Wigans goes there. Cadence!

[heart_attack_man]

http://cyclingtips.com/2016/09/team-sky-tue-controversy-why-one-medical-expert-has-real-concerns/

Perhaps someone engaged by Sky themselves could help convince samhocking?

 

[Cycle Chic]

Wiggins isnt capable of fronting the media - he isnt the brightest star in the firmament. And not the most level headed, temper-wise.

 

[sniper]

Wiggins isnt capable of fronting the media - he isnt the brightest star in the firmament. And not the most level headed, temper-wise.

Which is funny because only recently Brad had positioned himself as a kind of future Gary Lineker.

 

[ontheroad]

The silence from Brailsford is deafening. A coward.

 

[Ryo Hazuki]

Re:

To be honest I thought and still think there's more to the Wiggins weight loss puzzle than corticos - they've been freely available to everyone since the 80's but you never saw that level of weight loss back in the day.

cyclists in the 80s were still doing breakfast during a tour de france with eating big macs or a giant steak

 

[Benotti69]

Re: Re:

To be honest I thought and still think there's more to the Wiggins weight loss puzzle than corticos - they've been freely available to everyone since the 80's but you never saw that level of weight loss back in the day.

cyclists in the 80s were still doing breakfast during a tour de france with eating big macs or a giant steak

Bollix. Maybe 1 or 2 were because they were racing 200+ days in a year.

 

[Benotti69]

Re:

http://cyclingtips.com/2016/09/team-sky-tue-controversy-why-one-medical-expert-has-real-concerns/

Perhaps someone engaged by Sky themselves could help convince samhocking?

samhocking comes across all public strategies, no point to convince someone who has an agenda.

 

[sniper]

Greg Lemond was laughed at by some of his colleagues for not being serious with his diet, eating too many burgers and icecream. (In fact he couldn't believe he had iron definciency in 1989 because he'd been eating so much red meat)
He subsequently crushed those joking colleagues at the 89 and 90 TdF.
Goes to show in the end it's all about the nutrition.
Not.

 

[TheSpud]

Re: Re:

I've been a respiratory physician for many years. I've practiced in European and American university affiliated medical centers.

For what it's worth, I have never used triamcinalone to treat asthma or allergies (nor to my knowledge have my colleagues). There are just too many more acceptable, equally efficacious alternatives.

Thanks, in what context would triamcinolone be used on a patient? Would you agree that it's performance enhancing as an injection?

.

It is a glucocorticoid (GC) that technically is indicated for treatment of refractory allergic disorders, but it has simply just been superseded by other therapies, including LTB4 antagonists and omalizumab, which he does not appear to have been prescribed based on the TUE forms (both were available at the time). I'm puzzled why they did not just use the more conveniently administered oral glucocorticoid, prednisone, which is generally (and understandably) preferred by patients over me or my nurses sticking needles in their butt.

I used it once in a patient with a condition called sarcoidosis. The patient had a severe psychiatric disorder and was unable to comply with oral prednisone. We figured that high dose Kenalog might give her more durable therapeutic levels if we injected her every few weeks. My perception has been that it leads to more sustained blood levels that orally administered glucocorticoids. I had a quick look on Pubmed to find really good pharmacokinetic data for levels after IM injection, but didn't come across compelling data (apart from an equine study, where it was still detectable after 360 hours, though I freely admit that Humans are not horses!

With respect to performance enhancement, I would think that it would share whatever performance enhancing effects GC drugs have (if they indeed do). The problem with a lot of WADA-banned substances and methods is that there is no quality scientific data that prove or deny performance enhancing capability (given ethical and funding obstacles to doing the research right). That said, on balance, my belief is that GCs probably do enhance performance, and that view was shared by Lance Armstrong and Michele Ferrari, which should tell you something. 40mgs of triamcinolone is equivalent to 50mgs of prednisone.

Omalizumab is a biologic / monoclonal drug so likely much more expensive than the Triam which would be a well known substance to use, and probably already in the Sky medicine cabinet. Not heard of the other things (LTB4).

 

[TheSpud]

Re: Re:

Just to recap:

4. The ENT consultant, Mr. Hargreaves, who is listed in the TUE as the medical expert who deemed the treatment necessary, is he the Dr. Bonar of the north, or somebody with a level of specialist knowledge that could make any suspicions over the propriety of Brad's robust therapeutic strategy moot by delivering a diagnostic coup-de-grace?

