TUE's for Saline IV Hydration Drips at the TdF?

[Polish]

Using IV Hydration Drips to aid in the recovery process during the TdF was legal throughout the 80's and 90's and up to and including 2005.

It was not uncommon to see riders with band-aids on their arms after particularly hot days during the Scorching French Summer heat.
Central France during a heat wave can be very dangerous indeed.
Fatal.

So does it make sense for Teams to prep TUE's to be able to use IV Drips?
Give WADA a heads up? Just in case of a dangerous heat wave?
It certainly does NOT make sense to risk a rider's health.
The current anti-doping crusader era is a recipe for tragedy.

Here is an old CN story dicussing IV Drips during a TdF.
Scroll down on the link....

Armstrong's dehydration
In light of his difficulties in the Stage 12 individual time trial and the following day's Stage 13, Cyclingnews asked Lance Armstrong to speak on the issue of hydration. "Well, the problem is when you drink water, all you do is pee a lot," Armstrong explained bluntly. "Water's great, but you reach a point that you're just passing it through and if it doesn't contain the proper minerals and salts, it won't be absorbed. You can't just put it in your mouth]you've got to have IV's and big bottle of saline[/b] when you lose 7 or 8 kilos in a race... What are you going to do, drink 8 litres of water at one go?"

Armstrong felt the effects of a hot, tough time trial, even the following day. In Sunday's mammoth Stage 14, however, he appeared to have bounced back. Even if not his old dominant self in the mountains, Armstrong appeared to have recovered from the dehydration which made him vulnerable to the attacks of his rivals in the hot mountains.

http://autobus.cyclingnews.com/road/2003/tour03/?id=news/jul03/jul21news
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[131313]

Your comments are interesting, as are the comments from Armstrong. They really seem to demonstrate just how skewed people's perceptions have become.

First off, the '7-8 kilos' comment is ridiculous on its face. If riders lost 10% of their body weight in water on a regular basis there would be riders dying in droves from organ failure. The bigger issue though is that acclimatizing to heat and replacing fluids while you're racing is all part of, well, racing! If you can't do these things properly, then you shouldn't be looking for a solution from the end of a needle. From a sporting perspective it makes very little sense. And from a health perspective, people conveniently ignore the heath risks of anything administered IV, even saline.

I could see one requiring an IV if they had dysentery, but if it's serious enough to require an IV, then they probably shouldn't be racing.

To answer Armstrong's comment, "what are your supposed to do"? Well, first, train in the heat if you're going to be racing in the heat, to help your body acclimatize, and secondly stay on top of hydration before, during and after the event, so you don't lose more than 2% of your body weight. Staying hydrated is all part of performance, and those who do a better job of it are going to perform better, as they should. Of course, when you're used to relying on the end of a needle for everything else, I guess it gets easy to lose perspective.

 

[lancaster]

if LA thinks it's a good idea to dehydrate to the extent of 10% of his body weight and then drink distilled water he's an idiot. seeing as he has had some significant input from drs and experts in physiology we can assume he's aware that this is a ridiculous idea. therefore i can only assume he thinks fans will think this means there are good reasons for him to have members of staff disposing of needles.


also, if you'd inject saline, why would a fair comparison be drinking water (over an isotonic drink containing electrolytes).

anyone who's ever ridden regularly or watched a bike race knows that riders drink, very regularly. if you genuinely lost 7-8 kilos of water on a 70kilo frame due to dehydration ones ability to cycle (or even move, live) would be greatly hindered.

he's fighting a position that is indefensible and is non existent to rationalise the use of needles.


anyone who get's so dehydrated that a drip is necessary should not be allowed to continue racing. if a drip isn't needed, just a shortcut, then obviously it shouldn't be allowed.

 

[JibberJim]

Wada don't think there's any reason to give a TUE for rehydration in that situation:

"It must be clearly stated however that the use of IV fluid replacement following exercise to correct mild rehydration is neither clinically indicated nor substantiated by the TUE process. There is a well-established body of scientific opinion to confirm that oral rehydration is the preferred therapeutic choice, deemed by some authorities as being even more effective than the parenteral option"

And given that opinion, a TUE would never be granted. Certainly not in advance!

http://www.wada-ama.org/Documents/S...ical_info_IV_infusions_v.2.2_March2010_EN.pdf

 

[Oldman]

Wada don't think there's any reason to give a TUE for rehydration in that situation:

"It must be clearly stated however that the use of IV fluid replacement following exercise to correct mild rehydration is neither clinically indicated nor substantiated by the TUE process. There is a well-established body of scientific opinion to confirm that oral rehydration is the preferred therapeutic choice, deemed by some authorities as being even more effective than the parenteral option"

And given that opinion, a TUE would never be granted. Certainly not in advance!

http://www.wada-ama.org/Documents/S...ical_info_IV_infusions_v.2.2_March2010_EN.pdf

Like Lancaster said it shouldn't be allowed, period. Denying IV anything won't stop PED use but at least it can minimizie the dangerous short cuts many riders have previously been subjected to.

