Pantani Dead

Carl Fogel wrote: <snip>

Quoted message said:

My impression is that young pro cyclists have been waking up dead or dying while doing nothing
more strenuous than walking around for about twenty years.

I'd probably see a doctor if I started waking up dead.

In article <[email hidden]>, [email hidden] says... ~ Carl Fogel wrote: ~ <snip> ~ > ~ >
My impression is that young pro cyclists have been waking ~ > up dead or dying while doing nothing
more strenuous than ~ > walking around for about twenty years. ~ ~ I'd probably see a doctor if I
started waking up dead. ~ ~ I think you'd be more likely to see a mortician.

Rick

"S o r n i" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

carlfogel said:

Robin Hubert said:

Another cyclist dead recently, 32y.o., team Banesto (sp?).

Anybody know > about this?

Quoted message said:

Quoted message said:

Robin Hubert

Dear Robin,

Possibly you're thinking of Jose Maria Jimenez?

Suffering from depression, he died at 32 in December 2003 in a Spanish psychiatric hospital.

Some articles say heart attack, but usually add that an autopsy was pending. Perhaps someone
knows if the autopsy results were ever published.

Newspapers are rarely good at distinguishing a heart attack (blocked arteries) from heart
failure.

In either case, it was (as usual) quite unusual.

In a November rec.bicycling.racing thread, the astonishingly credulous posters debated in
apparent good faith absurd figures from a college student's web site about 100,000 young U.S.
athletes suffering sudden cardiac death while or just after exercising, including some 45,000
said to perish every year while playing basketball.

Here's the post in the thread:

groups.google.comgroupsOpen ↗
news.atl.earthlink.net&output=gplain

Here's the cited article:

www-unix.oit.umass.edusdathlete.htmOpen ↗

Elsewhere, the cited article did give the more plausible figure of .75 such deaths per year per
100,000 young male athletes.

The article also referred to a JAMA study that consisted of only 158 such sudden deaths among
young male athletes--over eleven years. Ninety per cent of these sudden deaths took place while
exercising or immediately afterward, not after the young athletes went to bed.

Here's where Benjamin Weiner pointed out how absurd the 100,000 per year figure was and cited
more believable data:

--

groups.google.comgroupsOpen ↗ put=gplain

A real article on sudden cardiac death is at cdc.govmm5106.pdfOpen ↗

Table 1: all cardiac deaths, US 1999, age 0-34 years: 7546
(1/3rd of these are 0-4 years old) Table 2: sudden cardiac deaths, US 1999, age 0-34 years:
3976

Until proven otherwise, I wouldn't believe that the 100,000 number is for young athletes
worldwide, either. It could be somebody's misinterpreted BS.

---

I must add that this just Benjamin's telling comment demolishing an outrageously bad statistic
that everyone was taking as gospel, and that it should not be taken as implying that he was
taking any position about drugs and cardiac deaths.

Cardiac problems are pretty much limited to the very young (children with serious congenital
problems) and the older population (blocked arteries and creeping problems). Teenagers and young
men rarely die of abrupt heart failure and even more rarely in their sleep. Normally, roughly
nine times as many people the age of the cyclists in question would die sudden cardiac deaths
while exercising or immediately afterward as would be found dead in their beds the next morning.

Possibly someone will find an impressive list of professional cyclists dropping dead of heart
failure during or just after races, but mostly they seem to die in their sleep in an unusual
fashion.

Carl Fogel

It was a yes or no question, Carl 🙂

Bill "j/k...good stuff" S.

Dear Bill,

Actually, a yes or know.

(First bad pun of the day.)

Carl Fogel

[email hidden] (Rik O'Shea) wrote in message news:<[email hidden]>...

Quoted message said:

John Everett <[email hidden]> wrote in message
news:<[email hidden]>...

Quoted message said:

rec.bicycles.misc, rec.bicycles.racing, rec.bicycles.soc...all 'bout bikes...and each a more
appropriate forum for discussing Pantani's death.

Yes, but in this newsgroup the quality of the information contained in the postings is far
superior (even with threads which are slightly off topic). rec.bicycles.racing on the other hand
attracts every nutcase and his wife - and the general tone of the newgroup is frequently abusive -
"Dumbass".

Dear Rik,

Our modesty is positively Shakespearean!

I do not know that Englishman alive With whom my soul is any jot at odds More than the infant that
is born to-night. I thank God for my humility. --Richard the Third, Act II, scene i

(Of course, Richard chopped the heads off almost everyone who was listening.)

Carl Fogel

Carl Fogel said:

If two different groups with the same birth year have different death rates, they have different
death rates. You seem to be the only poster in this thread who was not controlling for birth rates
or other obvious matters.

The study whose partial remembrance by Tim McNamara and others kicked this discussion off was cited
as "the life expectancy of pro cyclists was well below average (like 53 years)." This kind of study
is clearly subject to the problem of not controlling for birth dates, since you can't measure the
longevity of all the cyclists still alive. The procycling.com reference you dug up reports second
hand that the incidence of dying young is high among Tour cyclists. This might be legitimate, but
since a comparison to the French population as a whole is used, it still might have problems. We
can't really evaluate the legitimacy of any studies since no details have been presented.

Quoted message said:

If professional cyclists do die markedly younger on average than the general population, due to
drug use or other factors, studies would confirm this. Dodging this seems to be the point of
your post.

That is an unwarranted accusation. People have thought about this before and not reached a
significant conclusion. You are confident that if there is a phenomenon, studies will confirm it. I
am not even sure that the numbers are large enough to reach a conclusion. It's important not to
seize on a result because it fits in with what seems likely.

I am not papering over this issue. If you read the archives of rbr, beyond the locker-room cosmetics
there have been a number of intense discussions of the issues involved. How does one justify the
rules against performance enhancing drugs? Should caffeine and altitude tents be legal, while
steroids and EPO are banned? One ethical principle on which to justify these rules is that the
athletes should not have to choose between a competitive advantage and a short or long term health
risk. In the archives you will find various people flaming one rbr regular who believes that since
dope tests can never catch every cheater, we should legalize everything. The objection is that it
would effectively require athletes to sacrifice their health for fear of losing, and turn the whole
world of athletics into the former East German program. A little inaccuracy and hypocrisy is
preferable.

It is generally believed that the cardiac deaths of a number of cyclists in the late 80s were due to
early experiments with EPO and overcooking the blood thickening. Eventually the UCI adopted a 50%
hematocrit limit, which doesn't necessarily eliminate doping, but means that the riders don't have
to worry that someone else will push too close to death to gain a competitive advantage - it limits
the race to the bottom, if you will.

The deaths of this year are disturbing but not yet of the suspicious magnitude of the late 80s
deaths. Pantani and Jimenez, who got the most press, had both been treated for depression and in and
out of psychiatric and addiction treatment. Morbidity is higher among such persons. Depression
sucks. Whatever the etiology, I think Pantani's mind killed him; the contents of his bloodstream, no
matter what if anything they turn out to be, were simply the vehicle.

Benjamin Weiner <[email hidden]> wrote in message news:<403433fb@darkstar>...

Quoted message said:

Carl Fogel said:

If two different groups with the same birth year have different death rates, they have different
death rates. You seem to be the only poster in this thread who was not controlling for birth
rates or other obvious matters.

The study whose partial remembrance by Tim McNamara and others kicked this discussion off was
cited as "the life expectancy of pro cyclists was well below average (like 53 years)." This kind
of study is clearly subject to the problem of not controlling for birth dates, since you can't
measure the longevity of all the cyclists still alive. The procycling.com reference you dug up
reports second hand that the incidence of dying young is high among Tour cyclists. This might be
legitimate, but since a comparison to the French population as a whole is used, it still might
have problems. We can't really evaluate the legitimacy of any studies since no details have been
presented.

Quoted message said:

If professional cyclists do die markedly younger on average than the general population, due to
drug use or other factors, studies would confirm this. Dodging this seems to be the point of
your post.

That is an unwarranted accusation. People have thought about this before and not reached a
significant conclusion. You are confident that if there is a phenomenon, studies will confirm it.
I am not even sure that the numbers are large enough to reach a conclusion. It's important not to
seize on a result because it fits in with what seems likely.

I am not papering over this issue. If you read the archives of rbr, beyond the locker-room
cosmetics there have been a number of intense discussions of the issues involved. How does one
justify the rules against performance enhancing drugs? Should caffeine and altitude tents be
legal, while steroids and EPO are banned? One ethical principle on which to justify these rules is
that the athletes should not have to choose between a competitive advantage and a short or long
term health risk. In the archives you will find various people flaming one rbr regular who
believes that since dope tests can never catch every cheater, we should legalize everything. The
objection is that it would effectively require athletes to sacrifice their health for fear of
losing, and turn the whole world of athletics into the former East German program. A little
inaccuracy and hypocrisy is preferable.

It is generally believed that the cardiac deaths of a number of cyclists in the late 80s were due
to early experiments with EPO and overcooking the blood thickening. Eventually the UCI adopted a
50% hematocrit limit, which doesn't necessarily eliminate doping, but means that the riders don't
have to worry that someone else will push too close to death to gain a competitive advantage - it
limits the race to the bottom, if you will.

The deaths of this year are disturbing but not yet of the suspicious magnitude of the late 80s
deaths. Pantani and Jimenez, who got the most press, had both been treated for depression and in
and out of psychiatric and addiction treatment. Morbidity is higher among such persons. Depression
sucks. Whatever the etiology, I think Pantani's mind killed him; the contents of his bloodstream,
no matter what if anything they turn out to be, were simply the vehicle.

Dear Benjamin,

If Pantani died of an extremely rare, hard-to-diagnose, congenital heart problem, what did his mind
have to do with it? The unhappy can be the victims of same physical problems as everyone else.

If Pantani died of the physical side-effects of long-term use of a like EPO, retiring, stopping its
use, gaining a few pounds, and getting into the kind of trouble that doctors predict, he was still
hardly taking the EPO out of depression. The unhappy can take performance-enhancing drugs to cheat
at sports just like anyone else.

You're dodging again, this time into altitude tents and caffeine, neither of which is thought to be
a likely cause of professional bicyclists dying young of heart attacks while walking across parking
lots after parties, having their teeth cleaned, or lying in bed asleep.

How many professional cyclists are dropping dead of heart problems during or right after races?
That's when nine out of ten sudden cardiac deaths occur in the general young population.

There could be some subtle and fascinating explanation, but it seems unlikely. Given widespread and
plausible claims of extensive abuse of all kinds of drugs in professional cycling (supported by
riders failing drug tests), why on earth would the cyclists miraculously suffer no ill effects?

And given the cyclists' expertise at outwitting testers, why wouldn't ordinary coroners be at a loss
to prove what was happening?

Carl Fogel

some people are destructive of others, of themselves. a rocket scientist or mathman can be self
destructive. he's on the outside lookin in? but the point of origin(s)have a lot to do with the
total statistic when yawl go to interpret the "data." trajectory!! educationally, self actually,
nutritionally.and socially. blahblah how's Joseba healing?

Carl Fogel <[email hidden]> wrote [reordered]:

Quoted message said:

You're dodging again, this time into altitude tents and caffeine, neither of which is thought to
be a likely cause of professional bicyclists dying young of heart attacks while walking across
parking lots after parties, having their teeth cleaned, or lying in bed asleep.

Carl, I did not dodge, I digressed, which you should be familiar with. You seem to have made your
mind up about what this case proves without citing any real studies, other than perhaps the
frequency of non-exercise-induced sudden cardiac death, much less waiting for a pathologists'
report. What you call dodging, I thought was a caution about the difficulty of proving causation. If
you can't tone down the rhetoric, I see no need to continue this discussion.

I mentioned altitude tents and caffeine (which presumably have only minor side effects) to bring out
the ethical basis for anti-doping rules (beyond "they're against the rules"😉.

Quoted message said:

If Pantani died of an extremely rare, hard-to-diagnose, congenital heart problem, what did
his mind have to do with it? The unhappy can be the victims of same physical problems as
everyone else.

Quoted message said:

If Pantani died of the physical side-effects of long-term use of a like EPO, retiring, stopping
its use, gaining a few pounds, and getting into the kind of trouble that doctors predict, he was
still hardly taking the EPO out of depression. The unhappy can take performance-enhancing drugs to
cheat at sports just like anyone else.

The toxicological report hasn't come back, but when someone with a history of depression and
recreational drug abuse is found dead in a room with a half finished morose reminiscence, open boxes
of either tranquilizers or antidepressants, and the investigators want to find his cocaine supplier,
a congenital defect is not the diagnosis that leaps to mind. It is quite possible though that
Pantani's body was weakened by performance enhancing drug abuse. That's what everybody in rbr
assumed was the primary cause before hearing about the pills, and it's what the rumor mill figures
happened to Florence Griffith Joyner. I doubt it will be more than a contributory factor in the case
of Pantani.

Quoted message said:

How many professional cyclists are dropping dead of heart problems during or right after races?
That's when nine out of ten sudden cardiac deaths occur in the general young population.

Quoted message said:

There could be some subtle and fascinating explanation, but it seems unlikely. Given widespread
and plausible claims of extensive abuse of all kinds of drugs in professional cycling (supported
by riders failing drug tests), why on earth would the cyclists miraculously suffer no ill effects?

Quoted message said:

And given the cyclists' expertise at outwitting testers, why wouldn't ordinary coroners be at a
loss to prove what was happening?

These are all plausible but anecdotal at best, except for the coroners; it's at least probable they
can distinguish between various types of heart damage. All I'm telling you is that anecdotes don't
make a case, and one needs to actually establish a statistical results and a mechanism before
calling the case proven. I knew two people in high school who died of sudden heart failure, and one
was in his sleep. What does that prove? Nothing.

