Doping in Soccer/Football

[Libertine Seguros]

Henry Winter ‏ @henrywinter Reply Retweet Favorite · Open
#bwfc say Fabrice Muamba ''is now able to breathe independently without a ventilator. He is able to recognise family & respond to questions'

That's some much better news. For all the bickering on what we might or might not be allowed to discuss, this is good news to everyone.

 

[Mambo95]

Mambo, of course, knows all this, but the word "investigation" in the Clinic has some specific connotations that set off red alerts in his mind. And those of us who would like to see something done about the number of players who have collapsed and continued to collapse become the bad guys because we have to refer to potential reasons, which in the absence of proper information begets idle and sometimes ghoulish speculation. Mambo is of course the good guy here, because he will not speculate. I'm just interested how those that think "too many people are getting hurt, we must find out why this is and try to reduce it" are the bad guys and lumped in with the (mostly fictitious) "oh my god it must be dope he doped and that's why it happened" group, and those who think "this is terrible. Still, let's keep on keeping on" and then rinse and repeat when the next player collapses are the good guys.

OK. So you want to make a difference. How are you going to this? What are your goals and how will you achieve them.

Are you going to spread the word to football forums?
Are you going to pressure Bolton Wanderers to launch an inquiry into doping?
Are you going to present a report of your half formed ideas to cardiologists saying who they've got everything wrong?
Are you going to obstruct the message of charities like CRY by creating misinformation?

Or are you just going to just indulge in tawdry innuendo about a man still fighting for his life with people who are so obsessed with doping that they couldn't wait until they knew whether Muamba had survived before starting the gossip mill and couldn't hide their glee at Tondo's death and the conspiracy theories it threw up.

Don't hide behind some BS sense of making a difference. You are doing nothing to make any change for the good. You're just gossips and passing it off as some sort of community concern just makes it even more distasteful.

 

[Albatros]

The following stat is probably just a coincidence unrelated to doping, but I'll post it anyway:

http://es.eurosport.yahoo.com/18032012/47/liga-gran-cambio-xavi-madurez.html


and especially this:

Let's do the math. So Xavi turns into this complete player some seven seasons ago and was quite mediocre before that (let's be honest). Seven seasons ago...Isn't that when Rijkaard came in and when the Puerto-connection-rumors emerged? Basically when Barca began turning into this freaky unbeatable football machine?

All signs indicate that the year 2005 marked some significant change of program in Barca's medical department.
HGH? EPO? Or a combination?

I am pretty sure that Barcelona are on a good doping program, but they are not the only ones. They tried to sign Eufemiano Fuentes twice before Laporta arrived. That is well documented. I can even provide the radio excerpt if anyone is interested.

And I am saying they are not the only ones because looking at the UEFA stats of distance covered they are just middle of the pack. So if they are doping the rest are not with their arms crossed.

 

[Albatros]

Ok i am going to say this again for ya.

I am not going to consider doping whatsoever and the only thing i am thinking about is if there is sufficient screening being done in football and how the heart problem wasnt detected. That is the only thing i am considering and that is the only issue that has the basis to be discussed at this time.

I think its already disrespectful to players who already have died coz of cardiac issues to insinuate this nonsense of doping.

Doping has been widespread in football for almost as long as the sport existed. Do your research and the question would be when footballers stopped doping rather than if they dope at all.

It is all too natural in a forum that discusses doping issues to especulate with the posibility of a link between the numeorus cardiac arrests in recent years and doping. We are not even discussing Muamba de the individual.

 

[Markyboyzx6r]

OK. So you want to make a difference. How are you going to this? What are your goals and how will you achieve them.

Are you going to spread the word to football forums?
Are you going to pressure Bolton Wanderers to launch an inquiry into doping?
Are you going to present a report of your half formed ideas to cardiologists saying who they've got everything wrong?
Are you going to obstruct the message of charities like CRY by creating misinformation?

