Wednesday, February 24, 2010

Warriors’ Ronny Turiaf donates defibrillators to prevent deaths among high school athletes

By: Elise Craig February 23, 2010 – 3:38 pm


Ronny Turiaf poses with school children at the kickoff of his charity foundation.


After an enlarged aortic root nearly kept him from his dream of playing NBA basketball, Warriors’ center Ronny Turiaf learned how dangerous heart problems could be. Now, in the wake of three recent cardiac emergencies on East Bay high school basketball courts, Turiaf is donating automatic electronic defibrillators (AEDs) and CPR training to four local high schools. “As someone who has been affected directly by a heart health issue, it is important for me to assist others in their efforts to prepare for a heart trauma incident,” Turiaf said.

Since October, two Bay Area student athletes have died while playing basketball, and one survived a near-lethal cardiac arrest. Joshua Ellison, the 17 year-old co-captain of El Sobrante Calvary Christian Academy, collapsed on the court and died on January 29. De La Salle freshman Darius Jones, 14, died during a preseason basketball camp at Diablo Valley College on October 11. A third student, El Cerrito High School sophomore David Gurganious, went into cardiac arrest on February 2 while sitting on the bench, but was saved by CPR administered by his basketball coach, who is a Richmond police officer, and parents in the stands.

The three schools, along with Oakland’s Life Academy High School, will each receive defibrillators, as well as AED and CPR training for ten staff members and CPR training for 30 students. The donation, which was announced Tuesday on the basketball court of Oakland’s Leonard J. Meltzer Boys and Girls Club, comes from the Ronny Turiaf Heart to Heart Foundation, which Turiaf established in 2009 to help provide medical care for children without health insurance. Through the foundation, Turiaf hopes to provide EKGs, heart surgeries and defibrillators to kids in need.

About 100 students attended Tuesday’s event, along with representatives from the schools, the American Heart Association and Cardiac Science, the company that manufactures the defibrillators and provides training. Some members of the audience also wore black armbands with “Josh #1” in white writing in honor of Ellison.

“I don’t get nervous very often,” Turiaf said. “I play in front of 20,000 people.” But he said that talking about things that matter to him, in front of a crowd that was mostly composed of high school students, as well as some parents, coaches and younger kids in Warriors apparel, was a little more nerve-wracking.

Kent Mercer, head athletic trainer De La Salle, a private Catholic school in Concord, is glad to have the defibrillator, particularly after the death of Jones, whose “dream was to play basketball at La Salle,” he said.

“It’s a great thing that they’re doing to have something in place to save somebody—not only students at the school, but anyone who comes to the school,” Mercer said. “Hopefully, it continues to spread.”

El Cerrito High School Assistant principal Marcos Garcia said he will be relieved to have a defibrillator on campus, even though coaches at El Cerrito have already been trained in CPR. “The health and safety of our students is our utmost concern,” he said. “We’re very grateful.”
As for Gurganious, the sophomore who survived cardiac arrest thanks to quick action by coach Michael Booker, he was released from the hospital last week, and is expected to make a full recovery. “We want to bring him back slowly,” Garcia said.

“It’s a whole transition between collapsing on the basketball court and going back to a full academic load,” said Kenny Kahn, head football coach at El Cerrito High and Gurganious’s creative writing teacher. “I’m looking forward to his poems and creative writing—he’s quite the poet.”

Dr. Junaid Khan, a heart surgeon at Alta Bates Summit Medical Center in Oakland and president of the East Bay division of the American Heart Association, addressed the students directly, telling them not to be too scared about sudden cardiac arrest: it’s highly unusual in teens, he said, and very rare to see three cases at the same time in the same area. Chances are better that a young person would die in a car accident, or of cancer, Khan said. “It’s like lightening striking the same place twice,” he said. “It’s that rare. In a 26 year period, there were only 30 events around the country.”

