Tuesday, April 21, 2009

Ultra Performance Lab Rat

I'm Richie Dagger
I can stomp and swagger
I can take on your heroes.
Richie Dagger
Young and haggard
Boy that nobody owns.
--Darby Crash


Richie Dagger's Crime (GI) Version.  I have the original vinyl GI album mailed to me by Slash records, not poser digital remix garbage, in case you were interested.

"Rise and Fall of Tyler Hamilton" elicited unfavorable comments. Some people complained that the tone resembled something former WADA president Dick Pound would say. Dick Pound is not a person who serves as a role model to be emulated, supported, or agreed with. Mr. Pound was convinced that all athletes facing doping accusations who denied the charges were either guilty or liars. Dick Pound's philosophy emerged from a confrontation with Canadian sprinter Ben Johnson. Mr. Johnson swore that his Olympic games world record sprint positive test for prohibited substances was a mistake. Pound reassured the world that Johnson was clean. Johnson later recanted and admitted not only did he use performance enhancing drugs, but that his doctors tried to make him into a ultra performance lab rat. The implication of Mr. Johnson was clear; doctors of the Canadian Olympic national team may have used a performance enhancing drug regimen to boost athletic performance and team doctors may have employed strategies to avoid detection of these drugs. Dick Pound never forgave Ben Johnson for these slights to himself and Canada. From that moment onward Dick Pound would declare war on any athlete accused of PED use. Unreasoning in his judgmental pronouncements, Dick Pound would resort to any statement to support his positions. Mr. Pound, the WADA president, used character assassinations expressed in outlandish statements as a matter of policy. This cancer metastasized into policy action of the Court of Arbitration of Sport where Mr. Pound also served as a member of the board.

When allegations surfaced of synthetic testosterone use by Floyd Landis, Ben Johnson made some interesting comments on the Floyd Landis Topix cycling forum. In essence Mr. Johnson hinted that Floyd Landis may have been manipulated by team Phonak and team physician Dr. Denise Demir.   In short, Mr. Johnson suggested that team Phonak may have been doing the same sort of experimentation on Floyd Landis that the Canadian Olympic team may have done on Ben Johnson. Floyd Landis was to be another ultra performance lab rat.

This assertion would be laughable, but, when Floyd Landis tested "positive" for synthetic testosterone, Phonak general manager John Lelangue abandoned Floyd Landis to his fate. After all the support John Lelangue had given Floyd Landis during the 2006 Tour de France concerning the injured hip, suddenly Lelangue declared that Mr. Landis was fired from team Phonak. Mr. Lelangue then declared that the future Floyd Landis legal defense costs were a personal matter; of no concern to team Phonak. Dr. Allen Lim very quickly separated himself as personal trainer and advisor to Floyd Landis and vanished into thin air. Floyd Landis and Dr. Allen Lim have never reconciled, there is very little contact. Very suggestive. Phonak ceased as a cycling team sponsor after the 2006 Tour de France. Phonak had a history of riders testing positive for PED use before the 2006 Tour de France. Perhaps John Lelangue would care to explain why? Very suggestive.

Tyler Hamilton -Reprise

When Tyler Hamilton was riding for the United States Postal Service Professional Cycling Team as super domestic for Lance Armstrong I liked him very much. Make no mistake about that. When Tyler Hamilton rode the 2004 Giro d' Italia with an injured shoulder and the 2004 Tour de France with a fractured collar bone I liked him even more. When Tyler Hamilton won the Olympic individual time trial gold medal I was surprised. I had no idea that he may have cheated. The thought never entered my mind! I have no personal agenda against Tyler Hamilton.

But Tyler has no defense against using a supplement that he knew contained dehydroepinandrosterone (DHEA). Mitamin looks like some holistic hocus-pocus cure all snake oil that can treat anything under the sun. Mitamin has a formula for unipolar depression, bipolar depression, anxiety, you name it. Some supplements, like Mitamin are not regulated like common anti-depressants or other prescription drugs and some contain very dangerous compounds, like DHEA, 20Mg, that are on the WADA prohibited list. Tyler Hamilton knew the supplement contained DHEA, he knew how the Richard Young WADA code works. Tyler knew that the mere presence of a prohibited substance in an athlete is enough for a suspension. People had been suspended for the presence of a prohibited substance in their bodies taken by mistake. These people had no intention of boosting performance.

