Category Archives: sports medicine

Lance Armstrong – Cheat, Liar & Cancer Survivor

armstrong1

Confession on TV..the body language speaks volumes

A serial cheat and liar he may be after his confession on the Oprah Winfrey show, but there’s no denying he’s a cancer survivor. In this blog entry, I would like to elaborate on what he suffered from – cancer of the testes with spread to the brain and lungs – and the chances of survival in patients with this condition.

In  October 1996, after delaying seeing a doctor and after his testes had swollen up to three times the normal size( he was also coughing up blood), he finally sought a medical consultation which confirmed that he had advanced stage three testicular cancer, of the subtype embryonal carcinoma. Worse, the cancer had already spread to the lungs and brain. Immediate surgery was done to remove the diseased testicle as well as the satellite tumors in the brain. Subsequently,  chemotherapy, an essential part of the two-step treatment, was planned.

Here, instead of the standard chemotherapeutic regimen (the BEP regime), he opted for one (the VIP regime) which did not contain the drug bleomycin, which has toxic effects on the lungs and would probably have meant that his cycling career would have been finished. The course of chemotherapy finished in December 1996, and in February 1997, he was declared cancer-free, which he apparently remains to this day.

armstrong2

An interesting fact to note is that, prior to the surgery, he had already won two Tour de France titles. Following the cancer treatment, he was recruited by US Postals, resumed training, and was able to win the Tour de France every year from 1999 till 2005, when he officially retired.

Quite an amazing feat, even if it was tainted by the use of performance-enhancing substances. I would be hesitant to call them drugs, as the alleged substances involved (EPO, testosterone , human growth hormone, corticosteriods and blood transfusions) are all part of normal body constituents.

So, is what Armstrong the cancer survivor experiencing  something out of the ordinary? Unknown to many, testicular cancer has one of the testeshighest cure rates of all cancers –  in excess of 90 percent overall; almost 100 percent if it has not spread elsewhere. Even if the cancer had spread widely, as in Armstrong’s case, the cure rate is over 80% following chemotherapy. Indeed, it is the most common form of cancer in males aged 20-39 years.

 

Advertisements

Match Your Body With Olympic Athletes

In keeping with the flavor of the month, the BBC has come up with an interesting interactive chart which allows you to compare your body-type with the athletes competing in the current 2012 London Olympics.

All you have to do is fill in your body-weight and height and you get to see which Olympic athlete you closely resemble..

You can access the site here.

Fasting, Fast Times and the Olympics

The fact that the 2012 London Olympics is going to be held entirely during the Muslim fasting month of Ramadhan in August this year poses  the question: does fasting affect sports performance?

In July 2012, it is estimated that more than 11,000 athletes will compete, of which about a quarter of whom will be Muslims who will be expected to undertake a dawn-to-dusk complete abstinence of all food and water. That means, at the height of summer, no food or drink from something like from 4.30am till 9.30pm daily.

In the 2012 Olympic long-distance races, contestants from East Africa,mainly Muslims, will compete during the fasting period.

Lets take a look at how fasting may affect sports performance. Broadly, it does so in the following ways:

1. Energy restriction – while it is generally held that the total calories will drop in a day, the food intake is very cultural and depends also on whether the diet is balanced. So it is possible to ingest more calories than one would normally do when not fasting with consequent weight gain. Experts are divided whether there is any curb on energy at all.

2.Hydration – dehydration of more than 2% of body weight will impair aerobic exercise performance, despite the attempt by the body to conserve water, as seen by one’s highly concentrated urine when fasting and the fact that one tends to sweat less when exercising.

3.Body temperature is governed by circadian rhythm of one’s body and explains why body temperature, muscular strength and reflexes become optimum in the late afternoon, at the peak of the circadian rhythm. When fasting, the alteration of sleep (sleep deprivation)and altered eating habits affect the circadian rhythm. This may cause a reduction in exercise performance.

4.Training load – while it is generally believed that fasting will affect training, largely by a perception of easy tiredness, professional coaches have established that, if diet, sleep, a balanced diet and hydration are maintained, athletes can undergo the same physical training load as those who are non-fasting.

Most authorities accept that athletes who maintain their energy intake and  prefasting hydration status and who get adequate sleep can maintain their training load during fasting without suffering any substantial impairment in performance. Of course, if the fasting is on religious grounds, this is a personal matter for the athlete to decide as to whether, in the first place, he should fast at all and defer the fasting period till after the race.

Share this Post

Football – When the Violence Is At Home

Balotelli reacts after an apparent foul in the Italy vs Spain match at Euro 2012

With the Euro 2012 soccer finals in progress, its quite understandable when episodes of violence, real or simulated, occur on the field, or even nearby( as the riots after the Russia-Poland game showed). But when this extends into the home, then its a cause of public concern.