Benjamin Weiner <[email hidden]> wrote in message news:<4035dc0d$1@darkstar>...

Quoted message said:

Carl Fogel <[email hidden]> wrote [reordered]:

Quoted message said:

You're dodging again, this time into altitude tents and caffeine, neither of which is thought to
be a likely cause of professional bicyclists dying young of heart attacks while walking across
parking lots after parties, having their teeth cleaned, or lying in bed asleep.

Carl, I did not dodge, I digressed, which you should be familiar with. You seem to have made your
mind up about what this case proves without citing any real studies, other than perhaps the
frequency of non-exercise-induced sudden cardiac death, much less waiting for a pathologists'
report. What you call dodging, I thought was a caution about the difficulty of proving causation.
If you can't tone down the rhetoric, I see no need to continue this discussion.

I mentioned altitude tents and caffeine (which presumably have only minor side effects) to bring
out the ethical basis for anti-doping rules (beyond "they're against the rules"😉.

Quoted message said:

If Pantani died of an extremely rare, hard-to-diagnose, congenital heart problem, what did
his mind have to do with it? The unhappy can be the victims of same physical problems as
everyone else.

Quoted message said:

If Pantani died of the physical side-effects of long-term use of a like EPO, retiring, stopping
its use, gaining a few pounds, and getting into the kind of trouble that doctors predict, he was
still hardly taking the EPO out of depression. The unhappy can take performance-enhancing drugs
to cheat at sports just like anyone else.

The toxicological report hasn't come back, but when someone with a history of depression and
recreational drug abuse is found dead in a room with a half finished morose reminiscence, open
boxes of either tranquilizers or antidepressants, and the investigators want to find his cocaine
supplier, a congenital defect is not the diagnosis that leaps to mind. It is quite possible though
that Pantani's body was weakened by performance enhancing drug abuse. That's what everybody in rbr
assumed was the primary cause before hearing about the pills, and it's what the rumor mill figures
happened to Florence Griffith Joyner. I doubt it will be more than a contributory factor in the
case of Pantani.

Quoted message said:

How many professional cyclists are dropping dead of heart problems during or right after races?
That's when nine out of ten sudden cardiac deaths occur in the general young population.

Quoted message said:

There could be some subtle and fascinating explanation, but it seems unlikely. Given widespread
and plausible claims of extensive abuse of all kinds of drugs in professional cycling (supported
by riders failing drug tests), why on earth would the cyclists miraculously suffer no ill
effects?

Quoted message said:

And given the cyclists' expertise at outwitting testers, why wouldn't ordinary coroners be at a
loss to prove what was happening?

These are all plausible but anecdotal at best, except for the coroners; it's at least probable
they can distinguish between various types of heart damage. All I'm telling you is that anecdotes
don't make a case, and one needs to actually establish a statistical results and a mechanism
before calling the case proven. I knew two people in high school who died of sudden heart failure,
and one was in his sleep. What does that prove? Nothing.

Dear Benjamin,

Are there any circumstances under which you would begin to suspect that widespread drug abuse among
professional bicyclists might affect longevity?

Carl Fogel

How about waiting for the coroner's report to come out, and in the meantime showing some respect for
the man and his family?

Matt O.

"Matt O'Toole" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

How about waiting for the coroner's report to come out, and in the meantime showing some respect
for the man and his family?

Matt O.

Dear Matt,

Judging by other recent deaths, we may be waiting months for inconclusive reports from government
employees.

The man himself is dead, so I doubt that he cares what anyone says. His family is understandably
distraught, but I doubt that they're concerned about rec.bicycles.tech.

Pleas for respect are unfortunately often used to ignore serious problems. It's a shame that
Pantani died young. It's also a shame that he was banned for repeated drug problems while he was
riding. And it will be a shame if more young professional cyclists die of unusual and mysterious
cardiac problems.

Silence is not the same as respect, particularly in serious matters.

Carl Fogel

Carl Fogel said:

Dear Benjamin,

Quoted message said:

Are there any circumstances under which you would begin to suspect that widespread drug abuse
among professional bicyclists might affect longevity?

Dear Carl,

Yes.

You get the last word. Enjoy it.

Ben

Carl Fogel said:

If professional cyclists do die markedly younger on average than the general population, due to
drug use or other factors, studies would confirm this.

No serious study that I've ever been able to find confirms this. The article in Le Nouvel
Observateur is more properly described as an opinion piece than a scientific study. You can see a
copy of the text of the article here:
ciblepreparation.comepreuves synthese.pdfOpen ↗

It appears as "Document 3." It also helps to understand what kind of journal "Le Nouvel Observateur"
is, the background for why and when it appeared there, and the affiliation of the author.

yeah 3 for 3