Young, Athletic, and at Risk: The Reality of Sudden Cardiac Arrest in Sports

100:00:00,521 --> 00:00:02,444Speaker 1: Welcome to the Healthy, wealthy and Wise 200:00:02,544 --> 00:00:08,122podcast with Dr William Chokta, mdjd. Our mission is to empower 300:00:08,143 --> 00:00:11,930you with the knowledge and the tools you need to thrive in all 400:00:12,131 --> 00:00:16,225aspects of your life. Join us now as we discuss everything 500:00:16,306 --> 00:00:19,862from nutrition and exercise to money management and personal 600:00:19,882 --> 00:00:24,772growth. Dr Chokta will provide insightful advice on how to 700:00:24,812 --> 00:00:28,103improve your physical and financial health, as well as 800:00:28,143 --> 00:00:31,501your emotional and mental well-being. Whether you're 900:00:31,521 --> 00:00:35,976looking to boost your energy levels, unlike financial freedom1000:00:35,976 --> 00:00:40,268or cultivate a more positive mindset, we've got you covered. 1100:00:41,899 --> 00:00:45,951Get ready to become the best version of yourself, so let's 1200:00:45,990 --> 00:00:50,240get started. Here's Dr William Chokta, mdjd. 1300:00:50,990 --> 00:00:54,447Speaker 2: Good morning, welcometo our Healthy, wealthy and 1400:00:54,487 --> 00:00:59,908Wise podcast. I'm Dr William T Chokta and we're delighted to 1500:00:59,988 --> 00:01:04,168have you with us. Today we're going to talk about Bonnie James1600:01:04,168 --> 00:01:09,069. Bonnie James why young, healthy athletes have sudden 1700:01:09,109 --> 00:01:14,088cardiac arrest. Why young, healthy athletes have sudden 1800:01:14,108 --> 00:01:17,930cardiac arrest Each month. We strive to provide you, our 1900:01:17,971 --> 00:01:21,522listeners, with mental, physicaland spiritual strength by 2000:01:21,563 --> 00:01:26,176giving actual advice, tips, guidance and information to help2100:01:26,176 --> 00:01:30,147you achieve your own personal, professional and spiritual goals2200:01:30,147 --> 00:01:35,412. We consider the health of the mind, body and spirit paramount 2300:01:35,993 --> 00:01:40,384as a single unit that provides accumulative strength greater 2400:01:40,424 --> 00:01:46,799than the individual parts to strengthen the whole person. So 2500:01:46,840 --> 00:01:50,721today we're going to look at sudden cardiac arrest. This is a2600:01:50,721 --> 00:01:54,495problem that's been in the newslately and we've done some 2700:01:54,575 --> 00:01:57,263interesting reviews, and we're going to give you our 2800:01:57,364 --> 00:02:01,531suggestions about how this particular issue should be 2900:02:01,591 --> 00:02:07,125addressed. I believe knowledge is power. I believe life is 3000:02:07,204 --> 00:02:11,986about being of service to others. I believe leaders can change 3100:02:12,048 --> 00:02:15,367the world. As always, we like togive you an outline of what 3200:02:15,388 --> 00:02:17,883we're going to talk about. We'regoing to talk about sudden 3300:02:18,223 --> 00:02:23,360cardiac arrest, not just cardiacarrest sudden cardiac arrest in3400:02:23,360 --> 00:02:27,920young people, young athletes, to be specific. We're going to 3500:02:27,941 --> 00:02:31,030talk about some of the causes ofthis sudden cardiac arrest. 3600:02:31,680 --> 00:02:34,187We're going to define the differences between cardiac 3700:02:34,247 --> 00:02:39,745arrest and heart attacks and we're going to discuss ways that3800:02:39,745 --> 00:02:45,379you can prevent it and suggest certain treatment modalities or 3900:02:45,441 --> 00:02:49,050methods that we think will help to mitigate this problem in the 4000:02:49,129 --> 00:02:52,544future. As part of our masterclass series, we always 4100:02:52,765 --> 00:02:56,840frequently look into healthcare-related issues. As we4200:02:56,840 --> 00:03:00,288said before, we're going to look into healthcare issues as 4300:03:00,367 --> 00:03:05,246it relates to our youth and as it relates to our youth involved4400:03:05,246 --> 00:03:10,105in competitive sports. When I talk about athletic competition 4500:03:10,627 --> 00:03:15,622or athletics, we can either lookat it as recreational or 4600:03:15,663 --> 00:03:20,586competitive. For our purposes today, we're going to combine 4700:03:20,627 --> 00:03:24,580the two, that there is no distinction between competitive 4800:03:25,282 --> 00:03:30,691sports or competitive athletic competition or recreational 4900:03:31,111 --> 00:03:34,764athletic competition. The reasonis that the main issue that 5000:03:34,804 --> 00:03:39,480we're looking at today primarilyinvolves the effect of the 5100:03:39,662 --> 00:03:44,764activity on the body itself. Ourbelief is that whether you are 5200:03:45,406 --> 00:03:49,300playing in the final of the USC basketball tournament, at the 5300:03:49,341 --> 00:03:54,192Pac-10 or Pac-8, or whether you're playing 101 basketball 5400:03:54,231 --> 00:03:57,247with your brother in the backyard, you're still going to 5500:03:57,268 --> 00:04:00,941be just as competitive physically and the effects on 5600:04:00,980 --> 00:04:05,586your body will be similar. If you look at athletes and if you 5700:04:05,627 --> 00:04:10,882look at athletics among our children, particularly in junior5800:04:10,882 --> 00:04:14,710high and high school and in college. You would note that 5900:04:14,770 --> 00:04:18,932about 8 million high school athletes are active in the 6000:04:19,033 --> 00:04:23,105United States presently. Of thatnumber, and maybe a little 6100:04:23,146 --> 00:04:28,358higher now, about 500,000 college athletes are active 6200:04:28,699 --> 00:04:33,312presently. A lot of the very good work about student athletes6300:04:33,312 --> 00:04:37,904and health has really been doneby Dr Charles Welb at LSU 6400:04:38,065 --> 00:04:42,204Health in Shreveport, louisiana.I would encourage you to look 6500:04:42,283 --> 00:04:46,997up some of his very interesting work and very thorough and very 6600:04:47,077 --> 00:04:51,954informative. It will give you anidea about the scope of what 6700:04:51,975 --> 00:04:56,648we're talking about and some of the issues that we learn to 6800:04:57,269 --> 00:05:02,007evaluate. Specifically, what we're going to focus on is 6900:05:02,288 --> 00:05:09,680sudden cardiac arrest. Sudden cardiac arrest. Sudden means 7000:05:09,781 --> 00:05:13,850it's immediate cardiac means. Itinvolves the heart. Arrest 7100:05:13,910 --> 00:05:17,625means the heart stops. Sudden means that it's immediate 7200:05:17,966 --> 00:05:21,762cardiac means. It involves the heart and arrest means the heart7300:05:21,762 --> 00:05:27,218stops. We're going to look at the most common causes studying 7400:05:27,237 --> 00:05:32,656cardiac arrest. What's importantfor you to know is that sudden 7500:05:32,675 --> 00:05:37,625cardiac arrest is the most common cause of death in 7600:05:37,927 --> 00:05:42,879athletes. Let me say that again Sudden cardiac arrest is the 7700:05:42,940 --> 00:05:47,577most common cause of death in our athletes. I'm sure many of 7800:05:47,617 --> 00:05:52,017you may have heard in the news about Bronnie James. Bronnie is 7900:05:52,137 --> 00:05:56,742a freshman at USC. He's on the basketball team and, as you may 8000:05:56,882 --> 00:06:01,555already know, he's the son of the legendary superstar Lebron 8100:06:01,576 --> 00:06:07,601James, a professional basketballplayer. Bronnie, his son was in8200:06:07,601 --> 00:06:12,863basketball practice at USC and he suddenly had a cardiac arrest8300:06:12,863 --> 00:06:17,158. He immediately dropped to the floor and individuals rushed to 8400:06:17,199 --> 00:06:22,002him with a cardiac arrest. Even though you may not have heard of8500:06:22,002 --> 00:06:26,139this a lot you don't hear aboutit a lot it does happen, and I 8600:06:26,178 --> 00:06:30,279will submit that it's happening more and more. Why? One? Because8700:06:30,279 --> 00:06:33,680our population is growing. We're up to 8 billion people in 8800:06:33,701 --> 00:06:37,302the world now. Obviously, our population in this country is 8900:06:37,343 --> 00:06:40,901growing. I'm going to argue thatthere are more student athletes9000:06:40,901 --> 00:06:44,076now, just because of that, and also because of the popularity 9100:06:44,637 --> 00:06:48,165of various types of sports like football, basketball, soccer, 9200:06:48,547 --> 00:06:54,060etc. If you were to research theliterature, you will find that 9300:06:54,180 --> 00:06:57,817among children and when I say children, I'm talking about less9400:06:57,817 --> 00:07:05,583than 20 years of age the most common cause of cardiac death in9500:07:05,583 --> 00:07:10,701children is myocarditis. What does that mean? Myocardium means9600:07:10,701 --> 00:07:15,103muscle, heart muscle. This means inflammation of 9700:07:15,975 --> 00:07:20,064Myocarditis, means inflammation of the heart muscle or 9800:07:20,144 --> 00:07:24,920inflammation of the heart. Myocarditis is recognized as the9900:07:24,920 --> 00:07:29,908leading cardiac cause of death in young people and children. 10000:07:30,836 --> 00:07:35,298Having said that, though, it is not the leading cause of death 10100:07:35,839 --> 00:07:41,548of sudden cardiac arrest or the leading cause of sudden cardiac 10200:07:41,608 --> 00:07:50,324arrest. Sudden cardiac arrest isthe main cause of death in our 10300:07:50,404 --> 00:07:55,096youth or in individuals less than 25 years of age. Again, 10400:07:55,237 --> 00:07:58,225sudden cardiac arrest is when the heart immediately stops. 10500:07:58,475 --> 00:08:02,004Patient drops to the floor, to the ground, wherever he or she 10600:08:02,024 --> 00:08:07,362may be. What we know, and we already know this, is that the 10700:08:07,423 --> 00:08:12,399most common cause of sudden cardiac arrest and athletic 10800:08:12,478 --> 00:08:16,898children or youth is cardiomyopathy. What is 10900:08:16,918 --> 00:08:21,923cardiomyopathy? Cardiomyopathy, as the name might implies, means11000:08:21,923 --> 00:08:27,642that the heart muscle, the cardiomyome, is diseased somehow11100:08:27,642 --> 00:08:33,381or does not function normally. Cardiomyopathy is an inherited 11200:08:33,763 --> 00:08:37,802weakness of the heart muscle, most apparent with extreme 11300:08:37,961 --> 00:08:41,124exercise. The thing about cardiomyopathy that you need to 11400:08:41,144 --> 00:08:44,259know first thing is it is inherited. You get it in your 11500:08:44,278 --> 00:08:48,782genes. It is in the genes. Some people have it, some people 11600:08:48,802 --> 00:08:53,455don't. There is nothing that thestudent has done to create it. 11700:08:53,575 --> 00:08:59,705It is in the genes. If you were to look at cardiomyopathy and if11800:08:59,705 --> 00:09:06,284you know that it is in the genes and if you know that it 11900:09:06,304 --> 00:09:09,714alone is the most single cause of sudden cardiac arrest in an 12000:09:09,813 --> 00:09:12,730athletic young person, your nextquestion would be how do I 12100:09:12,769 --> 00:09:16,855detect it? How can I prevent it.What can I do? Believe it or 12200:09:16,956 --> 00:09:19,745not? The electrocardiogram, which has been around for 12300:09:19,765 --> 00:09:24,940generations as a test and as a standard for the heart. It is a 12400:09:24,960 --> 00:09:29,197very, very important thing. It has been around for generations 12500:09:29,677 --> 00:09:35,888as a test and as a standard test, is one of the best tests to 12600:09:36,168 --> 00:09:41,515use to identify individuals who may have cardiomyopathy. Some 12700:09:41,535 --> 00:09:45,705studies have even suggested over90% can be identified with 12800:09:45,765 --> 00:09:50,245electrocardiogram. But would it not surprise you to know that 12900:09:50,365 --> 00:09:53,735not all and I would argue, probably most programs I'm 13000:09:53,755 --> 00:09:58,004talking about school athletic programs, athletic clubs that 13100:09:58,105 --> 00:10:02,500our kids play on probably don't use the EKG, the 13200:10:02,561 --> 00:10:06,722electrocardiogram, as a normal screening too? Let me say that 13300:10:06,763 --> 00:10:11,000again. Cardiomyopathy is the most common cause of sudden 13400:10:11,039 --> 00:10:15,616death, causing death and atollated young people in this 13500:10:15,697 --> 00:10:20,936country. One of the best ways toscreen for cardiomyopathy is a 13600:10:20,995 --> 00:10:24,336method that we already have called electrocardiogram or the 13700:10:24,395 --> 00:10:30,241EKG, but the majority of the programs probably don't use it. 13800:10:30,571 --> 00:10:33,913There may be a number of reasonswhy they don't use it. Some may13900:10:33,913 --> 00:10:38,059be costs, some may be just the idea of this. Doesn't happen 14000:10:38,080 --> 00:10:41,671very often, which is true, and we'll get to the numbers. It is 14100:10:41,730 --> 00:10:46,933not often that a sudden cardiac arrest occurs, but I'm going to 14200:10:46,974 --> 00:10:52,120suggest to you, would you reallycare, whatever the percentage 14300:10:52,379 --> 00:10:56,778is, if there was any chance thata minimum of your family or a 14400:10:56,839 --> 00:11:00,634child or your family, your son, your daughter, your grandkids, 14500:11:02,219 --> 00:11:06,721family members or just the kids down the street would die or be 14600:11:06,889 --> 00:11:12,613injured with a particular medical condition? Let's look at14700:11:12,613 --> 00:11:17,092, take a broader view. If you look at adults, the most common 14800:11:17,113 --> 00:11:20,792cause of cardiac injury or cardiac death is carny artery 14900:11:20,831 --> 00:11:24,392disease and we'll talk about this in detail a bit later. But 15000:11:24,432 --> 00:11:27,053if you look at the youth and again I'm going to define youth 15100:11:27,114 --> 00:11:31,076as less than 25 years of age it's going to be cardiomyopathy 15200:11:31,176 --> 00:11:34,373or some type of arrhythmia. Those who are at highest risk 15300:11:34,433 --> 00:11:41,474for sudden death with cardiac disease are going to be athletes15400:11:41,474 --> 00:11:44,753who are less than 25 years of age. They're going to be 15500:11:44,893 --> 00:11:47,650athletes who play soccer, basketball and football, which 15600:11:47,711 --> 00:11:51,375is obviously going to be the majority. Many believe that one 15700:11:51,414 --> 00:11:57,178of the reasons why this occurs, the sudden cardiac arrest occurs15800:11:57,178 --> 00:12:00,173in these young people, is that they're at the end stage of 15900:12:00,253 --> 00:12:05,096puberty, the last growth spurts,if you will 19, 20, 21, all the16000:12:05,096 --> 00:12:09,456way up to 25. The heart is at its peak maturity and the 16100:12:09,495 --> 00:12:14,855hormone levels are surging at this point. Just a theory, some 16200:12:14,894 --> 00:12:17,400believe that's one of the reasons why these individuals 16300:12:17,461 --> 00:12:21,698may be more susceptible at this age or at this stage in their 16400:12:21,759 --> 00:12:25,456life and their development, but what we do know is the cardiac 16500:12:25,677 --> 00:12:29,837disease alone a heart disease alone is the most common cause 16600:12:29,898 --> 00:12:35,332of death in this country, be youadult or a youth. What we're 16700:12:35,373 --> 00:12:40,749trying to do is to focus on our youth and a certain segment of 16800:12:40,828 --> 00:12:43,951our youth. These are the athletic youth and what things 16900:12:44,052 --> 00:12:48,022we can do to mitigate the problem of sudden cardiac death 17000:12:48,429 --> 00:12:54,652and this subset of athletes in our environment. Studies have 17100:12:54,672 --> 00:12:58,921shown that if you look at data from the NCAA and the first part17200:12:58,921 --> 00:13:04,679of the 2000s, you get an idea that football and basketball and17300:13:04,679 --> 00:13:07,395other types of competitive sports that are higher on the 17400:13:07,416 --> 00:13:11,240list, they suggest that boys aremore susceptible than girls. 17500:13:11,269 --> 00:13:14,910That may very well be that actually, early on, there were 17600:13:14,951 --> 00:13:18,600more opportunities for boys to compete than there were for 17700:13:18,620 --> 00:13:22,011girls, so those numbers may be abit skewed. But the point I 17800:13:22,032 --> 00:13:25,620want to make is that more and more of our children are 17900:13:25,660 --> 00:13:28,677participating athletically, which in general is a good thing18000:13:28,677 --> 00:13:33,830, but also just be aware of one very serious risk with this 18100:13:34,051 --> 00:13:37,720enjoyable competition and thingsthat we can do to mitigate the 18200:13:37,759 --> 00:13:41,515causes. Let me also, parenthetically, add that there 18300:13:41,615 --> 00:13:47,336is a difference between cardiac arrest, heart stopping and heart18400:13:47,336 --> 00:13:51,899attack. There's a difference between cardiac arrest and heart18500:13:51,899 --> 00:13:55,759attack. A cardiac arrest, whichis what we're talking about 18600:13:55,798 --> 00:14:00,711today, is basically an electrical problem Because, 18700:14:00,751 --> 00:14:04,094remember, the heart is a muscle,but it is a muscle that 18800:14:04,234 --> 00:14:08,636functions with electrical current. The electrical the 18900:14:08,716 --> 00:14:11,772essay fires an electrical current to the muscle, squeezes 19000:14:11,812 --> 00:14:16,815down, pushes blood out of the heart. Electrical current fires 19100:14:16,916 --> 00:14:20,751and occur to the muscle in the heart. The muscle squeezes down,19200:14:20,751 --> 00:14:25,640pushes blood out of the heart. On the other hand, a heart 19300:14:25,701 --> 00:14:29,998attack is not an electrical problem. A heart attack is a 19400:14:30,038 --> 00:14:34,787situation that occurs in mostly in people 25 years of age and 19500:14:35,048 --> 00:14:40,601older. It is basically a situation where the blood supply19600:14:40,601 --> 00:14:45,889to the heart is impeded or decreased or blocked completely.19700:14:45,889 --> 00:14:51,142So you have arteries that feed the heart, the blood to the 19800:14:51,182 --> 00:14:56,109heart muscle, that allow it to be healthy and to function 19900:14:56,190 --> 00:14:59,961normally when it receives the current, the electrical current 20000:15:00,182 --> 00:15:06,059to push blood out of the heart. But if that muscle is not fed 20100:15:06,120 --> 00:15:10,265with appropriate nutrition or nutrients via its own blood 20200:15:10,285 --> 00:15:15,018supply, ie the coronary artery, if those arteries are blocked, 20300:15:15,418 --> 00:15:18,384then that muscle will not get that sufficient amount of blood 20400:15:18,804 --> 00:15:21,856and then that muscle will not function properly, and that's 20500:15:21,917 --> 00:15:25,178what we call heart attack. Cardiac arrest, which is what we20600:15:25,178 --> 00:15:28,475primarily talk about today, is an electrical problem. Heart 20700:15:28,514 --> 00:15:33,378attack is a plumbing problem. Cardiac arrest is an electrical 20800:15:33,418 --> 00:15:36,643problem that we're talking aboutwith young people, particularly20900:15:36,643 --> 00:15:40,788young athletes who are less than 25 years of age or younger 21000:15:41,635 --> 00:15:45,239who are less than 25 years of age. Heart attack is a plumbing 21100:15:45,278 --> 00:15:48,585problem that occurs in individuals who are greater than21200:15:48,585 --> 00:15:52,03825 years of age. Another important point to remember, 21300:15:52,118 --> 00:15:55,605particularly when we talk about heart attacks, is that the 21400:15:55,706 --> 00:16:00,163symptoms of heart attacks differsignificantly sometimes between21500:16:00,163 --> 00:16:03,720men and women. This is an important factor because one of 21600:16:03,740 --> 00:16:07,105the things that we've learned I graduated from medical school in21700:16:07,105 --> 00:16:11,198the 70s and back in the 70s we were taught that the heart 21800:16:11,239 --> 00:16:15,245attack was a classic substernialchest pain with pain that 21900:16:15,264 --> 00:16:17,849crushed the substernial chest pain, with pain radiating to the22000:16:17,849 --> 00:16:22,298left arm. And indeed that was true. But what we didn't know at22100:16:22,298 --> 00:16:26,817that time, that was primarily true in men that indeed women 22200:16:26,876 --> 00:16:32,265don't have that classic male approach or male symptomatology 22300:16:32,846 --> 00:16:37,419of heart attack. Women may have nausea and vomiting, they may 22400:16:37,500 --> 00:16:41,686have neck pain, they may have lower abdominal pain, they may 22500:16:41,725 --> 00:16:45,375have indigestion, they may have extreme fatigue and, indeed, in 22600:16:45,416 --> 00:16:51,565the last 30 plus years, a whole area of specialty has developed 22700:16:51,865 --> 00:16:55,710in terms of female heart disease, a heart disease that affects 22800:16:55,730 --> 00:16:59,740women. Recognizing the fact thatmen and women are different in 22900:16:59,780 --> 00:17:03,467multiple ways and indeed how they have heart attacks, is one 23000:17:03,508 --> 00:17:08,182of those ways. Another way that we can end up creating a heart 23100:17:08,241 --> 00:17:13,310attack or heart disease or sudden heart attack is by 23200:17:13,431 --> 00:17:16,897stressing our heart inappropriately. In addition to 23300:17:17,077 --> 00:17:21,105exercise, believe it or not, theenvironment can be a stressor 23400:17:21,125 --> 00:17:25,355for our heart, particularly if it's very hot. What we know is 23500:17:25,395 --> 00:17:30,623that this year, particularly in 2023, in the summer 2023, has 23600:17:30,702 --> 00:17:34,968been the hottest summer on record in the history of the 23700:17:35,167 --> 00:17:38,797earth or recorded history of theearth. What that means is that 23800:17:38,817 --> 00:17:42,583the climate is getting hotter and hotter. The hotter it gets, 23900:17:43,023 --> 00:17:46,008the more stress it puts on the heart, because it makes the 24000:17:46,028 --> 00:17:49,318heart have to work more, and obviously that affects those of 24100:17:49,398 --> 00:17:52,526us who are extremes of age the very young and the very, very 24200:17:52,686 --> 00:17:57,021old. So let's get back to our subject sudden cardiac arrest. 24300:17:57,481 --> 00:17:59,747Again, we're talking about sudden cardiac arrest that 24400:17:59,787 --> 00:18:03,657occurs in young athletes. Another athlete that we heard 24500:18:03,698 --> 00:18:07,864about a few months ago also was DeMar Hamlin, a football player,24600:18:07,864 --> 00:18:12,009buffalo Bills, who end up having a sudden cardiac arrest, 24700:18:12,694 --> 00:18:18,521both DeMar Hamlin and Brody James. Both were in an 24800:18:18,582 --> 00:18:22,625environment where individuals could get to them quickly, do 24900:18:22,645 --> 00:18:28,897CPR and also do defibrillation if needed. So what would be some25000:18:28,897 --> 00:18:33,084symptoms if you were coaching ateam or you were just observing25100:18:33,084 --> 00:18:36,915a team of a group of soccer players, let's say, and let's 25200:18:36,935 --> 00:18:40,461say one of those students, one of those young people, had this 25300:18:40,823 --> 00:18:44,535developmental abnormality that they would not know about. What 25400:18:44,575 --> 00:18:47,601would be some symptoms? Are there any symptoms to them 25500:18:47,662 --> 00:18:52,817developing a sudden cardiac arrest? Studies show that there 25600:18:52,916 --> 00:18:55,880are some mild symptoms that would be important to be aware 25700:18:56,019 --> 00:19:00,705of. One is that during the exercise, immediately afterwards25800:19:00,705 --> 00:19:04,971, they may start to feel an unexpected type of shortness of 25900:19:04,990 --> 00:19:08,460breath. Let's say, for example, the coach has the team to run 26000:19:08,500 --> 00:19:13,048around the field after practice say football practice, soccer 26100:19:13,067 --> 00:19:16,898practice, whatever but this timewhen the student runs around 26200:19:16,939 --> 00:19:20,483the field, he's starting to feelmore short of breath than usual26300:19:20,483 --> 00:19:23,709and indeed cannot really make it all the way around the field.26400:19:23,709 --> 00:19:26,738Now, this is always one of those situations where, 26500:19:26,857 --> 00:19:33,265obviously, it is the coach's purpose to push the athlete and 26600:19:33,285 --> 00:19:35,527you want to get the best out of them and you want to make sure 26700:19:35,567 --> 00:19:40,236that they are putting 110% into their activity. But at the same 26800:19:40,296 --> 00:19:44,080time, it's important to be awarethat some problems can develop 26900:19:44,622 --> 00:19:48,487and sometimes they may not be able to do what they really want27000:19:48,487 --> 00:19:53,354to do and run around the field as fast or as many times as they27100:19:53,354 --> 00:19:56,878have done in the past. Other symptoms could be the student 27200:19:56,898 --> 00:19:59,983may feel, or began to feel, faint or a little dizzy, or just27300:19:59,983 --> 00:20:05,017out of it. Another symptom may very well be chest pain. So what27400:20:05,017 --> 00:20:10,144should individuals who work with youth and bond with various27500:20:10,144 --> 00:20:13,348types of sports be aware of? First, you need to have a 27600:20:13,388 --> 00:20:16,798heightened awareness. Now I realize that this is challenging27700:20:16,798 --> 00:20:22,730One, because the incidence of individuals having sudden 27800:20:22,750 --> 00:20:25,957cardiac arrest is going to be very small. It's going to be 27900:20:25,997 --> 00:20:30,263like $1,000 and $40,000. That's really very small. But think 28000:20:30,305 --> 00:20:34,602about it. Would it really matterwhether it's one in 40,000 or 28100:20:34,781 --> 00:20:39,659one in four if it were your child or your family member, or 28200:20:39,679 --> 00:20:43,626a child that you do, etc. My point very simply is admittedly 28300:20:43,708 --> 00:20:49,205it occurs rarely, but the occurrence should be zero, the 28400:20:49,326 --> 00:20:53,256risk should be zero, and that's the point I'm trying to make 28500:20:53,316 --> 00:20:59,665here. Why should we accept one in 40,000 or one in 80,000? The 28600:20:59,726 --> 00:21:03,438risk should be zero. We certainly. Many times, when I 28700:21:03,557 --> 00:21:06,265was working with the drug commission on the latter part of28800:21:06,265 --> 00:21:11,105my practice, we were suggestingto hospitals that we would 28900:21:11,146 --> 00:21:16,363survey, that we want them to have zero patient harm Zero. And29000:21:16,363 --> 00:21:19,412certainly anytime you say zero harm with anything, people say 29100:21:19,451 --> 00:21:23,181oh, come on, you're dealing withhumans and we're not all, we're29200:21:23,181 --> 00:21:26,954not perfect, blah, blah, blah. And zero is not possible. And 29300:21:27,056 --> 00:21:31,002our reply would be you can get zero harm if you think you can 29400:21:31,022 --> 00:21:35,920get zero harm. We expect zero planes to fall out of the sky 29500:21:36,240 --> 00:21:40,574when we get on an airplane. We do not expect one in 40,000 or 29600:21:40,694 --> 00:21:46,106one in 80,000. We want zero, we want no risk, we want no 29700:21:46,186 --> 00:21:50,096problems at all and I submit that we can do the same thing 29800:21:50,155 --> 00:21:53,663for our children who are involved at Sledikly. Another 29900:21:53,723 --> 00:21:57,540thing is that all of these kids and all of the youth, whether 30000:21:57,580 --> 00:22:01,634it's college, whether it's high school, whether it's club soccer30100:22:01,634 --> 00:22:05,521or club football or club basketball, all have physical 30200:22:05,602 --> 00:22:08,888exams. I suggest that those specific exams should be 30300:22:09,015 --> 00:22:12,142purposeful. It should not just be a single sheet where you 30400:22:12,162 --> 00:22:16,637check a box, but there should bea medical person who actually 30500:22:16,718 --> 00:22:22,887does a medical exam, ask the right questions, etc, etc. I 30600:22:23,028 --> 00:22:26,920personally think, because we nowknow that the EKG, the 30700:22:26,980 --> 00:22:32,368electrocardiogram, can pick up or identify those students who 30800:22:32,429 --> 00:22:37,663are most likely to have a problem with cardiomyopathy, 30900:22:38,243 --> 00:22:41,828that every student who is involved with athletic 31000:22:42,434 --> 00:22:46,751competition should have a screenin the electrocardiogram. I 31100:22:46,791 --> 00:22:49,357just think that should be the good one. Yes, I'm sure there's 31200:22:49,417 --> 00:22:54,208a cost associated with EKG. Yes,I'm sure that it might be a 31300:22:54,248 --> 00:22:57,669little disconcerting for a lot of individuals to think that, oh31400:22:57,669 --> 00:22:59,959my goodness, you mean there could be a medical condition 31500:23:00,019 --> 00:23:04,153here. But ask yourself the question what if it were your 31600:23:04,192 --> 00:23:07,704child? Wouldn't you want to know? I certainly want to know. My 31700:23:07,724 --> 00:23:10,895grandkids are very, very active in soccer and I want them to be 31800:23:10,935 --> 00:23:15,450safe, as I'm sure you do with your children. We should be 31900:23:15,529 --> 00:23:18,159educated all of us who are involved, supporting our case 32000:23:18,500 --> 00:23:22,393with risk factors. We should be able to identify them and we 32100:23:22,413 --> 00:23:25,804should be able to provide treatment as necessary. One of 32200:23:25,824 --> 00:23:29,134the main treatments, obviously, if someone develops a cardiac 32300:23:29,275 --> 00:23:32,682arrest, is cardiopulmonary resuscitation of what we call 32400:23:32,742 --> 00:23:36,858CPR. Cpr has been around for a very, very long time. Many of 32500:23:36,898 --> 00:23:39,767you have not most of you are familiar with it. First thing 32600:23:39,807 --> 00:23:43,844you do is call 911. Second thingyou do is lay the patient flat,32700:23:43,844 --> 00:23:47,237or the person flat, so they canbreathe. If indeed they are 32800:23:47,297 --> 00:23:49,929breathing, you want to listen tosee if you can tell if they're 32900:23:49,949 --> 00:23:52,278breathing. If they're not breathing, then you want to 33000:23:52,317 --> 00:23:55,445start chest compressions. It's chest compressions, third of 33100:23:55,486 --> 00:23:58,680compressions, to two breaths, and you want to do that until 33200:23:59,040 --> 00:24:03,436you can get a help. Additionally, if indeed it is a cardiac 33300:24:03,497 --> 00:24:07,969arrest, studies have shown that you can significantly improve 33400:24:07,989 --> 00:24:12,920survival with what's called an automated external defibrillator33500:24:12,920 --> 00:24:17,228. Basically, this is just a unitthat shocks the heart. Think 33600:24:17,268 --> 00:24:21,827about when your computer goes down. Think about in a situation33700:24:21,827 --> 00:24:24,798that's electrical. Many times what you do is you just turn it 33800:24:24,857 --> 00:24:27,545off and try to back on again, oryou unplug it and you plug it 33900:24:27,565 --> 00:24:31,962back in. It's similar to that Ifthat heart is stopped. Remember34000:24:31,962 --> 00:24:34,897it's an electrical unit and youwant to shock it with a 34100:24:34,917 --> 00:24:37,788defibrillator. It's one of the reasons why you will see 34200:24:37,829 --> 00:24:41,278defibrillators in airports and in a lot of public places. Now 34300:24:42,221 --> 00:24:46,429Studies have shown that a portable defibrillator can make 34400:24:46,509 --> 00:24:49,601a huge difference in survival ina lot of these patients, 34500:24:50,063 --> 00:24:54,577because time is really valuable.Many times, just by doing this 34600:24:54,659 --> 00:24:58,988on the spot, you can save their lives before you can get them to34700:24:58,988 --> 00:25:03,281the hospital. So what have we learned? What we know is that 34800:25:03,342 --> 00:25:07,715sudden cardiac arrests in youth is uncommon. Again, as I said, 34900:25:07,736 --> 00:25:12,363it's like one in 40,000 or one in 80,000 per year. But again, 35000:25:12,462 --> 00:25:18,472my point is who cares if your child is that one, or a child 35100:25:18,512 --> 00:25:22,118that you know is that one, or a child in your neighborhood is 35200:25:22,159 --> 00:25:26,471that one? And that's something that we all can do, individually35300:25:26,471 --> 00:25:31,807or collectively, to decrease that risk. We know that the 35400:25:31,847 --> 00:25:35,994majority of children who get sudden cardiac arrest, or 35500:25:36,095 --> 00:25:40,146individuals less than 25 years of age who gets a cardiac arrest35600:25:40,146 --> 00:25:46,155while exercising competitively,that it is from a congenitive 35700:25:46,195 --> 00:25:50,807defects called hypertrophic cardiomyopathy. That 35800:25:51,789 --> 00:25:55,266cardiomyopathy is the most common cause. We know that a 35900:25:55,326 --> 00:25:58,932cardiomyopathy is basically a weakness of the muscle when 36000:25:59,053 --> 00:26:06,032pushed to extremes Athletically,a weakness of the muscle when 36100:26:06,073 --> 00:26:10,548that muscle is pushed to extremes Athletically. We know 36200:26:10,648 --> 00:26:14,355that it is inherited and that itis not something that you can 36300:26:14,415 --> 00:26:20,230prevent yourself from having. Wealso know that over 90% of 36400:26:20,371 --> 00:26:23,817individuals with this condition can be diagnosed with a basic 36500:26:23,977 --> 00:26:29,787electrocardiogram A basic electrocardiogram. So what's my 36600:26:29,826 --> 00:26:34,874point? My point is that there should be a zero risk of our 36700:26:34,913 --> 00:26:39,298children having cardiac arrest doing athletic competition or 36800:26:39,400 --> 00:26:44,214any other time. Zero risk. And so what I recommend is the 36900:26:44,255 --> 00:26:49,573following One, have a good history and physical done when 37000:26:49,614 --> 00:26:52,077the kids all get, because all ofthem have to have history and 37100:26:52,117 --> 00:26:55,310physicals, but many times the quality of those history and 37200:26:55,330 --> 00:26:59,367physicals may not be the same. Make sure, if you are a parent 37300:26:59,489 --> 00:27:04,237or guardian or just a concerned citizen, make sure good history 37400:27:04,277 --> 00:27:08,109and physicals are done, good questions are asked to make sure37500:27:08,109 --> 00:27:13,086that the screening is done in an appropriate manner. Next, if 37600:27:13,146 --> 00:27:17,433you are a parent or concerned adult with children who engage 37700:27:17,494 --> 00:27:23,652in athletic competition, be proactive, notice things and, at37800:27:23,652 --> 00:27:27,489the same time, ask questions. Now I'm going to caution. You Be37900:27:27,489 --> 00:27:30,335diplomatic with your questions,because if you walk up to a 38000:27:30,394 --> 00:27:35,204soccer coach and say, by the way, do you guys have an EKG? And 38100:27:35,244 --> 00:27:39,232did you EKG my son before you put him on your soccer team and 38200:27:39,673 --> 00:27:42,646go ahead and start mentioning statistics, that sort of thing? 38300:27:42,907 --> 00:27:46,326The coach is going to start running from you, okay. So you 38400:27:46,366 --> 00:27:50,354want to be diplomatic, but you want to say bring it up in 38500:27:50,413 --> 00:27:53,419general, or maybe even bring it up in a group discussion among 38600:27:53,459 --> 00:27:56,811parents, maybe before even talking to the coach, if there's38700:27:56,811 --> 00:28:01,990a support column, etc. Etc. Or if there's a teen mom or a teen 38800:28:02,030 --> 00:28:05,839dad, bring it up with that person in a very diplomatic way.38900:28:05,839 --> 00:28:10,336But the goal is to make things safer for your children. That's 39000:28:10,415 --> 00:28:18,165the goal. We want zero risk, not1%, not 5%, not 10%, zero. And 39100:28:18,405 --> 00:28:21,131when they used to tell us in thehospital, zero is important. As39200:28:21,131 --> 00:28:26,226I said before, you get zero if you think you get zero. Also, 39300:28:26,405 --> 00:28:29,652one of the things that you want to suggest is that all the kids 39400:28:29,711 --> 00:28:34,847should get EKGs, a screening EKG. Again, you can pick up the 39500:28:34,887 --> 00:28:38,567most common reason for sudden cardiac arrest Most of the time 39600:28:38,606 --> 00:28:41,974with a screening EKG, electrocardiogram. Find the 39700:28:42,095 --> 00:28:46,451world when we get them. Again. Iunderstand that it could be 39800:28:46,811 --> 00:28:50,465diplomatically difficult or challenging. Folks may say it's 39900:28:50,486 --> 00:28:55,295just too much money. But we see a lot of kids who have signs and40000:28:55,295 --> 00:28:59,770have car washes to get uniforms. We have car washes or raise 40100:28:59,891 --> 00:29:04,128money to go on trips with the team. Certainly, something like 40200:29:04,190 --> 00:29:08,625getting an EKG can be done in that manner. If necessary, I 40300:29:08,644 --> 00:29:13,752would argue that parents and or adults would just donate money 40400:29:14,113 --> 00:29:20,126to get to buy an EKG and have a certified person to do it, which40500:29:20,126 --> 00:29:23,353brings me to my next point. I think there should be 40600:29:23,733 --> 00:29:29,568individuals associated with eachteam, soccer team, basketball 40700:29:29,588 --> 00:29:35,617team, football team, college, high school, junior high or club40800:29:35,617 --> 00:29:39,048or just recreational. That should be an adult, a minimum 40900:29:39,368 --> 00:29:43,054one adult, if not more, of individuals who are associated 41000:29:43,095 --> 00:29:47,467with all of these teams, who know CPR, cardiopulmonary 41100:29:47,507 --> 00:29:52,056resuscitation. Just take a course and become a certified 41200:29:52,076 --> 00:29:56,530CPR person. Most hospitals will offer a free course. You can 41300:29:56,590 --> 00:30:01,305find them in schools, just go online or just look it up. I 41400:30:01,444 --> 00:30:04,488guarantee you you can find someone close to you that gives 41500:30:05,088 --> 00:30:09,173certified, that gives CPR classes, and you become the 41600:30:09,232 --> 00:30:13,458person who is able to do cardiopulmonary resuscitation 41700:30:13,538 --> 00:30:17,305should you be in the area when something like that occurs and 41800:30:17,345 --> 00:30:20,108it's just something that's good to have who may be at a family 41900:30:20,148 --> 00:30:25,136gathering and someone elderly may end up having a cardiac 42000:30:25,196 --> 00:30:28,066arrest, and you can be of assistance there. It's the one 42100:30:28,145 --> 00:30:31,348is my point, but I'm thinking about it specifically with our 42200:30:31,388 --> 00:30:34,932youth and specifically with our children who have these cardiac 42300:30:34,973 --> 00:30:38,998arrests and things that we can do to help them and doing those 42400:30:39,057 --> 00:30:42,906critical moments to save their lives. Certainly, one of the 42500:30:42,946 --> 00:30:47,897suggestions that's available is things like fundraisers for EKGs42600:30:47,897 --> 00:30:53,513and also I think each unit, each school, should have an AED,42700:30:53,513 --> 00:30:57,806an automatic electronic defibrillator. I'm sure many 42800:30:57,846 --> 00:31:01,152schools have them, but I've got all schools, though, and I've 42900:31:01,172 --> 00:31:04,518got all teams though. These are very small units that can be 43000:31:04,597 --> 00:31:09,450hand carried and I think someoneshould be designated. It 43100:31:09,490 --> 00:31:12,374doesn't have to be a coach, it could be a team mom, team dad or43200:31:12,374 --> 00:31:17,079just a good parent who's at every game to be responsible for43300:31:17,079 --> 00:31:22,670that and know how to use it. Granted, these are things that 43400:31:22,710 --> 00:31:28,066may be outside of the norm, but I suggest to you that, certainly43500:31:28,066 --> 00:31:31,951, as leaders and as individuals who want to make the world a 43600:31:31,990 --> 00:31:35,795better place, these are some little things, small things that43700:31:35,795 --> 00:31:40,461are within our control, that wecan do to save somebody's life.43800:31:40,461 --> 00:31:45,471I wouldn't want to do that. So,in conclusion, the most common 43900:31:45,531 --> 00:31:48,457reasons for sudden cardiac arrest and child athletes is 44000:31:48,477 --> 00:31:53,448hypertrophy cardiomyopathy. Thisis a genetic condition that can44100:31:53,448 --> 00:31:57,753be identified most of the timeswith use of an 44200:31:57,834 --> 00:32:04,709electrocardiogram as a screeningtool. If you are in the area 44300:32:04,808 --> 00:32:08,295where a cardiac arrest has occurred remember it is an 44400:32:08,355 --> 00:32:13,163electrical problem you want to start CPR. First thing is called44500:32:13,163 --> 00:32:17,631911. Then began cardiopulmonaryresuscitation pushing on the 44600:32:17,651 --> 00:32:22,546chest and breathing for the person if possible. You want to 44700:32:22,865 --> 00:32:28,913make sure that if there's an AEDin the area, that you use that 44800:32:29,074 --> 00:32:34,740if necessary. And, above all, remember, we want zero risk of 44900:32:34,780 --> 00:32:40,905cardiac arrest in our children or, you know, child athletes. My45000:32:40,905 --> 00:32:45,107basic principles number one Godis in charge. I am a physician 45100:32:45,167 --> 00:32:48,247of faith and I would believe very strongly that I would not 45200:32:48,848 --> 00:32:53,832be who I am or do what I'm able to do, but for God being in my 45300:32:53,893 --> 00:32:58,008life. Second principle is. I have no bad days I used to have 45400:32:58,067 --> 00:33:01,127bad days and I decided about 30 years ago that I'd had enough, 45500:33:01,765 --> 00:33:05,628so I figured out that a day was good or bad If I said it was 45600:33:05,789 --> 00:33:10,089good or bad, so I eliminated them. I now have good days and I45700:33:10,089 --> 00:33:13,511have great days. Don't sweat the small stuff, and most stuff 45800:33:13,592 --> 00:33:18,076is small. I have learned that whenever something happens to me45900:33:18,076 --> 00:33:23,369that I perceive as negative or bad, that most of the times it's46000:33:23,369 --> 00:33:27,809not as big a deal as I think itis, and so I figured out to go 46100:33:27,890 --> 00:33:31,329slow and just not sweat a lot ofthe things and most of the 46200:33:31,349 --> 00:33:35,008things that, when I put them in perspective, they're not that 46300:33:35,028 --> 00:33:38,909big a deal. Forgiveness is therapy. I have also learned 46400:33:39,309 --> 00:33:42,190that when I perceive that someone has done or said 46500:33:42,250 --> 00:33:47,685something negative toward me, I forgive them immediately, that 46600:33:47,726 --> 00:33:50,448it does not matter who's right or wrong. It does not matter 46700:33:50,468 --> 00:33:54,093what the facts are, that automatic forgiveness is therapy46800:33:54,093 --> 00:33:58,290and I have learned to practice that. And finally, everything is46900:33:58,290 --> 00:34:02,405a relationship. Relationships are based on three things Mutual47000:34:02,405 --> 00:34:06,229respect, mutual trust and good communication. If you have those47100:34:06,229 --> 00:34:10,329three things, you have a good relationship. If you do not, you47200:34:10,329 --> 00:34:17,867have work to do. These podcastsare available every week and 47300:34:17,947 --> 00:34:27,547you can subscribe to them. You go to wwwbusproutcom for slash 47400:34:27,628 --> 00:34:41,72821003. That's wwwbusproutcom forslash 21003. And finally, be 47500:34:41,748 --> 00:34:47,530the change you want to see in the world. Thank you, have a 47600:34:47,550 --> 00:34:48,231wonderful day. 47700:34:48,585 --> 00:34:50,552Speaker 1: Thanks for listening to the Healthy, wealthy and Wise47800:34:50,552 --> 00:34:55,389podcast with Dr William Choctaw, mdjd. We hope you enjoyed this47900:34:55,389 --> 00:34:59,346episode. In fact, if you found this episode helpful, you can 48000:34:59,405 --> 00:35:03,630support and subscribe to the podcast on your favorite podcast48100:35:03,630 --> 00:35:08,166platform with the keywords Dr William Choctaw, and you'll find48200:35:08,166 --> 00:35:13,126it very quickly. Also, subscribing helps ensure that 48300:35:13,206 --> 00:35:17,148you don't miss any future episodes. And then takes the 48400:35:17,248 --> 00:35:21,025next step of action and share itwith your family, friends and 48500:35:21,106 --> 00:35:25,427or your coworkers. They'll be glad you did so. Until the next 48600:35:25,469 --> 00:35:29,974time, live your best possible life the best possible way. 48700:35:30,385 --> 00:35:32,673You've been listening to the Healthy, wealthy and Wise 48800:35:32,804 --> 00:35:35,570podcast with Dr William Choctaw,mdjd.