PCA medical committee revoked my race license
#991
Race Car
I've changed my view about whether OSA could increase the chance of an incident when someone is driving on track. The evidence seems to indicate that it could, and it's not just a matter of being sleepy or falling asleep. I was wrong to assume that OSA couldn't increase risk simply because one's adrenaline is pumping when they're on track.
#992
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No, but you could assess the level of impairment that a given individual is exhibiting and then compare that to the population data.
Again, that would also only be useful if comparing to some standard of performance so as to understand how the medical issue is impacting the person in comparison to what is required to compete.
What I keep seeing is the application of generalized population data that assumes an impact of an unknown severity and without a precise probability that can be applied to a particular person.
AND no clear standard by which to evaluate.
Again, that would also only be useful if comparing to some standard of performance so as to understand how the medical issue is impacting the person in comparison to what is required to compete.
What I keep seeing is the application of generalized population data that assumes an impact of an unknown severity and without a precise probability that can be applied to a particular person.
AND no clear standard by which to evaluate.
That's why, if CPAP has been judged to be an effective treatment for someone, just have them attest that they're using the CPAP.
Or even better, just have their personal doctor sign off that they have no untreated health conditions which should prevent them from racing, and have the racer attest that they're complying with the prescribed treatments. You shouldn't even have to disclose what health conditions you have on the form, nor what treatments you have. PCA doesn't need to know any of that.
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#993
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If this were such a critical problem when racing, considering the over 85% undiagnosed OSA rate, the only path to take would be for racing organizations to require all racers to undergo testing to see if they have OSA. Those results would have to be reported back to the racing organization. Those with OSA would not only have prove they had CPAP machines, they would have to prove they were using them.
But as long as there's a medical form, and OSA is one of the things required to be disclosed on the form, I think it's reasonable for PCA to want some kind of assurance that the OSA is adequately treated. Just because there's a lot of undiagnosed OSA, that doesn't mean you don't require that diagnosed OSA be treated in order to go on track.
Last edited by Manifold; 06-21-2024 at 09:47 PM.
#994
Not at all realistic to try to do testing to assess what the effect of OSA is on a particular individual driving on the race track.
That's why, if CPAP has been judged to be an effective treatment for someone, just have them attest that they're using the CPAP.
Or even better, just have their personal doctor sign off that they have no untreated health conditions which should prevent them from racing, and have the racer attest that they're complying with the prescribed treatments. You shouldn't even have to disclose what health conditions you have on the form, nor what treatments you have. PCA doesn't need to know any of that.
That's why, if CPAP has been judged to be an effective treatment for someone, just have them attest that they're using the CPAP.
Or even better, just have their personal doctor sign off that they have no untreated health conditions which should prevent them from racing, and have the racer attest that they're complying with the prescribed treatments. You shouldn't even have to disclose what health conditions you have on the form, nor what treatments you have. PCA doesn't need to know any of that.
I agree that a racer’s PCP attesting that the person is fit to race should be sufficient. Unfortunately, that isn’t the path PCA took.
Therefore if they are going to apply a given standard, they should not be let off the hook to do it in an objective and measurable manner just because it’s “hard to do”
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#995
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That is a completely different discussion.
I agree that a racer’s PCP attesting that the person is fit to race should be sufficient. Unfortunately, that isn’t the path PCA took.
Therefore if they are going to apply a given standard, they should not be let off the hook to do it in an objective and measurable manner just because it’s “hard to do”
I agree that a racer’s PCP attesting that the person is fit to race should be sufficient. Unfortunately, that isn’t the path PCA took.
Therefore if they are going to apply a given standard, they should not be let off the hook to do it in an objective and measurable manner just because it’s “hard to do”
#996
My proposal was above. Couple of options (although I’m sure there are others):
1. Rely on the sign off by an applicant’s primary care physician based on a clear standard.
2. Treat certain conditions as an immediate disqualification but allow for waivers that would require additional consideration. (Note: this should be ideally based on a clear set of risk factors that the applicant has demonstrated a clear mitigation).
But I don’t ascribe to “give it to the doctor just because it was requested”
1. Rely on the sign off by an applicant’s primary care physician based on a clear standard.
2. Treat certain conditions as an immediate disqualification but allow for waivers that would require additional consideration. (Note: this should be ideally based on a clear set of risk factors that the applicant has demonstrated a clear mitigation).
But I don’t ascribe to “give it to the doctor just because it was requested”
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ProCoach (06-21-2024)
#997
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"But as long as there's a medical form, and OSA is one of the things required to be disclosed on the form, I think it's reasonable for PCA to want some kind of assurance that the OSA is adequately treated. Just because there's a lot of undiagnosed OSA, that doesn't mean you don't require that diagnosed OSA be treated in order to go on track"
This is so *** backwards. If you go to your physician, get diagnosed, and are under treatment, you should be held to a higher standard than the walking heart attack, overweight, beer drinking, out of shape guy who has undiagnosed sleep apnea, clearly doesn't take care of himself as well, and is MUCH more likely to have an on track "event", but has no diagnosis, so doesn't need to provide compliance? Makes no sense.