Hargreaves lists 'cycling' as one of his hobbies, no doubt that selected a fan to get the right letter signed off for Wiggins.

https://www.bmihealthcare.co.uk/consultants/simon-peter-hargreaves

He is also a head & neck surgeon, not sure what he is doing consulting on allergies but I guess in someways they are related.

BMI Healthcare - the comedy gold just keeps on flowing. I presume BMI stands for 'Body Mass Index'?

So Brad's TUEs are championed by a professional fat-burning clinic with a consultant who specializes in cosmetic surgery? That's definitely who I'd go to if my hay fever was acting up!

Truth is funnier than fiction.

BMI is a private healthcare provider in the UK. It's not a weight loss clinic. Just so you know it is very common for consultants to work in the NHS (state funded healthcare) and also in other private providers (often across multiple providers). Not sure if facial surgery goes with ENT often but a quick Google could probably clear that up.

 

[buckle]

Re:

Wiggins isnt capable of fronting the media - he isnt the brightest star in the firmament. And not the most level headed, temper-wise.

Which is funny because only recently Brad had positioned himself as a kind of future Gary Lineker.

http://www.walesonline.co.uk/sport/other-sport/cycling/cycling-bradley-wiggins-shocked-lance-2020999

Wiggins added:: “I never raced against him (Armstrong) in the Tour de France, just the once in the Criterium in 2004.

 

[vedrafjord]

Re: Re:

To be honest I thought and still think there's more to the Wiggins weight loss puzzle than corticos - they've been freely available to everyone since the 80's but you never saw that level of weight loss back in the day.

cyclists in the 80s were still doing breakfast during a tour de france with eating big macs or a giant steak

That's nonsense, apart from the fact that you weren't going to find a Macdo up the Alps in the 80's, nutrition was already improving at the time.

http://www.outsideonline.com/2099916/how-tour-de-france-diet-has-changed-over-decades

In the '80s, the pendulum began to swing the other direction—from high-meat to high-carb diets. “The daily diet during races was pretty basic back in the 1980s,” says Chris Carmichael, who rode the 1986 Tour de France for Team 7-1. “Lots of pasta, rice, potatoes. There was some meat, but not that much.”

But on the bike, things were beginning to change. Riders began shifting away from real food and toward packaged bars and drinks. “Everyone was taking a reductionist approach to nutrition—carbohydrates, protein, fat, antioxidants—trying to isolate and package these things into very convenient, rapidly-absorbed, technical food products

My point though was about the whole cortico era from the 80's to the present day - from Jeff Bernard using the to win on Ventoux in 1987 and then bonking the next day after Roche's camp bluffed, to Lance's wife handing out cortisone tablets wrapped in tinfoil to the American team at the 1998 worlds, Joerg Jaksche saying he pulled the same trick as Wiggins during his career (probably 2004 as multiple riders have testified against CSC) to Europcar's comical 2011/2012, to Horner not being allowed to defend his Vuelta title.

Corticos have been in widespread use for several decades, but it's only in the last few years that the extreme Rasmussen-style physique has become common for climbers and GC guys, So something has changed:

• Riders are eating vastly different diets even compared to ten years ago (dunno about that one)
• Increased use OOC, or different patterns of usage
• Use of additional drugs like thyroid medication, metabolism modulators/AICAR, etc

Corticos are clearly an important piece of the puzzle but IMO we're still missing some insider knowledge about why some riders like Wiggins lose a ton of weight and peak for 6 months, while someone like Hesjedal does the same and falls apart. Is it possible to get there through grey areas and dodgy TUEs, or is plain old rule breaking required?

 

[veji11]

I think we have a mix of cortico, less blood doping meaning less big turbo and also that the gear is now so flalwess in transmiting almost all produced energy into movement on the road, that there is a lot less need for power in pushing up those gears in the moutain, meaning everybody goes for the "lighter even if you lose power" tendency. Until the early 90s and the advent of blood doping, raw power was a very very important element, you had to be able to push on your bike hard and not have too high a pedal frequency because energy loss was a lot higher than. Power by itself is now not that useful to some extent.

EDIT : of course this just some very uneducated opinion.

