The Dope on Drugs in Sport

A short primer on the hottest (illegal) sports-enhancing drugs.

EPO

EPO (erythropoietin) is a kidney-produced hormone that stimulates the growth of new red blood cells (RBCs) from stem cells within the bone marrow. The hormone can be synthesized and given to patients suffering from anemia--a low RBC count-- related to chemotherapy and end-stage kidney disease. Athletes gain an edge from shooting EPO (Aranesp, Epogen, or Procrit) because more RBCs translates into greater oxygen transference to muscle, increasing an athlete’s overall endurance. The same effect can be gained by transfusing previously stored blood.

As with any drug, the potential side-effects of EPO are numerous. Common side-effects include flu-like symptoms, injection-site pain, and high-blood pressure. Less common but more concerning side-effects include red blood-cell aplasia (the sudden inability to make red blood cells) and stroke. The latter is caused by the increasing viscosity of blood resulting from an increased proportion of RBCs (i.e. the blood turns into sludge, like engine oil that has not been changed for 20,000 miles). Couple that with the dehydration common during exercise and you have a recipe for lethal stroke in a seemingly healthy athelete. While transfusing one’s own blood may seem the safest bet, their is a risk of infection and clots from improper storage/handling.

HGH

Human growth hormone (GH) is a pituitary hormone that stimulates another hormone called insulin-growth factor (IGF-1)--the hormone that mediates growth in children. Synthetic GH can be given to congenitally short-statured children to increase their height. Athletes use it to boost muscle mass and aid in recovery of muscles after injury or intense training.

Exogenous (synthetic) GH in adults causes acromegaly, or the abnormal growth of soft tissue. Obvious signs include the widening and thickening of the jaw bone, forehead, hands, and feet, resulting in a more coarse or Neanderthal-like appearance. Headaches, hand-numbness, sight-impairment, and back pain may occur as a result of excessive bone enlargement. Worse still, abusers of GH are more likely to become diabetic, impotent, and develop irreversible heart disease. (The heart grows until it outstrips its blood supply and begins dying.)

STEROIDS

Anabolic steroids are a class of synthetic hormones, the most commonly of which is the male hormone, testosterone. Like GH, anabolic steroids increase lean muscle mass. Low-dosage steroids can be given to patients with delayed puberty, low libido, and AIDs (to treat muscle wasting).

The list of steroid side-effects is long and gender-dependent. Commonly, most abusers will be afflicted with acne, water retention, volatile behavior, rapid weight gain and immunosuppression. Men using steroids chronically may suffer testicular shrinkage, increased balding, and gynecomastia (a.k.a., ‘man boobs’). Women may develop a male hair-pattern (i.e. chin and nipple whiskers), baldness, clitoral enlargement, breast shrinkage, deepening of the voice, and irregular periods. Severe effects include steroid-induced psychosis, sleep apnea, and heart attack.

WRAP

While many a career has been made using illegal sports-enhancing drugs, there is always a price exacted: be it eventual humiliation by the press, alienation of family and friends, poor health, or premature death.

~ Medagogue

Killer Mice, Part II

The one creature that may scare us Southwesterners more than an angry rattlesnake or hairy tarantula is an ancient demon called hantavirus. Hanta is a cousin of the better-known ebola virus. Having plagued the Navajo Nation for years, its source was not identified by the CDC until 1993, an El Nino year marked by an explosive rodent population.

Vermin, like the ubiquitous deer mouse, shed the hantavirus into their urine, feces, and saliva. The excrement then aerosolizes and is inhaled by unsuspecting humans. The result is a fatal disease known as Hantavirus Pulmonary Syndrome (HPS).

HPS begins like a bad case of the flu, with fever, chills, aches, and GI upset. The next stage involves the rapid filling of a victim's lungs with fluid. Even the healthiest of souls cannot avoid drowning. And if you do not drown, then you may bleed to death, hemorrhaging from your IV and catheter sites~~as hantavirus disables one's platelets from clotting.

So, the next time you see a beady-eyed whiskered soul do not coo at him as if he were Mickey or Jerry. Be smart; turn tail, and run!

~ Medagogue

Killer Mice, Part I

When I fled the Pacific Northwest for 300-days of sunshine per year, I did not realize that I would be trading in fresh salmon for killer mice. I kid you not, in the covenant document that came along with my first Southwestern home it mentioned the “occasional” incidence of plague─The Black Death that killed off 1/3 of Europe’s population during the Middle Ages. Plague is caused by the bacteria Yersinia pestis that lives in the guts of fleas that piggyback on vermin like ground squirrels and rats.

So then it should have come as no surprise, one spring afternoon, when my vet casually mentioned the need to test my cat for plague. Leo, my Siamese, had the habit of leaving mice in the canoe stored in my garage. I assume this makeshift morgue was a demonstration of his love (though, I would have preferred half-pound packets of smoked salmon, thank you). It seems Leo had tussled with a ninja-like deer mouse who left him with a golf-ball-sized pus pocket on his neck.

