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

1 00:00:00,521 --> 00:00:02,444 Speaker 1: Welcome to the Healthy, wealthy and Wise 2 00:00:02,544 --> 00:00:08,122 podcast with Dr William Chokta, mdjd. Our mission is to empower 3 00:00:08,143 --> 00:00:11,930 you with the knowledge and the tools you need to thrive in all 4 00:00:12,131 --> 00:00:16,225 aspects of your life. Join us now as we discuss everything 5 00:00:16,306 --> 00:00:19,862 from nutrition and exercise to money management and personal 6 00:00:19,882 --> 00:00:24,772 growth. Dr Chokta will provide insightful advice on how to 7 00:00:24,812 --> 00:00:28,103 improve your physical and financial health, as well as 8 00:00:28,143 --> 00:00:31,501 your emotional and mental well-being. Whether you're 9 00:00:31,521 --> 00:00:35,976 looking to boost your energy levels, unlike financial freedom 10 00:00:35,976 --> 00:00:40,268 or cultivate a more positive mindset, we've got you covered. 11 00:00:41,899 --> 00:00:45,951 Get ready to become the best version of yourself, so let's 12 00:00:45,990 --> 00:00:50,240 get started. Here's Dr William Chokta, mdjd. 13 00:00:50,990 --> 00:00:54,447 Speaker 2: Good morning, welcome to our Healthy, wealthy and 14 00:00:54,487 --> 00:00:59,908 Wise podcast. I'm Dr William T Chokta and we're delighted to 15 00:00:59,988 --> 00:01:04,168 have you with us. Today we're going to talk about Bonnie James 16 00:01:04,168 --> 00:01:09,069 . Bonnie James why young, healthy athletes have sudden 17 00:01:09,109 --> 00:01:14,088 cardiac arrest. Why young, healthy athletes have sudden 18 00:01:14,108 --> 00:01:17,930 cardiac arrest Each month. We strive to provide you, our 19 00:01:17,971 --> 00:01:21,522 listeners, with mental, physical and spiritual strength by 20 00:01:21,563 --> 00:01:26,176 giving actual advice, tips, guidance and information to help 21 00:01:26,176 --> 00:01:30,147 you achieve your own personal, professional and spiritual goals 22 00:01:30,147 --> 00:01:35,412 . We consider the health of the mind, body and spirit paramount 23 00:01:35,993 --> 00:01:40,384 as a single unit that provides accumulative strength greater 24 00:01:40,424 --> 00:01:46,799 than the individual parts to strengthen the whole person. So 25 00:01:46,840 --> 00:01:50,721 today we're going to look at sudden cardiac arrest. This is a 26 00:01:50,721 --> 00:01:54,495 problem that's been in the news lately and we've done some 27 00:01:54,575 --> 00:01:57,263 interesting reviews, and we're going to give you our 28 00:01:57,364 --> 00:02:01,531 suggestions about how this particular issue should be 29 00:02:01,591 --> 00:02:07,125 addressed. I believe knowledge is power. I believe life is 30 00:02:07,204 --> 00:02:11,986 about being of service to others . I believe leaders can change 31 00:02:12,048 --> 00:02:15,367 the world. As always, we like to give you an outline of what 32 00:02:15,388 --> 00:02:17,883 we're going to talk about. We're going to talk about sudden 33 00:02:18,223 --> 00:02:23,360 cardiac arrest, not just cardiac arrest sudden cardiac arrest in 34 00:02:23,360 --> 00:02:27,920 young people, young athletes, to be specific. We're going to 35 00:02:27,941 --> 00:02:31,030 talk about some of the causes of this sudden cardiac arrest. 36 00:02:31,680 --> 00:02:34,187 We're going to define the differences between cardiac 37 00:02:34,247 --> 00:02:39,745 arrest and heart attacks and we're going to discuss ways that 38 00:02:39,745 --> 00:02:45,379 you can prevent it and suggest certain treatment modalities or 39 00:02:45,441 --> 00:02:49,050 methods that we think will help to mitigate this problem in the 40 00:02:49,129 --> 00:02:52,544 future. As part of our masterclass series, we always 41 00:02:52,765 --> 00:02:56,840 frequently look into healthcare-related issues. As we 42 00:02:56,840 --> 00:03:00,288 said before, we're going to look into healthcare issues as 43 00:03:00,367 --> 00:03:05,246 it relates to our youth and as it relates to our youth involved 44 00:03:05,246 --> 00:03:10,105 in competitive sports. When I talk about athletic competition 45 00:03:10,627 --> 00:03:15,622 or athletics, we can either look at it as recreational or 46 00:03:15,663 --> 00:03:20,586 competitive. For our purposes today, we're going to combine 47 00:03:20,627 --> 00:03:24,580 the two, that there is no distinction between competitive 48 00:03:25,282 --> 00:03:30,691 sports or competitive athletic competition or recreational 49 00:03:31,111 --> 00:03:34,764 athletic competition. The reason is that the main issue that 50 00:03:34,804 --> 00:03:39,480 we're looking at today primarily involves the effect of the 51 00:03:39,662 --> 00:03:44,764 activity on the body itself. Our belief is that whether you are 52 00:03:45,406 --> 00:03:49,300 playing in the final of the USC basketball tournament, at the 53 00:03:49,341 --> 00:03:54,192 Pac-10 or Pac-8, or whether you're playing 101 basketball 54 00:03:54,231 --> 00:03:57,247 with your brother in the backyard, you're still going to 55 00:03:57,268 --> 00:04:00,941 be just as competitive physically and the effects on 56 00:04:00,980 --> 00:04:05,586 your body will be similar. If you look at athletes and if you 57 00:04:05,627 --> 00:04:10,882 look at athletics among our children, particularly in junior 58 00:04:10,882 --> 00:04:14,710 high and high school and in college. You would note that 59 00:04:14,770 --> 00:04:18,932 about 8 million high school athletes are active in the 60 00:04:19,033 --> 00:04:23,105 United States presently. Of that number, and maybe a little 61 00:04:23,146 --> 00:04:28,358 higher now, about 500,000 college athletes are active 62 00:04:28,699 --> 00:04:33,312 presently. A lot of the very good