Or are you just going to just indulge in tawdry innuendo about a man still fighting for his life with people who are so obsessed with doping that they couldn't wait until they knew whether Muamba had survived before starting the gossip mill and couldn't hide their glee at Tondo's death and the conspiracy theories it threw up.

Don't hide behind some BS sense of making a difference. You are doing nothing to make any change for the good. You're just gossips and passing it off as some sort of community concern just makes it even more distasteful.

Excellent post Mambo. Bang on target. Funny thing is, when you work in Cardiology (as I do), you quite often run into people who have survived a sudden death episode normally by sheer good luck (an AICD is present, they're next to a passing ambulance etc). The thing about it is - sometimes even with ECG, Echo and all the normal cardiac tests, these things can go undetected. They weren't doping, they did nothing to promote the arrhythmia - yet it happened to them.

I know this is the Clinic and all, but these things happen to all sorts of people in all sorts of circumstances, it's a terrible fact of life. The ones I talk to are the ones who've been very very lucky to have survived. There's many more who don't live to tell the tale. It is SO typical of the Clinic that suddenly "Drugs in Football" is the lead topic. A+B=Z.

99.9% of the posters on this topic wouldn't know one end of a heart from another yet they think it's okay to speculate on what caused Saturday's arrest. VF arrests happen for a number of clinic reasons. If the speculators on this forum had any cardiac knowledge at all they would know to keep their council until...

1. The lad was out of danger.
2. His cardiac diagnosis established.

I'm no expert of most things in life, but I AM an expert on Electrophysiology. This thread is truly bang out of order to even mention poor Fabrice Muamba. Ignorance is no barrier to an opinion in the Clinic, but to link him and doping is ignorance in the extreme (even in speculation).

 

[hrotha]

Mambo, misrepresentation much?
http://forum.cyclingnews.com/showthread.php?t=13673&highlight=Tondo

The vast majority of the Clinic, including many who are now debating this with you, were very clear on the Tondo thing.

 

[Libertine Seguros]

Or are you just going to just indulge in tawdry innuendo about a man still fighting for his life with people who are so obsessed with doping that they couldn't wait until they knew whether Muamba had survived before starting the gossip mill and couldn't hide their glee at Tondo's death and the conspiracy theories it threw up.

Point me to where I said that Muamba's collapse had anything to do with doping, and maybe I'll listen to your crusade.

Something caused him to have cardiac arrest. It has happened to a number of sportsmen. If there is a causal connection, then measures can be taken to prevent it happening to others, no? That causal connection could very easily have nothing to do with doping - as the medical sources seem to be suggesting that, as with Foé, this is likely a previously undisclosed hereditary condition.

Maybe it's too soon to discuss, but it should be discussed, and telling anybody off for having an opinion other than "nothing to see here, carry on" is just as counterproductive as the conspiracy theorists.

 

[Caruut]

OK. So you want to make a difference. How are you going to this? What are your goals and how will you achieve them.

Are you going to spread the word to football forums?
Are you going to pressure Bolton Wanderers to launch an inquiry into doping?
Are you going to present a report of your half formed ideas to cardiologists saying who they've got everything wrong?
Are you going to obstruct the message of charities like CRY by creating misinformation?

Or are you just going to just indulge in tawdry innuendo about a man still fighting for his life with people who are so obsessed with doping that they couldn't wait until they knew whether Muamba had survived before starting the gossip mill and couldn't hide their glee at Tondo's death and the conspiracy theories it threw up.

Don't hide behind some BS sense of making a difference. You are doing nothing to make any change for the good. You're just gossips and passing it off as some sort of community concern just makes it even more distasteful.

If no-one is reading it, it doesn't matter.

If people are reading it, then it might be making a difference.

We also might just be curious.

 

[Mambo95]

Something caused him to have cardiac arrest. It has happened to a number of sportsmen. If there is a causal connection, then measures can be taken to prevent it happening to others, no? That causal connection could very easily have nothing to do with doping - as the medical sources seem to be suggesting that, as with Foé, this is likely a previously undisclosed hereditary condition.

