Wiggins, Clinic respect?

[ColonelKidneyBeans]

Re: Re:

He isn't "being difficult", when he tries to pass triamcinolone as a perfectly normal drug to take for seasonal allergies, he is propagating a falsehood (either by ignorance or deliberately i don't know) and is called out on it.

It's not unusual. Here's the first link that came up on Google: https://www.everydayhealth.com/specialists/allergies-asthma/feldweg/qa/kenalog-shots-for-allergies/index.aspx

It might not be what you you would take. Your employer can manage without you for a few days if you have a bad attack. But if you're sports team that has put months of work into this you are going to use the best option available.


Put it this way. One of your kids is sitting exams that will define their future. GCESs/SATs etc. They get really bad hay fever that could flare up at that time during exam period. You have two choices of medicine. The government approved version with a 50% success rate, or the (non-dodgy) Internet pill option with a confirmed 100% success rate. Which one do you buy?

And once again, it isn't the best option, it's what you give someone with severe breathing problems, not someone who would go on to win the Tour. Unless you have no qualms cracking a nut with a sledgehammer of course.

As for your fallacious equivalence, if the pill with the 100% success rate also has a super nasty list of side effects that might end up more debilitating than the 50% one (you know, a bit like systemic corticosteroids), they will get the 50% one. And they always can retake the exam latter, it's not the end of the world, just like not winning the Tour isn't the end of the world.

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

 

[Parker]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line. Most people in sport agree with me.


*The exception to this of course is crash victims. The blood speaks to the traditional cycling fan who applauds their progress (often comparing them to the likes of football - who would just bring on a substitute). As long as they suffering is visible and untreatable then it's great. But god forbid anyone effectively treating an affliction and denying us the suffering.

 

[Ripper]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line like dope till the athlete is an alien being and glows in the dark because who care about ethics .

Just helping you be more clear on your stance on things

 

[The Hitch]

Re: Re:

Jarvo: Your posts may be few, but your insights, intuition and common sense are right on the mark.

because the system can be gamed if you have a doc (in this case that would be the doc who lost the laptop and never turned up to the committee) who is prepared to say you need a TUE when you may not need a TUE

If that were to be the case then there is an infringement

also not sure if you noticed that the pharmacy cupboard was a shared resource between BC and SKY and...well...they have no records....

oh...and we have an 'outperforming' track team at BC... lots of enhanced performances there.......

Rabbit warren of after the fact sleuths on duty today. All for great purpose of justice and all that. FFS. :lol: :lol: :lol:

after the facts?! this forum has existed a long time and numerous contributors have pointed to skys (and other teams) suspicious results long before now!

Go for it, mate.

Just a suggestion ... discuss what you 'know.' Concede what you don't know. Add a little bit of speculation to taste. Garnish cautiously ( it can be overpowering) with suspicion ... if want to go all out and impress your hosts.

That's a reasonable expectation of most healthy, within the rules of good practice, debate and discussion.

Considering half your posts are personal attacks on posters, questioning and making assumptions about their motives, I'm not sure if "discuss what you know" is advice you should be giving

 

[Robert5091]

http://www.dailymail.co.uk/sport/ot...publicly-Sir-Bradley-Wiggins-allegations.html

Skoda, one of Sir Bradley Wiggins's main personal sponsors, have refused to publicly back the under-fire star.

The Czech car manufacturer agreed a three-year, seven-figure deal with Wiggins in January 2017, but twice declined to offer their continued support when contacted by Sportsmail in light of Monday's damning allegations by MPs.

Wiggins has fronted a Skoda advertising campaign, which includes the tag-line: 'Driven by something different.'

Since Skoda are part of VW - the people with the cheating software - it seems fitting they're backing Wiggo.

 

[53*11]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line. Most people in sport agree with me.


*The exception to this of course is crash victims. The blood speaks to the traditional cycling fan who applauds their progress (often comparing them to the likes of football - who would just bring on a substitute). As long as they suffering is visible and untreatable then it's great. But god forbid anyone effectively treating an affliction and denying us the suffering.

really???

 

[53*11]

Re:

That's an extremely disingenuous comparison - the universally accepted treatment for diabetes is insulin, and has been since the 20's. The universally accepted treatment for chronic asthma is inhaled doses of a mild corticosteroid (generally beclomethasone) with inhaled beta-2 agonists (generally salbutamol) for acute attacks. The universally accepted treatment for chronic respiratory allergies is either antihistamines or the same mild corticosteroids (eg beclomethasone as a nasal spray) or both. They're so universal that WADA have stopped requiring TUEs for these substances.

