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Therapeutic Use Exemption (TUE's)

The Clinic is the only place on Cyclingnews where you can discuss doping-related issues. Ask questions, discuss positives or improvements to procedures.

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Re:

29 Apr 2018 13:50

vedrafjord wrote:No motivation for Westra to tell all while his active years as a rider are within the statute of limitations and Vino can sue him.

I think the main flaws with the TUE situation currently are
a) doctors are employed by the teams so their motivation is results as well as rider health
b) no distinction between chronic/acute conditions eg diabetes where a rider will need insulin for the rest of their life vs say a chest infection
c) no distinction between serious cases and minor niggles - rider motivation is to get the strongest treatment with the most performance-enhancing side-effects (eg Wiggins) rather than treatment proportional to the condition.

I think at minimum the list of banned substances needs to be categorised into compete/no-compete lists - you get a TUE for something minor like sudafed for congestion and you can still race, but if you need, say, morphine, it means it's yoiu're not healthy to race and you need a one or two week break before you can come back.

This is more or less my view on the matter, thank you.
ColonelKidneyBeans
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Re: Re:

29 Apr 2018 14:21

Bolder wrote:
Ferminal wrote:
vedrafjord wrote:Lieuwe Westra (Vacansoleil 2009-2013, Astana 2014-2016) admits cortisone use throughout his career on the back of fraudulent TUEs: https://www.lc.nl/sport/Lieuwe-Westra-biecht-gebruik-cortisonen-op-23137654.html


Hmm, I'm not buying that Vacansoleil A-listers were just your standard cortisone happy team, but it's a nice story for Westra to be able to maintain he never crossed the line.


I don't think that cortisone shots are something to build your doping program around. they are handed out with abandon if you have any kind of undiagnosed pain, whether you're an athlete or just sprain your thumb picking up a bag of groceries. Also not sure (having received a few) that there are any benefits to getting more than one at a time in any specific spot.
However, I agree with ^^ that Westra is probably holding back a somewhat. But why hold back? If you really want to sell books nowadays you'll have to do better than TUE abuse...


Wiggins might disagree......
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Re: Re:

29 Apr 2018 16:24

ColonelKidneyBeans wrote:
Koronin wrote:
ColonelKidneyBeans wrote:
Parker wrote:
ColonelKidneyBeans wrote:Maybe it's time to change that mentality, and frankly physician should not allow it, they are enabler in that case.
It's... weird to claim that TUE have minimal performance effects given what we have learned during the past few years i beleive, i completely disagree with you there, but i don't think we need to discuss that much, we have irreconcilable positions there, no need to beat a dead horse.

I really don't think you appreciate what pro sportsmen are like. They devote their life to competition. They are not going to give that up just because they are a little ill.

What if an athlete is ill but the medicine required to treat them isn't banned. Should they withdraw as well?

But you seem to think you know better than WADA. Spoiler: you don't.

When you need corticoids you are not "just a little ill"
Yeah because WADA has such a good track record at preventing doping, would it bother you just one time to respond to the actual content of the post instead of using thinly veiled personal attacks and shifting goalpost continuously? Like, where do you get that TUE aren't performance enhancing and abused after the whole sky mess, Zorzoli, Europcar, Horner, riders being unable to start because of low cortisol levels, and now Westra coming clean?


These guys want to race at all costs. Last year Tour Valverde broke his kneecap and his ankle. 6 weeks later he was riding out on the road (first Vuelta rest day he showed up for the team's training ride). He'd tried to talk to the team into letting him start la Vuelta less than 8 weeks after that injury. Then he tried to talk them into letting him race at Lombardia, and then China the final race of the season. The flat out refused because they didn't want to risk him re-injuring anything. Now, yes, this might be a bit extreme on his part, but this is very much the mentality of elite athletes.

I don't know what Valverde has to do with anything i wrote here, yes pro sportsmen push their bodies very far, yes sometimes TUE might be justified, but that doesn't mean they aren't abused, and to claim the contrary sounds absurd right now.


Just an example of a rider wanting to race regardless of reasons why he shouldn't be racing.
Are TUEs abused, I'm sure they are. What's the best way to fix that problem, not really sure because there are reasons for them and are legitimate reasons that some riders need them while racing (such as the one Yates twin).
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Re: Re:

29 Apr 2018 16:32

ColonelKidneyBeans wrote:I know, and they should not, in a better world, but i'm not the one trying to pass the decision to take a TUE as a choice between death and disgrace (a bit hyperbolic FMK no?) when there is also the possibility to simply not compete.
It will never cease to amuse me how those who open with hyperbolic statements calling for all TUEs to be banned quickly admit exceptions to their brave new world.

"You have a permanent problem, like diabetes? OK, you can be an exception, once we get a doctor to confirm the situation. You need a banned drug for an injury? You can be an exception, but you'll have to stop competing for a period of time."