While Leo turned out to have a run-of-the-mill abscess, a couple living down the street from us were not so lucky. While walking their dogs, they became lunch for some plague-carrying fleas. Unfortunately, their plague was diagnosed while on a visit to NYC, putting that part of the country into a panic. Most often, plague can be treated successfully with antibiotics (like gentamicin). However, because plague is rare and unheard of on the East Coast, the diagnosis came late, prompting the amputation of the husband's legs to save his life.

(Stay tuned for more chilling stories of Mickey's revenge...)

~ Medagogue

Deadly Greens

Preschool recess found me plucking plugs of grass and stuffing them into my gullet, emulating my then hero, Popeye. At the time, I did not realize my pica (eating of non-edible material) exposed me to pinworm or fecal-oral transmitted diseases.

But, adults should know better. Or maybe, they are so far removed from the food-chain that they forget that most vegetables are fertilized with ground-up animal body parts and feces and irrigated with unsanitized water. Produce is washed to rid it of pesticides, herbicides, and harmful bacteria.

The culprit currently making children and the elderly sick when eating spinach is E. coli 0157:H7. This bacterial strain gives off a toxin that sloughs off the lining of the gastrointestinal tract and kidneys, resulting in bloody diarrhea and the decreased ability to urinate.

Unlike most bacterial infections, E. coli 0157:H7 is not treated with antibiotics, as the killing of the bacteria releases more toxin (causing more internal damage). Instead, the affected are hospitalized and receive appropriate supportive care. Most recover; however, some are left with irreversible kidney damage. In the most severe cases, patients die.

So, as a public service announcement, wash your fruits and veggies. And, the next time you go to sneak an unwashed carrot, remind yourself it may have been raised in a deadly mix of fowl guts and pig poop.

~ Medagogue

Lost...Toothbrush

Sometimes, the only thing standing between man and a Darwinian death is medicine. Case-in-point, the construction worker that itched his scalp with a nail gun. Pass the Excedrin.

In the southwest, some states’ legislators think that mandatory helmet laws infringe on motorcyclists’ freedom. I think it is a government conspiracy to provide hospitals with more organ donors.

The creators of the ‘This is your brain on drugs’ ad should come up with a new public service announcement. Take an egg; throw it on pavement with the voiceover: Attention bikers, this is you brain on asphalt. Any questions?!

Of course, the patients that provide the most hospital mirth are those with foreign bodies. No, not the French, but those who swallow and plumb the depths with non-food items. Prisoners are infamous for swallowing razor blades and eating utensils to buy themselves a week in the hospital spa. The chronically constipated and anally erotic furnish ER docs with vast collections of pop bottles, vibrators, toothbrushes, light bulbs, rodents, etc.

So, to those of you who feel that man is the apotheosis of evolution, I have evidence to the contrary. Want to see my toothbrush collection?

~ Medagogue

Grubby Surgeons

Once nuisances relegated to our trashcans, maggots are now being welcomed into leading US hospitals. Because evolutionary pressures have honed housefly larvae into lean, mean dead-flesh-eating machines, they are ideal candidates for removing necrotic tissue from poorly healing wounds. Initially popular in the 1930s and 40s, maggot therapy declined with advent of antibiotics. However, with the rise in multi-drug resistant bacteria, maggot therapy is making a comeback.

A mesh bag filled with hungry sterilized maggots is placed on a wound. The wriggling, rice-sized larvae liquefy the devitalized tissue using secreted proteolytic enzymes and then swallow it. Unlike surgical debridement, underlying new tissue is not harmed. The amount of bleeding is significantly less too. The process also releases an ammonia byproduct that disinfects the wound. It is both safe and economical. However, as one patient put it, "You have to get over the psychological and aesthetic considerations."' Plus, munching maggots have a tendency to tickle!

~Medagogue

Breast Accessories

Surprisingly, the presence of extra nipples and breasts is not uncommon. Anne Boleyn was rumored to have a third breast (making her popular, temporarily, with King Henry VIII). The ability of humans to grow more than two breasts has its genesis in our primordial past. Much like a nursing sow, our distant primate relatives had nipples running from their armpits to their groins.

Today, supernumerary breasts can germinate along these same “milk lines” when awash with sex hormones. It is not odd for a pregnant woman to grow a breast in her armpit, often resulting in discomfort post-childbearing, as it lactates in unison with its two sanctioned colleagues. One poor woman grew an extra breast on her the bottom of her foot, ouch!. Men are not immune to this phenomenon. The congenital extra nipple is quite common. There are also cases of men sporting milk-secreting breasts. In 1980, there was a 74-year-old man documented as having a fully formed breast on the back of his thigh, which he mistook for a fatty tumor.

~ Medagogue