In contrast, triamcinolone is a much stronger drug, and injected tramcinolone means a systemic dose and greatly increased negative side-effects. Corticosteroids are really powerful drugs - they can change the expression levels of around 10% of your genes - and ones taken orally/via injection have an especially heavy list of side-effects, such as bruising and thinning of the skin, immune system suppression, water retention leading to weight gain and bloated facial appearance, and serious mood disturbances such as anxiety and mania.

There's not a doctor in the world (apart from the ones with endurance sports teams signing their pay cheques) who would prescribe injected tramcinolone for allergies or asthma except in the most extreme cases. Extreme cases means "I've been hospitalised, the peak flow meter says my lungs are functioning below 50% capacity, and I can't walk up a single flight of stairs" (which I have personally been through several times and still wasn't treated with anything as strong as triamcinolone, just nebulised salbutamol and a short course of prednisolone tablets), not "I've just won Paris-Nice, Romandie, and the Dauphiné and I want to be in super shape for this upcoming GT".

+1

 

[53*11]

Re: Re:

Alpe73"]

Can I ask a question and I don't know if it has been asked or answered as I haven't gone back through the dozens of pages, but, why does anyone actually care about this?

The parliamentary report stated that no anti doping violations have taken place but sky have 'crossed an ethical boundary' Team Sky are a privately funded team, why do the government feel it necessary to stick their nose in?

Professional sport is result orientated, there are rules in place, if no rule has been broken, why does it matter? professional teams will always go as far as they can up to the line, this happens in all sports. If a footballer dives in the penalty area to get a penalty, that is crossing an ethical line, but there isn't this fervour to brandish them a cheat to this extent.

If I am not mistaken, TUE's have to be granted by a panel of experts after the medical facts are presented to them? if that panel have the wool pulled over there eyes and grant a TUE, then surely that is where the spotlight should be? the team have only done what they can to tip the balance in their favour, at the end of then day a board of medical professionals were presented with evidence and signed off on the TUE's why then is Bradley Wiggins being branded a cheat? Why is the board that grant the TUE's not been held accountable? And surely if their medical expertise resulted in the granting of the TUE's, how is this now such a big issue? surely some kind of medical need had to be established? and if it cannot be established then the TUE system needs a massive overhaul and that should be the story, not a team working within the system that was in front of them

Also if I am not mistaken Triamcinalone is not a banned substance out of competition either? so if the team wanted to use it during training blocks, this is also not illegal, so again what is the issue? Also if it is such a powerful performance enhancer why is it not on the complete banned list by WADA?

Caffeine is a limited drug during competition as well, but if riders choose to use inflated levels and drink 30 espressos before training that is surely no different?

I am just so confused why everyone is piling on as if Bradley Wiggins and Sky are the same as Lance and USPS, they systematically were using EPO and blood bags which were illegal

All I see Sky and Wiggins guilty of is studying the rules of the game better than others (or finding loopholes in the rulebook) none of which are illegal. Have they been found guilty of breaking any rules on this matter? if not, to me it is a non-story. Professional sportsmen and teams will use any small advantage to win, as professional sport is result based, like it or not

BTW this is not a Team Sky/Wiggins love fest. I would have the same puzzled response is this were any team or rider

Jarvo: Your posts may be few, but your insights, intuition and common sense are right on the mark.

because the system can be gamed if you have a doc (in this case that would be the doc who lost the laptop and never turned up to the committee) who is prepared to say you need a TUE when you may not need a TUE

If that were to be the case then there is an infringement

also not sure if you noticed that the pharmacy cupboard was a shared resource between BC and SKY and...well...they have no records....

oh...and we have an 'outperforming' track team at BC... lots of enhanced performances there.......

Rabbit warren of after the fact sleuths on duty today. All for great purpose of justice and all that. FFS. :lol: :lol: :lol:[/quote]


after the facts?! this forum has existed a long time and numerous contributors have pointed to skys (and other teams) suspicious results long before now![/quote]

Go for it, mate.

Just a suggestion ... discuss what you 'know.' Concede what you don't know. Add a little bit of speculation to taste. Garnish cautiously ( it can be overpowering) with suspicion ... if want to go all out and impress your hosts.

That's a reasonable expectation of most healthy, within the rules of good practice, debate and discussion. [/quote]

you make zero sense here, unless you are just trolling, the last refuge of the lost causes. of course no one outside the team really knows how much they got up to; we have the fancy bears hacking to thank for shining a light on their 'marginal gains' and fluffy pillows. this weeks stories are all sky and it looks likely to be the case for a long time to come, but im sure if other teams riders get popped it will be covered here in these pages also, eg contador and others. we know sky have lied through their collective teeth for years now, gaming the TUES system, triamcinalone, jiffygate, DBs clumsy lies to explain it, and froomes little difficulty with his inhaler! the committee report has been excoriatingly critical of them, their lack of morals/ethics, and this has kept the sky scandals story top of the news all week.

