UCI helped Froome with illegal(?) TUE at Romandie

[gooner]

Yes, but still missing the point. Why was a rider who was pulled from LBL 3 days previously riding Romandie when in "acute" need of such a drug just to compete? Why not pull him from Romandie? Why the rush TUE?How was he smashing the field if in such respiratory distress?

No one seems to want to answer those questions, and no one in the press seems to want to ask.

That was put to Freeman back in 2011 when Uran got a TUE.

I didn't know about this until The Irish Times tonight mentioned a Cycle Sport article back then on it. Went searching for it:

The doc is in the hotel’s bar, laptop open, phone pressed to his ear, looking concerned.
Rigoberto Uran has been suffering with breathing difficulties for the past couple of days and Dr Freeman is trying to get a Therapeutic Use Exemption for a drug to treat him.

“It can be very tricky, especially at the weekends,” he says. Yesterday, Dr Freeman contacted the race’s anti-doping doctor and put the case for a TUE. The drug is a steroid that can mimic a corticosteroid in the urine and can be misused.

“Rigo has got a chest problem,” he says. “With most asthma patients, you will never find out specifically what causes it. We’ve tested for pollen and in Rigo’s case it doesn’t appear to be that.

“The ADAMS [World Anti-Doping Agency’s Administration and Management System] website can be tricky. Your worst fear is that you’re stuck in the mountains with no internet connection but we would not give anything that’s on the list to a rider until we had everything confirmed through the proper channels.”

Could he not use the ADAMS hotline and make a phone call? “That works well Monday to Friday but not so well at the weekends,” he says wryly, acknowledging that the onus is always on the athlete and the team doctor to ensure everything is done properly.

It took a few tries but eventually, he got through to Dr Mario Zorzoli of the UCI and gained the necessary permission.

But isn’t there an argument that if Uran is unwell and his breathing is seriously affected, he should pull out of the race? “He may well do that. But he’s an ambitious young man who wants to support Bradley and he wants to secure his Tour team.

“We are not talking about performance-enhancement here. The TUE is designed to enable an athlete to take medication that a normal human being would be prescribed by a doctor. It cannot be right that you and I could go to a doctor and be prescribed something that an athlete with the same condition could not use.”

http://www.cyclesportmag.com/features/all-aboard-the-magic-bus/

 

[The Hitch]

he can't have said "i have never had a TUE". or if he did then something doesn't add up: because as early as this week he said

http://www.cyclingnews.com/news/froome-surprised-at-controversy-over-in-race-inhaler-use

and the thing is: up until 1st january 2010, you had to have a TUE to use this asthma inhaler he is talking about in the quote (salbutamol inhaler)...

so either
1- he is genuinely asthmatic since childhood and he has had a TUE until december 2009,
or
2- he is only asthmatic since recently and indeed he has never had a TUE (because salbutamol dropped off the Prohibited List in 2010)

but not both

Froome has lied plenty of times, so the point of my post was to see if he is lying here again.

 

[Granville57]

BRODEAL IS BACK!!!!

And just when I was about to start a poll (mew can confirm this) to lure him out of hiding.

The events of the past few weeks have just been begging for his return.

Now the real fun begins.

 

[bridgeman]

It is good to have BroDeal back.

I don't know how close prednisolone to prednisone, but the latter is basically poison. I had it prescribed once, and I told the doctor to go to hell. I threw the prescription away.

WTF is Froome doing taking this stuff? This is insane.

This. I had it prescribed many years ago as well for a lung infection. I honestly felt like I was being poisoned and vowed to never take it again. I've heard others mention the same reaction. There were no gains, in fact this stuff rendered me weak as a kitten.

I do remember my doctor mentioning that I needed to take it as I was clearly headed for pneumonia.

 

[Granville57]

Some people here posted that Froome has said that he has never had a TUE.

Is there a link for that? I don't remember it. IIRC he said he didn't have it for the most recent tour, not ever.

You are correct, I've never seen Froome claim that he "never" had TUEs.

I posted this in another thread earlier (can't recall which one). But I now I see there are some other relevant parts as well.
http://velonews.competitor.com/2013/07/news/froome-confirms-no-tue-still-treated-for-bilharzia-parasite_295548

July 16, 2013
Froome also confirmed Tuesday he does not have a TUE (therapeutic use exemption) during this Tour, not for bilharzia treatment, nor anything else. Biltricide is not included in the World Anti-Doping Agency’s banned substances list and does not require a TUE.