work about student athletes 63 00:04:33,312 --> 00:04:37,904 and health has really been done by Dr Charles Welb at LSU 64 00:04:38,065 --> 00:04:42,204 Health in Shreveport, louisiana. I would encourage you to look 65 00:04:42,283 --> 00:04:46,997 up some of his very interesting work and very thorough and very 66 00:04:47,077 --> 00:04:51,954 informative. It will give you an idea about the scope of what 67 00:04:51,975 --> 00:04:56,648 we're talking about and some of the issues that we learn to 68 00:04:57,269 --> 00:05:02,007 evaluate. Specifically, what we're going to focus on is 69 00:05:02,288 --> 00:05:09,680 sudden cardiac arrest. Sudden cardiac arrest. Sudden means 70 00:05:09,781 --> 00:05:13,850 it's immediate cardiac means. It involves the heart. Arrest 71 00:05:13,910 --> 00:05:17,625 means the heart stops. Sudden means that it's immediate 72 00:05:17,966 --> 00:05:21,762 cardiac means. It involves the heart and arrest means the heart 73 00:05:21,762 --> 00:05:27,218 stops. We're going to look at the most common causes studying 74 00:05:27,237 --> 00:05:32,656 cardiac arrest. What's important for you to know is that sudden 75 00:05:32,675 --> 00:05:37,625 cardiac arrest is the most common cause of death in 76 00:05:37,927 --> 00:05:42,879 athletes. Let me say that again Sudden cardiac arrest is the 77 00:05:42,940 --> 00:05:47,577 most common cause of death in our athletes. I'm sure many of 78 00:05:47,617 --> 00:05:52,017 you may have heard in the news about Bronnie James. Bronnie is 79 00:05:52,137 --> 00:05:56,742 a freshman at USC. He's on the basketball team and, as you may 80 00:05:56,882 --> 00:06:01,555 already know, he's the son of the legendary superstar Lebron 81 00:06:01,576 --> 00:06:07,601 James, a professional basketball player. Bronnie, his son was in 82 00:06:07,601 --> 00:06:12,863 basketball practice at USC and he suddenly had a cardiac arrest 83 00:06:12,863 --> 00:06:17,158 . He immediately dropped to the floor and individuals rushed to 84 00:06:17,199 --> 00:06:22,002 him with a cardiac arrest. Even though you may not have heard of 85 00:06:22,002 --> 00:06:26,139 this a lot you don't hear about it a lot it does happen, and I 86 00:06:26,178 --> 00:06:30,279 will submit that it's happening more and more. Why? One? Because 87 00:06:30,279 --> 00:06:33,680 our population is growing. We're up to 8 billion people in 88 00:06:33,701 --> 00:06:37,302 the world now. Obviously, our population in this country is 89 00:06:37,343 --> 00:06:40,901 growing. I'm going to argue that there are more student athletes 90 00:06:40,901 --> 00:06:44,076 now, just because of that, and also because of the popularity 91 00:06:44,637 --> 00:06:48,165 of various types of sports like football, basketball, soccer, 92 00:06:48,547 --> 00:06:54,060 etc. If you were to research the literature, you will find that 93 00:06:54,180 --> 00:06:57,817 among children and when I say children, I'm talking about less 94 00:06:57,817 --> 00:07:05,583 than 20 years of age the most common cause of cardiac death in 95 00:07:05,583 --> 00:07:10,701 children is myocarditis. What does that mean? Myocardium means 96 00:07:10,701 --> 00:07:15,103 muscle, heart muscle. This means inflammation of 97 00:07:15,975 --> 00:07:20,064 Myocarditis, means inflammation of the heart muscle or 98 00:07:20,144 --> 00:07:24,920 inflammation of the heart. Myocarditis is recognized as the 99 00:07:24,920 --> 00:07:29,908 leading cardiac cause of death in young people and children. 100 00:07:30,836 --> 00:07:35,298 Having said that, though, it is not the leading cause of death 101 00:07:35,839 --> 00:07:41,548 of sudden cardiac arrest or the leading cause of sudden cardiac 102 00:07:41,608 --> 00:07:50,324 arrest. Sudden cardiac arrest is the main cause of death in our 103 00:07:50,404 --> 00:07:55,096 youth or in individuals less than 25 years of age. Again, 104 00:07:55,237 --> 00:07:58,225 sudden cardiac arrest is when the heart immediately stops. 105 00:07:58,475 --> 00:08:02,004 Patient drops to the floor, to the ground, wherever he or she 106 00:08:02,024 --> 00:08:07,362 may be. What we know, and we already know this, is that the 107 00:08:07,423 --> 00:08:12,399 most common cause of sudden cardiac arrest and athletic 108 00:08:12,478 --> 00:08:16,898 children or youth is cardiomyopathy. What is 109 00:08:16,918 --> 00:08:21,923 cardiomyopathy? Cardiomyopathy, as the name might implies, means 110 00:08:21,923 --> 00:08:27,642 that the heart muscle, the cardiomyome, is diseased somehow 111 00:08:27,642 --> 00:08:33,381 or does not function normally. Cardiomyopathy is an inherited 112 00:08:33,763 --> 00:08:37,802 weakness of the heart muscle, most apparent with extreme 113 00:08:37,961 --> 00:08:41,124 exercise. The thing about cardiomyopathy that you need to 114 00:08:41,144 --> 00:08:44,259 know first thing is it is inherited. You get it in your 115 00:08:44,278 --> 00:08:48,782 genes. It is in the genes. Some people have it, some people 116 00:08:48,802 --> 00:08:53,455 don't. There is nothing that the student has done to create it. 117 00:08:53,575 --> 00:08:59,705 It is in the genes. If you were to look at cardiomyopathy and if 118 00:08:59,705 --> 00:09:06,284 you know that it is in the genes and if you know that it 119 00:09:06,304 --> 00:09:09,714 alone is the most single cause of sudden cardiac arrest in an 120 00:09:09,813 --> 00:09:12,730 athletic young person, your next question would be how do I 121 00:09:12,769 --> 00:09:16,855 detect it? How can I prevent it. What can I do? Believe it or 122 00:09:16,956 --> 00:09:19,745 not? The electrocardiogram, which has been around for 123 00:09:19,765 --> 00:09:24,940 generations as a test and as a standard for the heart. It is a 124 00:09:24,960 --> 00:09:29,197 very, very important thing. It has been around for generations 125 00:09:29,677 --> 00:09:35,888 as a test and as a standard test , is one of the best tests to 126 00:09:36,168 --> 00:09:41,515 use to identify individuals who may have cardiomyopathy. Some 127 00:09:41,535 --> 00:09:45,705 studies have even suggested over 90% can be identified with 128 00:09:45,765 --> 00:09:50,245 electrocardiogram. But would it not surprise you to know that 129 00:09:50,365 --> 00:09:53,735 not all and I would argue, probably most programs I'm 130 00:09:53,755 --> 00:09:58,004 talking about school athletic programs, athletic clubs that 131 00:09:58,105 --> 00:10:02,500 our kids play on probably don't use the EKG, the 132 00:10:02,561 --> 00:10:06,722 electrocardiogram, as a normal screening too? Let me say that 133 00:10:06,763 --> 00:10:11,000 again. Cardiomyopathy is the most common cause of sudden 134 00:10:11,039 --> 00:10:15,616 death, causing death and atollated young people in this 135 00:10:15,697 --> 00:10:20,936 country. One of the best ways to screen for cardiomyopathy is a 136 00:10:20,995 --> 00:10:24,336 method that we already have called electrocardiogram or the 137 00:10:24,395 --> 00:10:30,241 EKG, but the majority of the programs probably don't use it. 138 00:10:30,571 --> 00:10:33,913 There may be a number of reasons why they don't use it. Some may 139 00:10:33,913 --> 00:10:38,059 be costs, some may be just the idea of this. Doesn't happen 140 00:10:38,080 --> 00:10:41,671 very often, which is true, and we'll get to the numbers. It is 141 00:10:41,730 --> 00:10:46,933 not often that a sudden cardiac arrest occurs, but I'm going to 142 00:10:46,974 --> 00:10:52,120 suggest to you, would you really care, whatever the percentage 143 00:10:52,379 --> 00:10:56,778 is, if there was any chance that a minimum of your family or a 144 00:10:56,839 --> 00:11:00,634 child or your family, your son, your daughter, your grandkids, 145 00:11:02,219 --> 00:11:06,721 family members or just the kids down the street would die or be 146 00:11:06,889 --> 00:11:12,613 injured with a particular medical condition? Let's look at 147 00:11:12,613 --> 00:11:17,092 , take a broader view. If you look at adults, the most common 148 00:11:17,113 --> 00:11:20,792 cause of cardiac injury or cardiac death is carny artery 149 00:11:20,831 --> 00:11:24,392 disease and we'll talk about this in detail a bit later. But 150 00:11:24,432 --> 00:11:27,053 if you look at the youth and again I'm going to define youth 151 00:11:27,114 --> 00:11:31,076 as less than 25 years of age it's going to be cardiomyopathy 152 00:11:31,176 --> 00:11:34,373 or some type of arrhythmia. Those who are at highest risk 153 00:11:34,433 --> 00:11:41,474 for sudden death with cardiac disease are going to be athletes 154 00:11:41,474 --> 00:11:44,753 who are less than 25 years of age. They're going to be 155 00:11:44,893 --> 00:11:47,650 athletes who play soccer, basketball and football, which 156 00:11:47,711 --> 00:11:51,375 is obviously going to be the majority. Many believe that one 157 00:11:51,414 --> 00:11:57,178 of the reasons why this occurs, the sudden cardiac arrest occurs 158 00:11:57,178 --> 00:12:00,173 in these young people, is that they're at the end stage of 159 00:12:00,253 --> 00:12:05,096 puberty, the last growth spurts, if you will 19, 20, 21, all the 160 00:12:05,096 --> 00:12:09,456 way up to 25. The heart is at its peak maturity and the 161 00:12:09,495 --> 00:12:14,855 hormone levels are surging at this point. Just a theory, some 162 00:12:14,894 --> 00:12:17,400 believe that's one of the reasons why these individuals 163 00:12:17,461 --> 00:12:21,698 may be more susceptible at this age or at this stage in their 164 00:12:21,759 --> 00:12:25,456 life and their development, but what we do know is the cardiac 165 00:12:25,677 --> 00:12:29,837 disease alone a heart disease alone is the most common cause 166 00:12:29,898 --> 00:12:35,332 of death in this country, be you adult or a youth. What we're 167 00:12:35,373 --> 00:12:40,749 trying to do is to focus on our youth and a certain segment of 168 00:12:40,828 --> 00:12:43,951 our youth. These are the athletic youth and what things 169 00:12:44,052 --> 00:12:48,022 we can do to mitigate the problem of sudden cardiac death 170 00:12:48,429 --> 00:12:54,652 and this subset of athletes in our environment. Studies have 171 00:12:54,672 --> 00:12:58,921 shown that if you look at data from the NCAA and the first part 172 00:12:58,921 --> 00:13:04,679 of the 2000s, you get an idea that football and basketball and 173 00:13:04,679 --> 00:13:07,395 other types of competitive sports that are higher on the 174 00:13:07,416 --> 00:13:11,240 list, they suggest that boys are more susceptible than girls. 175 00:13:11,269 --> 00:13:14,910 That may very well be that actually, early on, there were 176 00:13:14,951 --> 00:13:18,600 more opportunities for boys to compete than there were for 177 00:13:18,620 --> 00:13:22,011 girls, so those numbers may be a bit skewed. But the point I 178 00:13:22,032 --> 00:13:25,620 want to make is that more and more of our children are 179 00:13:25,660 --> 00:13:28,677 participating athletically, which in general is a good thing 180 00:13:28,677 --> 00:13:33,830 , but also just be aware of one very serious risk with this 181 00:13:34,051 --> 00:13:37,720 enjoyable competition and things that we can do to mitigate the 182 00:13:37,759 --> 00:13:41,515 causes. Let me also, parenthetically, add that there 183 00:13:41,615 --> 00:13:47,336 is a difference between cardiac arrest, heart stopping and heart 184 00:13:47,336 --> 00:13:51,899 attack. There's a difference between cardiac arrest and heart 185 00:13:51,899 --> 00:13:55,759 attack. A cardiac arrest, which is what we're talking about 186 00:13:55,798 --> 00:14:00,711 today, is basically an electrical problem Because, 187 00:14:00,751 --> 00:14:04,094 remember, the heart is a muscle, but it is a muscle that 188 00:14:04,234 --> 00:14:08,636 functions with electrical current. The electrical the 189 00:14:08,716 --> 00:14:11,772 essay fires an electrical current to the muscle, squeezes 190 00:14:11,812 --> 00:14:16,815 down, pushes blood out of the heart. Electrical current fires 191 00:14:16,916 --> 00:14:20,751 and occur to the muscle in the heart. The muscle squeezes down, 192 00:14:20,751 --> 00:14:25,640 pushes blood out of the heart. On the other hand, a heart 193 00:14:25,701 --> 00:14:29,998 attack is not an electrical problem. A heart attack is a 194 00:14:30,038 --> 00:14:34,787 situation that occurs in mostly in people 25 years of age and 195 00:14:35,048 --> 00:14:40,601 older. It is basically a situation where the blood supply 196 00:14:40,601 --> 00:14:45,889 to the heart is impeded or decreased or blocked completely. 197 00:14:45,889 --> 00:14:51,142 So you have arteries that feed the heart, the blood to the 198 00:14:51,182 --> 00:14:56,109 heart muscle, that allow it to be healthy and to function 199 00:14:56,190 --> 00:14:59,961 normally when it receives the current, the electrical current 200 00:15:00,182 --> 00:15:06,059 to push blood out of the heart. But if that muscle is not fed 201 00:15:06,120 --> 00:15:10,265 with appropriate nutrition or nutrients via its own blood 202 00:15:10,285 --> 00:15:15,018 supply, ie the coronary artery, if those arteries are blocked, 203 00:15:15,418 --> 00:15:18,384 then that muscle will not get that sufficient amount of blood 204 00:15:18,804 --> 00:15:21,856 and then that muscle will not function properly, and that's 205 00:15:21,917 --> 00:15:25,178 what we call heart attack. Cardiac arrest, which is what we 206 00:15:25,178 --> 00:15:28,475 primarily talk about today, is an electrical problem. Heart 207 00:15:28,514 --> 00:15:33,378 attack is a plumbing problem. Cardiac arrest is an electrical 208 00:15:33,418 --> 00:15:36,643 problem that we're talking about with young people, particularly 209 00:15:36,643 --> 00:15:40,788 young athletes who are less than 25 years of age or younger 210 00:15:41,635 --> 00:15:45,239 who are less than 25 years of age. Heart attack is a plumbing 211 00:15:45,278 --> 00:15:48,585 problem that occurs in individuals who are greater than 212 00:15:48,585 --> 00:15:52,038 25 years of age. Another important point to remember, 213 00:15:52,118 --> 00:15:55,605 particularly when we talk about heart attacks, is that the 214 00:15:55,706 --> 00:16:00,163 symptoms of heart attacks differ significantly sometimes between 215 00:16:00,163 --> 00:16:03,720 men and women. This is an important factor because one of 216 00:16:03,740 --> 00:16:07,105 the things that we've learned I graduated from medical school in 217 00:16:07,105 --> 00:16:11,198 the 70s and back in the 70s we were taught that the heart 218 00:16:11,239 --> 00:16:15,245 attack was a classic substernial chest pain with pain that 219 00:16:15,264 --> 00:16:17,849 crushed the substernial chest pain, with pain radiating to the 220 00:16:17,849 --> 00:16:22,298 left arm. And indeed that was true. But what we didn't know at 221 00:16:22,298 --> 00:16:26,817 that time, that was primarily true in men that indeed women 222 00:16:26,876 --> 00:16:32,265 don't have that classic male approach or male symptomatology 223 00:16:32,846 --> 00:16:37,419 of heart attack. Women may have nausea and vomiting, they may 224 00:16:37,500 --> 00:16:41,686 have neck pain, they may have lower abdominal pain, they may 225 00:16:41,725 --> 00:16:45,375 have indigestion, they may have extreme fatigue and, indeed, in 226 00:16:45,416 --> 00:16:51,565 the last 30 plus years, a whole area of specialty has developed 227 00:16:51,865 --> 00:16:55,710 in terms of female heart disease , a heart disease that affects 228 00:16:55,730 --> 00:16:59,740 women. Recognizing the fact that men and women are different in 229 00:16:59,780 --> 00:17:03,467 multiple ways and indeed how they have heart attacks, is one 230 00:17:03,508 --> 00:17:08,182 of those ways. Another way that we can end up creating a heart 231 00:17:08,241 --> 00:17:13,310 attack or heart disease or sudden heart attack is by 232 00:17:13,431 --> 00:17:16,897 stressing our heart inappropriately. In addition to 233 00:17:17,077 --> 00:17:21,105 exercise, believe it or not, the environment can be a stressor 234 00:17:21,125 --> 00:17:25,355 for our heart, particularly if it's very hot. What we know is 235 00:17:25,395 --> 00:17:30,623 that this year, particularly in 2023, in the summer 2023, has 236 00:17:30,702 --> 00:17:34,968 been the hottest summer on record in the history of the 237 00:17:35,167 --> 00:17:38,797 earth or recorded history of the earth. What that means is that 238 00:17:38,817 --> 00:17:42,583 the climate is getting hotter and hotter. The hotter it gets, 239 00:17:43,023 --> 00:17:46,008 the more stress it puts on the heart, because it makes the 240 00:17:46,028 --> 00:17:49,318 heart have to work more, and obviously that affects those of 241 00:17:49,398 --> 00:17:52,526 us who are extremes of age the very young and the very, very 242 00:17:52,686 --> 00:17:57,021 old. So let's get back to our subject sudden cardiac arrest. 