 

[thehog]

Re:

I think we have a mix of cortico, less blood doping meaning less big turbo and also that the gear is now so flalwess in transmiting almost all produced energy into movement on the road, that there is a lot less need for power in pushing up those gears in the moutain, meaning everybody goes for the "lighter even if you lose power" tendency. Until the early 90s and the advent of blood doping, raw power was a very very important element, you had to be able to push on your bike hard and not have too high a pedal frequency because energy loss was a lot higher than. Power by itself is now not that useful to some extent.

More to th point, when you're able to smash a bigger gear due to the EPO & blood doping you need cortisone to reduce the inflammation. It's all part of a bigger program.

 

[pastronef]

Re:

The silence from Brailsford is deafening. A coward.

he knows the clinic and twitter too well. he´ll be slaughtered about anything he´ll say. so better shut up

 

[sniper]

He doesn't owe the clinic or twitter a response.
He owes the press, the fans and the sponsors a response.

 

[Ryo Hazuki]

Re: Re:

To be honest I thought and still think there's more to the Wiggins weight loss puzzle than corticos - they've been freely available to everyone since the 80's but you never saw that level of weight loss back in the day.

cyclists in the 80s were still doing breakfast during a tour de france with eating big macs or a giant steak

Bollix. Maybe 1 or 2 were because they were racing 200+ days in a year.

adri van der poel ate a giant steak every morning he had a race. greg lemond ate big macs during the tour de frances, even on tv. those were top cyclists in the 80s. their food and training methods were hilarious and ridiculous by today's standards.

 

[popular jams]

Re:

Greg Lemond was laughed at by some of his colleagues for not being serious with his diet, eating too many burgers and icecream. (In fact he couldn't believe he had iron definciency in 1989 because he'd been eating so much red meat)
He subsequently crushed those joking colleagues at the 89 and 90 TdF.
Goes to show in the end it's all about the nutrition.
Not.

I'm a little thick. Are you inferring something here?

Help me out.

 

[arcus]

Re: Re:

I've been a respiratory physician for many years. I've practiced in European and American university affiliated medical centers.

For what it's worth, I have never used triamcinalone to treat asthma or allergies (nor to my knowledge have my colleagues). There are just too many more acceptable, equally efficacious alternatives.

Thanks, in what context would triamcinolone be used on a patient? Would you agree that it's performance enhancing as an injection?

.

It is a glucocorticoid (GC) that technically is indicated for treatment of refractory allergic disorders, but it has simply just been superseded by other therapies, including LTB4 antagonists and omalizumab, which he does not appear to have been prescribed based on the TUE forms (both were available at the time). I'm puzzled why they did not just use the more conveniently administered oral glucocorticoid, prednisone, which is generally (and understandably) preferred by patients over me or my nurses sticking needles in their butt.

I used it once in a patient with a condition called sarcoidosis. The patient had a severe psychiatric disorder and was unable to comply with oral prednisone. We figured that high dose Kenalog might give her more durable therapeutic levels if we injected her every few weeks. My perception has been that it leads to more sustained blood levels that orally administered glucocorticoids. I had a quick look on Pubmed to find really good pharmacokinetic data for levels after IM injection, but didn't come across compelling data (apart from an equine study, where it was still detectable after 360 hours, though I freely admit that Humans are not horses!

With respect to performance enhancement, I would think that it would share whatever performance enhancing effects GC drugs have (if they indeed do). The problem with a lot of WADA-banned substances and methods is that there is no quality scientific data that prove or deny performance enhancing capability (given ethical and funding obstacles to doing the research right). That said, on balance, my belief is that GCs probably do enhance performance, and that view was shared by Lance Armstrong and Michele Ferrari, which should tell you something. 40mgs of triamcinolone is equivalent to 50mgs of prednisone.

Omalizumab is a biologic / monoclonal drug so likely much more expensive than the Triam which would be a well known substance to use, and probably already in the Sky medicine cabinet. Not heard of the other things (LTB4).

LTB4 antagonists include Montelukast, which trades as Singulair. It is a pill, and very commonly used to treat asthma / allergies.

 

[ontheroad]

Re: Re:

The silence from Brailsford is deafening. A coward.

he knows the clinic and twitter too well. he´ll be slaughtered about anything he´ll say. so better shut up

Or another perspective is that if he has nothing to hide he could quieten Twitter down by setting the story straight. The problem is that when you keep telling lies sooner or later it will catch up with you. Now he is unable to face the music.

Walsh told us that he tried to contact Freeman but he refused to return his calls. Given that he has unlimited access to Sky did he do likewise with Brailsford as I've yet to read the full article?