“TUEs are a rather personal issue, but I am able to say I do not have any TUEs during this Tour,” Froome said. “Hopefully I will not have any.”

Team Sky principal Sir Dave Brailsford told French television in an interview, broadcast Tuesday, that all TUEs should be publicly released before the Tour, as a step to be transparent and to rebuild credibility.

One source told VeloNews that none of the Team Sky riders have TUEs during this Tour de France.

Will be interesting to see if Sky makes of all their pre-Tour TUEs public. Just a few weeks to go, and counting...

 

[proffate]

Why are TUEs a personal issue? I don't talk to strangers about my medical history, but as a top-level sportsman you are a public figure and you must sacrifice some privacy. Besides, if the TUE is for asthma, how is that "personal"? That's about like being embarrassed about a nut allergy or broken arm.

 

[uspostal]

I haven't posted in here yet mostly due to the fact I haven't read the article myself but if the cycling news article is the same I was wondering why according to the cycling news article?

"Froome had missed Liège-Bastogne-Liège due to a chest infection and initially consulted with his personal doctor in Monaco, Dr. Bermon, who did not prescribe any oral corticosteroids to treat the ailment."

Only to go to a team doctor who

Ahead of the Tour de Romandie, Le Journal du Dimanche reports, Sky team doctor Alan Farrell requested a TUE that would allow Froome to take 40mg per day of the oral corticosteroid prednisolone throughout the race.

Why would a personal doctor who should have a better knowledge of his medical problems not prescribe anything, but a team doctor seen something that he needed a prescription for ?

 

[Catwhoorg]

You can't get a TUE for every drug, e.g. EPO is banned in and out of competition, no TUE possible. They could easily ban prednisone in-competition TUEs.

Not true, a TUE may be granted for just about anything, if there is 1) clinical need and 2) no reasonable alternative.

If for example an elite athlete was undergoing chemo, but wanted to remain in the testing pool so they could compete after treatment the use of EPO (or transfusions) probably would be given clearance as part of a TUE.
Extreme case I know.

A to get a TUE for testosterone, the standard is pretty much emasculation, but such a thing is possible.

 

[red_flanders]

I haven't posted in here yet mostly due to the fact I haven't read the article myself but if the cycling news article is the same I was wondering why according to the cycling news article?

"Froome had missed Liège-Bastogne-Liège due to a chest infection and initially consulted with his personal doctor in Monaco, Dr. Bermon, who did not prescribe any oral corticosteroids to treat the ailment."

Only to go to a team doctor who

Ahead of the Tour de Romandie, Le Journal du Dimanche reports, Sky team doctor Alan Farrell requested a TUE that would allow Froome to take 40mg per day of the oral corticosteroid prednisolone throughout the race.

Why would a personal doctor who should have a better knowledge of his medical problems not prescribe anything, but a team doctor seen something that he needed a prescription for ?

Because he's doping. Great stuff, do you have a link.

 

[Granville57]

Why are TUEs a personal issue?

I've wondered about that ever since reading that quote from Froome. It makes think that he sometimes does have TUEs for reasons that he considers to be "personal" and therefore wouldn't' be comfortable disclosing them. Hemorrhoids or something like that maybe? I dunno. I suppose there could be things that might be embarrassing, but can anyone list what those might be? (Not sure if I really want to open that up for discussion though. )

Why would a personal doctor who should have a better knowledge of his medical problems not prescribe anything, but a team doctor seen something that he needed a prescription for ?

I think you've answered your own question.

 

[Granville57]

Because he's doping. Great stuff, do you have a link.

The reference is to the CN article.
http://www.cyclingnews.com/news/report-uci-fast-tracked-froome-tue-request-at-tour-de-romandie

 

[proffate]

Not true, a TUE may be granted for just about anything, if there is 1) clinical need and 2) no reasonable alternative.

If for example an elite athlete was undergoing chemo, but wanted to remain in the testing pool so they could compete after treatment the use of EPO (or transfusions) probably would be given clearance as part of a TUE.
Extreme case I know.

This is nonsense, see here: http://www.wada-ama.org/en/Resources/Q-and-A/Therapeutic-Use-Exemption-TUE/ TUEs are only available if "The therapeutic use of the substance would not produce significant enhancement of performance". It's impossible that EPO will ever meet this requirement.

