.

How discomforting to know the New York Times makes no sense on this issue.

Seth Mnookin says pro players health compromised by club's avarice, player's macho

Carried in the Boston Globe today (registration) Seth Mnookin examines the phenomenon of professional player's health and future compromised by injuries suffered on the field, that are not given time to heal completely.  Moonkin focuses a great deal  on concussion and traumatic brain injury, including cases of NFL players Mike Webster and Andre Waters who died most likely secondary to complications of brain injuries (Waters suicided, however showed evidence of brain atrophy).  Many athletes from basketball to pro wrestling are examined.  The issues extend down to Little League and high school football, where  kids die after poor handling of serious injuries.

Moonkin implicates the rush to play through pain, and the need for a profit-driven pro industry to suit up important players.

Moonkin also looks at the conspiracy of silence in 'roids.  From a sports doctor:

“On the other hand, what can I do? Speak out? The players would never say anything was wrong. They want the money. And the fans wouldn’t be too happy, either. So I’d lose my job, all of my colleagues would hate me, and I wouldn’t have accomplished a [expletive] thing."

He’s right. Take, for instance, the steroid controversy in Major League Baseball. Its players (and the players union) have been fighting against more stringent testing, testing that could, at least theoretically, both level the playing field and protect their future health. But in the short term, there’s a good argument to be made that the more steroids that are in the game, the better it is for everyone involved. The league and its owners would make more money, the players would get bigger salaries, and fans, who certainly weren’t complaining about the home-run binge of the late 1990s, would get to watch the offensive fireworks they love. “You think it’s the doctors who are covering this up because it’s what the teams want?" asks a local team doctor. “You’re out of your mind. If you so much as hint to a player that you want to talk about the risks of, say, HGH [human growth hormone], you’re risking a lawsuit. You’ll have the union up your ass. You’ll have the player’s agent saying the team is just trying to find a way to knock down his value for his next contract. Eventually you throw up your hands. If a patient fights that much against [as little] as being educated, well, fine."

This attitude filters down to the kiddie leagues:

Some fans don’t want to know, either. Or don’t care. And that only contributes to the pervasive mind-set that a player’s health doesn’t matter nearly as much as his statistics. “Kids and their parents both look up to professional athletes," says Guskiewicz of the Center for the Study of Retired Athletes. “They take their lead from these guys. I mean, if it’s good enough for your hero, the guy making however many millions a year, isn’t it good enough for you?

Transsexual sports, transsexual sportswriters

(Tonight, Christine Daniels on Sportsradio; see information at the end of this post)

Last week, Mike Penner --sportswriter for the Los Angeles Times-- announced he would soon become Christine Daniels. (Our post here).  Sportswriters called Penner 'courageous'.  Angry bloggers called the announcement  'unimpressive':

Whether you care or not, this is some funny shit.

Changing genders isn't funny nor is it shit.  Penner/Daniels follows Christina Kahrl (photo, below left), an editor at the Baseball Prospectus who transitioned in 2003.

Outsports, reporting on gay sports, carried stories on Penner. (and here) saying:

Transgender issues are barely on anyone's radar screen outside of the relatively small community of self-aware transgender people. They're the "T" in GLBT – always last.. I feel blessed to have met Molly Lenore, an incredible woman who joined the New York Gay Football League two years ago...In college, she was a man, and no one would have guessed Molly was deep inside him waiting to get out. But she did, and the people in her life are better for it. The people in Penner's life will be better for it, too.

Confusing.  What is 'transsexual'?  That term defines a male changing lifestyle and anatomy to a female or a female changing to a male.  That does not mean gay, nor does it indicate transvestism.

Gay means libidinous attraction to the same sex (gender).  Transvestites are men,generally heterosexual, who enjoy dressing as women;  this is referred to as transvestite fetishism (the men at the left).

Transsexuals can become heterosexual or homosexual.  Most we know become heterosexual; men change to females, then are attracted to males.  Before the change these men were not gay, but were heterosexual males.  This is not a hard and fast rule. There are transsexual females who are attracted to other females.

Why the change?  There are a myriad of reasons: depression, personality problems, and feelings of always being a women trapped in a man's body.