243 00:17:57,481 --> 00:17:59,747 Again, we're talking about sudden cardiac arrest that 244 00:17:59,787 --> 00:18:03,657 occurs in young athletes. Another athlete that we heard 245 00:18:03,698 --> 00:18:07,864 about a few months ago also was DeMar Hamlin, a football player, 246 00:18:07,864 --> 00:18:12,009 buffalo Bills, who end up having a sudden cardiac arrest, 247 00:18:12,694 --> 00:18:18,521 both DeMar Hamlin and Brody James. Both were in an 248 00:18:18,582 --> 00:18:22,625 environment where individuals could get to them quickly, do 249 00:18:22,645 --> 00:18:28,897 CPR and also do defibrillation if needed. So what would be some 250 00:18:28,897 --> 00:18:33,084 symptoms if you were coaching a team or you were just observing 251 00:18:33,084 --> 00:18:36,915 a team of a group of soccer players, let's say, and let's 252 00:18:36,935 --> 00:18:40,461 say one of those students, one of those young people, had this 253 00:18:40,823 --> 00:18:44,535 developmental abnormality that they would not know about. What 254 00:18:44,575 --> 00:18:47,601 would be some symptoms? Are there any symptoms to them 255 00:18:47,662 --> 00:18:52,817 developing a sudden cardiac arrest? Studies show that there 256 00:18:52,916 --> 00:18:55,880 are some mild symptoms that would be important to be aware 257 00:18:56,019 --> 00:19:00,705 of. One is that during the exercise, immediately afterwards 258 00:19:00,705 --> 00:19:04,971 , they may start to feel an unexpected type of shortness of 259 00:19:04,990 --> 00:19:08,460 breath. Let's say, for example, the coach has the team to run 260 00:19:08,500 --> 00:19:13,048 around the field after practice say football practice, soccer 261 00:19:13,067 --> 00:19:16,898 practice, whatever but this time when the student runs around 262 00:19:16,939 --> 00:19:20,483 the field, he's starting to feel more short of breath than usual 263 00:19:20,483 --> 00:19:23,709 and indeed cannot really make it all the way around the field. 264 00:19:23,709 --> 00:19:26,738 Now, this is always one of those situations where, 265 00:19:26,857 --> 00:19:33,265 obviously, it is the coach's purpose to push the athlete and 266 00:19:33,285 --> 00:19:35,527 you want to get the best out of them and you want to make sure 267 00:19:35,567 --> 00:19:40,236 that they are putting 110% into their activity. But at the same 268 00:19:40,296 --> 00:19:44,080 time, it's important to be aware that some problems can develop 269 00:19:44,622 --> 00:19:48,487 and sometimes they may not be able to do what they really want 270 00:19:48,487 --> 00:19:53,354 to do and run around the field as fast or as many times as they 271 00:19:53,354 --> 00:19:56,878 have done in the past. Other symptoms could be the student 272 00:19:56,898 --> 00:19:59,983 may feel, or began to feel, faint or a little dizzy, or just 273 00:19:59,983 --> 00:20:05,017 out of it. Another symptom may very well be chest pain. So what 274 00:20:05,017 --> 00:20:10,144 should individuals who work with youth and bond with various 275 00:20:10,144 --> 00:20:13,348 types of sports be aware of? First, you need to have a 276 00:20:13,388 --> 00:20:16,798 heightened awareness. Now I realize that this is challenging 277 00:20:16,798 --> 00:20:22,730 One, because the incidence of individuals having sudden 278 00:20:22,750 --> 00:20:25,957 cardiac arrest is going to be very small. It's going to be 279 00:20:25,997 --> 00:20:30,263 like $1,000 and $40,000. That's really very small. But think 280 00:20:30,305 --> 00:20:34,602 about it. Would it really matter whether it's one in 40,000 or 281 00:20:34,781 --> 00:20:39,659 one in four if it were your child or your family member, or 282 00:20:39,679 --> 00:20:43,626 a child that you do, etc. My point very simply is admittedly 283 00:20:43,708 --> 00:20:49,205 it occurs rarely, but the occurrence should be zero, the 284 00:20:49,326 --> 00:20:53,256 risk should be zero, and that's the point I'm trying to make 285 00:20:53,316 --> 00:20:59,665 here. Why should we accept one in 40,000 or one in 80,000? The 286 00:20:59,726 --> 00:21:03,438 risk should be zero. We certainly. Many times, when I 287 00:21:03,557 --> 00:21:06,265 was working with the drug commission on the latter part of 288 00:21:06,265 --> 00:21:11,105 my practice, we were suggesting to hospitals that we would 289 00:21:11,146 --> 00:21:16,363 survey, that we want them to have zero patient harm Zero. And 290 00:21:16,363 --> 00:21:19,412 certainly anytime you say zero harm with anything, people say 291 00:21:19,451 --> 00:21:23,181 oh, come on, you're dealing with humans and we're not all, we're 292 00:21:23,181 --> 00:21:26,954 not perfect, blah, blah, blah. And zero is not possible. And 293 00:21:27,056 --> 00:21:31,002 our reply would be you can get zero harm if you think you can 294 00:21:31,022 --> 00:21:35,920 get zero harm. We expect zero planes to fall out of the sky 295 00:21:36,240 --> 00:21:40,574 when we get on an airplane. We do not expect one in 40,000 or 296 00:21:40,694 --> 00:21:46,106 one in 80,000. We want zero, we want no risk, we want no 297 00:21:46,186 --> 00:21:50,096 problems at all and I submit that we can do the same thing 298 00:21:50,155 --> 00:21:53,663 for our children who are involved at Sledikly. Another 299 00:21:53,723 --> 00:21:57,540 thing is that all of these kids and all of the youth, whether 300 00:21:57,580 --> 00:22:01,634 it's college, whether it's high school, whether it's club soccer 301 00:22:01,634 --> 00:22:05,521 or club football or club basketball, all have physical 302 00:22:05,602 --> 00:22:08,888 exams. I suggest that those specific exams should be 303 00:22:09,015 --> 00:22:12,142 purposeful. It should not just be a single sheet where you 304 00:22:12,162 --> 00:22:16,637 check a box, but there should be a medical person who actually 305 00:22:16,718 --> 00:22:22,887 does a medical exam, ask the right questions, etc, etc. I 306 00:22:23,028 --> 00:22:26,920 personally think, because we now know that the EKG, the 307 00:22:26,980 --> 00:22:32,368 electrocardiogram, can pick up or identify those students who 308 00:22:32,429 --> 00:22:37,663 are most likely to have a problem with cardiomyopathy, 309 00:22:38,243 --> 00:22:41,828 that every student who is involved with athletic 310 00:22:42,434 --> 00:22:46,751 competition should have a screen in the electrocardiogram. I 311 00:22:46,791 --> 00:22:49,357 just think that should be the good one. Yes, I'm sure there's 312 00:22:49,417 --> 00:22:54,208 a cost associated with EKG. Yes, I'm sure that it might be a 313 00:22:54,248 --> 00:22:57,669 little disconcerting for a lot of individuals to think that, oh 314 00:22:57,669 --> 00:22:59,959 my goodness, you mean there could be a medical condition 315 00:23:00,019 --> 00:23:04,153 here. But ask yourself the question what if it were your 316 00:23:04,192 --> 00:23:07,704 child? Wouldn't you want to know ? I certainly want to know. My 317 00:23:07,724 --> 00:23:10,895 grandkids are very, very active in soccer and I want them to be 318 00:23:10,935 --> 00:23:15,450 safe, as I'm sure you do with your children. We should be 319 00:23:15,529 --> 00:23:18,159 educated all of us who are involved, supporting our case 320 00:23:18,500 --> 00:23:22,393 with risk factors. We should be able to identify them and we 321 00:23:22,413 --> 00:23:25,804 should be able to provide treatment as necessary. One of 322 00:23:25,824 --> 00:23:29,134 the main treatments, obviously, if someone develops a cardiac 323 00:23:29,275 --> 00:23:32,682 arrest, is cardiopulmonary resuscitation of what we call 324 00:23:32,742 --> 00:23:36,858 CPR. Cpr has been around for a very, very long time. Many of 325 00:23:36,898 --> 00:23:39,767 you have not most of you are familiar with it. First thing 326 00:23:39,807 --> 00:23:43,844 you do is call 911. Second thing you do is lay the patient flat, 327 00:23:43,844 --> 00:23:47,237 or the person flat, so they can breathe. If indeed they are 328 00:23:47,297 --> 00:23:49,929 breathing, you want to listen to see if you can tell if they're 329 00:23:49,949 --> 00:23:52,278 breathing. If they're not breathing, then you want to 330 00:23:52,317 --> 00:23:55,445 start chest compressions. It's chest compressions, third of 331 00:23:55,486 --> 00:23:58,680 compressions, to two breaths, and you want to do that until 332 00:23:59,040 --> 00:24:03,436 you can get a help. Additionally , if indeed it is a cardiac 333 00:24:03,497 --> 00:24:07,969 arrest, studies have shown that you can significantly improve 334 00:24:07,989 --> 00:24:12,920 survival with what's called an automated external defibrillator 335 00:24:12,920 --> 00:24:17,228 . Basically, this is just a unit that shocks the heart. Think 336 00:24:17,268 --> 00:24:21,827 about when your computer goes down. Think about in a situation 337 00:24:21,827 --> 00:24:24,798 that's electrical. Many times what you do is you just turn it 338 00:24:24,857 --> 00:24:27,545 off and try to back on again, or you unplug it and you plug it 339 00:24:27,565 --> 00:24:31,962 back in. It's similar to that If that heart is stopped. Remember 340 00:24:31,962 --> 00:24:34,897 it's an electrical unit and you want to shock it with a 341 00:24:34,917 --> 00:24:37,788 defibrillator. It's one of the reasons why you will see 342 00:24:37,829 --> 00:24:41,278 defibrillators in airports and in a lot of public places. Now 343 00:24:42,221 --> 00:24:46,429 Studies have shown that a portable defibrillator can make 344 00:24:46,509 --> 00:24:49,601 a huge difference in survival in a lot of these patients, 345 00:24:50,063 --> 00:24:54,577 because time is really valuable. Many times, just by doing this 346 00:24:54,659 --> 00:24:58,988 on the spot, you can save their lives before you can get them to 347 00:24:58,988 --> 00:25:03,281 the hospital. So what have we learned? What we know is that 348 00:25:03,342 --> 00:25:07,715 sudden cardiac arrests in youth is uncommon. Again, as I said, 349 00:25:07,736 --> 00:25:12,363 it's like one in 40,000 or one in 80,000 per year. But again, 350 00:25:12,462 --> 00:25:18,472 my point is who cares if your child is that one, or a child 351 00:25:18,512 --> 00:25:22,118 that you know is that one, or a child in your neighborhood is 352 00:25:22,159 --> 00:25:26,471 that one? And that's something that we all can do, individually 353 00:25:26,471 --> 00:25:31,807 or collectively, to decrease that risk. We know that the 354 00:25:31,847 --> 00:25:35,994 majority of children who get sudden cardiac arrest, or 355 00:25:36,095 --> 00:25:40,146 individuals less than 25 years of age who gets a cardiac arrest 356 00:25:40,146 --> 00:25:46,155 while exercising competitively, that it is from a congenitive 357 00:25:46,195 --> 00:25:50,807 defects called hypertrophic cardiomyopathy. That 358 00:25:51,789 --> 00:25:55,266 cardiomyopathy is the most common cause. We know that a 359 00:25:55,326 --> 00:25:58,932 cardiomyopathy is basically a weakness of the muscle when 360 00:25:59,053 --> 00:26:06,032 pushed to extremes Athletically, a weakness of the muscle when 361 00:26:06,073 --> 00:26:10,548 that muscle is pushed to extremes Athletically. We know 362 00:26:10,648 --> 00:26:14,355 that it is inherited and that it is not something that you can 363 00:26:14,415 --> 00:26:20,230 prevent yourself from having. We also know that over 90% of 364 00:26:20,371 --> 00:26:23,817 individuals with this condition can be diagnosed with a basic 365 00:26:23,977 --> 00:26:29,787 electrocardiogram A basic electrocardiogram. So what's my 366 00:26:29,826 --> 00:26:34,874 point? My point is that there should be a zero risk of our 367 00:26:34,913 --> 00:26:39,298 children having cardiac arrest doing athletic competition or 368 00:26:39,400 --> 00:26:44,214 any other time. Zero risk. And so what I recommend is the 369 00:26:44,255 --> 00:26:49,573 following One, have a good history and physical done when 370 00:26:49,614 --> 00:26:52,077 the kids all get, because all of them have to have history and 371 00:26:52,117 --> 00:26:55,310 physicals, but many times the quality of those history and 372 00:26:55,330 --> 00:26:59,367 physicals may not be the same. Make sure, if you are a parent 373 00:26:59,489 --> 00:27:04,237 or guardian or just a concerned citizen, make sure good history 374 00:27:04,277 --> 00:27:08,109 and physicals are done, good questions are asked to make sure 375 00:27:08,109 --> 00:27:13,086 that the screening is done in an appropriate manner. Next, if 376 00:27:13,146 --> 00:27:17,433 you are a parent or concerned adult with children who engage 377 00:27:17,494 --> 00:27:23,652 in athletic competition, be proactive, notice things and, at 378 00:27:23,652 --> 00:27:27,489 the same time, ask questions. Now I'm going to caution. You Be 379 00:27:27,489 --> 00:27:30,335 diplomatic with your questions, because if you walk up to a 380 00:27:30,394 --> 00:27:35,204 soccer coach and say, by the way , do you guys have an EKG? And 381 00:27:35,244 --> 00:27:39,232 did you EKG my son before you put him on your soccer team and 382 00:27:39,673 --> 00:27:42,646 go ahead and start mentioning statistics, that sort of thing? 383 00:27:42,907 --> 00:27:46,326 The coach is going to start running from you, okay. So you 384 00:27:46,366 --> 00:27:50,354 want to be diplomatic, but you want to say bring it up in 385 00:27:50,413 --> 00:27:53,419 general, or maybe even bring it up in a group discussion among 386 00:27:53,459 --> 00:27:56,811 parents, maybe before even talking to the coach, if there's 387 00:27:56,811 --> 00:28:01,990 a support column, etc. Etc. Or if there's a teen mom or a teen 388 00:28:02,030 --> 00:28:05,839 dad, bring it up with that person in a very diplomatic way. 389 00:28:05,839 --> 00:28:10,336 But the goal is to make things safer for your children. That's 390 00:28:10,415 --> 00:28:18,165 the goal. We want zero risk, not 1%, not 5%, not 10%, zero. And 391 00:28:18,405 --> 00:28:21,131 when they used to tell us in the hospital, zero is important. As 392 00:28:21,131 --> 00:28:26,226 I said before, you get zero if you think you get zero. Also, 393 00:28:26,405 --> 00:28:29,652 one of the things that you want to suggest is that all the kids 394 00:28:29,711 --> 00:28:34,847 should get EKGs, a screening EKG . Again, you can pick up the 395 00:28:34,887 --> 00:28:38,567 most common reason for sudden cardiac arrest Most of the time 396 00:28:38,606 --> 00:28:41,974 with a screening EKG, electrocardiogram. Find the 397 00:28:42,095 --> 00:28:46,451 world when we get them. Again. I understand that it could be 398 00:28:46,811 --> 00:28:50,465 diplomatically difficult or challenging. Folks may say it's 399 00:28:50,486 --> 00:28:55,295 just too much money. But we see a lot of kids who have signs and 400 00:28:55,295 --> 00:28:59,770 have car washes to get uniforms . We have car washes or raise 401 00:28:59,891 --> 00:29:04,128 money to go on trips with the team. Certainly, something like 402 00:29:04,190 --> 00:29:08,625 getting an EKG can be done in that manner. If necessary, I 403 00:29:08,644 --> 00:29:13,752 would argue that parents and or adults would just donate money 404 00:29:14,113 --> 00:29:20,126 to get to buy an EKG and have a certified person to do it, which 405 00:29:20,126 --> 00:29:23,353 brings me to my next point. I think there should be 406 00:29:23,733 --> 00:29:29,568 individuals associated with each team, soccer team, basketball 407 00:29:29,588 --> 00:29:35,617 team, football team, college, high school, junior high or club 408 00:29:35,617 --> 00:29:39,048 or just recreational. That should be an adult, a minimum 409 00:29:39,368 --> 00:29:43,054 one adult, if not more, of individuals who are associated 410 00:29:43,095 --> 00:29:47,467 with all of these teams, who know CPR, cardiopulmonary 411 00:29:47,507 --> 00:29:52,056 resuscitation. Just take a course and become a certified 412 00:29:52,076 --> 00:29:56,530 CPR person. Most hospitals will offer a free course. You can 413 00:29:56,590 --> 00:30:01,305 find them in schools, just go online or just look it up. I 414 00:30:01,444 --> 00:30:04,488 guarantee you you can find someone close to you that gives 415 00:30:05,088 --> 00:30:09,173 certified, that gives CPR classes, and you become the 416 00:30:09,232 --> 00:30:13,458 person who is able to do cardiopulmonary resuscitation 417 00:30:13,538 --> 00:30:17,305 should you be in the area when something like that occurs and 418 00:30:17,345 --> 00:30:20,108 it's just something that's good to have who may be at a family 419 00:30:20,148 --> 00:30:25,136 gathering and someone elderly may end up having a cardiac 420 00:30:25,196 --> 00:30:28,066 arrest, and you can be of assistance there. It's the one 421 00:30:28,145 --> 00:30:31,348 is my point, but I'm thinking about it specifically with our 422 00:30:31,388 --> 00:30:34,932 youth and specifically with our children who have these cardiac 423 00:30:34,973 --> 00:30:38,998 arrests and things that we can do to help them and doing those 424 00:30:39,057 --> 00:30:42,906 critical moments to save their lives. Certainly, one of the 425 00:30:42,946 --> 00:30:47,897 suggestions that's available is things like fundraisers for EKGs 426 00:30:47,897 --> 00:30:53,513 and also I think each unit, each school, should have an AED, 427 00:30:53,513 --> 00:30:57,806 an automatic electronic defibrillator. I'm sure many 428 00:30:57,846 --> 00:31:01,152 schools have them, but I've got all schools, though, and I've 429 00:31:01,172 --> 00:31:04,518 got all teams though. These are very small units that can be 430 00:31:04,597 --> 00:31:09,450 hand carried and I think someone should be designated. It 431 00:31:09,490 --> 00:31:12,374 doesn't have to be a coach, it could be a team mom, team dad or 432 00:31:12,374 --> 00:31:17,079 just a good parent who's at every game to be responsible for 433 00:31:17,079 --> 00:31:22,670 that and know how to use it. Granted, these are things that 434 00:31:22,710 --> 00:31:28,066 may be outside of the norm, but I suggest to you that, certainly 435 00:31:28,066 --> 00:31:31,951 , as leaders and as individuals who want to make the world a 436 00:31:31,990 --> 00:31:35,795 better place, these are some little things, small things that 437 00:31:35,795 --> 00:31:40,461 are within our control, that we can do to save somebody's life. 438 00:31:40,461 --> 00:31:45,471 I wouldn't want to do that. So, in conclusion, the most common 439 00:31:45,531 --> 00:31:48,457 reasons for sudden cardiac arrest and child athletes is 440 00:31:48,477 --> 00:31:53,448 hypertrophy cardiomyopathy. This is a genetic condition that can 441 00:31:53,448 --> 00:31:57,753 be identified most of the times with use of an 442 00:31:57,834 --> 00:32:04,709 electrocardiogram as a screening tool. If you are in the area 443 00:32:04,808 --> 00:32:08,295 where a cardiac arrest has occurred remember it is an 444 00:32:08,355 --> 00:32:13,163 electrical problem you want to start CPR. First thing is called 445 00:32:13,163 --> 00:32:17,631 911. Then began cardiopulmonary resuscitation pushing on the 446 00:32:17,651 --> 00:32:22,546 chest and breathing for the person if possible. You want to 447 00:32:22,865 --> 00:32:28,913 make sure that if there's an AED in the area, that you use that 448 00:32:29,074 --> 00:32:34,740 if necessary. And, above all, remember, we want zero risk of 449 00:32:34,780 --> 00:32:40,905 cardiac arrest in our children or, you know, child athletes. My 450 00:32:40,905 --> 00:32:45,107 basic principles number one God is in charge. I am a physician 451 00:32:45,167 --> 00:32:48,247 of faith and I would believe very strongly that I would not 452 00:32:48,848 --> 00:32:53,832 be who I am or do what I'm able to do, but for God being in my 453 00:32:53,893 --> 00:32:58,008 life. Second principle is. I have no bad days I used to have 454 00:32:58,067 --> 00:33:01,127 bad days and I decided about 30 years ago that I'd had enough, 455 00:33:01,765 --> 00:33:05,628 so I figured out that a day was good or bad If I said it was 456 00:33:05,789 --> 00:33:10,089 good or bad, so I eliminated them. I now have good days and I 457 00:33:10,089 --> 00:33:13,511 have great days. Don't sweat the small stuff, and most stuff 458 00:33:13,592 --> 00:33:18,076 is small. I have learned that whenever something happens to me 459 00:33:18,076 --> 00:33:23,369 that I perceive as negative or bad, that most of the times it's 460 00:33:23,369 --> 00:33:27,809 not as big a deal as I think it is, and so I figured out to go 461 00:33:27,890 --> 00:33:31,329 slow and just not sweat a lot of the things and most of the 462 00:33:31,349 --> 00:33:35,008 things that, when I put them in perspective, they're not that 463 00:33:35,028 --> 00:33:38,909 big a deal. Forgiveness is therapy. I have also learned 464 00:33:39,309 --> 00:33:42,190 that when I perceive that someone has done or said 465 00:33:42,250 --> 00:33:47,685 something negative toward me, I forgive them immediately, that 466 00:33:47,726 --> 00:33:50,448 it does not matter who's right or wrong. It does not matter 467 00:33:50,468 --> 00:33:54,093 what the facts are, that automatic forgiveness is therapy 468 00:33:54,093 --> 00:33:58,290 and I have learned to practice that. And finally, everything is 469 00:33:58,290 --> 00:34:02,405 a relationship. Relationships are based on three things Mutual 470 00:34:02,405 --> 00:34:06,229 respect, mutual trust and good communication. If you have those 471 00:34:06,229 --> 00:34:10,329 three things, you have a good relationship. If you do not, you 472 00:34:10,329 --> 00:34:17,867 have work to do. These podcasts are available every week and 473 00:34:17,947 --> 00:34:27,547 you can subscribe to them. You go to wwwbusproutcom for slash 474 00:34:27,628 --> 00:34:41,728 21003. That's wwwbusproutcom for slash 21003. And finally, be 475 00:34:41,748 --> 00:34:47,530 the change you want to see in the world. Thank you, have a 476 00:34:47,550 --> 00:34:48,231 wonderful day. 477 00:34:48,585 --> 00:34:50,552 Speaker 1: Thanks for listening to the Healthy, wealthy and Wise 478 00:34:50,552 --> 00:34:55,389 podcast with Dr William Choctaw , mdjd. We hope you enjoyed this 479 00:34:55,389 --> 00:34:59,346 episode. In fact, if you found this episode helpful, you can 480 00:34:59,405 --> 00:35:03,630 support and subscribe to the podcast on your favorite podcast 481 00:35:03,630 --> 00:35:08,166 platform with the keywords Dr William Choctaw, and you'll find 482 00:35:08,166 --> 00:35:13,126 it very quickly. Also, subscribing helps ensure that 483 00:35:13,206 --> 00:35:17,148 you don't miss any future episodes. And then takes the 484 00:35:17,248 --> 00:35:21,025 next step of action and share it with your family, friends and 485 00:35:21,106 --> 00:35:25,427 or your coworkers. They'll be glad you did so. Until the next 486 00:35:25,469 --> 00:35:29,974 time, live your best possible life the best possible way. 487 00:35:30,385 --> 00:35:32,673 You've been listening to the Healthy, wealthy and Wise 488 00:35:32,804 --> 00:35:35,570 podcast with Dr William Choctaw, mdjd.