But, when it does happen, CPR and defibrillators increase survival rates significantly. Only five percent of people survive sudden cardiac arrest without CPR or defibrillation. With CPR, the odds go up to 30 percent. If a defibrillator is present, they go up to 50 percent. “Automatic defibrillators really are the key to saving lives,” Khan said. “These things are so easy to use. Just put them on and they do the rest of the work. But the devices alone, not including the training to use them, can cost between $1,500 and $2,500.

Brett Reisner, a representative from Cardiac Science who lost his own brother to sudden cardiac death, applauded Turiaf for his donation, and advocated for a new State Assembly bill that would require schools to have defibrillators available at sports contests and practices. The bill is co-sponsored by State Assembly Members Mary Hayashi (D-Hayward) and Jerry Hill (D-Castro Valley). “Fourteen states in the US have laws requiring AEDs in schools,” he said. “California is not one of them. We need to support bill 1647.”

Turiaf started his charity, the Ronny Turiaf Heart to Heart Foundation, in 2009, but he had been thinking about starting a charity for a long time. “I played basketball my whole life to make a living for my family,” said Turiaf. “In 2005, I finally signed a contract. I thought everything was perfect.”

Two days after he signed with the Los Angeles Lakers in 2005, Turiaf, now 27, was diagnosed with an enlarged aortic root during a physical exam. His doctor, Stanford surgeon Craig Miller, told him had two options: quit basketball, or have surgery. Turiaf told the crowd of students that Miller told him to have the surgery, and that he had “confidence in my ability to get you back on track.”

Turiaf believed him. “If the guy that’s going to open me up like a lobster tells me I’m going to be able to play basketball again, I have confidence in myself to do the rest,” he said.

The open-heart surgery lasted six hours, and Turiaf was back on the court in less than six months. “After I went through my surgery,” he said, “I told myself that if one day I was financially stable enough, I would do whatever I could to give back to the community.”

Wednesday, February 17, 2010

How to live your heart-healthiest life

Click here to check out Dr. Khan in this article by the American Heart Association...

Monday, February 8, 2010

Limiting dangers for young athletes

Thanks to Junaid Khan, MD, cardiac surgeon with Alta Bates Summit for his help in educating the community regarding sudden cardiac events in young athletes. The attached article appeared in yesterday’s Contra Costa Times.

http://www.contracostatimes.com/high-school-sports/ci_14359447


Limiting dangers for young athletes
By Sandy Kleffman, Chace Bryson and Ben EnosContra Costa Times
Posted: 02/08/2010 02:02:45 PM PST
Updated: 02/09/2010 07:06:44 AM PST

In a four-day span, two seemingly healthy East Bay high school basketball players suddenly collapsed during games this year. One died and the other was hospitalized.

The incidents, on Jan. 29 and Feb. 2, have shaken the school sports community and prompted soul-searching about avoiding such tragedies.

Experts point to many ways that students, coaches and administrators can lessen the risks such as better physical exams, more attention to players' problems and concerns, better emergency equipment and training.

But sometimes, despite everyone's best attempts, problems remain hidden and the first symptom is a collapse, said Dr. Casey Batten, associate team physician for UC Berkeley.

It has not yet been determined what caused the death of Joshua Ellison, a 17-year-old senior at Calvary Christian Academy in El Sobrante, or the collapse of 15-year-old David Gurganious, a varsity basketball player at El Cerrito High School.

But most sudden deaths of young athletes involve heart problems, according to a 2009 study in the Journal of the American Heart Association.

Researchers looked at 1,866 athletes in 38 sports who died suddenly or survived cardiac arrest from 1980 to 2006. The athletes ranged in age from 8 to 39.
Of the deaths:
· 56 percent were due to cardiovascular disease. About a third of these deaths involved an enlarged heart.
· 22 percent were caused by a chest injury that structurally damaged the heart.
· 4 percent were due to a chest blow that interrupted heart rhythm.
· 2 percent were caused by heat stroke.

Such deaths remain rare. Young people have a much greater risk of dying from cancer, leukemia, cystic fibrosis, automobile fatalities, meningitis and homicides.

"It's like getting struck by lightning," said Dr. Junaid Khan, director of cardiac services at Alta Bates Summit Medical Center in Oakland.

Yet prevalence statistics matter little to communities rattled by tragedies, and the most recent incidents were not the first in the East Bay.

Last year, 15-year-old Darius Jones from Concord's De La Salle High School collapsed and died of apparent heart failure at a nonschool league basketball game.

And Cal freshman Tierra Rogers's basketball career ended after having a defibrillator implanted to address a rare heart problem. Doctors discovered her condition, known as arrhythmogenic right ventricular dysplasia, after a workout in which she had trouble breathing and then collapsed.

So what can be done to protect young athletes?

A thorough pre-screening can be an important step, experts say.

The California Interscholastic Federation, which oversees high school sports, requires all students to have a physical exam before participating in a practice or game. The exam must include a family health history.

Among the questions doctors should ask, Batten said, is whether any of the student's relatives died of heart problems before age 50.

Students should also reveal whether during exertion they have nearly passed out, felt discomfort or pain in the chest, or had their heart race or skip beats.

Although young athletes must file a form with the school indicating they have had a physical exam, how much scrutiny such forms receive varies.

"Sometimes those forms just get put in a file and that's the end of it," said Frank Allocco, De La Salle basketball coach. His school's training staff is " taking those forms and looking at them and taking action on them," he said. At Oakley's Freedom High School, athletes must get an annual physical from either their personal physician or a chiropractor. Because some insurance companies pay for a physical only once every two years, many athletes choose the cheaper option of seeing a chiropractor the second year, said athletic director Steve Amaro.

Students with risk factors such as a family history of heart disease or warning signs should have an electrocardiogram, or EKG, recommends Khan, president of the East Bay division of the American Heart Association.

But experts are divided over requiring EKGs of all young athletes. Khan worries that false positives could needlessly disqualify students or subject them to additional costly tests. EKGs can also miss problems, giving a false sense of security.

Khan noted that in Italy, where EKGs are mandatory for young athletes, the frequency of sudden deaths is slightly higher than in the United States.

The cost could also be prohibitive. Mandatory EKG screening of all middle school and high school athletes in the United States could run as high as $2 billion annually, according to a 2007 statement by the American Heart Association Council on Nutrition, Physical Activity and Metabolism.

As a result, such massive EKG screening is probably impractical, the council said.
But others insist that screening requires additional study, particularly since an EKG can pick up signs of an enlarged heart, the cause of many of the sudden deaths.

This condition, known as hypertrophic cardiomyopathy, typically results from an inherited genetic defect. The walls of the ventricles thicken and become stiff. The problem may be present at birth, or it can develop later. That means that screening a student at 14 would not reveal a condition that develops at age 18, Batten said.

For these reasons, experts say it is crucial that students and coaches watch for warning signs, including fainting, chest pain, shortness of breath, irregular heartbeats, severe headaches, dizziness and blurry vision. Students should tell their coaches if they feel ill rather than "toughing it out," Khan said.

Parents and coaches need to be observant and proactive when an athlete may be struggling, said Lindsay Wisely, girls basketball coach at Antioch's Deer Valley high.

"One thing to be aware of is that sports are not just a seasonal thing anymore," Wisely said. "We're training kids 365 days a year. "... with athletes trying to play and train at an elite level, perhaps we should be screening them a little more than a standard physical."

Amaro agreed that coaches must be attuned to students who appear to be having difficulties.
Communication is key, he said. "If they're not feeling better, you need to dig a little deeper and find out why."

Such suggestions struck a chord with Travis Carrie, who sat out two years of athletic competition at De La Salle High after he fainted during football conditioning and doctors discovered a heart condition.

Carrie's coronary artery developed on the wrong side of his heart. It was operable; he returned to the field and earned a scholarship to Ohio University.

"The doctors knew I had a problem," he said. "But until I fainted, we didn't know how serious it was and exactly what it was."...

"I think coaches should listen more," he said. "During a couple of my incidents while running. I'd tell my coach that my chest is really hurting and I think I need to stop. Coaches need to really pay attention to their players and listen to them. That's a big factor."

Some say much more can be done to protect young athletes.

"I think we have a long way to go," North Coast Section Commissioner Gil Lemmon said. "I'm not saying that our contests are unsafe, but if we're talking about having top-notch safety within our programs, then I think every school needs a full-time trainer on campus and maybe some reform needs to go into our physicals."

For the past four years, the NCS has partnered with Children's Hospital to have a certified medic at its championship events. Lemmon said that 90 percent of the section's fall championships were covered and 100 percent of its football games.

But along with the focus on safety, Batten encourages people not to lose sight of the many health benefits of exercise and team sports.

"There's a much more well-defined risk of inactivity than there is with activity," he said.

REDUCING RISKS
Pre-screening
Students must have a physical exam before playing sports. The exam should include a family history, including relatives' heart-related deaths before age 50, or who had Marfan syndrome. Students should be asked whether during exertion they have ever nearly passed out, felt discomfort or pressure in the chest, or had their heart race or skip beats. Those with risk factors should have an electrocardiogram, or EKG. Experts are divided about whether EKGs should be required of all young athletes.

Warning signs
Fainting, chest pain, shortness of breath, irregular heartbeats, severe headaches, dizziness and blurry vision.

What students can do
Don't "tough it out": Tell a coach if you feel ill during a workout or game.
Make sure you drink enough water.
Avoid energy drinks, which cause dehydration.

What schools can do
Have an automatic external defibrillator on-site.
Ensure water and First Aid supplies are available at all practices and games.
Make sure all coaches know how to use the school phone system to call 911.

Source: Bay Area News Group research

Saturday, February 6, 2010

Rare heart conditions a danger to teen athletes--San Francisco Chronicle

Thanks to Junaid Khan, MD, cardiac surgeon at Alta Bates Summit, for his assistance in the following article from today’s San Francisco Chronicle on teenage athletes – and the possibility of undiagnosed cardiac conditions.

Rare heart conditions a danger to teen athletes
Victoria Colliver, Chronicle Staff Writer
Friday, February 5, 2010

The collapse of two teenaged basketball players in less than a week - one of whom died - highlights the fact that even young, seemingly healthy athletes may have hidden defects that can strike with little warning.

Heart specialists acknowledge that it's extremely rare for a young athlete to collapse or die after physical exertion, but say that an undiagnosed cardiac condition is the most likely cause.
"Unfortunately, the first presentation of these diseases can be sudden death, and that's what makes it so vexing of a problem," said Dr. Byron Lee, professor of medicine in UCSF's cardiology division. "Often, there are no warning signs."

The death last Friday of 17-year-old Joshua Ellison, co-captain of El Sobrante's Calvary Christian Academy high school basketball team, was followed Tuesday night by the collapse of a 16-year-old varsity basketball player from El Cerrito High School. The boy, whose name has not been released, remains hospitalized and is in stable condition, according to his coach.

While the cause of the boys' collapses has not been determined, physicians say the most likely culprit is a heart problem, one of the most common being a condition called hypertrophic cardiomyopathy, which causes the heart muscle to thicken and makes it harder to pump blood.

Other common reasons for athletes to collapse include concussions and heat-related illnesses, but those seem less likely in these cases.

The statistics

A study published last year in the journal of the American Heart Association looked at 1,866 U.S. athletes, ages 8 to 39, who either died from or survived sudden cardiac arrest between 1980 and 2006. Of the athletes who died, 56 percent suffered cardiac arrest; about a third of them were attributed to cardiomyopathy.

Blunt trauma to the chest causing structural damage to the heart was the second-most common cause, accounting for 22 percent of deaths. About 4 percent were caused by a chest blow that interrupted the rhythm of the heart, and just 2 percent resulted from heat stroke.

But even cardiac arrest - the most common cause - is so rare that doctors were shocked by the collapse of the two teenage basketball players from the East Bay within four days.

