EMS: Courage And Compassion In Action

By Shawn Godfrey
07:40AM / Monday, April 23, 2007

Shawn Godfrey is a certified paramedic and the operations manager for the Village Ambulabce Service Inc.

Welcome to "EMS:Courage and Compassion In Action," a weekly column written by Village Ambulance Services Operations Manager and paramedic Shawn Godfrey. Godfrey's columns will appear on Monday and will focus on the reality of the emergency services medical profession.

“Building” a Lie

With the start of the Major League Baseball season finally underway, it seems the only thing that holds fan interest is the scandal surrounding some players' alleged use of anabolic steroids and other league restricted performance-enhancing drugs.

Unfortunately, the overwhelming attention paid to these “buff” athletes has led to a growing number of teenagers quietly using or at least experimenting with these potentially dangerous bodybuilding supplements. Recent studies suggest that just as teenage girls may use dangerous strategies, like anorexia or bulimia, to lose unwanted body fat, teenage boys may also employ unhealthy ways, like anabolic steroids, to achieve their desired physique.

A Growing Epidemic

Today, the number of teens abusing steroids is rising at an alarming rate. The desire to be accepted has lured teenagers to the immediate gratification of anabolic steroids; however, the guarantees of increased masculinity conceal a more menacing reality. Studies have shown that the side effects of anabolic steroids can actually lead to a decrease in long-term muscle and tissue development as well as overall masculinity.

What are steroids?

In brief, anabolic steroids are synthetic versions of the primary male sex hormone, testosterone. Testosterone is both anabolic and androgenic, meaning that it not only builds tissue but also helps control the development and maintenance of male sexual characteristics.

The average man produces about 4-7 mgs of testosterone a day. It is not uncommon for doctors to prescribe a replacement dosage of approximately 100mg weekly to help maintain normal levels for men whose bodies are not properly producing the hormone. Non-medical steroid users - the population against which recent laws have been aimed - typically administer between 10 and 100 times that dosage [1].

There are ten major classes of anabolic steroids:

Oral (taken by mouth)

Injection/oil-based

Injection/water-based

Patch or gel

Aerosol, propellant based preparation

Sublingual preparation (under the tongue)

Trans-dermal preparation (absorbed through the skin)

Androgen and estrogen combination

Counterfeit anabolic steroids

Over the counter (OTC)

Doctors may prescribe a different category of steroid termed "corticosteroids." These substances are used to decrease swelling. Corticosteroids are NOT anabolic steroids and do not typically produce the same harmful side effects.

Although steroid use may tarnish the achievements and reputation of those who are caught using them, teenagers who want to quickly increase their strength, speed, stamina, physical appearance, and the acceptance of their peers don’t seem to care.

A Damaged Heart

A 19 year old boy, with an impressive physique and severe acne, called 9-1-1 complaining of “a heavy discomfort” in his chest.

After the ambulance arrives, his girlfriend tells the paramedics that the patient has had a volatile temper lately and the facial acne seems to be getting worse.

While conducting the history component of their assessment, the paramedics learn that the patient has been experiencing progressively worsening chest discomfort and shortness of breath since the morning, however, did not call the ambulance because he believed it would eventually “go away.”

The patient denies taking any prescribed medications, but his girlfriend says he takes a large amount of daily supplements consisting of “powders, pills, and sometimes a needle in his butt.”

After finding significant negative changes on the patient’s EKG tracing, the paramedics treat the patient using a specific protocol designed for heart attack victims, then immediately transport him to the emergency department.

Reality Sets In

At the hospital, the heart attack is confirmed and the patient is again interviewed by the emergency room physician.

After learning of the severity of his condition, the patient finally admits to just completing a 10-week cycle of injected anabolic steroids.

Although steroid abuse cannot clinically be proven as the sole cause for the heart attack, the patient is warned that anabolic steroid use can increase the risk for blood clot formation in the blood vessels, potentially disrupting blood flow and ultimately damaging the heart muscle.

What Can We Do?

Early attempts to prevent steroid abuse must begin with educating not only the teenager, but also the parents or guardians about the drugs harmful effects. Many school districts now test for abuse of illicit drugs, including anabolic steroids, and studies are currently being conducted to determine whether such testing reduces abuse.

This column is not intended to force personal beliefs on others but is meant to stand as a warning to those who may consider using anabolic steroids.


Sources

[1] Collins, Rick. "PUMPED: A Truth-Enhancing Seminar on Steroid Use and the Law." Powerpoint presentation. May 10, 2006.