If an athlete needs EPO for cancer recovery, they have to "retire", and if they un-retire it's a 6 month window of testing pool with no competition.

In any case, your example is about (imaginary) OOC TUEs, and we're currently discussing in-competition TUEs.

A to get a TUE for testosterone, the standard is pretty much emasculation, but such a thing is possible.

I did not claim testosterone TUEs didn't exist. And I believe the word you're looking for is "castration".

 

[_nm___]

Yes, but still missing the point. Why was a rider who was pulled from LBL 3 days previously riding Romandie when in "acute" need of such a drug just to compete? Why not pull him from Romandie? Why the rush TUE? How was he smashing the field if in such respiratory distress?

No one seems to want to answer those questions, and no one in the press seems to want to ask.

an asthma exacerbation is a pretty frequent occurence; in practice you might easily see one or two patients per day with it

exacerbations come in different grades of severity and not all patients are in "acute" need of prednisolone at the time you give it to them. it's just that if they don't take it soon their symptoms might worsen out of control. so sometimes giving prednisolone is more a precautionary measure

so i don't think Froome was in "acute" need of prednisolone on the day of LBL

and they thought that him sitting out LBL would give him enough time to recover

i think it's after the intense effort at Romandie that symptoms started to look like his body might not make it back on its own: Froome says that after the Romandie prologue he couldn't stop coughing

prednisolone works in 99% of the cases and it works within 4 hours so you're quasi certain that if he takes them at night, the next morning you can take a clear decision as to whether you need to pull him from the race or not. so here prednisolone can be used as a test for "do i need to pull him out or not?"

and because it works within 4 hours this could explain why he was "smashing the field" the next morning: his lungs had already recovered pretty well overnight thanks to the efficacy and the very fast action of prednisolone



by the way: prednisolone in short courses is a pretty trivial drug, and 40mg (i just checked) is actually the normal dose from 5 years old onwards (when treating exacerbation of asthma)

 

[_nm___]

Yes, but still missing the point. Why was a rider who was pulled from LBL 3 days previously riding Romandie when in "acute" need of such a drug just to compete? Why not pull him from Romandie? Why the rush TUE? How was he smashing the field if in such respiratory distress?

No one seems to want to answer those questions, and no one in the press seems to want to ask.

at the end of the day, team medical staff are there to put riders on their bikes: you only stop riding when there really isn't anything left they can do to fix you up. and i wouldn't be surprised if the sky doctor had exaggerated his diagnosis a little bit to get his TUE through. but i suspect that's what they all do.

in fact we don't know if a normal doctor treating a normal citizen would have estimated that this level coughing needed prednisolone, but a normal citizen doesn't stress their lungs as much, but we just can't check and neither can the UCI, or WADA for that matter

 

[red_flanders]

The reference is to the CN article.
http://www.cyclingnews.com/news/report-uci-fast-tracked-froome-tue-request-at-tour-de-romandie

And he mentioned that in his post. Sometimes I have to read more closely. Thanks!

 

[mewmewmew13]

And just when I was about to start a poll (mew can confirm this) to lure him out of hiding.

The events of the past few weeks have just been begging for his return.

Now the real fun begins.

YAY

yes I can confirm...

 

[red_flanders]

at the end of the day, team medical staff are there to put riders on their bikes: you only stop riding when there really isn't anything left they can do to fix you up. and i wouldn't be surprised if the sky doctor had exaggerated his diagnosis a little bit to get his TUE through. but i suspect that's what they all do.

Why did they not "put him on his bike" for LBL 3 days before and then let him ride in Romandie? Why, if so ill that he's being "put on the bike" by the medical staff, how was he able to crush the field in Romandie? I don't think prednisone gives you that much of a boost that it allows a guy with a major respiratory infection to ride at his top level. Of course I also come at this assuming that's probably one of the milder drugs these guys are on, so performance gains are all relative.

in fact we don't know if a normal doctor treating a normal citizen would have estimated that this level coughing needed prednisolone, but a normal citizen doesn't stress their lungs as much, but we just can't check and neither can the UCI, or WADA for that matter

His regular doctor apparently evaluated him and didn't give it to him, but then the team doctor did.

What you say isn't impossible, it's just not even remotely the most likely explanation.

