The players are on their feet all day in temperatures above 30 degrees Celsius. How did you manage to avoid dehydration and muscle cramps?
"These are certainly major concerns playing cricket in India and oral hydration is still the central pillar of avoiding dehydration and cramps. Most of the time the players can keep up, but when you throw gastroenteritis in the mix (which increases fluid loss and decreases digestion) then it can be enough to stop oral rehydration from being adequate. Interestingly, this means prevention of gastroenteritis is also an important part of prevention of dehydration. The Aussie cricket team uses a supplement called Travelan, which has some anti-E Coli properties derived from components of cow’s milk, and their un-controlled experience with this product is positive. As a nerdy doctor, I was prepared to follow my own advice to brush teeth using bottled water only, but I don’t know how many of the red-blooded Australian males in the team actually went to extreme measures like this. When players did get gastro to the point of being unable to keep bottled water down, I was quick to use Intra Venous therapy (including fluid and antibiotics). This was legal in 2007 although it will now require a full permission from anti doping authorities in 2008. This wouldn’t stop me from proceeding as it can totally be medically justified once a player is dehydrated and can’t keep fluids down.
"On the cramps side we used Quinine in players who were susceptible. Apparently most of the Indian team takes Quinine routinely for matches. I have a lot of experience with Aussie Rules and rugby league players taking it in summer and it appears to be both effective (for preventing cramps) and safe in the athletic population. There are reports of arrhythmias (abnormal heart rythms) and thrombocytopenias (decreased number of platelets in the blood, which causes bleeding) with Quinine although these are mainly in old women taking it every night for night cramps. We need a study analysing efficacy and safety of Quinine in athletes and I have a sports physician registrar who recently submitted an excellent protocol for a randomised controlled trial in sportsmen. Just to prove the research world is going as mad as every other sector is, he got this knocked back by an ethics committee because one of the members of the jury was worried about side effects of Quinine. So rather than let us study the issue and work out what is scientifically best, the ethics committee has covered its own arse. We’ll just have to keep using (or not using if you are petrified about rare side effects) Quinine thinking that it works but not really being certain. One extra bonus (whilst in India) is that it is also an anti-malarial."
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