What are the issues in sports?  In the male to female case, a mature male, who developed his skeleton and muscles under the influence of testosterone, competes as an adult female.  She will not have the typical male physiological dose of testosterone (she will take estrogen too) thus her muscle will atrophy; however she will be taller, and bigger than biological women.  The influence of testosterone on development cannot be erased.  Is that fair to biological women?

Transsexual athletes:

1.  Renee Richards holds the court as the first prominent transsexual athlete.  As Richard Raskind, he became a husband and father, an excellent ophthalmologist, strabismus surgeon and amateur tennis player.  As Renee Richards, she became controversial on the pro tennis tour. (reference). From NPR:

In 1976, I was one of the most famous people in the world. The paparazzi were on my trail twenty-four hours a day, hungry for any photo, the less flattering the better. The mainstream press was better, sometimes. People, Time, Newsweek, Sports Illustrated — I was featured in them all, an international phenomenon...

And what had I done to merit this interest?  I had undergone a male-to-female sex-change operation and then had the temerity to play in an amateur women's tennis tournament. Of course there was more to it than that, but basically that was the source of my infamy. To compound my audacity, I had not hung my head and apologized. I had gone to court, won my case, and played professional tennis as a woman...

Many people know that I coached Martina Navratilova to two of her Wimbledon championships.

Going to play in the NFL? Get set for pain and depression.

Interesting piece from Earth Times, abstracting a University of Michigan study that examined the health of former NFL players.  Michigan researchers sent out a questionnaire to former NFL players.  Of around 3400 surveys sent, about 50% responded.  The results appear to The Nation to be somewhat surprising.

LA Times Sportswriter switching hormones

A columnist for the Los Angeles Times today announced 'he' is switching genders to become 'she'.  Mike Penner will become Christine Daniels.

During my 23 years with The Times' sports department, I have held a wide variety of roles and titles. Tennis writer. Angels beat reporter. Olympics writer. Essayist. Sports media critic. NFL columnist. Recent keeper of the Morning Briefing flame.

Today I leave for a few weeks' vacation, and when I return, I will come back in yet another incarnation.

As Christine.

I am a transsexual sportswriter. It has taken more than 40 years, a million tears and hundreds of hours of soul-wrenching therapy for me to work up the courage to type those words. I realize many readers and colleagues and friends will be shocked to read them.

That's OK. I understand that I am not the only one in transition as I move from Mike to Christine. Everyone who knows me and my work will be transitioning as well. That will take time. And that's all right. To borrow a piece of well-worn sports parlance, we will take it one day at a time.

Transsexualism is a complicated and widely misunderstood medical condition. It is a natural occurrence — unusual, no question, but natural.

I am not sure of the science behind the new part.  Maybe it's an LA thing?

Recent studies have shown that such physiological factors as genetics and hormonal fluctuations during pregnancy can significantly affect how our brains are "wired" at birth.

As extensive therapy and testing have confirmed, my brain was wired female.

The response of his/her editor is a classic:

When I told my boss Randy Harvey, he leaned back in his chair, looked through his office window to scan the newsroom and mused, "Well, no one can ever say we don't have diversity on this staff."

Governor Schwarzenegger's appontments to State Board of Chiropractors has California in 'roid rage

Governor Arnold Schwarzenegger of the great state of California clearly takes political juice to another level.  Arnold greased the way for his gear-popping bodybuilder buddies to control the California Board of Chiropractors.  The gang still suffers from 'roid rage because the CHIPs were called to settle down the gang during recent Board of Chiropractic meeting (from Mother Jones)

Who needs to watch "Conan the Barbarian" when there’s the California Board of Chiropractic Examiners? The board, which includes two friends from Schwarzenegger’s bodybuilding days, one of whom played a part in the film, has launched a coup. They’ve ousted the board’s executive director and ejected their own lawyer, a deputy attorney general, from a meeting. The board is so mired in controversy, reports the Sacramento Bee, that five California Highway Patrol officers were called into a meeting last week to keep the peace.

The Midway Driller get down to the nitty gritty of the gear-grinding government:

...Schwarzenegger still doesn't understand why California has a state government. That became clear the other day, after his appointees to the state Board of Chiropractic Examiners - including two of his old steroid-popping bodybuilding buddies - pushed the board into utter chaos by firing its executive director and claiming chiropractors can cure earaches, when there's no evidence to suggest this is true.

A Terminator appointee kinda goofed-up says the Sac Bee. 

