Help, my top HS girl has anemia, 2 weeks to State

That's the worst ferritin I've ever heard of. Mine was 12 and I wanted to walk halfway through every race.

realdoctor wrote:

Her health long term should be the main concern.

I am with "realdoctor." These are CHILDREN who you are "coaching."

Your number one concern is keeping them alive and healthy, next is academics.

Scoring points at the state meet is not important. You have little control over what the kid is eating (or not eating) and the other stresses in her life, such as hormonal changes, as well as the stresses in her home life and social life. You just get to advise her on how far and how fast to run in her training.

I would cut her off immediately.....Make sure she is on a regimen supported by her DR. to get her back on track.

The female mental aspect of running is a fragile thing. Racing now and under performing could have long term effects, even after coming back full strength.

Long term and maybe short term I'd recommend Hema-Plex. For whatever reason it has worked way better for my athletes than any other supplementation. I have had a few people get infusions but that is usually an extreme case(which you may have) and expensive and honestly hard to get the Doc to do.

I have had a girl who had ferritin of 18 take Hema-Plex and feel somewhat better in around 3 weeks.

I'd go with what the kid wants to do here, if she really wants to race and not doing that is going to break her mentally then pick one. Back off a TON on workouts and miles.

Make sure to her that it is her HEALTH you are concerned with, make sure she knows this and that you support a thorough work up of her iron/anemia issues from her physician or specialist if needed. Track is secondary at this point.

It concerns me like it has concerned others that you are so involved in this child's medical condition. You have no business as a coach being involved in her medical issues You especially have exceeded the boundaries as a coach because it is quite clear that your concerns are not about her health but her performance.

You are not qualified to give medical advice to this child's parents or doctor, you need to step back think about what the priorities are in life. Hers not yours!!

How about a little perspective?

Her doctor is correct that she can still safely compete however as for correcting the medical condition in 2 weeks it can not be done.

I disagree with you completely Run Doctor. Imagine if the coach had NO idea of the condition and expected her to run at a top level. Would that be healthy?

As a coach, it is our responsibility to do what is best for a kid. That means having knowledge of medical conditions/issues.

I would agree with this but this coach has already proven that he/she is more concerned with how to get more points than girls health. She is already has signs of trouble and coach is looking for way to have her triple.

CantDoIt wrote:

I disagree with you completely Run Doctor. Imagine if the coach had NO idea of the condition and expected her to run at a top level. Would that be healthy?

As a coach, it is our responsibility to do what is best for a kid. That means having knowledge of medical conditions/issues.

Absolutely the coach should know basic signs of common running injuries/conditions, but he/she shouldn't be giving any advice outside of "Get some rest, see the doctor or see the trainer".

More so, the telltale sign that this coach is overly involved in the medical process is that the coach knows that she hasn't been having her period... that's not a conversation you should be having with a student.

Ehhhh.... wrote:

CantDoIt wrote:

I disagree with you completely Run Doctor. Imagine if the coach had NO idea of the condition and expected her to run at a top level. Would that be healthy?

As a coach, it is our responsibility to do what is best for a kid. That means having knowledge of medical conditions/issues.

Absolutely the coach should know basic signs of common running injuries/conditions, but he/she shouldn't be giving any advice outside of "Get some rest, see the doctor or see the trainer".

More so, the telltale sign that this coach is overly involved in the medical process is that the coach knows that she hasn't been having her period... that's not a conversation you should be having with a student.

Nah....coach said NO HEAVY menstruation. Which would be a flag for low crit. So calm down.

Ehhhh.... wrote:

Absolutely the coach should know basic signs of common running injuries/conditions, but he/she shouldn't be giving any advice outside of "Get some rest, see the doctor or see the trainer".

More so, the telltale sign that this coach is overly involved in the medical process is that the coach knows that she hasn't been having her period... that's not a conversation you should be having with a student.

The coach said they know the athlete doesn't have 'heavy' periods, as in some women have ones where blood loss is very significant compared to 'normal', which could be an non-running related explanation for anemia conditions.

Quite frankly, a distance coach who seriously trains their athletes should be aware of their female athletes' menstruation situation. If an athlete has 'heavy' menstrual cycles, its important for me to know so I can back off on training a bit, just like you wouldn't expect someone who donated a pint of blood to be training at full volume and intensity for a few days afterwards. Even more significant is an athlete who completely misses their period. While other factors can cause this, and it doesn't automatically mean you're overtraining and overstressing an athlete, its a pretty huge red flag to the possibility and you need to be extra alert to other symptoms if this has happened. Amenorrhea can be an exercise induced condition that can have long term health impacts on some women, and if you have an athlete who sees it as a convenient side effect, that can be a pretty big warning sign of other body image issues with that person.

A serious coach who cares about the well-being of their female athletes is going to be aware of these issues, be able to use the information to make adjustments if necessary, and steer them to medical professionals if they're having issues. On the opposite side, if they're having issues, seeking medical help, and not keeping you in the loop as necessary, you could be perpetuating issues by operating in the dark.