No matter. 20Mg of dehydroepiandrosterone (DHEA) mixed up in a magical elixir purported to cure unipolar depression will not enhance your performance. But Tyler Hamilton was not concerned with performance, he just wanted some relief. Perhaps he was convinced that the conventional selective serotonin re uptake inhibitor he was taking at the time did not have the desired effect. As any good psychiatrist will tell you if the drug you are taking does not work...try something different. There are enough conventional drugs on the market...you don't have to turn to holistic doctors who offer snake oil potions. These so called holistic doctors are trying to turn us all into ultra performance lab rats...or so they claim.

I hope Tyler Hamilton found the relief he was seeking. It is a shame to lose a career in professional cycling by taking something that probably will not work. Best of luck to you Tyler and thanks for the great bicycle race memories you gave us all.

Sunday, April 19, 2009

Rise and Fall of Tyler Hamilton

Tyler Hamilton has tested positive for a prohibited substance and has retired from professional racing. Tyler Hamilton says he took a supplement that he knew contained DHEA, a banned drug.

The Court of Arbitration of Sport (CAS) has decided in the Tim Montgomery case and in other arbitration cases RE: Marion Jones, that admissions are considered enough for suspensions. So, there should be little argument as to the fate of Tyler Hamilton. A lifetime ban.

The Rise

Tyler Hamilton is a classic case of a career of a professional cyclist that went terribly wrong. Caught in an accident during the 2003 Tour de France, Tyler Hamilton cracked his collar bone in an early stage. Most people predicted that Tyler Hamilton would be swept up by the broom wagon. Instead, Tyler Hamilton fought on suffering from pain so intense that he puked after every stage. Other teams questioned if the collar bone injury was real given the success Tyler Hamilton was achieving during the race. CSC released medical x-rays showing the fracture. Tyler Hamilton won a stage and finished forth in the general classification during the 2003 Tour de France, and was deemed a hero by many cycling fanatics. A tough man and a resolute fighter, no question of that.

Tyler Hamilton was a good guy too. He loved his sick dog Tugboat and his wife, Haven. Poor Tugboat died so Tyler Hamilton wore his dog tag around his neck during races. Some people might have concluded that Tyler Hamilton was a sentimentalist about the dog, others might have cynically concluded that Tyler Hamilton was skillfully drawing attention to himself. Given that the behavior of Tyler Hamilton seemed strange, most people laughingly overlooked these antics, and some may have even approved. At the time people were not too judgmental of Tyler Hamilton.

The Fall

This would all change. Tyler Hamilton stunned the world by winning the 2004 Olympic individual cycling time trial gold medal in Athens, Greece. Sadly, when tested by the International Olympic Committee (IOC) accredited laboratory, Tyler Hamilton's blood revealed a heterogeneous blood cell population. In essence, Tyler Hamilton had been transfused with blood from another person to boost performance, a banned practice. Unfortunately, the laboratory had found the tainted blood in the "A" sample. Under IOC rules a confirmation "B" sample test must be undertaken to confirm a result. Unfortunately, the "B" portion of the blood sample was frozen by the laboratory rendering it useless for further testing. So, Tyler Hamilton was allowed to keep his medal even though everyone was convinced that he cheated to win.

From that point on the World Anti-Doping Agency (WADA) and the International Cycling Union (UCI) had Tyler Hamilton red flagged. Essentially the UCI and WADA were doing longitudinal tests looking for anomalies in Tyler Hamilton's blood samples. The UCI claims that Tyler Hamilton was warned in letters that they were detecting strange blood profile data that suggested heterogeneous blood cell populations.

In the 2004 Vuelta d' Espana, Tyler Hamilton tested positive for blood doping on both the "A" and "B" samples. Tyler Hamilton won the September eleventh, 2004, Vuelta d' Espana individual time trial. Tyler Hamilton was motivated by a "political gesture" to honor the victims of 911.

Tyler Hamilton denied the blood doping charges. Tyler Hamilton cited a "chimera" or a twin who was conceived but whom died in the womb as a source of the second blood cell population. Tyler Hamilton claimed that under no circumstances would he endanger his wife and family by accepting a transfusion of another persons' blood.