"Leukemia, cancer, motor vehicle accidents - this is infinitesimally smaller compared to those," said Dr. Junaid Khan, a heart surgeon at Alta Bates Summit Medical Center in Oakland. "This is compared to getting struck by lightning."

High school athletes in California must have a physical examination before playing sports. Since 2004, the California Interscholastic Federation, which oversees high school sports, has required athletes to also submit a complete family medical history to their doctors.

Physicians say such information could help prevent tragedy. A heart attack or sudden death of a non-elderly relative could indicate that a more extensive evaluation is needed.

Controversial EKGs

But doctors don't agree whether all young athletes should undergo routine electrocardiogram, or EKG, screenings, which can show signs of cardiomyopathy or other heart conditions that may indicate the need for additional tests.

Khan, president of the East Bay division of the American Heart Association, said mass EKG screenings of student athletes would not only be costly and impractical, but potentially lead to both false positive and negative results. He recommended EKG screenings only for athletes with other risk factors.

Khan said studies show that the incidence of young athlete deaths in the United States is not statistically different than that in Italy, where all professional and amateur athletes are required to undergo EKG testing before they can participate in competitive sports.

But Lee, of UCSF, disagrees. "It's an opportunity to save lives," he said, acknowledging the hassles that false EKG results could cause. "If lives are saved, it seems like a reasonable price to pay."

Physicians also recommend that parents and children be aware of symptoms that could indicate a heart problem. Such symptoms include extreme shortness of breath, dizziness, heart palpations and, most significantly, fainting.

Warning signs, however, can be difficult for young athletes to recognize and easy to ignore.
In a high-profile case, Cal basketball player Tierra Rogers had to give up the sport last year after being diagnosed with another heart condition known to cause sudden death called arrhythmogenic right ventricular dysplasia. She fell ill during a workout in September, but said her only warning signs before that were two episodes of a racing heart and shortness of breath several years earlier.

Dr. Zian Tseng of UCSF, who was part of the medical team who implanted a defibrillator in Rogers to manage her condition, said she was fortunate to have had some warning signs.
"If some of these symptoms were present in these two young victims, there might have been the time for intervention," he said.

One advantage the El Cerrito athlete had was the quick action of the coach and two parents, who administered CPR to the youth.

Physicians say another potentially lifesaving tool would be the increased availability of automated external defibrillators, which use electricity to help the heart re-establish its rhythm.
A proposed state law co-authored by Assemblywoman Mary Hayashi, D-Castro Valley, and Assemblyman Jerry Hill, D-San Mateo, would require that an external defibrillator be available at all high school games and practices.

Sudden cardiac death in young athletes

A study published last year in the journal of the American Heart Association looked at 1,866 young U.S. athletes between 1980 and 2006. Of the deaths:

-- 56 percent were due to cardiovascular disease. A condition called hypertrophic cardiomyopathy, which causes an enlarged heart, is the most common form of the disease.

-- 22 percent were caused by blunt trauma to the chest, which damaged the heart.

-- 4 percent were due to a chest blow that interrupted the heart rhythm.

-- 2 percent were related to heat stroke.

Source: Circulation: Journal of the American Heart Association

Lowering the risk

Here are some of the ways physicians say teenage athletes can reduce the chances for cardiac arrest:

Get a physical with a complete family history
Sudden cardiac arrest in a non-elderly relative is a key part of a family's medical history that may signal a young athlete's need for additional medical screenings such as an EKG.

Be aware of the warning symptoms
Extreme shortness of breath, light headedness, heart palpitations and, in particular, fainting with exertion are signs that warrant immediate attention.

Talk about heeding the signs
Parents should talk with their children about these health symptoms because kids are prone to ignoring the signs, in part because they feel young and invincible. But they also may lack the life experience to know when something is wrong.

Source: Chronicle research.
E-mail Victoria Colliver at vcolliver@sfchornicle.com.
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/02/05/BABG1BS14N.DTL
This article appeared on page C - 1 of the San Francisco Chronicle


https://mailbox.sutterhealth.org/exchweb/bin/redir.asp?URL=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/02/04/BABG1BS14N.DTL