Cardiologists know the things that lead to these arrests. There's been plenty of study into it. There is no casual connection to doping. Do you really think that a group of inexperienced doping obsessives have come up with an alternative reason, which they can't explain properly, and which has eluded the medical community and the millions of pounds of research?

By creating misinformation about the causes of diseases, it can create the impression that this can't happen to you or those you know. It helps perpetuate the myth that healthy young people don't drop dead, and it must be down to something they did? Don't worry this can't happen to you, eh?

Uninformed speculation does no good, it does not make an iota of difference, it does not prevent anything or implement any measures. All it does is sate the distasteful lust for gossip from some individuals who need to ask themselves a few questions.

 

[Mambo95]

If people are reading it, then it might be making a difference.

Yes, one person at risk may turn down the opportunity of a heart scan as he thinks this is a doping related casualty and can't effect him.

 

[The Hitch]

Yes, one person at risk may turn down the opportunity of a heart scan as he thinks this is a doping related casualty and can't effect him.

Thats a stretch.

It's like suggesting that people who read the clinic will think they are immune from cancer because they hear theories that Lance may have gotten it from doping.

Just because the probability of a problem might be increased by doping doesn't mean that doping is the only way it can be achieved.

How you get from doping can cause x to doping is the only cause of x is beyond me.


Besides even if there was such a person the probability that that 1 person is the 1 with a heart problem is very low.

 

[The Hitch]

Point me to where I said that Muamba's collapse had anything to do with doping, and maybe I'll listen to your crusade.
.

This is getting ridiculous now.


He has now accused me, hrotha and you of attacking the player as a doper even though not one of us has even spoken on the issue.

Mambo, you say it is very wrong to talk about the issue as the man lies in hospital.

Is it also not very wrong to accuse posters of attacking a man suffering a heart attack, when they have done no such thing ???

Please do answer

 

[unclem0nty]

Dr Amanda Varnava, a consultant cardiologist for HarleyStreet.com and at St Mary's and Imperial in London, who runs a centre for inherited heart conditions and screens players at a number of clubs including West Ham, Fulham, Spurs, Watford and Stoke City...

...Varnava thinks Muamba's cardiac arrest was probably caused by an electrical defect in his heart, which will have interfered with the normal rhythm, rather than the other main possibility, hypertrophic cardiomyopathy – a thickening of the wall of the heart due to intense athletic training coupled with a genetic propensity. That can be spotted during screening and Muamba is said to have been screened relatively recently. A problem with the heart rhythm may not so easily show up.

http://www.guardian.co.uk/football/2012/mar/19/fabrice-muamba-brain-damage-heart?intcmp=239

 

[Caruut]

I will clear this up for you once and for all so read very carefully and take it in this time. Many medical experts i heard on TV are saying:

IT IS MOST LIKELY HYPERTROPHIC CARDIOMYOPATHY WHICH IS A HERIDITARY CONDITION WHICH IS KNOWN TO INCREASE THE RISK OF DEATH DURING PHYSICAL EXERCISE.

So quit the rubbish about doping today please. Younger people are likely to have more severe forms of hypertrophic cardiomyopathy.

Why bring one sentence out of a post about 6 pages ago?

The question was whether drug use might make such things more likely. You don't just die "of drugs", the drugs generally cause or contribute to another condition. It was not a specific accusation against Muamba, and was not intended to smear his character.

You say people are "obsessed with linking it to doping". The "Doping in Soccer/Football" has been one of the most active Clinic threads in recent weeks.

When I first posted this, I didn't know a thing about SCA or any of its many variants. Not knowing that, it made me wonder. Then several posters came on here saying "You aren't allowed to wonder". You know what, back off. There's nothing wrong with wondering whether institutionalised doping might be a CONTRIBUTING FACTOR to these tragedies.