Tyler Hamilton was given a two year suspension from cycling for blood doping. Apparently, the Court of Arbitration of Sport was not convinced that his blood profile was a result of a chimera.

From that moment on Tyler Hamilton was considered as a dishonest person who would resort to any means to achieve success.

Denial

For two years Tyler Hamilton tried to convince the world that his 2004 Vuelta d' Espana test results were wrong and that he was a victim of bad science. This denial gave birth to the Tyler Hamilton Foundation, a cult, where visitors were cajoled by a group of Tyler Hamilton fanatical groupies into believing that Tyler Hamilton was innocent. One encounter reported in Bicycling magazine has a reporter confronted by Tyler Hamilton's father belligerently shouting into his face..."believe Tyler!"

A Victim

At the conclusion of the two year suspension Tyler Hamilton faced the wrath of the anti-doping crusade. Tyler Hamilton was given a brief stint with Tinkoff, then fired, because allegations surfaced that he was linked to Operation Puerto. Unlike other ex-UCI pro team professional racers with a history of doping, Tyler Hamilton was next hired by Michael Ball of Rock Racing. Michael Ball espoused a philosophy of giving people a "second chance" to race. Rock Racing has been invited to several United States domestic races including the Tour of California. However, even though Rock Racing was allowed to race the Tour of California, AEG excluded Tyler Hamilton. Some fans thought this exclusion was unfair and vindictive in nature. Another example of persona non grata in cycling.

Depression

As a result of his shattered career and his inability to convince anyone of his innocence Tyler Hamilton fell into depression.

Depression is a medical condition not a psycho somatic condition. Depression is characterized as unipolar or bipolar. Unipolar depression symptoms include loss of self esteem, energy, and motivation. Moods become painful experiences, ideation can focus on suicidal behavior. Bipolar depression cycles between retarded depressive symptoms (lows) to symptoms of mania (highs). Mania causes destructive behavior such as binge spending, that leads to destructive consequences. Treatment of depression includes behavioral therapy, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin re-uptake inhibitors (SSRIs), lithium salts (LI++) and electroconvulsive therapy (ECT).

As you can see depression is multi-faceted and requires different medical interventions. Retarded depression would be treated by a tricyclic antidepressant such as desipramine, a drug that inhibits the reuptake of norepinephrine. Norepinephrine is a catecholamine that regulates blood flow in the brain. An increase of norepinephrine in the synaptic cleft (increased/prolonged neuronal firing rate) may have performance enhancing properties. Desipramine may increase dopamine levels in the brain. Increases in dopamine have proven performance enhancing qualities, RE: Ritalin. Desipramine is given to patients specifically to increase energy and motivation and to lift mood.

Anxious depression would be treated by selective serotonin re-uptake inhibitors (SSRIs). This increases serotonin in the synapse, increases firing of receptors, and causes a calming effect of mood. Prozac would probably not increase physical performance levels although it may have a psychological component of performance enhancement in sport.

Monoamine oxidase inhibitors (MAOIs) increase the levels of CNS catecholamines, norepinephrine, and dopamine. MAOIs are a very dangerous class of drugs that definitively would increase performance and should be placed on the prohibited list.

Lithium salts are used to stabilize moods/energy in manic depressive bipolar II disorder. The performance value of lithium salts is questionable but of probative value.

Electroconvulsive therapy (ECT) is for constant depressive illness that cannot be treated by any other method and usually requires hospitalization.

Tyler Hamilton was prescribed Celexa a selective serotonin reuptake inhibitor. There is no performance enhancement value in Celexa. So, there is no need to include the drug on the prohibited substance list.

The End

Tyler Hamilton was racing again. Hamilton was employed by a professional cycling team Rock Racing. Tyler Hamilton won the road race Stars and Stripes jersey as National Champion. Tyler Hamilton sought professional help for his medical illness, depression.  Tyler Hamilton was on anti-depressant drugs and probably was seeking professional counseling.

Tyler Hamilton has no excuse for taking a supplement that contained DHEA.  Doctors have long known that if a drug does not work for a patient, another can be substituted that may be effective.  Therefore, there is no need to experiment with unproven supplements to achieve relief,  especially when these supplements are known to contain banned substances.  Procedures and exemptions can be taken with the approval of a doctor that allows use of prohibited substances to protect health, the therapeutic use exemption.  Although depression is cognitively debilitating and painful, Tyler Hamilton still had full control of his mental faculties and he still had the power to discern the consequences of his actions.  Tyler Hamilton could have complied with the rules.