Acknowledging "gross errors in judgment," Tyler, appointed to the (Chiropractic) board by his longtime friend, Gov. Arnold Schwarzenegger, began the meeting with a contrite statement reflecting on the board's actions in a meeting earlier this month.

In that March 1 meeting, the board fired its executive director without due notice, ejected a deputy attorney general, endorsed a controversial procedure involving anesthesia and accredited a college despite the lack of an active application.

Wow.  That's more trouble than doing hang cleans on a soapy wood floor.

Arnold appointed longtime friend, Mr Olympia,  Franco Columbo to the board.  Controversy ensued when someone found out Franco's degrees are somewhat bogus.  How about that, a bogus degree was obtained under bogus cover.

One of two personal friends Gov. Arnold Schwarzenegger appointed to the state Board of Chiropractic Examiners last year had received a cease-and-desist letter in 2004 from the board ordering him to stop advertising a doctorate from an unaccredited correspondence school (Franco Columbo, shown below apparently treating a patient with neck pain).

Columbo, who trained with Schwarzenegger and was best man at his wedding, is one of four board members facing legislative scrutiny after they admitted running afoul of open-meeting laws and declared they wanted the board to better serve chiropractic interests. Board Chairman Richard Tyler, also a former friend of Schwarzenegger from his bodybuilding days, apologized at a recent legislative hearing for the panel's actions.

The head of the Chiropractic board, has his own educational credibility:

Another board member appointed by Schwarzenegger in February, Frederick Lerner, claims a Ph.D. in electromedical sciences from City University Los Angeles on his biography at Cedars-Sinai Medical Center.

CULA is unaccredited and is no longer approved by the state Bureau for Private Postsecondary and Vocational Education. The school maintains a Web site on which it cites recognition from Nigeria to operate.

What a mess.  However, The Barbarian Governor didn't stop at cracking up Chiropractic;  he now is getting drilled for appointing his own dentist to the State Dental Board.

Eight year old girl runs a marathon schedule

A recent article in the San Francisco Examiner looked at the increase in overuse injuries in kids.  Then this story comes along. From the Daily O'Collegian, by way of the Chicago Tribune is the story of an 8 year old girl who trains for marathons.  She runs with her father - alot.

Second-grader Zhang Huimin, who weighs 42 pounds and likes the Little Mermaid, sat up and gave a groggy glance around the one-room home she shares with her father, an out-of-work fish farmer with a singular goal: grooming his daughter for the 2016 Olympics...
 
On this Saturday, as she does most weekends, the girl will run more than 26 miles before school — on top of dozens of miles she runs before school each week. Those statistics cry out for skepticism, but watching her run for more than four hours or interviewing marathon officials who recorded her recent races makes it hard to find suspect a hoax...

Zhang said he started running with his daughter when she was 4, adding distance each morning. By age 6, she could run 8 miles; at 7, she completed the Haikou marathon in 3 hours, 28 minutes and 45 seconds.

Most recently, she finished China’s Xiamen International Marathon on March 31, with a time of 3 hours, 44 minutes and 51 seconds. Organizers waived the minimum age of 18 and allowed her father to bike beside her because “she is a special case,” said He Xi, vice director of the race.

The Examiner article says this:

One of the costs of the hypercompetitive sports life is physical injury, the subject of the following excerpt. Previously, kids played multiple sports seasonally and usually didn't specialize in one sport or get serious about team sports until middle school or high school. Now kids often play one sport all year long, which has caused a dramatic rise in overuse injuries.

Meanwhile our 8 year-old marathoner has a few familiar elements in her story:

Rather, her story is most revealing about the conditions that created her: a father whose dream of sporting glory never materialized, an impoverished town dazzled by attention and a nation where the power of fame can make anything seem worthwhile.

What happens when a youngster, who does not possess mature bones, cartilage, muscles, and joints...

Overtraining at such a young age can erode the cartilage in joints, delay menstruation, reduce bone density and cause a range of orthopedic problems, including stunted growth. At 42 pounds, Huimin is underweight, her father concedes, but she has never had a full check-up, so he does not know what toll her training has taken.

You thought your parents were hard on you...

Sports Column link.