This thread is dead, now, and I apologise for indirectly ruining it.

Gooner, I don't feel like you've read any of my posts properly before replying to them.

Mambo, some of these posts contain wild fantasies that are beyond even being funny.

I don't see any point in posting again while the thought police are still out.

 

[Paco_P]

How about children who have to take corticosteroids for asthma?

Have you never wondered why so many Olympic swimmers are asthmatics?

 

[Markyboyzx6r]

Good post.

Its intersesting to hear you say these things can go undetected. I was reading something like hypertrophic cardiomyopathy(which many medical people on TV say is the likely cause) can be detected with an echocardiogram with only around an 80% accuracy. I am no cardiologist expert so i will go with what i am listening from the medical experts on TV and newspapers who know the issue and not some of the people here who know jack s*** about cardiology.

If his arrest has been mediated by HOCM (which can cause sudden death), then if all he has had is an ECG it could (in theory and in practice) be missed. Here's why...

HOCM means thicker heart muscle, which shows up as an increased amplitude R wave on the ECG (sorry if this is all a bit technical but it's the easiest way to explain it). Increased LV thickness means more electrical activation and therefore higher voltage seen on the ECG. Okay so far? Ah, well here's where it gets complicated...

You will also see this pattern on people with low body fat (less adipose tissue for the signal to be detected through), the athletically trained (obviously) and in other circumstances, less relevant to what I'm describing. So a young Premiership footballer comes into the ECG Room - he has large amplitude R waves - the Consultant then needs to consider whether this is normal varient for the patient or the signs of something more sinister. An Echocardiogram, a stress echo, a stress MRI, a cardiac CT or a CPX may be ordered - but unless there is a Fx, previous dizziness/collapse etc - they may not.

See this is the point I was trying to make with my previous post. It's not just a case of getting all the tests done then seeing the form - there has to be justification for doing them (risk/reward). We could take every Premiership footballer into the EP Lab, do all sorts of VT stimulation tests, and weed them out that way. But EP has a 0.5 to 3% complication rate (so the risk outways the reward).

Muamba was a very unlucky lad, and my heart goes out to him. Hopefully his superior fitness will help him to pull through and allow him to see his child grow up. That's my first wish - everything else will be a bonus. Could we have spotted this problem through clinical testing? Maybe, maybe not. Every case is individual and different.

However, I will say this. Speculation from people who know NOTHING about Cardiology makes the Clinic look like a mean-spirited nasty little place which is unable to look beyond its own obsessions.

 

[unclem0nty]

Your apparent ignorance of clinical studies that have suggested links between PEDs and the increasing incidence of sudden cardiac death amongst sportsmen makes you look like a part-time St John's Ambulanceman.

 

[Markyboyzx6r]

Your apparent ignorance of clinical studies that have suggested links between PEDs and the increasing incidence of sudden cardiac death amongst sportsmen makes you look like a part-time St John's Ambulanceman.

I'm not ignorant of those studies. There is a link between PED use and SCD. Absolutely.

However, is that the full story? No, it's not. As I explained in my post there are a number of reasons why SCD can occur, and a number of reasons why we cardiac professionals can miss the diagnosis. While this lad is lying in ITU it would be a mark of respect to wind your neck in until the full story is established, no?

...and by the way, there's nothing wrong with part-time St John's Ambulance workers, they do a valuable job as volunteers. Next time you collapse in front of them be sure not to ask for their help given that you're so much better than them. Yeah?

 

[hrotha]

There is a link between PED use and SCD. Absolutely.

However, is that the full story? No, it's not. As I explained in my post there are a number of reasons why SCD can occur, and a number of reasons why we cardiac professionals can miss the diagnosis. While this lad is lying in ITU it would be a mark of respect to wind your neck in until the full story is established, no?

There you go again, ignoring the MANY posts that have pointed out this isn't specifically about Muamba. In fact, if you acknowledged that, you'd find out we're apparently not saying anything you disagree with.