 

[sometriguy]

Losing 7 to 8 kilos seems like a pretty amateur mistake, especially for a protected rider. Guess Lance still had a lot to learn

So 7 to 8 kilos is 7-8 liters! .... umm.... that is a lot of time on the IV bag.

In all seriousness, if I am a race doctor, I would immediately put a rider on an IV bag if they lost that much weight. Unless they had chronic diarrhea or had spent the day vomiting, I would be asking the team some serious questions about preparation

 

[Polish]

Wada don't think there's any reason to give a TUE for rehydration in that situation:

"It must be clearly stated however that the use of IV fluid replacement following exercise to correct mild rehydration is neither clinically indicated nor substantiated by the TUE process. There is a well-established body of scientific opinion to confirm that oral rehydration is the preferred therapeutic choice, deemed by some authorities as being even more effective than the parenteral option"

And given that opinion, a TUE would never be granted. Certainly not in advance!

http://www.wada-ama.org/Documents/S...ical_info_IV_infusions_v.2.2_March2010_EN.pdf

Thank you for that link JibberJim.

It appears that WADA will NOT require a TUE in the case of severe dehydration that would require an IV Hydration.

The Team Doc / Hospital can make the call without a TUE and without the rider facing a ban.

Good that WADA was thinking ahead on this matter.
The riders should be glad too - one less thing to worry about.

But proper and modern hi-tech hydration is the key it seems - thanks 131313
No more "old-school" IV Drips for moderate or non-emergency hydration...
Check out this article from USA Cycling and Dr Allen Lim & Dr Stacy Sims:

https://www.usacycling.org/news/user/story.php?id=4698
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[TERMINATOR]

Using IV Hydration Drips to aid in the recovery process during the TdF was legal throughout the 80's and 90's and up to and including 2005.

It was not uncommon to see riders with band-aids on their arms after particularly hot days during the Scorching French Summer heat.
Central France during a heat wave can be very dangerous indeed.
Fatal.

So does it make sense for Teams to prep TUE's to be able to use IV Drips?
Give WADA a heads up? Just in case of a dangerous heat wave?
It certainly does NOT make sense to risk a rider's health.
The current anti-doping crusader era is a recipe for tragedy.

Here is an old CN story dicussing IV Drips during a TdF.
Scroll down on the link....


http://autobus.cyclingnews.com/road/2003/tour03/?id=news/jul03/jul21news
.

You questions is stupid. Using IV's to "aid in recovery" has NOTHING to do with a medical need and is nothing but performance enhancing. So you would never get a TUE for it.

Second, the only thing an IV has over ingesting same orally is time. I don't see how IV's aid in recovery. I really don't. That's a misnomer.

Greg LeMond never took IV's to aid in recovery during the Tour.

 

[zigmeister]

Your comments are interesting, as are the comments from Armstrong. They really seem to demonstrate just how skewed people's perceptions have become.

First off, the '7-8 kilos' comment is ridiculous on its face. If riders lost 10% of their body weight in water on a regular basis there would be riders dying in droves from organ failure. The bigger issue though is that acclimatizing to heat and replacing fluids while you're racing is all part of, well, racing! If you can't do these things properly, then you shouldn't be looking for a solution from the end of a needle. From a sporting perspective it makes very little sense. And from a health perspective, people conveniently ignore the heath risks of anything administered IV, even saline.

I could see one requiring an IV if they had dysentery, but if it's serious enough to require an IV, then they probably shouldn't be racing.

To answer Armstrong's comment, "what are your supposed to do"? Well, first, train in the heat if you're going to be racing in the heat, to help your body acclimatize, and secondly stay on top of hydration before, during and after the event, so you don't lose more than 2% of your body weight. Staying hydrated is all part of performance, and those who do a better job of it are going to perform better, as they should. Of course, when you're used to relying on the end of a needle for everything else, I guess it gets easy to lose perspective.

You are so uneducated and spouting such nonsense it deserves a reply.

First of all, your body can sweat and lose more liquid than is possible to consume to replenish it during the same time period. That is a simple fact. Whether you want to believe it or not.

Next, ever heard of guys cutting weight for MMA, Boxing, Wrestling matches? They can sweat out 10-15lbs is a matter of hours. Many of these guys are 155lb weight classs fighters, which would put them at the 10% body weight loss fluid you purport is impossible to do and they would all be dying of organ failure.

Wow..get a clue and learn something before posting such bogus information.

 

[131313]

You are so uneducated and spouting such nonsense it deserves a reply.

First of all, your body can sweat and lose more liquid than is possible to consume to replenish it during the same time period. That is a simple fact. Whether you want to believe it or not.

Of course that is correct. Where did I say otherwise?

Next, ever heard of guys cutting weight for MMA, Boxing, Wrestling matches? They can sweat out 10-15lbs is a matter of hours. Many of these guys are 155lb weight classs fighters, which would put them at the 10% body weight loss fluid you purport is impossible to do and they would all be dying of organ failure.

A loss of 10% of one's body weight "in a matter of hours" would put one in a clinical state of severe hydration. Severe dehydration is universally described in all of the available medical literature as a life-threatening event.

Wow..get a clue and learn something before posting such bogus information.

Irony. It never goes out of style.

 

[131313]

Next, ever heard of guys cutting weight for MMA, Boxing, Wrestling matches? They can sweat out 10-15lbs is a matter of hours. Many of these guys are 155lb weight classs fighters, which would put them at the 10% body weight loss fluid you purport is impossible to do and they would all be dying of organ failure.

http://www.vanderbilt.edu/ans/psychology/health_psychology/Weight-Wrestling.htm

how did that work out for these guys?

 

[Merckx index]

ever heard of guys cutting weight for MMA, Boxing, Wrestling matches? They can sweat out 10-15lbs is a matter of hours. Many of these guys are 155lb weight class fighters, which would put them at the 10% body weight loss fluid you purport is impossible to do and they would all be dying of organ failure.

See 131313's link. I think you’re confusing rapid weight loss with rapid weight gain. Boxers et al. can gain close to 10% of their body weight relatively rapidly, though not in a few hours. But they don’t normally lose this much this quickly. They typically shed weight gradually to make the limit, over a period of weeks. By the day of the weigh-in, they are very close to the limit.

I’ve never heard of a professional fighter losing large amounts of weight on the final day, or indeed on any day. It’s now thought that a major reason why Oscar de la Hoya was destroyed by Manny Pacquiao is because he went down to the 147 lb limit too quickly—not on the last day, certainly not in a few hours, but in a period of a week or two long before the fight took place. Most trainers would recommend losing that weight very gradually, giving the body time to adjust throughout. The last thing a fighter wants to do at any stage of his training is experience rapid weight loss.

The Livestrong site inf act gives an example of a fighter losing 9 lb in three days as an example of very rapid weight loss, and undergone only through desperation, not as an example of smart training. Another example is a loss of 40 lb--more than 20% of body weight for that fighter--in 6-8 weeks. Again, not recommended training, but still undergone over a relatively long period of time.

After they make the limit, fighters can rapidly gain weight by both eating and drinking. But not in a few hours, over a period of twenty-four hours. Indeed, there is some controversy now in boxing, with some arguing that having a weigh-in 24 hours before the fight allows boxers to gain too much weight over the weigh-in limit—it allows a naturally larger man to have too much of a weight advantage over his opponent. This could be prevented by having the weigh-in a few hours before the fight, but the argument against this is precisely that a few hours is not enough time to regain the weight lost from fasting and dehydration.

 

[mastersracer]

how much weight do professional bodybuilders lose in the last few days prior to competition? My understanding is that through diet, diuretics, and water restriction they are severely dehydrated, with some having significant health complications as a result.

 

[dbrower]

I think there's nothing wrong with a saline IV if someone wants it for severe medical reasons. And it should come with a 2 week vacation, not a doping charge.

If you really need, it, you can choose to take it, with predictable and reasonable consequences. If you don't want the consequence, drink more or pace yourself more conservatively.

-dB

 

[Oldman]

I think there's nothing wrong with a saline IV if someone wants it for severe medical reasons. And it should come with a 2 week vacation, not a doping charge.

If you really need, it, you can choose to take it, with predictable and reasonable consequences. If you don't want the consequence, drink more or pace yourself more conservatively.

-dB

Not to assist LA's posit on weight loss but he could be talking about his expected overall fluid loss during an event; which the bulk of gets replaced orally. I do agree with your proposal wholeheartedly although the vacation would be long for any cyclist with a contract. Most DS would rather see the rider not draw a salary...

 

[131313]

Not to assist LA's posit on weight loss but he could be talking about his expected overall fluid loss during an event; which the bulk of gets replaced orally.

If you go back and read the accounts after the fateful timetrial where Ullrich crushed him, he (or his handlers) did actually claim a 9-10% weight loss from dehydration. It's not believable at all, but then again consider the source.

I don't doubt for a second that there was some physiological parameter out of whack, and that an IV was used for recuperation. I just doubt there was saline in the bag.