Going outside 'roids: updates on campus shootings

We are going beyond steroids today, and into the world of campus shootings.  Two reasons give us some cred on this subject:

1. We are in psychiatry and in the business of evaluating violence
2. We are on the campus of the University of Iowa, where in 1991 Gang Lu, 28, a graduate student in physics from China, killed 5 'professors'.

Look at this list of campus shootings.

Something appears to emerge: The shooters hunt people down.  They are different from isolated domestic shootings.  These killers strike at professors and students, and they seem hunt people down in multiple settings.

Thus, administration on campuses must understand the behavior of these aberrant shooters...they are deranged hunters.  Shut the campus down!

_Aug. 1, 1966: Charles Whitman points a rifle from the observation deck of the University of Texas at Austin's Tower and begins shooting in a homicidal rampage that goes on for 96 minutes. Sixteen people are killed, 31 wounded.

_July 12, 1976: Edward Charles Allaway, a custodian in the library of California State University, Fullerton, fatally shoots seven fellow employees and wounds two others. Mentally ill, Allaway believed his colleagues were pornographers and were forcing his estranged wife to appear in their movies. A judge found him innocent by reason of insanity in 1977 after a jury was unable to reach a verdict and he was committed to the state mental health system.

_Nov. 1, 1991: Gang Lu, 28, a graduate student in physics from China, reportedly upset because he was passed over for an academic honor, opens fire in two buildings on the University of Iowa campus. Five university employees are killed, including four members of the physics department; one other person was wounded. The student fatally shoots himself.

_Aug. 15, 1996: Frederick Martin Davidson, 36, a graduate engineering student at San Diego State, is defending his thesis before a faculty committee when he pulls out a handgun and kills three professors.

_Oct. 28, 2002: Failing University of Arizona Nursing College student and Gulf War veteran Robert Flores, 40, walks into an instructor's office and fatally shoots her. A few minutes later, armed with five guns, he enters one of his nursing classrooms and kills two more of his instructors before fatally shooting himself.

_Aug. 28, 2000: James Easton Kelly, 36, a University of Arkansas graduate student recently dropped from a doctoral program after a decade of study and John Locke, 67, the English professor overseeing his coursework, are shot to death in an apparent murder-suicide.

_Jan. 16, 2002: Graduate student Peter Odighizuwa, 42, recently dismissed from Virginia's Appalachian School of Law, returns to campus and kills the dean, a professor and a student before being tackled by students. The attack also wounds three female students. Odighizuwa is serving six life sentences after pleading guilty.

April 16, 2007: A gunman identified as 23-year-old student Cho Seung-Hui fatally shoots 32 people in a dorm and a classroom at Virginia Tech in Blacksburg, Va., then kills himself.

Daily News reports Barry Bonds cited the Therapeutic Use Exemption

The New York Daily News reports that following his bust for amphetamine use, Barry Bonds cited the TUE - Therapeutic Use Exception. (The Nation addressed amphetamine use yesterday)  It appears there is less to this Bonds angle than the News would like, though.  The paper doesn't say Bonds even applied for a TUE. What illness he is going to use to apply for a TUE: 'dwarfism' for HGH, 'diabetes' for insulin, 'ADHD' for modafinil and dextroamphetamine, 'AIDS' for steroids?

By now, casual fans know that when Barry Bonds was told he had failed an amphetamines test last season, the first thing he did was suggest that he had taken some kind of substance that belonged to teammate Mark Sweeney.

What fans don't know, however, was what Bonds did next. According to several sources, Bonds said he knew that several of his teammates had permission to take banned drugs for medical reasons, and he wanted that permission, too.

Bonds never applied, but that permission, known as a therapeutic use exemption, or TUE, is a fragile loophole in any league's anti-doping system. Every sports league, even those that follow the strict World Anti-Doping Agency code, allows athletes to take drugs for a legitimate medical need. The question is whether the need is always legitimate, and how TUEs are given out.

The TUE is amateur and professional sports way of dealing with the medical use of these banned drugs (overview, extensive list), as prescribed by a physician.  The most typical banned drug that could be used to treat a disorder would be amphetamine or methylphendate.  Amphetamine would be the molecule in Dexedrine or Adderall;  methylphenedate the drug in Ritalin or Concerta.  Both are legitimate treatments for ADHD.