Research by BBC News has found there was a surge in domestic violence reports to police during the 2010 World Cup.Police in England noted that reports of domestic violence increased by some 29% during games when England played in the recent 2010 World Cup.  The police expect a similar increase in domestic violence during the current Euro finals and have placed themselves on alert, apart from publicising awareness in the media and working together with related agencies like Domestic Violence UK.

Chris Hancox, from White Ribbon UK, which campaigns against violence to women, said: “If someone’s football team loses, that’s no reason to take it out on anyone, particularly the person they’re supposed to love.”  But the reality is quite the opposite:  arguments about the amount of television watched, alcohol intake, jealousy due to people spending more time with friends and an increase in money spent could lead to an increase in tensions.

Many would agree that alcohol by itself does not cause domestic violence, but could be the catalyst, especially when there is disinhibition after excessive alcohol and deeper emotions begin to surface.

So what does the Football Association (FA) has to say about it? It said it could not comment on what was not a footballing matter. Is that really a fair statement?

Heart Disease – The Goal of Soccer Managers

English soccer team Tottenham Hotspur’s manager, Harry Redknapp will undergo minor heart surgery on Wednesday, according to reports here. As always, the media tends to exaggerate, possibly to increase readership. As anyone knows, a medical procedure to relieve a blockage of one of the heart arteries is basically that – a procedure (called coronary angioplasty)  usually done under local anaesthetic with the patient able to go home the next day. Hardly what is implied when heart surgery is mentioned – an open-heart operation under general anaesthetic carrying far higher risks.

Anyway, the point here is that there seems an increasing number of soccer managers, especially in the English League that have succumbed to various heart ailments. The list includes:

  • Gerard Houlier of Liverpool – in 2001, he  underwent an 11-hour operation for aortic dissection, only for it to recur last year while in charge of Aston Villa, forcing him to quit football altogether.
  • Sir Alex Furguson of Manchester United – has had a permanent pacemaker fitted in 2004 for irregular heartbeats (supraventricular tachycardia).
  • Sam Alladyce of West Ham United –  has had coronary angioplasty in 2009.
  • Joe Kinnear of Newcastle FC –  has had bypass surgery in 2009.

Is there any connection between the rigors of running a Premier League soccer club with players valued at millions of pounds and shareholders baying for a healthy bottom-line with that of heart disease? Your guess is as good as mine. If one were to look at evidence-based clinical research, then there’s not going to be many that will link stress with heart disease. One report by the World Council for Cardiopulmonary Rehabilitation concluded that almost half of England’s football managers have “significant” heart problems and their life-consuming, high-pressure jobs are a “recipe for potential disaster” .However, there’s plenty of anecdotal evidence (see above!) that leads many to believe that a football manager’s life is full of stress, never mind the financial rewards.

The Stress of Managing A Football Club Can Make a Man Go On His Knees

Says Harry Redknapp : “I am absolutely fine and have no worries about my health but this game can make the most mild-mannered of people explode as when you are sitting on the bench you get eaten up inside from first to last whistle.”

 “After a game I cannot sleep, there is too much going on in my head as I go over moves, think about game plans, think about which player has had a good or bad game – and it’s worse if you lose.”

Indeed, the beautiful game can kill you!

Fasting, Fast Times and the Olympics

2012 Summer Olympics

Image via Wikipedia

The news that the 2012 London Olympics is going to be held entirely during the Muslim fasting month of Ramadhan in August next year poses  the question: does fasting affect sports performance?

In July 2012, it is estimated that more than 11,000 athletes will compete, of which about a quarter of whom will be Muslims who will be expected to undertake a dawn-to-dusk complete abstinence of all food and water. That means, at the height of summer, no food or drink from something like from 4.30am till 9.30pm daily.

In the 2012 Olympic long-distance races, contestants from East Africa,mainly Muslims, will compete during the fasting period.

Lets take a look at how fasting may affect sports performance. Broadly, it does so in the following ways:

1. Energy restriction – while it is generally held that the total calories will drop in a day, the food intake is very cultural and depends also on whether the diet is balanced. So it is possible to ingest more calories than one would normally do when not fasting with consequent weight gain. Experts are divided whether there is any curb on energy at all.

2.Hydration – dehydration of more than 2% of body weight will impair aerobic exercise performance, despite the attempt by the body to conserve water, as seen by one’s highly concentrated urine when fasting and the fact that one tends to sweat less when exercising.

3.Body temperature is governed by circadian rhythm of one’s body and explains why body temperature, muscular strength and reflexes become optimum in the late afternoon, at the peak of the circadian rhythm. When fasting, the alteration of sleep (sleep deprivation)and altered eating habits affect the circadian rhythm. This may cause a reduction in exercise performance.