 

[mewmewmew13]

a lot of BS flying around here from SKY + UCI re TUE

 

[red_flanders]

so i don't think Froome was in "acute" need of prednisolone on the day of LBL

He was pulled from LBL due to some kind of respiratory illness.

"Acute" is the word the UCI uses in their "rush TUE" process. He would have to be an "acute" case to qualify. It wasn't LBL, it was Romandie from which he was pulled, apparently qualifying for the "acute" label.

 

[BYOP88]

a lot of BS flying around here from SKY + UCI re TUE

RRRRR-men...

 

[GreasyMonkey]

It is good to have BroDeal back.

I don't know how close prednisolone to prednisone, but the latter is basically poison. I had it prescribed once, and I told the doctor to go to hell. I threw the prescription away.

WTF is Froome doing taking this stuff? This is insane.

Very close.....

Prednisone is an inactive drug precursor that must be converted to prednisolone in the liver to become active.

 

[sideshadow]

an asthma exacerbation is a pretty frequent occurence; in practice you might easily see one or two patients per day with it

exacerbations come in different grades of severity and not all patients are in "acute" need of prednisolone at the time you give it to them. it's just that if they don't take it soon their symptoms might worsen out of control. so sometimes giving prednisolone is more a precautionary measure

so i don't think Froome was in "acute" need of prednisolone on the day of LBL

and they thought that him sitting out LBL would give him enough time to recover

i think it's after the intense effort at Romandie that symptoms started to look like his body might not make it back on its own: Froome says that after the Romandie prologue he couldn't stop coughing

prednisolone works in 99% of the cases and it works within 4 hours so you're quasi certain that if he takes them at night, the next morning you can take a clear decision as to whether you need to pull him from the race or not. so here prednisolone can be used as a test for "do i need to pull him out or not?"

and because it works within 4 hours this could explain why he was "smashing the field" the next morning: his lungs had already recovered pretty well overnight thanks to the efficacy and the very fast action of prednisolone



by the way: prednisolone in short courses is a pretty trivial drug, and 40mg (i just checked) is actually the normal dose from 5 years old onwards (when treating exacerbation of asthma)

Agree, currently we use steroids for patients with acute exacerbations of asthma, those same patients are also preferably in hospital on oxygen and using a nebulizer. We usually give intravenous Methylprednisolone.

Steroids aren't indicated as prophylactic treatment as you seem to suggest, except in cases where the asthma is severe and persistent, in the wheezy kid sitting in the corner unable to play with the others, not the dude smashing climbs.

Another point is that Froome said he has exercise induced asthma and for this steroids certainly aren't indicated, a SABA such as albuterol is indicated and while it looks bad if you're puffing away on tv, is fair for riders to use i'd say.

I think it's clear what happened here. Froome was prescribed a performance enhancing substance that needed an excuse and they used asthma same as when Lance used saddle sores as an excuse. I think that this probably happens very often in all sports and he was the unlucky one to get caught. And while it's true that a short course of Prednisone can be pretty much used for anything it's certainly proven to be performance enhancing.

For me at least, when you stuff like 'I fail to see how I could be any cleaner' and then this comes out, it makes me think that he is probably lying about more than a couple of pills.

 

[Will Carter]

I haven't posted in here yet mostly due to the fact I haven't read the article myself but if the cycling news article is the same I was wondering why according to the cycling news article?

"Froome had missed Liège-Bastogne-Liège due to a chest infection and initially consulted with his personal doctor in Monaco, Dr. Bermon, who did not prescribe any oral corticosteroids to treat the ailment."

Only to go to a team doctor who

Ahead of the Tour de Romandie, Le Journal du Dimanche reports, Sky team doctor Alan Farrell requested a TUE that would allow Froome to take 40mg per day of the oral corticosteroid prednisolone throughout the race.

Why would a personal doctor who should have a better knowledge of his medical problems not prescribe anything, but a team doctor seen something that he needed a prescription for ?

I'd be surprised if his 'personal' (which probably means local, ie based in Monaco, in this situation) would know more about him than the team doctor.

 

[86TDFWinner]

This is a surprise to some? Hmm, not the least bit surprising to most here.

 

[Dazed and Confused]

Lets see if Sky can get Froome sufficiently upgraded at the tour, otherwise a top 5 might be the target.