 

[Markyboyzx6r]

There you go again, ignoring the MANY posts that have pointed out this isn't specifically about Muamba. In fact, if you acknowledged that, you'd find out we're apparently not saying anything you disagree with.

The guy is lying in ITU and may still die. But don't let us stop you from your "is it PED's? Must be PED's! I've seen studies!" sewing circle. I'm not the only one to see how distasteful this speculation is. Especially as it's likely to be total BS.

 

[unclem0nty]

I'm not ignorant of those studies. There is a link between PED use and SCD. Absolutely.

However, is that the full story? No, it's not.

Well, that's a step in the right direction. I had the impression from your posts to date that you didn't want it to be any part of the story. Is it OK with you if we carry on debating just how much of the story it might be? Even those of us who aren't cardiologists, but can read?

...and by the way, there's nothing wrong with part-time St John's Ambulance workers, they do a valuable job as volunteers. Next time you collapse in front of them be sure not to ask for their help given that you're so much better than them. Yeah?

OK, I'll try. Except I wasn't comparing myself to a St John's Ambulanceman. I was comparing you to one.

 

[Markyboyzx6r]

Well, that's a step in the right direction. I had the impression from your posts to date that you didn't want it to be any part of the story. Is it OK with you if we carry on debating just how much of the story it might be? Even those of us who aren't cardiologists, but can read

Yeah mate, crack on. Fill your boots. Speculate all you want. Don't let little things like respect for the bloke get in the way of your fun. Debate away.

Oh, and given that you want to debate the subject... tell me please, how would you come to a differential diagnosis of HOCM via PED use, over and above other suspected pathologies? Come on, tell me how you are going to view any clinical data to pinpoint PED involvement? You want a debate... then this is a debate!

Well you could put him in the EP Lab (well, that is if he ever gets out of ITU, but let's not let a little detail like the blokes survival get in the way of a good 'debate', eh) What EP protocol are you going to use? What system - Carto or NavX? Which catheters and why?

You guys are experts. You've seen the studies. Link Muamba to PED use via a differential diagnosis and you'll deserve a pint or at least nice biscuit. Tell me how you're going to do it. If you can't, then you're just a pair of nobodys talking about a very ill patient who has a problem you know nothing about. Don't for pity's sake offer him your support, just get your white coats on, pop the stethescope on and do your best Dr House impression.

 

[unclem0nty]

For an important life-saving doctor you've got a worryingly short fuse. Bit concerned about your powers of analysis and recall, too.

Quick recap:

1) As you yourself accept, there's a link between PEDs and sudden cardiac death.

2) This link has so far been inadequately researched.

3) Fatal or near-fatal cardiac incidents are becoming more common amongst sportsmen in general, and footballers in particular.

4) Stamina and athleticism are becoming ever more important attributes in modern football. Further distances are being covered year on year, and at ever increasing speeds.

5) There have been many revelations in recent years about the use of PEDs and blood doping amongst European professional footballers, but almost no related action from clubs and governing bodies.

6) This anti-Muamba witch trial exists only in your mind. Number of posters who have accused him of taking PEDs = 0. Number of posters who have expressed anything but total sympathy for his plight = 0. Number of posters who are concerned that footballers might be being pressurised into potentially dangerous doping regimes = some.

7) I'm a big NavX man - and give me a brass-oxide Super Catheter 1500 every time. Those bad boys ROCK.

 

[Libertine Seguros]

The guy is lying in ITU and may still die. But don't let us stop you from your "is it PED's? Must be PED's! I've seen studies!" sewing circle. I'm not the only one to see how distasteful this speculation is. Especially as it's likely to be total BS.

hrotha has not stated once that Fabrice Muamba's collapse has anything to do with PEDs, except for words that have been put in his mouth.

