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Fred Thatch article


BJK

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While Fred may have a miracle in his future, if his MM is one of the more serious of the five complexes, or an advanced case of the simple complex, it can either limit, curtail, or end his basketball career.

I have a friend who has it, and was active all his life. He liked doing marathons, and refused to notice the symptoms until the second time he was stretcher carried down a mountain he used for training runs. On his bad days, he cannot do a 12 ounce curl.. and he was initially classed in the lowest impact complex. His was initially expressed when he was thirty.

This is hereditarial,  it can be managed in the sense of minimizing the number of cycles and severity for some people; but for others the cycles and severity increase if they push too hard.

This is a tremendously difficult passage of decisions for Fred. I am glad he is at a university where the strong academic programs and exceptional medical care will leave him well prepared for life, whatever basketball future he has.

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As old guy pointed out, yes these diseases are rare and have an odd mode of genetic transmission. Mitochondria have their own unique DNA and it is only inherited from the mother. But it gets complicated because each cell contains thousands of mitochondria which all have different small variations in their genetic code and based upon how these thousand mitochondria are partitioned during initial stages of development (when cells rapidly grow and split), the percentage of diseased mitochondria can be different from mother to child and indeed from cell to cell in the body. This mitochondrial specific DNA is small and only codes for a subset of proteins used in generating energy in muscles and handling oxidative stress so any mutations would cause issue with that i.e. cramping, pain, lactic acidosis/electrolyte abnormalities. To add to Old guy, an important factor of the severity of disease is also the proportion of diseased mitochondria. 

Due to the relative rareness and specific mtDNA tests needed, it is understandable why it was stated that tests were going to come back within a week or 10 days. At the moment, the best course will be probably to go slow with Fred. Try to work on his routine and do a lot of trial and error (slowly) to see what will work best for him. Regardless of the medical stuff, I echo whats already been said: I wish him all of the best and my prayers. 

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Let me start by saying that the number of people that really know these diseases is very limited.

These disorders can lead to all kinds of diagnostic issues, for example, a lot of people walking around (not playing sports, certainly not professional sports, not marathon runners or weight lifters) may live all their lives without showing symptoms. Why is this? simply because their mitochondria are functional to some degree or the other, what they lack is the capacity to respond to high level exertion from the muscles. This is where they run short and the guy gets in trouble. Let's say that Fred had chosen to be an actuary, or a CPA. These are very sedentary occupations and he might never have experienced the symptoms that would lead to a diagnosis. Are we all in the same page now?

I am not much of an expert in these kinds of disorders. What I know is basically what I just read about it, and I passed the best resource to you all. I honestly would not like to see Fred being carried out of the court in a stretcher, but (check the link if you want to go into some detail) with the proper supplementation he may have enough "fuel" available within the cells to be able to play basketball, if only for limited periods of time.

All of this stuff has yet to be determined. I think it is early to mourn for Fred and publish his RIP as an active player. However, it is entirely possible that his play time might be limited and I have no idea if this is feasible or if it is for how long. It is entirely possible that by adjusting his supplementation intake he might be fairly active with no problems. I really do not know, and I think Ford, his staff and his medical support team are going to have to be careful handling Fred, at least until they understand what he can and cannot do, and how to  manage the supplements.

This is not the end, it is the beginning of a new struggle to get him back playing if at all possible. I think, at this time, we just have to  cross our fingers, pray, and hope.

And for those of you who asked, having a faulty gene or a faulty intracellular component does not mean that the faults will be readily identifiable, for as long as a certain unknown threshold of something (fill the blank: activity, eating sugar, whatever) is not exceeded. All of these diseases are different from one another, and only the really bad deficits are generally found early on. Again a lot of people can and do live with faulty genes and cellular parts and find out only late in life or possibly never find out about it at all if the deficits are relatively mild.

Please let's not bring this into an almost metaphysical discussion or an attempt to use black and white, yes or no, options, or logic or reason. Nature is not necessarily logical or reasonable, things are the way they are. We are dealing with a very complex and variable set of issues which may be hard (or not) to manage. Just remember that the manifestations of a bad gene or faulty intracellular piece may be so subtle that the deficit remains unnoticed for a very long time.