 

[samhocking]

I tend to agree with Parker. In road racing performed outdoors over 3 weeks, with calorific output the same as running 20-odd marathons back-to-back every day, athletes will simply not survive without medical support. While we may applaud riders like Tim Wellens refusing his doctor trying to inject him with Triamcinolone with a TUE to cure his allergies suffered in the race and pulling out instead, if every rider refused medical support throughout the race this way, half the peloton would not exist, sponsors not be happy, riders unhappy they can't race and you would have perhaps a few dozen stragglers for GC in Paris and time gaps so huge there would be no actual GC race whatsoever after two weeks, letalone 3. It would be more like the days of Henri Desgrange where upto 3/4 of the starters never even make it to Paris due to poor health, crashes and injury left untreated without medical support allowed or even considered then and the time gaps from 1st to2nd place over 2 hours lol! As much as we want bread and water racing, it's not possible. Perhaps one day a team will launch that doesn't include any doctors on its staff lol, but they are there for a reason and thats to keep riders healthy in what is a very unhealthy activity without it as seen in non-medical support days of Henri Desgrange etc.

The problem with the TUE system for Corticosteroids especially, is we all know riders like Millar, Jascch, Rasmussen and everyone back then would get their doctor to fake they had a joint or tendon injury, because an Intra-Articular injection of Triamcinolone to fix it, would normally be granted under TUE easily back then. Once granted by UCI, then their team doctor would simply inject the rider intra-muscularly in the bum, not their fake knee or ankle injury and so the rider got the performance benefit of the Triamcinolone and the TUE protection because you can't easily detect route of administration of it. That was abuse of the TUE system, that was using fake injury to apply for TUEs under the premise you will be using an intra-articular injection to treat it and that wouldn't have such performance benefits, but injecting intra-muscularly once granted, knowing you couldn't get caught if tested from the intra-articular you were meant to have.

Wiggins TUE application was at the opposite end. He wasn't using the easy traditional fake injury to hide under an intra-articular TUE, his TUE was for intra-muscular from the beginning, no pretence. Knowing, his TUE would probably never be known about, why go to all that bother with the asthma documentation and trying to get a TUE for an unlikely intra-muscular injection if you don't really need to apply for with such complexity? As we saw with Wellens, clearly team doctors are treating riders for illness and injury in races with it still and I would expect them to be I think, because a rider invested all that time in training and shouldn't have to pull out, just because riders like Millar, Jascch, Rasmussen abused the system by faking what they are actually suffering from legitimately and not trying to abuse the system, but now in fear of us the fans based on the misdemeanours of their previous generation.

 

[gillan1969]

I tend to agree with Parker. In road racing performed outdoors over 3 weeks, with calorific output the same as running 20-odd marathons back-to-back every day, athletes will simply not survive without medical support. While we may applaud riders like Tim Wellens refusing his doctor trying to inject him with Triamcinolone with a TUE to cure his allergies suffered in the race and pulling out instead, if every rider refused medical support throughout the race this way, half the peloton would not exist, sponsors not be happy, riders unhappy they can't race and you would have perhaps a few dozen stragglers for GC in Paris and time gaps so huge there would be no actual GC race whatsoever after two weeks, letalone 3. It would be more like the days of Henri Desgrange where upto 3/4 of the starters never even make it to Paris due to poor health, crashes and injury left untreated without medical support allowed or even considered then and the time gaps from 1st to second place over 2 hours lol! As much as we want bread and water racing, it's not possible. Perhaps one day a team will launch that doesn't include any doctors on its staff lol, but they are there for a reason and thats to keep riders healthy in what is a very unhealthy activity without it as seen in non-medical support days of Henri Desgrange etc.

The problem with the TUE system for Corticosteroids especially, is we all know riders like Millar, Jascch, Rasmussen and everyone back then would get their doctor to fake they had a joint or tendon injury, because an Intra-Articular injection of Triamcinolone to fix it, would normally be granted under TUE easily back then. Once granted by UCI, then their team doctor would simply inject the rider intra-muscularly in the bum, not their fake knee or ankle injury and so the rider got the performance benefit of the Triamcinolone and the TUE protection because you can't easily detect route of administration of it. That was abuse of the TUE system, that was using fake injury to apply for TUEs under the premise you will be using an intra-articular injection to treat it and that wouldn't have such performance benefits, but injecting intra-muscularly once granted, knowing you couldn't get caught if tested from the intra-articular you were meant to have.

