Parents lobby for better tests to save student-athletes’ lives
By Susan DeMar Lafferty firstname.lastname@example.org June 8, 2012 10:08PM
Vera Angion Simmons, mother of Paul Simmons, the Marist student who collapsed and died one year ago playing basketball, continues to get support from the school and principal Larry Tucker in an effort and hope to get heart screenings for athletes at Marist High School in Chicago, Illinois, Monday, May 14, 2012. The school plans on adding Paul's name to the gym floor in some form to honor his memory when they refinish the gym this summer. | Joseph P. Meier~Sun-Times Media
Sudden Cardiac Arrest Foundation: www.sca-aware.org
Parent Heart Watch: www.parentheartwatch.org
Nick of Time Foundation: www.nickoftimefoundation.org
T3 Health Check: www.t3healthcheck.com
How to tell sudden cardiac arrest from a heart attack:
According to the Sudden Cardiac Arrest Foundation, sudden cardiac arrest is not the same as a heart attack, which occurs when blood vessels in the heart become clogged and prevent the flow of blood to sections of the heart muscle. It can lead to sudden arrest, which is like having an electrical problem in the heart. It typically occurs without warning.
Signs of sudden cardiac arrest include:
Loss of consciousness
Cessation of normal breathing
Loss of blood pressure
How to prepare for sudden cardiac arrest:
While Illinois mandates that at least one AED be in all publicly owned facilities, such as schools, parks, pools and athletic fields, the key is to have them available in less than three minutes. They should be on the sidelines during an athletic event and be regularly maintained.
All schools/sports teams should have a written emergency action plan that is practiced every year with staff, students and coaches. Those who can be first responders should be trained in CPR and the use of AEDs.
Know the warning signs and symptoms of a heart condition.
Immediately use an AED and CPR and continue it until paramedics arrive.
Updated: July 11, 2012 6:03AM
Dominic Duran, Kendall Tapley, Paul Simmons and Tom Schuman likely didn’t know each other, but they had a lot in common.
They all were Southland high school athletes. All played multiple sports and appeared to be
strong and healthy. All died suddenly of an undiagnosed heart condition. None showed any symptoms.
Dominic was 14 when he collapsed April 2, 2005, during baseball practice at Oak Lawn Community High School. He died 10 days later.
Kendall, 15, a baseball and football player at Homewood-Flossmoor High School, was found dead in his Homewood home Aug. 21, 2010.
Paul, 17, a senior basketball player, died after he collapsed while playing basketball during a lock-in event April 30, 2011, at Marist High School in Chicago.
Tom, 18, a star on the Lincoln-Way Central High School baseball and golf teams, failed to wake up for a Saturday morning doubleheader March 31.
The teens are among an annual 2,000 people nationwide younger than 25 to die of sudden cardiac arrest, according to the American Academy of Pediatrics.
While parents are burying their children, debate continues on the value of heart screenings for students.
Worth the cost?
An estimated one in 50,000 high school athletes die from sudden cardiac arrest every year, according to Dr. Jonathan Drezner, president of the American Medical Society for Sports Medicine.
To lower that number, some doctors believe an ounce of prevention is worth a pound of cure and support heart screenings wholeheartedly.
With ballooning health care costs, other medical experts say there is no need to mandate expensive testing for what they believe is a rare occurrence. Many strongly encourage schools to have automatic external defibrillators — AEDs — but the key is to have them immediately accessible. And others stress the need of parents to take their family history and sports physicals more seriously.
There is no standardized approach to student heart screenings in this country, according to Dr. Marc Silver, director of the heart failure program at Christ Medical Center in Oak Lawn.
It is not mandated here because it is not cost effective, he said.
Sudden cardiac arrest usually is due to hypertrophic cardiomyopathy (a thickening of the heart muscle which forces the heart to work harder), congenital anomalies, viral infection or chest trauma, he said.
Tests are needed if “red flags” appear in the family’s medical history or the student’s physical exam, including chest discomfort, dizziness, shortness of breath or elevated blood pressure.
As the parent of six athletic children, Silver said he always conducted his own thorough exams and made sure he carefully listened to their hearts while they were standing, squatting and lying down and checked their pulse in all four extremities.
“Parents would ring my doorbell on a Sunday night asking me to sign the (physical) form, and I would refuse,” he said.
It should not be a “drive through” physical, he said. “No one takes the physical seriously until there is the death of an athlete.”
Young people can live with undetected heart problems because they have “lots of reserves,” Silver said.
They may dismiss symptoms as trivial or not complain out of fear of being benched. Their hearts can function normally, but when they get dehydrated or exert themselves or the weather is too warm, that creates “the perfect storm,” he said. “The heart muscle gets squeezed too hard and the blood flow is interrupted.”
Drezner, however, said parents should be aware of the “limitations” of the medical history and physical forms. While screenings such as an electrocardiogram — EKG — may cost more, it will identify more athletes at risk, he said.
“If we do not believe that screening and early detection will mitigate risk, then we should not be screening at all,” Drezner said. “I believe it does decrease risk of disease progression, morbidity and mortality.”
But Drezner also said the U.S. does not have enough doctors trained in EKG interpretation in athletes, and his sports medicine society is now working with cardiologists to develop an online training module.
‘Where are your priorities?’
Joel DeJong, of Sportlink, and Dr. Yomi Adeyemi, of T3 Health Check, both of whom offer heart screenings, recommend the combination of an EKG with an echocardiogram, which, they said, should detect 90 percent of any defects. The EKG checks the heart’s electrical system, while the echo views its structural system.