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Many of these genetic disease come in different flavors, some variants being much more ugly and punishing than others. Here's to hoping that the unique variant affecting Fred is much less severe than some that I've read about. It's also important to keep in mind that some versions of the metabolic or mitochondrial diseases can be managed over time, but only become symptomatic during times of significant physical stress (i.e. illness, sports requiring a lot of physical exertion, etc.). 

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As @Old guysaid a lot of people don't know much about it and I never stated it was end of his career, he just needs a period of trial and error to see what works in terms of diet, fluids, warm up routine, etc and hopefully he will be back a new. He is already feeling better which is a GREAT positive.

On a side note, I tend not to post about medical stuff as I am not an internist nor an orthopedist and 18-22 year old athletes tend not to be treated in my field but I have done a little research on MM in the past and had given a review presentation for an institutional conference about 4 years ago so I thought I'd share a little added info. 

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1 hour ago, BourbanStreet said:

As @Old guysaid a lot of people don't know much about it and I never stated it was end of his career, he just needs a period of trial and error to see what works in terms of diet, fluids, warm up routine, etc and hopefully he will be back a new. He is already feeling better which is a GREAT positive.

On a side note, I tend not to post about medical stuff as I am not an internist nor an orthopedist and 18-22 year old athletes tend not to be treated in my field but I have done a little research on MM in the past and had given a review presentation for an institutional conference about 4 years ago so I thought I'd share a little added info. 

-thanks, just wondering with the vast medical facilities in StL would you expect all of the tests to have been run in town? not saying Fred had to travel, but perhaps his blood and whatnot might have

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No, I would expect the biopsies to be analyzed at whatever established center of excellence does mitochondrial research. Many rare disease and genetic research centers are only funded in one or two research hospitals in the country, and might have two or three research PhDs and a doctor in house, and a handful of doctors in the country who do treatments.

My friend flew to Boston for close to ten years back in the 1990s for studies and trial treatments.

When SLU med school managed to steal Dr. Belshe away from his previous job, he established a vaccine research program here that brought in hundreds of millions in federal grants and prestige.

Research programs are far different than MRI machines. I would wager MM research still is cutting edge.

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6 hours ago, Sheltiedave said:

No, I would expect the biopsies to be analyzed at whatever established center of excellence does mitochondrial research. Many rare disease and genetic research centers are only funded in one or two research hospitals in the country, and might have two or three research PhDs and a doctor in house, and a handful of doctors in the country who do treatments.

My friend flew to Boston for close to ten years back in the 1990s for studies and trial treatments.

When SLU med school managed to steal Dr. Belshe away from his previous job, he established a vaccine research program here that brought in hundreds of millions in federal grants and prestige.

Research programs are far different than MRI machines. I would wager MM research still is cutting edge.

One of the problems with this kind of research is that patients with these kinds of diseases are not common. So it may be some time before you can get enough patients and enough tissue samples to reach valid conclusions. For example, if a center for the study of Ebola viruses was established in St. Louis, they would find close to 0 patients in the whole US at this time. When a disease is infrequent or downright rare at a geographical location (and believe me we do not want Ebola anywhere near us), it is difficult to do research on it.

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21 minutes ago, wgstl said:

How do you practice at full force but unable to play 

Only thing I can think of is to preserve his argument for a medical redshirt? The injury, or in this case illness, has to be one that keeps you from playing.  If he played a few games this far into the season, maybe they think he’d lose that argument? 

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2 minutes ago, moytoy12 said:

Some more details on Thatch:

 

Interesting.

If practicing full bore doesn’t make it worse I would think you could use him for 2-3 minute spurts during game action.

Play him 6 minutes a half both half’s and you can get some productive minutes out of him.

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That is exactly the issue Ford has to  deal with. Do you really want to opt for getting a limited number of minutes of play per half from Thatch, or do you want to see how much more you might be able by adjusting his supplements and continue practice. If you opt for the few minutes per game option Fred will probably lose his medical redshirt for the year. If you opt to see if he can improve the amount of time going full tilt in practice before being put into play, you may wind up with a much better player (more minutes per game) and an extra year for Fred.

Not an easy decision to reach, and one that Fred should be centrally involved in.

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