How is that different to the situation we have today? Will it just be a name change? We'll call them Medical Need Exceptions, will we?

So what is actually meant by such radical calls to ban all TUEs? Is it just AD virtue signalling? Frustration? "I'm angry now. Look, this is how angry I am, I'm willing to say something very, very, stupid. Because I'm angry."

Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that athletes with certain permanent medical conditions will be banned from all WADA-accredited sport, which includes the Paralympics. Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that athletes in extreme situations with be asked to choose between death and disgrace. Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that this is a fascistic vision of sport, games for the übermensch.
Last edited by fmk_RoI on 29 Apr 2018 16:40, edited 1 time in total.
User avatar fmk_RoI
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29 Apr 2018 16:39

Due to the abuse of medications by those in the sport, TUEs should be banned. Tough luck on diabetics, asthmatics and others who require such meds. That as they say is life.

Might as well say, give me a motor as i was not born with the same consitution as Merckx..............

Give mountain climbers motors for TTs and sprinters motors for climbs.......or put weights on bikes.
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Re: Re:

29 Apr 2018 17:28

fmk_RoI wrote:
Craigee wrote:Shouldn't be any TUE's.
I'm an athlete. I'm ill. I need a banned drug. Do I risk my health and refuse or accept a four year ban for doping? Death or disgrace, which?


You sound like Choppy Warburton.
Craigee
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29 Apr 2018 17:43

If a rider breaks his collar bone a week before a big race or tour, no TUE can help him. He has to withdraw from the race. But you can take steroids in case you might get asthma? It's a joke and all the Pro Sports Organisations and WADA are doing the bare minimum to look like they're against doping. This is a fact because doping is so rampant world wide.
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Re: Re:

29 Apr 2018 17:47

Craigee wrote:
fmk_RoI wrote:
Craigee wrote:Shouldn't be any TUE's.
I'm an athlete. I'm ill. I need a banned drug. Do I risk my health and refuse or accept a four year ban for doping? Death or disgrace, which?


You sound like Choppy Warburton.
You sound like Colin from the Fast Show.
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Re: Re:

29 Apr 2018 17:52

fmk_RoI wrote:
ColonelKidneyBeans wrote:I know, and they should not, in a better world, but i'm not the one trying to pass the decision to take a TUE as a choice between death and disgrace (a bit hyperbolic FMK no?) when there is also the possibility to simply not compete.
It will never cease to amuse me how those who open with hyperbolic statements calling for all TUEs to be banned quickly admit exceptions to their brave new world.

"You have a permanent problem, like diabetes? OK, you can be an exception, once we get a doctor to confirm the situation. You need a banned drug for an injury? You can be an exception, but you'll have to stop competing for a period of time."

How is that different to the situation we have today? Will it just be a name change? We'll call them Medical Need Exceptions, will we?

So what is actually meant by such radical calls to ban all TUEs? Is it just AD virtue signalling? Frustration? "I'm angry now. Look, this is how angry I am, I'm willing to say something very, very, stupid. Because I'm angry."

Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that athletes with certain permanent medical conditions will be banned from all WADA-accredited sport, which includes the Paralympics. Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that athletes in extreme situations with be asked to choose between death and disgrace. Virtually nobody who calls for the banning of all TUEs is actually willing to defend such a ban to the hilt, to admit that this is a fascistic vision of sport, games for the übermensch.

Death and disgrace, please, what about not competing? No one is entitled to a pro sport career, and yes, it kinda has an "for the übermensch" character, that's the nature of pro sport, it's for people winning the genetic lottery regarding physical capacity. If it isn't, why not legalise doping, after all the people with low natural testosterone might take objection that the diabetics have the right to replace their insulin with an exogenous source while they cannot.
As for being angry, you should reread your production here, you are a treasure trove of informations and a good read, but you get kinda aggressive and personal when you disagree with someone, which tend to happens quite a lot.
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Re: Re:

29 Apr 2018 18:00

ColonelKidneyBeans wrote:No one is entitled to a pro sport career, and yes, it kinda has an "for the übermensch" character, that's the nature of pro sport, it's for people winning the genetic lottery regarding physical capacity.
Just so the moderators are aware, if, in the future, I should refer to you as "the fascist ColonelKidneyBeans" you're going to be cool with that, right? Cause that is what you're admitting to, right?
ColonelKidneyBeans wrote:As for being angry, you should reread your production here, you are a treasure trove of informations and a good read, but you get kinda aggressive and personal when you disagree with someone, which tend to happens quite a lot.
It will never cease to amuse me how many people round here can't read. Even when you tell them you're amused they feel all hurt and abused and accuse you of being angry. Honey, when I'm angry, I promise, you'll **** know it. :lol:
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Re: Re:

29 Apr 2018 18:29

fmk_RoI wrote:
ColonelKidneyBeans wrote:No one is entitled to a pro sport career, and yes, it kinda has an "for the übermensch" character, that's the nature of pro sport, it's for people winning the genetic lottery regarding physical capacity.
Just so the moderators are aware, if, in the future, I should refer to you as "the fascist ColonelKidneyBeans" you're going to be cool with that, right? Cause that is what you're admitting to, right?
ColonelKidneyBeans wrote:As for being angry, you should reread your production here, you are a treasure trove of informations and a good read, but you get kinda aggressive and personal when you disagree with someone, which tend to happens quite a lot.
It will never cease to amuse me how many people round here can't read. Even when you tell them you're amused they feel all hurt and abused and accuse you of being angry. Honey, when I'm angry, I promise, you'll **** know it. :lol:

I was wondering how long i was going to wait for it to come to that point, it was pretty obvious why you would use terms like übermensch, call me a fascist if you want, pro sport has nothing to do with politics... Congratulations for the reductio ad hitlerum tough.
I don't feel hurt or angry at all, maybe you should not make assumptions about the emotional state and the motivations of total strangers on an internet forum. If you are not angry yourself, i'd like to see what you would call me if you were. After all nothing exudes calmness like calling someone a fascist for a disagreement about TUE's.
Last edited by ColonelKidneyBeans on 29 Apr 2018 18:36, edited 1 time in total.
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Re: Re:

29 Apr 2018 18:34

ColonelKidneyBeans wrote:maybe you should not make assumptions about the emotional state and the motivations of total strangers on an internet forum.
It wasn't me making an assumption. I asked a question. You didn't.
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Re: Re:

29 Apr 2018 18:37

fmk_RoI wrote:
ColonelKidneyBeans wrote:maybe you should not make assumptions about the emotional state and the motivations of total strangers on an internet forum.
It wasn't me making an assumption. I asked a question. You didn't.

The question being? and i didn't what? (sorry i can't read, that much is clear :razz: )
ColonelKidneyBeans
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Re: Re:

29 Apr 2018 18:43

ColonelKidneyBeans wrote:sorry i can't read, that much is clear
This much we established several comments back.
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Re: Re:

30 Apr 2018 02:12

fmk_RoI wrote:
Craigee wrote:
fmk_RoI wrote:
Craigee wrote:Shouldn't be any TUE's.
I'm an athlete. I'm ill. I need a banned drug. Do I risk my health and refuse or accept a four year ban for doping? Death or disgrace, which?


You sound like Choppy Warburton.
You sound like Colin from the Fast Show.


Whose this Colin from the Fast Show? Another British Doper?
Craigee
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30 Apr 2018 09:22

just let people dope already
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Re:

30 Apr 2018 09:58

saganftw wrote:just let people dope already


I hate to tell you this, but I think some already do ... :D
Salbutamol - Breakfast of Champions!
"Are you going to believe me or what you see with your own eyes?"
Choco Loco for all your doping tips!
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Re: Therapeutic Use Exemption (TUE's)

30 Apr 2018 11:09

I don't even think TUE's are an issue today. What were there last year? Less than 20 in total across UCI Road, Track, BMX, MTB & Indoor UCI sanctioned competition?
I'd say the TUE system was abused in the past simply because UCI lacked resources with just one single doctor called Zorzoli who would never be able to logistically cross-reference +200 TUEs applications per year across several thousand athletes spread around the globe to confirm medical need or confirm abuse. The bets you could hope for is he could probably process 200 forms a year, not confirm legitimacy of each one. That is the teams doctors role.
End of the day the teams doctors are the ones who wrote each TUE application out at the demands of the rider/coach/team staff. I think the TUEC set-up works pretty well now and clearly very few are now granted anyway.
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Re: Therapeutic Use Exemption (TUE's)

30 Apr 2018 11:47

samhocking wrote:I don't even think TUE's are an issue today. What were there last year? Less than 20 in total across UCI Road, Track, BMX, MTB & Indoor UCI sanctioned competition?
No matter how many times this stat gets corrected, it keeps getting quoted. This refers solely to TUEs issued by the UCI. The UCI is not the sole agency issuing TUEs in cycling.
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Re: Therapeutic Use Exemption (TUE's)

30 Apr 2018 11:55

fmk_RoI wrote:
samhocking wrote:I don't even think TUE's are an issue today. What were there last year? Less than 20 in total across UCI Road, Track, BMX, MTB & Indoor UCI sanctioned competition?
No matter how many times this stat gets corrected, it keeps getting quoted. This refers solely to TUEs issued by the UCI. The UCI is not the sole agency issuing TUEs in cycling.

There is an elite testing pool of about 1300 cyclists. They can only get a TUE from the UCI.
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