Wiggins TUE application was at the opposite end. He wasn't using the easy traditional fake injury to hide under an intra-articular TUE, his TUE was for intra-muscular from the beginning, no pretence. Knowing, his TUE would probably never be known about, why go to all that bother with the asthma documentation and trying to get a TUE for an unlikely intra-muscular injection if you don't really need to apply for with such complexity? As we saw with Wellens, clearly team doctors are treating riders for illness and injury in races with it still and I would expect them to be I think, because a rider invested all that time in training and shouldn't have to pull out, just because riders like Millar, Jascch, Rasmussen abused the system by faking what they are actually suffering from legitimately and not trying to abuse the system, but now in fear of us the fans based on the misdemeanours of their previous generation.

sam

not sure you've been following...he wasn't ill, he was flying (2012)...funny enough the same with froome on that stage in the Vuelta...he was flying

on top of that even if he was worried about a flare up(itself not qualifying for a TUE) then the drug was a sledgehammer to crack a nut

oh...and the doc lost the laptop and wouldn't appear at committee (and probably ordered testosterone for microdosing)

so...exactly the same at Millar, Jaske and Rasmussen

carry on

 

[samhocking]

So why, when nobody ever applied for a TUE Triamcinolone injection back then using intra-muscular route of administration did Wiggins? Why not just request the TUE like Rasmussen, Millar and Jasch and most team doctors did back then? Why did Wiggins not simply hide behind a simple, very easily applied for and granted Intra-Articular TUE and get Freeman to inject him in the bum instead with the TUE protection of his fake injury, knowing the labs can't tell the difference anyway? That isn't abuse of the system. You're actually applying for the TUE and stating it will not be an intra-articular injection in the application. It's not the same at all, you're massively decreasing the likelihood you will be granted the TUE by doing that, because intra-muscular is the route of administration you use if you want to enhance performance with it. Intra-Articular much less so, perhaps of no benefit in fact and why easily granted under TUE, even today for injury.

 

[Craigee]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line. Most people in sport agree with me.


*The exception to this of course is crash victims. The blood speaks to the traditional cycling fan who applauds their progress (often comparing them to the likes of football - who would just bring on a substitute). As long as they suffering is visible and untreatable then it's great. But god forbid anyone effectively treating an affliction and denying us the suffering.

What an arrogant assumption to make. I doubt very much that most people would agree that an athlete should be allowed performance enhancing drugs for their health for an event. It's the shifty sporting bodies like the UCI who think it's a good idea.

 

[gillan1969]

Re:

So why, when nobody ever applied for a TUE Triamcinolone injection back then using intra-muscular route of administration did Wiggins? Why not just request the TUE like Rasmussen, Millar and Jasch and most team doctors did back then? Why did Wiggins not simply hide behind a simple, very easily applied for and granted Intra-Articular TUE and get Freeman to inject him in the bum instead with the TUE protection of his fake injury, knowing the labs can't tell the difference anyway? That isn't abuse of the system. You're actually applying for the TUE and stating it will not be an intra-articular injection in the application. It's not the same at all, you're massively decreasing the likelihood you will be granted the TUE by doing that, because intra-muscular is the route of administration you use if you want to enhance performance with it. Intra-Articular much less so, perhaps of no benefit in fact and why easily granted under TUE, even today for injury.

i think we know that SKY had no problems getting TUEs with their friend Zorzoli in position...they didn't need to hide behind anything

the only reason we're having this discussion at all is because of fancy bears hacking the system....

I mean Froome beat Tony Martin in a TT despite being so ill with a chest infection he needed prednisone with his TUE....this year of course he was dropping Nibali with severe asthma attack, bronchitis and, it would appear, a malfunctioning kidney....

no TUE in that instance however, and circumstantial at the moment, but again it appears as though SKY/Froome did not think that would be public....i.e. public at the end of the process, not due to the leak

 

[samhocking]

Yes, but Fancy Bears only hacked the TUE. All of the other documents relating to the TUEs they left on ADAMS didn't they. The reason for that is those documents would weaken the impact for trying to expose athletes cheating with TUEs by leaking them as those documents would justify the TUE medically in many cases. I repeat though, why bother with the ever-so convoluted TUE application under the pretence of Allergies, when a simple faked ankle injury would be all that is required to get the TUE anyway? Sky wouldn't have known the TUE would ever be hacked and public, so they have nobody to convince other than Zorzoli, so why not just apply for the TUE in the traditional manner like all other riders did back then if you wanted to cheat the TUE systen? That doesn't make sense to me.

If i'm going to illegally fake a medical reason for needing the TUE for Triamcinolone, i'm going to go for the simplest, most guaranteed method of faking a basic everyday injury all cyclists get, ask my friendly team doctor to kindly inject me in the bum instead when I get it, not my dodgy ankle that is in fact perfectly fine and ride to victory, knowing Zorzoli will grant it me if I do that. I'm not going to sit there and say, you know what, i'll make this as hard as I possibly as I can on myself to get this TUE by telling them i'm wanting to inject it intra-muscularly in the application, even though I don't have to do that and involve various others outside thew team to build a complex web of a story I don't need them to do for me as my doctor is all I need and a dodgy ankle. That doesn't make sense in Wiggins TUE. Why is the application for each TUE so pointlessly complex for back then, when we know Zorzoli would grant a TUE for Triamcinolone for joint injury as routine and confirmed by numerous riders saying that's how they cheated the system then?

 

[King Boonen]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line. Most people in sport agree with me.


*The exception to this of course is crash victims. The blood speaks to the traditional cycling fan who applauds their progress (often comparing them to the likes of football - who would just bring on a substitute). As long as they suffering is visible and untreatable then it's great. But god forbid anyone effectively treating an affliction and denying us the suffering.

What an arrogant assumption to make. I doubt very much that most people would agree that an athlete should be allowed performance enhancing drugs for their health for an event. It's the shifty sporting bodies like the UCI who think it's a good idea.

I have to disagree. I think if you were to ask any fan if their favourite athlete/team members should be allowed a steroid injection for pain relief so they can compete, the vast majority would say yes. There's plenty of empirical evidence to support this and other poor health-related medical decisions in sport, such as the problems with concussion in contact sports, to back up an assertion that most people would be happy for it to happen. I remember on the video of the 1997 Lions Tour there was footage of Martin Johnson receiving injections while off the field for a blood injury so that he could continue. It's extremely common in professional sport and there is little to no outrage. I Believe Ledley King was only able to have a football career because of continuous steroid injections in his knee. I've known rugby league players in similar positions, both in the UK and Australia and I'm sure it happens in football, cricket, basketball and so on.

 

[bambino]

Re:

Yes, but Fancy Bears only hacked the TUE. All of the other documents relating to the TUEs they left on ADAMS didn't they. The reason for that is those documents would weaken the impact for trying to expose athletes cheating with TUEs by leaking them as those documents would justify the TUE medically in many cases. I repeat though, why bother with the ever-so convoluted TUE application under the pretence of Allergies, when a simple faked ankle injury would be all that is required to get the TUE anyway? Sky wouldn't have known the TUE would ever be hacked and public, so they have nobody to convince other than Zorzoli, so why not just apply for the TUE in the traditional manner like all other riders did back then if you wanted to cheat the TUE systen? That doesn't make sense to me.

If i'm going to illegally fake a medical reason for needing the TUE for Triamcinolone, i'm going to go for the simplest, most guaranteed method of faking a basic everyday injury all cyclists get, ask my friendly team doctor to kindly inject me in the bum instead when I get it, not my dodgy ankle that is in fact perfectly fine and ride to victory, knowing Zorzoli will grant it me if I do that. I'm not going to sit there and say, you know what, i'll make this as hard as I possibly as I can on myself to get this TUE by telling them i'm wanting to inject it intra-muscularly in the application, even though I don't have to do that and involve various others outside thew team to build a complex web of a story I don't need them to do for me as my doctor is all I need and a dodgy ankle. That doesn't make sense in Wiggins TUE. Why is the application for each TUE so pointlessly complex for back then, when we know Zorzoli would grant a TUE for Triamcinolone for joint injury as routine and confirmed by numerous riders saying that's how they cheated the system then?

All of the three TUE's leaked by fancy bear were effective just few days before major GT's. I bet for security if he would still glow in the first day tests. We more or less know already there were fourt application of TUE few days before Dauphine 2011 on 30th May 2011 which, it seems, wasn't authorized. Did Wiggo still use the drug before the Dauphine? We don't know. Maybe he wasn't because he wasn't glowing in tests. But the key is... they wanted TUE to use the drug begore Dauphine. They didn't get the approval. He won the race. You think the allergy was so bad he needed steroids? And won Dauphine regardless?

The TUE's were clearly pre-caution to explain glowing out of constant OOC use. And we don't know how many there actually has. We know just the ones leaked by Fancy Bear.

 

[samhocking]

Other cases would be Murray having Corticosteroid and painkiller injections moments before a match in Monte Carlo iirc at the side of the court in order to carry on playing. That is the reality of professional sports, athletes are often ill and injured and Triamcinolone is a standard fix for many issues they face and organisers, fans, sponsors and themselves want to continue.

There is a huge confusion of not understanding the difference between intra-articular and intra-muscular administration though. Unfortunately you can't even separate the two in the lab as far as I know, so even if you only granted intra-articular TUEs and a third party carried out the injection, there's nothing then stopping you injecting yourself intra-muscular back in the hotel, knowing your TUE covers you anyway, so would still be open to abuse even if totally outside the hands of the Teams Doctors & TUEC.

 

[samhocking]

Re: Re:

Yes, but Fancy Bears only hacked the TUE. All of the other documents relating to the TUEs they left on ADAMS didn't they. The reason for that is those documents would weaken the impact for trying to expose athletes cheating with TUEs by leaking them as those documents would justify the TUE medically in many cases. I repeat though, why bother with the ever-so convoluted TUE application under the pretence of Allergies, when a simple faked ankle injury would be all that is required to get the TUE anyway? Sky wouldn't have known the TUE would ever be hacked and public, so they have nobody to convince other than Zorzoli, so why not just apply for the TUE in the traditional manner like all other riders did back then if you wanted to cheat the TUE systen? That doesn't make sense to me.

If i'm going to illegally fake a medical reason for needing the TUE for Triamcinolone, i'm going to go for the simplest, most guaranteed method of faking a basic everyday injury all cyclists get, ask my friendly team doctor to kindly inject me in the bum instead when I get it, not my dodgy ankle that is in fact perfectly fine and ride to victory, knowing Zorzoli will grant it me if I do that. I'm not going to sit there and say, you know what, i'll make this as hard as I possibly as I can on myself to get this TUE by telling them i'm wanting to inject it intra-muscularly in the application, even though I don't have to do that and involve various others outside thew team to build a complex web of a story I don't need them to do for me as my doctor is all I need and a dodgy ankle. That doesn't make sense in Wiggins TUE. Why is the application for each TUE so pointlessly complex for back then, when we know Zorzoli would grant a TUE for Triamcinolone for joint injury as routine and confirmed by numerous riders saying that's how they cheated the system then?

All of the three TUE's leaked by fancy bear were effective just few days before major GT's. I bet for security if he would still glow in the first day tests. We more or less know already there were fourt application of TUE few days before Dauphine 2011 on 30th May 2011 which, it seems, wasn't authorized. Did Wiggo still use the drug before the Dauphine? We don't know. Maybe he wasn't because he wasn't glowing in tests. But the key is... they wanted TUE to use the drug begore Dauphine. They didn't get the approval. He won the race. You think the allergy was so bad he needed steroids? And won Dauphine regardless?

The TUE's were clearly pre-caution to explain glowing out of constant OOC use. And we don't know how many there actually has. We know just the ones leaked by Fancy Bear.

Still doesn't explain why they applied using intra-muscular TUE though. A rider is still going to be granted a TUE for an intra-articular injury even an hour before the start line, so timing really makes no difference to the application. I repeat why bother with an intra-muscular TUE if you have a freindly Zorzoli who will tick you an easy guaranteed intra-articular in return for your doctor diagnosing a simple fake ankle injury day before Tour starts with very little supporting evidence required unlike allergies or asthma?

Clearly you will want the injection as close to Grand Depart as possible, be it for allergies or performance enhancement, because for allergies, it is most effective at suppressing the allergy in the first 3-4 weeks and then has diminished returns over maximal oral and topical therapy. For performance enhancement in a 3 week race, you also want to take it as close to the grand depart, because after 3 weeks, your immune system is then at its most suppressed and you risk getting too ill to complete the race anyway. That is why most allergy sufferers are injected as close to the big event in their lives as practical too, because you only have month window of both benefits and effective immune system. You wouldn't want it 3 weeks before cheating or not. Wiggins did only have 40mg though, rather than the more typical 50-100mg you would usually be given for allergies, so they clearly were not even going for maximum returns on it anyway. He could have had 100mg, but probably would increase risk illness before Olympics at least in 2012 taking too much, for too long a period.

 

[bambino]

Re: Re:

Yes, but Fancy Bears only hacked the TUE. All of the other documents relating to the TUEs they left on ADAMS didn't they. The reason for that is those documents would weaken the impact for trying to expose athletes cheating with TUEs by leaking them as those documents would justify the TUE medically in many cases. I repeat though, why bother with the ever-so convoluted TUE application under the pretence of Allergies, when a simple faked ankle injury would be all that is required to get the TUE anyway? Sky wouldn't have known the TUE would ever be hacked and public, so they have nobody to convince other than Zorzoli, so why not just apply for the TUE in the traditional manner like all other riders did back then if you wanted to cheat the TUE systen? That doesn't make sense to me.