Therein lies the sticky wicket for TUEs.  Players with legitimate ADHD will show m ouch improved performance with the use of, say, Adderall.  Two points however:

1. Those drugs will improve motor coordination, as well as concentration and endurance (energy)
2. Anyone would improve in these parameters, not just ADHD patients.

Thus, the TUE is difficult to obtain, as well is should be.

"There are some guys who (have exemptions) that probably don't need it," Chicago Cubs reliever Scott Eyre, who takes medication for attention-deficit disorder, said during spring training. "It bothers me a little bit."

The NFL and MLB manage their own TUE procedures.  How many pros receive TUEs?

Of the 1,959 players under contract, 29 have TUEs, NFL spokesman Greg Aiello says, and 27 of those are for ADD or ADHD drugs.

While half a team roster might sound like a lot, that number means 1.4% of NFL is under treatment for ADD or ADHD, compared to 4-5% of the adult population in the United States. The other two exemptions were for diuretics prescribed to players with hypertension, Aiello says. Diuretics, which increase urine production, are banned because they can be used to mask drug use. Aiello says no NFL players have TUEs for testosterone. Manfred says he is prevented from answering the question about baseball.

Actually the number of pros with ADHD receiving TUEs is fewer than expected from the epidemiological data.  However, it may be that ADHD athletes are at an disadvantage when developing in the system.

This story and the earlier Bonds stories hint that Bonds blamed his teammate for a positive amphetamine test.  It could be that Bonds knew his fellow Giant was granted a TUE, and thus could take a medicine for ADHD.  We will never know the actual story because positive amphetamine tests are not reported for the first several violations.

Lou Gehrig wants the stem cell research bill to pass Congress

There appears to be a big gunfight on the horizon over stem cell research.  Reports here at Reuters:

WASHINGTON (Reuters) - The White House threatened on Tuesday to veto a new bid to lift U.S. President George W. Bush's restrictions on federal funding of stem cell research as the Senate began considering the bipartisan bill.

and Therapeutics Daily: 

WASHINGTON, April 10, 2007 (AFP) - The US medical community is pressing on with its plea to end limits on government financing for embryonic stem cell research, but President George W. Bush refuses to lift the restrictions.

Beneficiaries of stem cell research would include victims of Amyotrophic Lateral Sclerosis (did I prove I am a doctor writing that), also known as Lou Gehrig's Disease.  ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Information here on ALS and at the National Institutes of Health on stem cell research.  Those dying nerve cell functions may be 'regenerated' using multipotent stem cells (information from the Cal Ripken funded Lou Gehrig Disease -ALS- research center at Johns Hopkins)

Stem cells might also be used in treated athletic injuries. Link to NY Times story here:
(Thanks to the Wizard of Odds)

The latest curative leap to heal professional athletes and weekend warriors alike may sound like science fiction, but it could transform sports medicine. Some doctors and researchers say that in a few years the use of primitive stem cells from infants' umbilical cord blood could grow new knee ligaments or elbow tendons creating a therapy that becomes the vanguard of sports injury repair.

Let's get this bill passed and going.  My cousin's husband died after a long and difficult course of Lou Gehrig's disease last year. ALS may be linked to chemicals on athletic fields and golf courses.  We need treatments for this fatal disease.  Lou Gehrig who died of ALS in 1941 says DO IT NOW!

Steroids: Letting the air out of your balls

As documented here at The Bleacher Report, a new ad from http://www.drugfree.org/  discusses the side effects of anabolic steroids.  Effects on systems including: tendons, internal organs, central nervous system, and of course your testicles.

The Bleacher report doesn't care for the ad:

I mean COME ON: We’ve already been told that steroids can cause strokes and heart attacks.  But that’s nothing!  THEY CAN ALSO SHRINK YOUR BALLS!

 

But wait, did you ever stop and think about the fact that YOU WON'T HAVE ANY BALLS TO SHRINK IF YOU'VE ALREADY DIED OF A HEART ATTACK?

If I had one suggestion for the people at drugfree.org, it would be to stop assuming that kids are so stupid.  This idea that some teenager is going to stop taking steroids—not because you warned him about dying of a heart attack, but because it's going to lower his sperm count—is just insane.  And if the kid is indeed stupid enough to be more concerned with the sexual side effects than he is with the risk of his heart stopping, then hell: He's probably dumb enough to miss the message altogether and continue juicing.

So, here are your balls on steroids: