Wednesday, March 31, 2010
As spring training winds down and the hope for a pennant burns bright for all baseball fans, the dark side of sports continues to rear its head. Players have been visiting with investigators in the US and Canada to talk about Dr. Anthony Galea, a sports medicine physician whose clientele included the brightest stars of the game. His claim to fame was the use of platelet rich plasma to help rehabilitate injuries but his downfall might be the discovery of human growth hormone among other chemicals being smuggles across the border by his associate.
It is no surprise that athletes try to find cutting edge treatments to heal injuries to allow them to return to competition sooner than later. Their careers can be measured in months instead of years and there is always a younger player waiting in the wings to take their place (see Wally Pipp). The question becomes: when does a treatment become performance enhancing instead of part of an accepted rehabilitation process.
Platelet rich plasma injections have been around for decades but have garnered little attention until recently. The American Academy of Orthopedic Surgery has published a variety of articles describing the procedure but it is still considered alternative therapy. Not enough research has been done to answer a few basic questions like what injuries are appropriate to be injected, how many injections are required, what is the timing between injections and what are the use restrictions afterwards. It may be that athletes will be the guinea pigs to help out the nation’s weekend warriors.
Cutting edge doesn’t always mean safe, effective and available. Patients with terminal illnesses sometimes seek alternative care as a last hope of life. Laetrile was a last hope for many cancer patients and while it was banned in the US as a cancer treatment, patients would travel to Mexico for care and hope. As with many treatments, there was a grain of truth in its history. Laetrile had been used for over a hundred years but its benefits couldn’t stand up to scientific analysis. It didn’t help that side effects included cyanide poisoning.
As with any therapy, there are cutting, edge early adopters and those who wait until the treatment is proven. Athletes may search out doctors who are innovators, just like patients with chronic or lethal illnesses seek providers who can return quality and quantity of life. Eye surgery is a prime example. Today’s techniques done to improve vision continue to evolve and the high tech computer surgeries like LASIK, PRK, EPI-LASIK and C-TEN make the hand made cuts of 1970s radial keratotomies look barbaric. But barbaric worked for many people; the newer procedures just work better without as many complications.
Deciding what works and what doesn’t requires research and that may takes years of study that many patients don’t have. Trying a new or experimental treatment may be the only option left for an athlete wanting to add another year to a career or a patient wanting another six months to be with family. If only doctor or drugs could stop time.