This is so *** backwards. If you go to your physician, get diagnosed, and are under treatment, you should be held to a higher standard than the walking heart attack, overweight, beer drinking, out of shape guy who has undiagnosed sleep apnea, clearly doesn't take care of himself as well, and is MUCH more likely to have an on track "event", but has no diagnosis, so doesn't need to provide compliance? Makes no sense.
Last edited by linzman; 06-21-2024 at 10:07 PM.
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#998
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"But as long as there's a medical form, and OSA is one of the things required to be disclosed on the form, I think it's reasonable for PCA to want some kind of assurance that the OSA is adequately treated. Just because there's a lot of undiagnosed OSA, that doesn't mean you don't require that diagnosed OSA be treated in order to go on track"
This is so *** backwards. If you go to your physician, get diagnosed, and are under treatment, you should be held to a higher standard than the walking heart attack, overweight, beer drinking, out of shape guy who has undiagnosed sleep apnea, clearly doesn't take care of himself as well, and is MUCH more likely to have an on track "event", but has no diagnosis, so doesn't need to provide compliance? Makes no sense.
This is so *** backwards. If you go to your physician, get diagnosed, and are under treatment, you should be held to a higher standard than the walking heart attack, overweight, beer drinking, out of shape guy who has undiagnosed sleep apnea, clearly doesn't take care of himself as well, and is MUCH more likely to have an on track "event", but has no diagnosis, so doesn't need to provide compliance? Makes no sense.
#999
Drifting
No, but you could assess the level of impairment that a given individual is exhibiting and then compare that to the population data.
Again, that would also only be useful if comparing to some standard of performance so as to understand how the medical issue is impacting the person in comparison to what is required to compete.
What I keep seeing is the application of generalized population data that assumes an impact of an unknown severity and without a precise probability that can be applied to a particular person.
AND no clear standard by which to evaluate.
Again, that would also only be useful if comparing to some standard of performance so as to understand how the medical issue is impacting the person in comparison to what is required to compete.
What I keep seeing is the application of generalized population data that assumes an impact of an unknown severity and without a precise probability that can be applied to a particular person.
AND no clear standard by which to evaluate.
Second, the test that is a million times more relevant for this situation is for a given OSA person with CPAP versus the exact same person without CPAP. You can’t get any more “apples to apples” than that —- it’s the SAME apple - and performance will be worse.
It’s hard to believe these are serious arguments. If an OSA person is driving on track alone, they can take whatever risks they want. When they are racing with others, they should not have that choice because they are putting others at risk.
Last edited by peterp; 06-21-2024 at 11:11 PM.
#1003
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Honestly I think most people here should mix themselves an Old Fashioned (Todd, you know what recipe to post) and delve into Petr Skrabanek's eminently readable screed "The Death of Humane Medicine and the Rise of Coercive Healthism".
Almost everyone older than 50 has a health problem of some sort, current, looming, occult, under-managed, over-managed... even if it's simply TMB (too many birthdays). At some point, something acute is likely to happen - #entropy - the hope being it doesn't occur behind the steering wheel on a track or near a school. Thankfully, the law of large numbers alone is protective.
A big part of the problem here is not purely medical concern, but medicolegal concern - a domain that is a giant clusterfvck particularly in the US. You cannot manage risk to zero but once the focus becomes safety-ism then... ugh. Well, here we are. I hope everyone involved can roll back to some kind of rational and reasonable standard, acknowledge that there is little good evidence to guide this situation, accept x-amount of uncertainty, and simply carry on.
Almost everyone older than 50 has a health problem of some sort, current, looming, occult, under-managed, over-managed... even if it's simply TMB (too many birthdays). At some point, something acute is likely to happen - #entropy - the hope being it doesn't occur behind the steering wheel on a track or near a school. Thankfully, the law of large numbers alone is protective.
A big part of the problem here is not purely medical concern, but medicolegal concern - a domain that is a giant clusterfvck particularly in the US. You cannot manage risk to zero but once the focus becomes safety-ism then... ugh. Well, here we are. I hope everyone involved can roll back to some kind of rational and reasonable standard, acknowledge that there is little good evidence to guide this situation, accept x-amount of uncertainty, and simply carry on.
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#1004
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I prefer this recipe over the original Waldorf Astoria version as it uses a maraschino cherry. Using anything but a a Luxardo maraschino cherry is an infamnia!
The Mid-Century (1960s) Old Fashioned Recipe
- 2 oz Whiskey
- 3 dashes bitters
- 1 maraschino cherry
- 1 orange wedge
- 1 sugar cube
- Garnish: orange wedge and maraschino cherry
- Mix sugar cube and cherry in a rocks glass and muddle to express the liquid. Add in the orange wedge and muddle.
- Add ice and pour whiskey and bitters. Quickly stir. Top with soda water (optional).
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#1005
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I prefer this recipe over the original Waldorf Astoria version as it uses a maraschino cherry. Using anything but a a Luxardo maraschino cherry is an infamnia!
The Mid-Century (1960s) Old Fashioned Recipe
- 2 oz Whiskey
- 3 dashes bitters
- 1 maraschino cherry
- 1 orange wedge
- 1 sugar cube
- Garnish: orange wedge and maraschino cherry
- Mix sugar cube and cherry in a rocks glass and muddle to express the liquid. Add in the orange wedge and muddle.
- Add ice and pour whiskey and bitters. Quickly stir. Top with soda water (optional).