“This should be a required part of school physicals. This can prevent death. You can’t put a price on that,” Adeyemi said. “You could spend $300 in one afternoon at Macy’s. Where are your priorities?”
If the parents have a heart condition but never exert themselves, the family may never know it’s there, he said. Or a child may have shortness of breath, is given an inhaler and sent back onto the field. Athletes don’t want to complain about symptoms out of fear of being benched. This is how it slips through the cracks.
Both DeJong and Adeyemi know that mandating such screenings is an uphill battle, but they are trying to get schools on board, one at a time.
Adeyemi said he sent letters to local high school athletic directors before school started in the fall, explaining what he does and why, but the response, “unfortunately” was not good.
“I’m not surprised,” he said. “It will take parents speaking out. It will take the athletic director seeing that letter I sent him in September and then seeing his star baseball player die six months later.”
DeJong has partnered with south suburban cardiologists to make heart screenings “accessible and affordable” through Heart Care Centers of Illinois in Palos Park and Mokena. The average is eight students in 1,000 will have an abnormality and his tests have reflected that, he said.
“We’re not saying you have to have it, but there are no excuses not to have it anymore,” DeJong said. And the tests don’t have to be done every year, he said.
To have such tests done on their own would cost $3,000, and preventive screenings are typically not covered by insurance, DeJong said. Sportlink offers both exams for $99, and T3 Health Check charges $280.
Kurt Gibson, associate executive director of the Illinois High School Association, stands by the sports physical form his office provides as a service to schools. Schools are not required to use it and may require additional testing if they want, he said.
The form is reviewed annually and is consistent with the latest national trends. It is “given a lot of thought” and is endorsed by the American Academy of Pediatrics, American College of Sports Medicine and the American Medical Society for Sports Medicine, he said.
It includes a dozen detailed questions about heart health and heart history, which must be answered honestly.
“We are not in a position to mandate (screening) because we can’t pay for it,” Gibson said. “Part of this has to address the cost factor.”
Lincoln-Way Central High School Athletic Director Hud Venerable said he has always — and will continue to — follow the guidelines of the IHSA. There are AEDs throughout the high school building and outside, and he has two athletic trainers — trained in CPR — at every athletic event.
“This has been a very difficult period for us. We have all been grieving (the loss of Tom Schuman),” he said.
Grieving parents try to save lives
“What the hell you talking about? My son collapsed?” Vera Angion-Simmons recalled saying when she got that phone call about Paul.
“He looked fine the night he left. It never crossed my mind. I’m mad at myself because I didn’t know,” she said.
“I freaked out,” Mike Duran said about his son Dominic. “There were no symptoms, no history of heart disease in our family. I had no clue. How did this slip through the system?”
Their seemingly healthy student-athletes all had undergone the sports physicals required by their high schools. But that did not detect Dominic’s enlarged heart and closed artery or the structural issues in Kendall’s heart that prevented it from being fully oxygenated.
In the wake of their loved one’s death, other family members have been screened for heart problems.
Angie Tapley and Mike Duran were surprised to discover problems in their other children but were able to address them.
That’s not enough, they said. They are trying to create awareness among all parents on the importance of heart screening. They want the tests to be required before athletes head out to the field.
Tapley is convinced Kendall still would be alive if he had been tested.
“His defects were so many, it’s shocking that they were never detected,” she said. “We need to do more proactive medicine instead of waiting until it is too late. To lose your child is the worse thing to happen ever.”
The Sudden Cardiac Arrest Foundation reported only 6 percent of people survive an event because of the lack of awareness and training. The use of AEDs and CPR can increase survival rates to 38 percent, but they must be used within three to five minutes.
“We really don’t know the specific numbers (of young cardiac victims),” said Michele Snyder, executive director of Parent Heart Watch, a national advocacy group. While more research and creation of a national registry of such deaths is critical, “there is something we can do about (sudden cardiac arrest),” she said. After losing her 17-year-old daughter Jennifer on a soccer field a few years ago, Snyder, of Northbrook, became involved with this group — a grass-roots effort to “save other children.”
According to Tapley, Duran, Angion-Simmons and Snyder, parents need to be aware of the quality of a doctor’s stethoscope, physicals and interpretation of test results. They need to be aware of family history and possible symptoms, such as chest pain, labored breathing, dizziness, fainting, gasping — although many times there aren’t any. They need to be aware of the tools available, such as tests and defibrillators, and make them easily accessible.
“You shouldn’t have to choose between groceries and testing your child,” Tapley said. “The echocardiogram and the EKG need to be part of a sports physical. Period.”
There are foundations, such as Nick of Time, that offer free screenings. Angion-Simmons is trying to raise money for free screenings and scholarships in her son’s name. Since Paul’s death last year, Marist High School has held three Paul Simmons Heart Screening Days with cardiologists donating their time to provide electrocardiograms and echocardiograms at the school for $75.
“Paul’s death woke up a lot of people,” Marist High School Principal Larry Tucker said. “We can’t require all our athletes to do this, but we do recommend it.”
So far, among the 200 students who have taken advantage of it, a few problems were discovered, and there’s a waiting list to be tested, Tucker said.
“We will continue to do the screenings as long as the doctors want to,” he said.
Parents outside the school have called about it, but for now, Marist is only offering this to members of the Marist family, the principal said.
“We’re making progress,” Snyder said. “The topic is now being discussed in the medical community. Over time, things will change.”