 

[Benotti69]

Re: Re:

To be honest I thought and still think there's more to the Wiggins weight loss puzzle than corticos - they've been freely available to everyone since the 80's but you never saw that level of weight loss back in the day.

cyclists in the 80s were still doing breakfast during a tour de france with eating big macs or a giant steak

Bollix. Maybe 1 or 2 were because they were racing 200+ days in a year.

adri van der poel ate a giant steak every morning he had a race. greg lemond ate big macs during the tour de frances, even on tv. those were top cyclists in the 80s. their food and training methods were hilarious and ridiculous by today's standards.

Kelly begs to differ, talking about Jean de Gribaldy "As a directeur, he was a long way ahead of his time. He had some great ideas. He was 10 years ahead of everyone else on diet. He was clear about what you could and couldn’t eat 10 years before the other teams started to think about it. "

Wiggins and Sky beg to differ on the training methods :lol:

 

[MatParker117]

Re: Re:

The silence from Brailsford is deafening. A coward.

he knows the clinic and twitter too well. he´ll be slaughtered about anything he´ll say. so better shut up

Or another perspective is that if he has nothing to hide he could quieten Twitter down by setting the story straight. The problem is that when you keep telling lies sooner or later it will catch up with you. Now he is unable to face the music.

Walsh told us that he tried to contact Freeman but he refused to return his calls. Given that he has unlimited access to Sky did he do likewise with Brailsford as I've yet to read the full article?

It's also PR 101 to shut the hell up as anything he says risks fueling the fire.

 

[thehog]

Re: Re:

The silence from Brailsford is deafening. A coward.

he knows the clinic and twitter too well. he´ll be slaughtered about anything he´ll say. so better shut up

Or another perspective is that if he has nothing to hide he could quieten Twitter down by setting the story straight. The problem is that when you keep telling lies sooner or later it will catch up with you. Now he is unable to face the music.

Walsh told us that he tried to contact Freeman but he refused to return his calls. Given that he has unlimited access to Sky did he do likewise with Brailsford as I've yet to read the full article?

It's also PR 101 to shut the hell up as anything he says risks fueling the fire.

No it's not...

Damage Control 101:

Take Quick and Decisive Action

Take quick and decisive action to address the problem internally, before issuing your statement to the public. Then issue your public statement soon thereafter. Remember, it’s always better for you to control the conversation than the press, so make sure you beat the press to it. The quicker you respond to an issue, the faster it runs through the news cycle. A quick response also illustrates that your company is concerned, proactive, and in control of the situation.

Know What to Address

When it comes to negative publicity, the public and media will be most interested in how your company is involved, and how it will affect the company in the future. Your public statement should entail what you have done to ameliorate the issue and/or what steps you will be taking to do so, when you expect the issue to be resolved, and how your company will prevent this type of issue in the future.

Be Transparent, Open and Candid

In this case, silence is not golden. Ignoring or being tight-lipped about a public mishap can do as much damage to your company’s reputation as the mishap itself. Companies who come forward and address their mistakes in an open and candid way regain the public’s trust, and help mitigate any reputation damage that has already occurred. Be open about the mistake as well as how the company is handling it, and be sure to make someone available for further questions, comments or concerns.

 

[ontheroad]

Re: Re:

The silence from Brailsford is deafening. A coward.

he knows the clinic and twitter too well. he´ll be slaughtered about anything he´ll say. so better shut up

Or another perspective is that if he has nothing to hide he could quieten Twitter down by setting the story straight. The problem is that when you keep telling lies sooner or later it will catch up with you. Now he is unable to face the music.

Walsh told us that he tried to contact Freeman but he refused to return his calls. Given that he has unlimited access to Sky did he do likewise with Brailsford as I've yet to read the full article?

It's also PR 101 to shut the hell up as anything he says risks fueling the fire.

But if journalists are doing their job properly they will at least try to get him to air his comments. My point is that Walsh made public Freeman's refusal to return his calls. Did he try contacting Brailsford, and if he also refused to comment then why not report that also. I can't imagine that he wouldn't seek to speak to the DS of the team that he has unlimited access to.

 

[sniper]

Re: Re:

It's also PR 101 to shut the hell up as anything he says risks fueling the fire.

Only if you have something to hide.
If you don't, it's always in your best interest to come forward.

Dave staying silent on this is mathematics 101.