If i'm going to illegally fake a medical reason for needing the TUE for Triamcinolone, i'm going to go for the simplest, most guaranteed method of faking a basic everyday injury all cyclists get, ask my friendly team doctor to kindly inject me in the bum instead when I get it, not my dodgy ankle that is in fact perfectly fine and ride to victory, knowing Zorzoli will grant it me if I do that. I'm not going to sit there and say, you know what, i'll make this as hard as I possibly as I can on myself to get this TUE by telling them i'm wanting to inject it intra-muscularly in the application, even though I don't have to do that and involve various others outside thew team to build a complex web of a story I don't need them to do for me as my doctor is all I need and a dodgy ankle. That doesn't make sense in Wiggins TUE. Why is the application for each TUE so pointlessly complex for back then, when we know Zorzoli would grant a TUE for Triamcinolone for joint injury as routine and confirmed by numerous riders saying that's how they cheated the system then?

All of the three TUE's leaked by fancy bear were effective just few days before major GT's. I bet for security if he would still glow in the first day tests. We more or less know already there were fourt application of TUE few days before Dauphine 2011 on 30th May 2011 which, it seems, wasn't authorized. Did Wiggo still use the drug before the Dauphine? We don't know. Maybe he wasn't because he wasn't glowing in tests. But the key is... they wanted TUE to use the drug begore Dauphine. They didn't get the approval. He won the race. You think the allergy was so bad he needed steroids? And won Dauphine regardless?

The TUE's were clearly pre-caution to explain glowing out of constant OOC use. And we don't know how many there actually has. We know just the ones leaked by Fancy Bear.

Still doesn't explain why they applied using intra-muscular TUE though. A rider is still going to be granted a TUE for an intra-articular injury even an hour before the start line, so timing really makes no difference to the application. I repeat why bother with an intra-muscular TUE if you have a freindly Zorzoli who will tick you an easy intra-articular in return for your doctor diagnosing a fake ankle injury day before Tour starts?

Clearly you will want the injection as close to Grand Depart as possible, be it for allergies or performance enhancement, because for allergies, it is most effective at suppressing the allergy in the first 3-4 weeks and then has diminished returns over maximal oral and topical therapy. For performance enhancement in a 3 week race, you also want to take it as close to the grand depart, because after 3 weeks, your immune system is then at its most suppressed and you risk getting too ill to complete the race anyway. That is why most allergy sufferers are injected as close to the big event in their lives as practical too, because you only have month window of both benefits and effective immune system. You wouldn't want it 3 weeks before cheating or not. Wiggins did only have 40mg though, rather than the more typical 50-100mg you would usually be given for allergies, so they clearly were not even going for maximum returns on it anyway. He could have had 100mg, but probably would be ill before Olympics at least in 2012.

I've always thought TUEs are granted for actual illnes and condition requiring medication. What you suggest is that it is competely normal to use TUEs to prevent illness and condition. Maybe I've mis-understood...

 

[ColonelKidneyBeans]

Re: Re:

But i believe we have a very different vision of medicine, to me it is used to heal in the most efficient way for your general well-being, it's seems that for you it is to be used as a tool to allow you to perform, damned be the long terms consequences. I wonder if Wiggo will think it was worth it if he ends up with health problems later in life, which i hope he don't.

No what we have is a different vision of medicine in sport. You think that any athlete who has trained for months for a goal should just sit it out on a sick day because best for their long term health*. I think that doctors should use whatever means they have available to get their on the start line. Most people in sport agree with me.


*The exception to this of course is crash victims. The blood speaks to the traditional cycling fan who applauds their progress (often comparing them to the likes of football - who would just bring on a substitute). As long as they suffering is visible and untreatable then it's great. But god forbid anyone effectively treating an affliction and denying us the suffering.

What an arrogant assumption to make. I doubt very much that most people would agree that an athlete should be allowed performance enhancing drugs for their health for an event. It's the shifty sporting bodies like the UCI who think it's a good idea.

I have to disagree. I think if you were to ask any fan if their favourite athlete/team members should be allowed a steroid injection for pain relief so they can compete, the vast majority would say yes. There's plenty of empirical evidence to support this and other poor health-related medical decisions in sport, such as the problems with concussion in contact sports, to back up an assertion that most people would be happy for it to happen. I remember on the video of the 1997 Lions Tour there was footage of Martin Johnson receiving injections while off the field for a blood injury so that he could continue. It's extremely common in professional sport and there is little to no outrage. I Believe Ledley King was only able to have a football career because of continuous steroid injections in his knee. I've known rugby league players in similar positions, both in the UK and Australia and I'm sure it happens in football, cricket, basketball and so on.