4.Training load – while it is generally believed that fasting will affect training, largely by a perception of easy tiredness, professional coaches have established that, if diet, sleep, a balanced diet and hydration are maintained, athletes can undergo the same physical training load as those who are non-fasting.

Most authorities accept that athletes who maintain their energy intake and  prefasting hydration status and who get adequate sleep can maintain their training load during fasting without suffering any substantial impairment in performance. Of course, if the fasting is on religious grounds, this is a personal matter for the athlete to decide as to whether, in the first place, he should fast at all and defer the fasting period till after the race.

Share this Post

Attending to Medical Condition May Be Novack Djokovic’s Recipe For Success

Djokovic becomes the new Wimbledon Mens Champion - July 3rd 2011

 

So Djokovic has captured the 2011 Wimbledon tennis title for men, against most peoples’ expectations. While its true that enhanced coaching techniques and training are essential ingredients for his success, the real reason could be attributed to his discovery that he was suffering from coeliac disease, a condition where he is allergic to certain foods.

I wrote in detail about this here.

Dieting Is Not Enough!

With regards to my previous posting, it looks like Novak Djokovic finally met his match, after 43 undefeated runs. Yesterday, he was defeated by the all-time tennis champion Roger Federer at the French Open.

Which goes to show..diet and fitness does not a champion maketh. To my mind, singularity of purpose and tactical changes (read aggression) also come into play…

The Secret of A Champion – His Diet

Many tennis afficionados (although I must admit I only have a passing interest in it) are surprised how Novak Djokovic, the Serbian, has been transformed overnight into a tennis machine, steamrolling past all he has played with (39 opponents so far). And that includes the likes of Rafael Nadal, Roger Federer and Andy Murray. As I write, his progress in the French Open is going the way many are predicting.

Djokovic - a tennis machine powered by a gluten-free diet

And yet..he is not a newcomer on the pro circuit, having made his debut in Wimbledon in 2006 but not making a significant impact until 2010. Apparently, his rejuvenation the last couple of years have been attributed to his diet.

The tennis ace attributes his amazing winning streak to overcoming a wheat allergy – a condition called coeliac disease. In this condition,  sufferers   eating foods containing gluten, which is found in many grains, will encounter chronic fatigue (tiredness) and chronic diarrhoea. The only known effective treatment is a lifelong gluten-free diet.

The other side of Djokovic- as a model at the ATP dinner (courtesy of curly's photostream)

Last month, Djokovic subscribed his new-found success on the court to his nutritionist (yes, tennis pros can afford one) who has steered him away from wheat, barley and rye. Basically, this means no pizza, pasta or wholemeal bread, amongst others.

In speaking publicly about the condition, Djokovic has become the world’s most famous coeliac, and living proof that sufferers can not only lead relatively normal lives but can excel. Not only that, it has raised the level of awareness of this relatively unknown condition to a new high.

How does one diagnose coeliac disease? Basically, via blood tests and endoscopy. See here.

An Unwanted Visitor to the Commonwealth Games

When New Delhi opens its doors to athletes at the Commonwealth Games October 3rd, it would have by then encountered innumerable problems leading to the Games.

While China impressed the world with an almost flawless Olympics, India’s has been dogged with inefficiencies and shoddiness. India’s preparations have been hampered by allegations of corruption, mismanagement and inadequate facilities which threaten whether the facilities will be completed in time at all.

Not least of all, the current impasse on the usage of Blackberry messenger in India will add to communication woes and possible chaos should Indian security agencies impose a ban.

Amidst this, an unwelcome visitor has started to make its presence felt – the dengue virus, the cause of dengue fever. Already, 937 cases have been reported in the last few weeks,  a figure which many consider a gross under-estimate due to a deficient reporting system.(Hospital figures estimate more than 2000 cases in what is described as the worse outbreak in 20 years). Part of the reason for this upsurge is the stagnant pools of water surfacing around the construction sites for the various Games venues.

The Aedes mosquito, which carries the Dengue virus, passes it on when it bites into a human.

The outbreak has already struck two top Indian cyclists and is beginning to instill fear among the arriving Commonwealth Games athletes who fear contracting this disease, especially the most severe form which can cause internal bleeding and death. This fear is heightened because dengue has no known cure or antidote, as are most diseases caused by viruses.

Also, the main fear among athletes is that contracting the disease, however mild, might  impair their chances in the forthcoming Asian Games in November, as well as the Olympics in 2012.

Meanwhile, authorities are scrambling to clear the construction sites of stagnant pools and improving the environment so that India’s aspirations of becoming a successful host remains intact.

Share this Post

%d bloggers like this: