MVN: Most Valuable Network

It was originally reported, way back in March, that Tampa Bay Rays center fielder Rocco Baldelli was going to start the 2008 season on the disabled list after having been diagnosed with a disease called mitochondrial myopathy. On Wednesday of this week, a report out of his home state of Rhode Island says that Baldelli recently made a visit to the renowned Cleveland Clinic and made a re-diagnosis for Baldelli of channelopathy.

It is as yet unconfirmed, as the Providence, RI reporter who broke the story (in all caps, as you can see) cited Baldelli's family as a source and has not yet had the report confirmed by anyone else, but it's still fair to take a look at these illnesses and exactly what they mean - both in terms of understanding the science, and in terms of what the differences are for Baldelli.

First, let's look at the original diagnosis: mitochondrial myopathy. The simplest description is in the literal root words - myo meaning muscle, pathy meany pathology or disease, mitochondria of course being that part of the cell responsible for generation and storage of energy. So in simplest terms, it is a muscle disease that is directly attributable to some dysfunction in the body's ability to generate and/or store energy at the cellular level.

More specifically, myopathies are usually indicated by a weakening of muscles, often in the form of the individual gradually losing muscle strength and/or tone. This diagnosis would make sense on the surface, since Baldelli said that his biggest problem was feeling unusually fatigued after what used to be a normal workout. Perhaps now his body doesn't quite have the same muscular ability but is trying to do the same amount of work.

A closer look would likely refute that idea. If Baldelli really was struggling to either produce or store the energy his muscles needed to function properly, then it should show itself in a decreased ability to perform the workout, not an increased amount of fatigue after the workout.

In that light, the newer diagnosis makes a bit more sense. An increased amount of fatigue likely means that Baldelli is not having an issue with generating or storing the energy his muscles need, but rather an issue with successfully recovering from the work that his muscles are doing when they are active.

How does that link to channelopathy? It doesn't, exactly. Channelopathy itself is merely a blanket term for a family of roughly two dozen diseases, all of which are channel pathologies - diseases involving the body's ion transport channels. Still confused? The cells in the body regulate the transport of everything across their membranes using sodium, potassium, and chloride (ions), and calcium is a key component in the muscle's use of ATP to contract.

Baldelli, since he specifically has problems with muscle fatigue, likely has one of the two channelopathies that are linked to skeletal muscle. The first is called kalemic periodic paralysis, which is almost exactly what it sounds like. Kalemia, specifically hypo- or hyperkalemia, refers to an unusually high or low concentration of potassium in the muscle cells due to leakage either from the cells into the blood stream or vice versa. The periodic paralysis is exactly that, where due to the potassium imbalance, some muscle cells become either periodically or in some cases permanently paralyzed, leading to inhibited muscle movement.

The other is called myotonia congenita. The congenita name simply means that the disease is usually congenital, or acquired genetically. This disease actually appears as either myotonia or paramyotonia, a small distinction. Again, the myo- refers to the muscle, and -tonia refers to muscle tone. Myotonia is an illness where the muscles have difficulty relaxing
and regaining their initial tone after contracting. The disction between the two is simply whether the condition is alleviated by exercise, like myotonia, or made worse by it, like paramyotonia.

This illness is most commonly seen in what are commonly called "fainting goats." Babay goats who develop this illness neveractually suffer any physical harm, but any time they are startled (and thusly flex their muscles quickly), they tense up and are unable to relax quicky, causing them to tip over or "faint."

This disease sounds much more like Baldelli's condition. He has muscle fatigue, and that fatigue is made worse when he endures prolonged bouts of exercise. Obviously he doesn't have the worst case of any of these scenarios, since he isn't experiencing any actual paralysis in his muscles. Where this is most relevant to Baldelli is in his defense out in center field. Myotonia is most often visible when an afflicted individual is forced to make sudden and/or forceful movements. Because the muscles struggle to relax properly, any sudden movements (muscle contractions) that are either fast, forceful, or both, can cause the muscle
to lock up once it has done its job, causing the sprinter to either slow down or freeze completely.

Fortunately, it is very treatable, especially if the newer diagnosis is an accurate one, and Baldelli should be able to get his illness under control and go to sign whatever free agent contract his heart desires