Sadly i think you're right, but it is very wrong IMHO, an elite sport career is already unhealthy, there's no need to add medications that are potentially harmful on top of that, especially if it's to allow you to play/ride injured.
What rubs me wrong in Parker's post is that he tries to paint Triamcinolone as a perfectly reasonable treatment for asthma/allergies and people who disagree has not having the athlete best interests in mind. I wonder if the OOC use described in the report was also completely justified and with the athlete health as the prime motivation?

 

[Parker]

Re:

Other cases would be Murray having Corticosteroid and painkiller injections moments before a match in Monte Carlo iirc at the side of the court in order to carry on playing. That is the reality of professional sports, athletes are often ill and injured and Triamcinolone is a standard fix for many issues they face and organisers, fans, sponsors and themselves want to continue.

Last year Andrew Flintoff said he had had 90 cortisone injections during his career. No-one thought that this was even newsworthy.

 

[Parker]

Re: Re:

What rubs me wrong in Parker's post is that he tries to paint Triamcinolone as a perfectly reasonable treatment for asthma/allergies and people who disagree has not having the athlete best interests in mind.

The Lotto doctor seemed to think it was reasonable treatment when he offered it to Wellens during last year's Tour.

 

[RownhamHill]

Re: Re:

I've always thought TUEs are granted for actual illnes and condition requiring medication. What you suggest is that it is competely normal to use TUEs to prevent illness and condition. Maybe I've mis-understood...

I guess here is the essential problem here.

Define illness. Define condition. Define requirement of medication.

Personally I take the view that TUEs probably shouldn't exist for banned substances. No matter how legitimate your medical need, if you need a banned drug to help you perform better then by definition you're using performance enhancing drugs.

I may be taking liberties with your position, but you seem to be of the view that TUEs are OK in circumstances where you're responding to an unpredictable illness/injury, but not for more 'strategic' or planned use to manage pre-existing conditions.

Parker seems to be taking the view that if you know you've got a chronic condition, and you know that could result in a race-ending performance issue (like difficulty breathing or a massive ashtma attack), then it's OK to take the most powerful medicine to manage that.

They are all different positions, but none of them are wrong or right, they're just judgements. Crucially though, the UCI who were managing the TUE system seem to have taken Parker's view, as it seems like the application for the TUE was clear on what it was for. So maybe we should be calling for some clearer WADA criteria of the definitions of illness, conditions and when medication can justifiably be required and when it can't.

 

[samhocking]

Well Allergies & Asthma is an incurable disease, not a temporary illness or injury that can be fixed with Triamcinolone, so pretty different. For injury Triamcinolone is the fix to get you better more quickly, for Allergies it isn't a fix, simply taken when you are well to prevent a possible attack that might or might not happen to you at some point in the future, but when it does will be pretty bad if you hadn't. As Wiggins said recently, without it, had he had an allergic reaction passing through a field in Tour de France, he would have lost the Tour de France whatever that day might have been.

The main point is if you apply for a TUE for injury, that injection would be intra-articular. There would be very little if no performance enhancement because that route of adminstration is not a systemic corticosteroid treatment, it's local. Wiggins treatment has to be systemic, so is intra-muscular, therefore highly unlikely it would be granted easily.

It all comes down to the ENT specialists report in his TUE. The notes say, pre-2011 he was on maximial therapy treatment for >3 years that wasn't effective according to the RAST tests etc. That means maximum oral, topical and inhaled steroids were not effective at returning him to normal level during the RAST. Next step after maximal therapy has been exhausted and 3 years would be considered long-enough is only Triamcinolone injection, there is no other method and plenty of sufferes are still treated this way if not benefiting from maximial therapy during hayfever season.

You either believe that maximal therapy happened or you don't. Clearly if you look at his TUEs at FdeJ, Cofidis, High Road & Garmin he was often on maximal therapy using topical, oral and inhales corticosteroids, so wasn't invented at Sky at all. His medical TUE history for asthma and allergies looking at what doctors were prescribing him to dea lwith them goes back to 2003 at FdeJ via French Anti-Doping long before Zorzoli.

 

[ColonelKidneyBeans]

Re: Re:

What rubs me wrong in Parker's post is that he tries to paint Triamcinolone as a perfectly reasonable treatment for asthma/allergies and people who disagree has not having the athlete best interests in mind.

The Lotto doctor seemed to think it was reasonable treatment when he offered it to Wellens during last year's Tour.

Was it triamcinolone or another form of corticosteroid? What was Wellens exact condition? It wasn't pollen allergies but something to do with the heat. Lotto is a pretty old school team, it doesn't surprise me at all that they would do that, it's wrong, and Wellens knew better than to take it, kudos to him.

So about the OOC use?