Some advice wrote:

Quite frankly, a distance coach who seriously trains their athletes should be aware of their female athletes' menstruation situation.

To be clear, this doesn't mean as a coach you should be making the athlete report to you every time they are having their period. It means if your athletes are adults (college or beyond), you should have an open discussion with them about situations they might go through where you should be made aware. If your athletes are still children, a conversation with parents suggesting they have this conversation with their child, and keep you informed if any issues come up.

Yes agree with the last few posts. Run Doctor is very wrong.

A slightly different reason that Coaches need to be involved is that the kids probably want the world, and want to run 3 events and wants to PR every time. We need to occasionally temper that desire and teach them how to be smart and healthy.

Also Doctors are idiots. We have never had a General Doc say that someone's Ferritin was an issue when we have had athletes at 5 or 8. They say they are fine.

Yesterday we had a Doc tell a kid that he tore his groin and he just needs to take a week off and ice and it should be fine.

Most Doctors are worthless.

I really disagree with you on this. I am usually the one who picks up on the fact something is not right with the athlete, and need to let the parents know what I think about their child's medical issues!! This year alone, I have notified three sets of parents that I suspected their daughter had low ferritin and I was correct on all counts. If I didn't tell the parents what to ask their doctor for, the wrong labs would be run. In fact, one of my girls' mother forgot to ask for ferritin, and guess what? The doctor didn't order it despite the girl's symptoms. Most pediatricians don't seem to understand anything about issues with adolescent endurance athletes, in my experience (and I have a few kids of my own, not saying this just based on my other athletes' experiences). A distance runner girl will have low normal ferritin levels, and the doctor thinks she's fine! NOT fine.

I have also had to talk to girls about whether or not they menstruate since in the past I have had girls who did NOT menstruate, and I did not know this (they were not super skinny types). Stress fracture occurs, and we start talking about this...their parents knew they didn't have a period but didn't think it was big deal. The doctors can be the pits about this as well- I had one girl who was a serious distance runner, no eating disorder, and normal weight, and her doctor told her, "Why do you run so much? Just stop running for a year and you will most likely get your period." Absolutely NO understanding or compassion for the kid. Great option for a kid who wants to run in college. Maybe they could explore some other ideas first, like some lab work?

Indoor? wrote:

Yes agree with the last few posts. Run Doctor is very wrong.

A slightly different reason that Coaches need to be involved is that the kids probably want the world, and want to run 3 events and wants to PR every time. We need to occasionally temper that desire and teach them how to be smart and healthy.

Also Doctors are idiots. We have never had a General Doc say that someone's Ferritin was an issue when we have had athletes at 5 or 8. They say they are fine.

Yesterday we had a Doc tell a kid that he tore his groin and he just needs to take a week off and ice and it should be fine.

Most Doctors are worthless.

Really? Well don't see one when you are sick and see how your life progresses from that point.

Coaches are the problem because egomaniacs like yourself seem to think you are qualified to make medical recommendations.

Coach G wrote:

Really? Well don't see one when you are sick and see how your life progresses from that point.

Coaches are the problem because egomaniacs like yourself seem to think you are qualified to make medical recommendations.

So then you think a doctor who sees a patient with a serum ferritin level of 8 is qualified to give medical advice to an endurance athlete?

When I get a checkup my resting HR is usually around 36, and if its with a doctor who hasn't seen me before, they start asking me concerned medical history and dietary questions. If I don't explain to them that I'm a (semi) trained runner, they think something is wrong, even though it is perfectly normal and healthy within the endurance population. If I didn't know my running caused that low HR, and that isn't one of the primary things a doctor checks on in that situation, maybe the doctor goes on thinking I do have an underlying condition and possibly running useless tests.

A substantial part of advanced coaching education programs quite specifically deals with how to handle certain medical situations. One of the biggest within these is identifying symptoms of low iron athletes, and interpreting blood results as it pertains to endurance athletes. Do you think a typical primary care M.D. program is going to cover the different iron level needs of endurance athlete vs the normal public?

Junebuggy wrote:

Ehhhh.... wrote:

Absolutely the coach should know basic signs of common running injuries/conditions, but he/she shouldn't be giving any advice outside of "Get some rest, see the doctor or see the trainer".

More so, the telltale sign that this coach is overly involved in the medical process is that the coach knows that she hasn't been having her period... that's not a conversation you should be having with a student.

Nah....coach said NO HEAVY menstruation. Which would be a flag for low crit. So calm down.

I get what he said, I don't get how the conversation took place.

Athlete: I haven't been feeling well... My energy levels are low.

Coach: What are the details of your period?

Athlete: ...........

oh, I thought you said enema

If you're training a girl/woman, you should absolutely know what their normal cycle is and if it's changing. Yes, that's a mature conversation you have with them or their parent. Good gravy, can you imagine how irresponsible it would be to train a girl and not know that she's become amennorheic?