Tyler Hamilton escaped the justice he deserved when he tested positive for blood doping in the Olympics, he escaped the Operation Puerto investigation. Tyler Hamilton deserves a lifetime ban.

Friday, April 10, 2009

Ashenden Interview: A Critique

Michael Ashenden is convinced that Lance Armstrong used rEPO during the 1999 Tour de France. In an interview in velocitynation he cites the results of the post-facto scientific tests LNDD did on the 1999 Tour samples as proof.

Ashenden may have made a number of unproven assumptions however. The lab personnel did a random blind test of samples that were coded with numbers unknown to the testers. In theory this would be the case if the sample was collected by AFLD then assigned a new number by the UCI. However, under WADA, transfer of samples seem to violate the true double blind standard. The Floyd Landis alternate "B" test samples were identified by UCLA with tape before they were shipped to Chatenay-Malabry. The testers were aware of whom they were testing. This fact was confirmed in the Pepperdine testimony. Stephen Schumacher claims that LNDD was aware of the identity of his samples. Stephen Schumacher claims that his "A" sample tested negative but that LNDD tested the "B" sample anyway. The "B" sample tested positive for rEPO CERA. The legal bases for Stephen Shumacher's claims should prove interesting in the Court of Arbitration of Sport.

That the 1999 Tour samples were stored properly, frozen at all times. Ashenden claims that if the samples were stored in an unfrozen state that the bands of endogenous EPO would have shifted, and this shift would have made the endogenous form indistinguishable from the synthetic. Ashenden claims that this did not happen citing some test that proved the samples integrity. The nature of this test was not explained in the interview, however.

It is not impossible to conclude that LNDD let the 1999 Tour samples lie about the lab unprotected. In the Floyd Landis case a calibration mix was injected in the GC/C/IRMS and left unattended for five hours, a clear violation of WADA chain-of-custody protocol. Unfortunately, there is no absolute proof that the 1999 Tour samples were stored in a warm environment, but there is no proof that the samples were stored correctly either.

Degraded samples would have caused rEPO molecules to disappear not to increase. Ashenden argues that all of the 1999 samples were in pristine condition, unchanged for the duration of the six years they were in storage. Ashenden also argues that the samples were of equal quality when they were tested. Ashenden also argues that the samples were secure with a clear chain-of-custody and that they were never tampered with. However, except for testimonial assurances from 'department of analyses' personnel (LNDD) or others involved in the collection, transfer, storage process, there is no absolute proof that the samples were not "spiked" in 1999.

If it was the intention of AFLD, the UCI or LNDD to prove that Lance Armstrong had used PED's all that would have been required is a presence of rEPO isoforms on a single sample collected during the 1999 Tour. The percentage of the rEPO found would be irrelevant. The mere presence of a prohibited substance is enough to establish an Adverse Analytical Finding under WADA code. If the samples were tampered with in the transport stage between race and laboratory then no complicated mathematical formula would have been required to account for the fluctuations in the isoform values measured between the stages by the laboratory personnel. No formula would have been needed to calculate the odds of a disgruntled person guessing from a coded number which samples belonged to whom, 1/300. The changes in isoform percentages measured at LNDD could have been accounted for by degradation of the samples stored for six years in LNDD's vault.

Even if a Currier would have been blind to the sample numbers, the people tested during the Tour de France is common knowledge. A list of people scheduled for testing during the stage is posted on the side of the doping control trailer. I distinctly remember a photograph listing Lance Armstrong, Jan Ullrich, the stage winner (person unknown) and perhaps a rider chosen at random, as people scheduled for testing that day. The odds of spiking the Armstrong sample in this situation is 1/4 or twenty five percent. The fact that the latter stages of the 1999 Tour de France Lance Armstrong tests showed no traces of rEPO may suggest that the person responsible was unsuccessful in some attempts, or he may have been replaced during the race.

Simply adding rEPO with an eye dropper would have precluded a need for a catheter needed to dispense micro quantities of rEPO to achieve a desired fluctuation of rEPO values that appeared plausible during a long term Grand Tour race. The rEPO value would have been 100% and the variations measured by LNDD would have been caused by degradation or decay as Christiane Ayotte suggested.