This whole thing blew out of proportion because of one hypothesis Caruut made, and partially recanted when presented with evidence to the contrary. They did a very rough calculation that suggested the number of cases of SCA among sportsmen was far above the normal level... then the next post, by one of the posters you are attacking, pointed out studies that showed that sportsmen are at greater risk, and the level of greater risk they are at seemed to bear out the calculations, thus meaning they weren't actually as suspicious as first suggested at all.

Mambo just saw that this thread was in the Clinic, and went on his usual crusade, only skim-reading the posts enough to know what he could mischaracterise.

In Al Franken's book The Truth (With Jokes), an openly biased but funny set of writings about America in the Bush years, there is a chapter on the Terri Schiavo case, a big court case about possible euthanasia a few years ago. In it, he talks about Wall Street Journal journalist Peggy Noonan, who published an article entitled "In Love with Death: the Bizarre Passion of the Pull-The-Tube People". I feel that it is appropriate to reproduce a passage here.

Her argument was based on a fundamental, and almost certainly deliberate, misconception about the nature of the debate. For a vast majority of Americans, the principle at stake in the Schiavo matter was whether Congress and the President should override the medical decisions of individual families. Because so many Americans had experienced similar tragedies in their own lives, they knew that this was painful enough as a private matter.

But to the people protesting outside the clinic, it wasn't about the appropriate limits of federal power. It was about whether to save a living, breathing, laughing, talking, thinking human being from judicially sanctioned murder. That gave the Peggy Noonans of this world an opening to attack Democrats.

"Why are they so committed to this woman's death?" she asked. Peggy, let me answer your question with a question of my own. If, in the middle of the whole thing, Terri's husband, Michael, had said, "I may have remembered her wishes wrong - please put the tube back in," do you honestly think any of the "pull-the-tube people" would have screamed, "No! Kill her anyway! Kill her! KILL HER!"? Is that really what you think, Peggy?

It seems that for many of the contributors to discussion here, discussion is no longer about Fabrice Muamba individually, but about the matter of SCA and other related problems in athletes, how it comes about and whether it can be reduced. But to Mambo95, people like Hitch, hrotha and I are those "pull-the-tube people", who are saying, even after we've been given at least two highly likely, natural causes for what happened, "NO! DOPER! DOPER!", despite the simple fact that none of us actually said there was any connection between doping and what happened to Fabrice Muamba.

It's a good racket, I have to say. Attack us as ghouls for something we didn't say, and if we then defend ourselves it's disrespectful as not letting it lie, and if we explain ourselves more contritely and are careful not to say anything that can be misconstrued, then we're acting holier-than-thou and feigning concern.

As such, the thread has become less about discussion of what people like myself, Hitch and hrotha have said, and more about discussion of what Mambo95 wants people to believe we've said.

 

[Markyboyzx6r]

For an important life-saving doctor you've got a worryingly short fuse. Bit concerned about your powers of analysis and recall, too.

Quick recap:

1) As you yourself accept, there's a link between PEDs and sudden cardiac death.

2) This link has so far been inadequately researched.

3) Fatal or near-fatal cardiac incidents are becoming more common amongst sportsmen in general, and footballers in particular.

4) Stamina and athleticism are becoming ever more important attributes in modern football. Further distances are being covered year on year, and at ever increasing speeds.

5) There have been many revelations in recent years about the use of PEDs and blood doping amongst European professional footballers, but almost no related action from clubs and governing bodies.

6) This anti-Muamba witch trial exists only in your mind. Number of posters who have accused him of taking PEDs = 0. Number of posters who have expressed anything but total sympathy for his plight = 0. Number of posters who are concerned that footballers might be being pressurised into potentially dangerous doping regimes = some.

7) I'm a big NavX man - and give me a brass-oxide Super Catheter 1500 every time. Those bad boys ROCK.

Okay, well let me recap too.

You know jack about Cardiology, yet are calling for more research into SCD? You insult me about my clinical knowledge, but when I ask you to put a differential diagnosis together, you mock instead.

Show some respect to Muamba and leave the doping 'debate' to another day.