62% hematocrit. it's EPO?

I just want to know who this cheat is

Monkey Magic wrote:

I just want to know who this cheat is

Female non US citizen, currently or very recently training at altitude, aiming for an A standard for 10k or marathon for London 2012 (which implies she doesn't have one yet), recently smashed her PB's (which implies she didn't have an A standard in the past either).

Not sure if he said where she is training, perhaps USA but he didn't say that... runs for a country who's federation might be inclined to turn a blind eye.

It's a wonder the letsrun sleuths haven't already posted a short list of suspects.

Just email the info to whereabouts@hq.iaaf.org

J.R. wrote:

Doc Block wrote:

Well i'd be more concerned if she never took EPO, she better get to a doctor. If she did, she can just donate a couple pints of blood. Levels should return back to normal.

Thank you. In lieu of donating blood, she could probably just stop the cause, and the levels would return to reasonable numbers.

...No. Well, yes, eventually it would, but the risk to her health is immediate, and should absolutely be remedied by a doctor immediately. Even if you're just playing dumb, stop it. A number of athletes have died BECAUSE of blood as thick as hers. This is not a wait and see situation.

webbwhacker wrote:

Its 50%.

And there are a couple of guys with naturally hiogh numbers - Daniel Cuenego is 52%, so is his Dad, and he has a medical certificate to prove it.

This numbe ris o far off the scale it can not be corect.

Or she got the dose wrong, and better make sure she does stroke out while she's asleep.

You're right, I was thinking of the Danish rider "Mr. 60%" Bjarne Riis, who never even tested at 60% anyway.

Remin me again how you came by these results? I think this is a very elaborate troll.

Gotta be a troll.

No blood panel comes without reticulocytes

I'm an Anesthesiologist and ICU MD (basically a clinical physiologist), not an exercise physiologist but I think there's quite a bit of crossover. So I will post in this viper pit for the first time. If you find it mundane or irrelevant, please skip my post and accept my apologies.

First off regarding your athlete's Hct. Highest likelihood would be a false result. That happens in my practice fairly frequently. If a lab test seems very out of whack, it's probably spurious. A simultaneous Arterial Blood Gas should show concomitant metabolic acidosis or else something is up. If I saw that I would send a recheck, then agressively re-hydrate her until she's peeing clear and copious and re-check again. If ABGs show that metabolic acidosis has normalized through hydration and the crit is still in the 60s, then she needs to be evaluated and phlebotomized. Anyone who gets into the 60s through fluid losses alone should feel like total crap, like crawling on all 4s down Alii Drive crappy. If her crit remains in the 60s with evidence of adequate intravascular volume status (not dehydrated) then she is in danger of an ischemic event and needs to be bled, Renaissance style. That's what I would do, but I can get a crit, ABG and lactate level every 5 minutes if I want to. I realize that's not the real world of athletics in the field.

If it turns out your athlete is doping, take her to a NeuroICU and show her a patient who has stroked out their Circle of Willis and can barely move, eat or talk ever again. Tell her that a true, sustained crit of 62 could easily get her a bed right next to that patient, not years from now, but hours from now. Then ask her if it's worth it.

That being said, I have always been concerned about the value placed on random, occasional hematocrits in the fight against doping. It is not at all uncommon to see a patient's crits fluctuate up and down during surgery or an ICU stay, even without bleeding, transfusion or EPO. There's a lot more in the bloodstream than just red cells. It's just a matter of hemoconcentration or dilution. We can make the crit go up 10-12 points in hours without transfusion or EPO (that's way too short of a time frame to make red cells anyway). A higher crit DOES NOT necessarily mean more red cells or oxygen transport in the body at large. Any fluid losses without bleeding can get your crit up. Diabetes Insipidus is a classic example. If we're not careful the crit can become quite high, and I assure you those people aren't doping.

The point I'm trying to make is that crit is not even close to an absolute factor. It goes up and down relative to fluid and hydration status hour by hour. If you take a crit at the end of a 2+ hour long, hot run without fluids you will get a high value. Let that person hydrate for 3-4 hours and you can get a much lower number. Certainly within the range 10-12 points change, I believe. This is why I've never been comfortable with the randomly chosen crit of 50% to define someone who "must be cheating". I always wonder, what were the circumstances when that crit was drawn? I need more data to say something like that and this is all I do 80 hours a week for the past 10 years. Even the Biologic Passport does not approach the number of samples over time I believe one would need to get a reliable sense of a person's natural trends and fluctuations. It's not uncommon for me to see dozens, even hundreds of crit values on a patient over time. After gathering all that then yes, I believe an outside observer could graph them out and say "something fishy changed at this time HERE. DOPAGE!!!!". I don't think the doping authorities are coming to every athlete's houses 2-3 times per day.

You may argue that the OR or ICU represent extremes of human experience that don't relate to exercise physiology and in the case of my running (or most people on these boards) I agree. But I believe the TDF, Ironman, or 2:03 marathon represent human physiology at an extreme equal to many surgical experiences or ICU stays.

I fear the whole strategy of non-positive doping investigation is unsound and frequently tragic. Spot-checking physiologic parameters of mutants who dance around the extremes of normal human physiology on a daily basis and comparing to normal values or randomly drawn lines in the sand seems like grasping at straws and ripe for injustice. It frankly seems a bit pathetic. I realize the authorities are battling substances and techniques that they may not even know about yet and there won't be a true chemical ID test for every substance, but what happened to good, old-fashioned police work? I can't care for a patient in the most simple way without producing Hefty Bags full of garbage and medical waste. It's quite ridiculous and wasteful. This is not ambiguous garbage. Frequently soiled with blood, toxic, and easily identifiable by a lay person from 100 yards away, I would imagine. In fact, when health care worker are caught diverting and using medical narctoics, they are almost always given away by their paraphernalia and disposal attempts rather than a positive drug test ("uhhh, why do you need to have used syringes in your locker?!?").

