Week 9 - Team physician, anti-doping Flashcards
What things would a team doctor consider for travel?
Vaccinations,illness, training, drugs, injury, education, altitude.
Symptoms of jet lag - fatigue, tiredness, poor quality sleep at night, loss of appetite, loss of concentration, headache, underperformance
Allow one day for each time zone to allow adaptation
How to cope with jet lag
Adjust to local time early, avoid coffee and alcohol, avoid dehydration, alter timings before departing
Use natural daylight, exercise stimulates catecholamine production and increases alertness so is an effective resynchroniser, moderate exercise encouraged on day of arrival
References for team physician
Leatherwood & Dragoo (2013) - effect of travel on performance
Lundy et al - altitude can be beneficial
When is WADA’s prohibited list updated?
1st Oct annually, coming into effect 1st Jan
What criteria must be met to be included in WADA
- The use of the substance or method has the potential to enhance or enhances sports performances
- Actual or potential health risk
- The use of the substance or method violates the spirit of sport
When are TUEs applied for?
Before the athlete starts taking the medication, except in an emergency when a retroactive TUE can be applied for
Criteria for granting a TUE
Necessary for a diagnosed medical condition, unlikely that the treatment will improve your performance, no reasonable permitted alternative
Recent WADA changes
Glucorticoids banned (any route), anabolic agents (more countries have banned), diuretics (Eg torsemide), medicine used in sickle cell disease, stimulants, narcotics (tramadol will be banned by jan 2024)
Who can test athletes?
National anti-doping organisations, international federations, major event organisers
Process of antidoping
Notified of their selection for doping control by a doping control officer, informed of rights and responsibilities, photo ID, Must report immediately if selected and show valid idea, remain in sight of chaperone. Can have a rep, request interpreter, ask questions, request a delay for valid reason (eg victory ceremony, finish a training session, medical attention, media, warm down)
Discuss altitude
Debate over its use for training (Lundy et al., 2012)
Risks of acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE)
Aetiology unknown thought to be likened to cerebral hypoxia and increased blood flow +/- increased water retention
Prevention:
Avoid rapid ascent, use stops, avoid vigorous exercise on first few days of arrival, acetazolamide only medication proven efficacious,
Mx:
If progressive symptoms high flow O2
Evacuation to low altitude if needed **
