Andreea Raducan lost her appeal of a decision that left her without one of her gold medals.

The case of Romanian gymnast Andreea Raducan, who was stripped of her gold medal in the women's all-around competition on Tuesday, highlights one of the biggest challenges facing physicians treating Olympic athletes in Sydney.

According to Dr. Paul Saenz, D.O., team physician for USA Boxing and coordinator of athlete medical services for the 1996 Atlanta Olympics boxing venue, the ailment that team physicians often have the most trouble treating is the common cold. Nasal decongestants contain a number of banned stimulants that can increase heart rate and pulse, which may improve performance.

In Raducan's case, she was given Nurofen, an over-the-counter cold medication that contains pseudoephedrine, a banned stimulant.

"Decongestants like pseudoephedrine and ephedrine-derived products are banned because they are felt to be somewhat ergogenic," says Dr. Saenz. This means that decongestants can increase the work output of muscle tissues. They also stimulate the sympathetic nervous system, which can increase secretion of epinephrine and norepinephrine, two naturally occurring performance enhancing substances.

According to reports from Sydney, it is unclear whether Ioachim Oana, the Romanian team doctor who administered the drug, was aware that it contained pseudoephedrine. Oana was expelled from the Games and suspended through the 2002 Winter Games in Salt Lake City and the 2004 Summer Games in Athens, the Associated Press reported.

During the Olympics, "you would not be able to treat nasal congestion in the normal fashion," says Dr. Saenz. "The alternative is to treat some of the symptoms, like the runny nose component, by using a non-sedating antihistamine. On the other hand, if athletes have stuffiness, I would be able to do no more for them than to suggest that they use something like a saline-based nose drop to try and moisten their nasal membranes. Sometimes they may have to resort to home remedies like inhaling steam from a shower."

For example, severe pain from damaged ligaments or tendons cannot be treated with narcotic drugs that athletes may use to increase their pain tolerance for an unfair advantage. Drugs used to treat high blood pressure, called beta blockers, are banned because of abuse in precision sports like archery and shooting, where a slow, tranquil heart beat can help steady an athlete's aim. Instead, Olympic athletes may be prescribed alternative high blood pressure medications with IOC approved drugs like ACE (angiotensin converting enzyme) inhibitors or calcium channel blockers. Many athletes, most notably three-time gold medalist Jackie Joyner-Kersee, suffer from exercise-induced asthma, which makes breathing difficult during exercise. The most popular asthma treatments prescribed by physicians for the general public contain banned substances, but some non-stimulant medications approved by the IOC can effectively treat the condition.

Many injuries and illnesses are unpredictable, but to avoid relying on last-minute medication, all athletes can take preventive health measures before important competitions. A healthy diet, mental relaxation, and proper rest should be an integral part of an athlete's training. Many athletes taper the intensity of their training as events approach, which can help strengthen their immune systems.