If I was a French journalist, my daily mission in life would have involved doing whatever is necessary to stalk and sort through Lance Armstrong's garbage and the garbage of every place he goes for the 4 months that led up to any his TsDF. I can't believe that any disposal scheme, no matter how elaborate and well-executed could have made every syringe, needle, vial, IV tubing, etc just disappear into the ether. All together over 8 years in pro cycling it would probably fill a garbage barge. I don't know which idea I find more incredible: that Lance was the only one NOT doping, or that NO ONE has ever found ANY leftover paraphernalia that either tested positive or was ridiculously suspicious enough to make his sponsors bolt. Especially when doing so would make you into the French equivalent of Woodward and Bernstein, the hero of the TDF and an entire nation.

sfadsf wrote:

Gotta be a troll.

No blood panel comes without reticulocytes

Not true. Reticulocytes have to be requested specifically.

IIIII wrote:

the cyclists would set their heart rate monitors to sound an alarm if their heart rate dropped below a certain level. On hearing the alarm, the cyclists would have to wake up, get the bike out and spend 10 minutes on the rollers, in their hotel rooms, just to jump start the circulation.

In the words of one cyclist: "During the day we live to ride, and at night, we ride to stay alive"."

------------------------------------------------

This is quite dramatic but also ridiculous. I believe that cyclists actually did this but it's only because they and their "support" system have little idea what they are dealing with. The body's repsonse to cerbral ischemia is tachycardia and hypertension, not bradycardia. Makes sense doesn't it? When plumbing is clogging up you wouldn't try to fix it by decreasing forward flow or pressure head, would you? The body will "jump start" it's own circulation and you may never even know about it as you stroke out. The idea that anything besides phlebotomy, many liters IV fluids and ceasing doping will protect them is very sad. As is that whole state affaris whenever young athletes are compelled and enabled to take these ridiculous risks.

I`m not a doctor certainly wrote:

I received an e-mail with a picture of this exams.

If there a chance the copy/scan of the test results made a '5' look like a '6'?

Could the hematocrit have been 52% instead of 62%?

another MD opinion wrote:

regarding your athlete's Hct. Highest likelihood would be a false result. That happens in my practice fairly frequently. If a lab test seems very out of whack, it's probably spurious.

If I saw that I would send a recheck, then agressively re-hydrate her until she's peeing clear and copious and re-check again.

Thanks much for your posting.

Thread Follower wrote:

to the poster that mentions the 50 level in bicycle testing - isn't amazing that all the riders are at 49.++??? Or get the two weeks off to get their blood work legal?!?!??!

It would be amazing had you not just made that 'fact' up.

Also, the IAAF can't ban people based on blood results. They need proof of doping, and by proof, they need the smoking gun. Not just a high hematocrit.

As far as I'm aware, they don't even target testing based on dodgy blood numbers (like the bio-passport in cycling). It's almost as if they're not that keen on catching these cheats, eh Renato?

To confirm some of the cycling numbers thrown out.

Prior to implementation of the bio-passport, 50% was the cut-off for the UCI.

Bjarne Riis, director of Saxo Bank and former tour winner, is widly regarded as the athlete who benefited most from doping (i.e. won the tour with the most doping/least talent) and was known as Mr. 60%.

The 52% is Damiano Cunego, never heard of Daniel.

I believe Floyd said Lance was usually racing at 56% prior to implementation of the 50% rule.

Ullrich was rumored to be at 42% for one of his runner-up finishes at the tour, shortly after the Festina scandal. Some consider this performance to have been clean.

From what I understand when you get into the mid-50s, that's when cyclists are getting up in the middle of the night to keep their heart rates high enough that they don't have a heart attack and die.

While running 90-100 miles per week at 5400 feet and having grown up at 7200 feet, my HCT was 49.4.

While I would like to see reticulytes as well, I would be willing to bet a large sum of money that this person is either on EPO, Cera or did a transfusion recently.

The picture (JPG.file) was taken at short distance from a paper taped to the wall, in which I believe, is a lab room located near the camp.

So I can see clearly the "62"

I repeat, the girl is Trying to manage "B" mark for London Marathon.

Although she's trying to get "B", i think is closer to get "A" Based in her new PB'S (i can't tell you because you would go to the IAAF lists and know who is)

the email took some significance in the web, so the federation would made ​​a statement about the "case" in the coming weeks. at least I hope so.

My dear suspicious friend, I want to inform you that every time there is a random test in Kenya doctors take both blood and urine. Currently, WADA, IAAF antidoping and, in US, USADA, ask the athletes the permission for using part of their blood for a research in order to create a line for everybody and a statistic line for events.

Many top athletes refuse, may be fearing some trick.

Of course, all my athletes accepted without any problem (the last was Moses Mosop last Friday).

OP, so you aren't her coach? If this is real, will you link to real news/IAAF info if it ever makes it that far?

And Renato, you should change the link under your name (the coach link) from your wiki page to

http://tinyurl.com/CANOVABADASS

Coach, this exams were taken by the local federation 2/3 weeks before the competition.

I speculate that if they wants to cover uo the girl, they simply would wait to lower levels, then, when the girl raced probably the levels were normal.(no one knows whether In Competition, or later, was controlled), It's possible to think something like that?

But let me tell you sompething, we know for sure in that competition, exams were taken by another federation, by agreement. It's possible?

If I find some new official statement about it, I'll post in this topic.

For now, the picture wasn't appear in the media (i hope they're cheking it). But buzz is growing fastly in local message boards, twitter acounts and facebook groups.