Ashenden seems to ignore a redundant problem at LNDD, coding errors. One look at the Lab Document Package of Floyd Landis is enough to convince anyone that the accumulated number of errors of any LNDD test is enough to invalidate the results. Perhaps when the 1999 samples were tested LNDD was more circumspect in their documentation.

Ashenden thinks that LNDD can conduct tests within the published margin of error. This did not happen in the Floyd Landis case. The CG/C/IRMS test results were expected to have an error rate of +/-.8mil. In fact, the tests had a margin of error closer to twenty percent.

Calibration. Ashenden assumes that all of the equipment used during the 1999 Tour tests were inspected and calibrated to render reliable and valid values. LNDD has a very bad track record of inspecting and calibrating instrumentation.

Conclusion

Michael Ashenden may have made a lot of unproven assumptions, but, he may be correct! Lance Armstrong may have used rEPO during the 1999 Tour de France. But Mr. Ashenden's argument as expressed in velocity nation is not proof beyond a shadow of a doubt. Ashenden's argument that the samples could not have been "spiked" by LNDD, a disgruntled AFLD CDO or a person associated with the UCI are not resolved by his argument. There could have been plenty of means, method, and opportunity for tampering.

Relying on recall of witness testimony of events is never reliable, valid, or factual and never should be the basis for an argument.



Decide for yourselves, readers, if the Michael Ashenden interview is convincing enough to conclude that Lance Armstrong used rEPO during the 1999 Tour de France.

Tuesday, April 7, 2009

AFLD Accuses Lance Armstrong of Improper Sample Collection Etiquette

Lance Armstrong, the most tested man on Earth, was approached by surprise on March 17, 2009 by an French Anti-Doping Authority (AFLD) doctor demanding hair, blood, and urine as part of an out-of-competition test for prohibited substances.

Although hair tests are prohibited by WADA they are allowed in France. AFLD was looking for a testosterone precursor DHEA, a prohibited substance that seems to be abused with great frequency among French athletes. DHEA according to AFLD cannot be detected in blood or urine but may be detected in hair samples.

Apparently, during the collection process Mr. Armstrong interrogated the doctor demanding the samples because there seemed to be a problem with his credentials. According to L'Equipe, Mr. Armstrong was reported to have "asked questions" of the AFLD doctor to ascertain whether he were genuine or an impostor. Update: Apparently the questions were asked by Astana Sport Director Johan Bruyneel who telephoned UCI czarina Anne Gripper. Ms. Gripper confirmed the doctor and the out-of-competition test. Lance Armstrong claimed that he asked the doctor for permission to take a shower. Armstrong claims the doctor gave his permission for the shower. Lance Armstrong was alone and unobserved in the bathroom for twenty minutes.

The 3/17/08 out-of-competition test results were negative.

The laboratory doctor has filed a complaint with the AFLD citing a WADA regulation that stipulates that the athlete may not leave the presence of a doctor who is in the process of conducting an out-of-competition test. The AFLD is vowing to "punish" Lance Armstrong with some sort of ban from racing in France.

The International Cycling Union (UCI) has taken a position of neutrality in this AFLD/Armstrong dispute until the AFLD writes an official report of condemnation. Then the UCI may support the ban and make it international.

Get Real People

The Anti-Doping Organizations could not be more plain, if they can't test Mr. Armstrong to death, last count was twenty-four competition and out-of-competition tests since he returned from retirement, they will find another way to preclude him from racing in the 2009 Tour de France or perhaps from racing again period.

But. Lance Armstrong should have known better than to absent himself in the shower when the doctor conducting the tests was present. This opens the Pandora Box and allows skeptics to wonder what he was doing in the bathroom? Tampering with his samples?

This story is still developing so hang on to your hats!

The Vampires Are Here Where Are You?

In other news the International Olympic Committee (IOC) wants athletes to be available for one hour every day for testing. The location of the athlete must be known to the IOC in advance. If a vampire shows up and the athlete is not instantly available this constitutes a missed test. Three missed tests in a year will result in a two year suspension. Some Olympic athletes complain that this amounts to one hour of house arrest. This one hour requirement seems unreasonable but in the suspect everyone of doping culture, what do you expect? Deal with it.