Athletic physicals grow in rigor for teen athletes

If you satisfied the doctor after he tapped your knee with the rubber hammer and passed the "turn your head and cough" examination, you were cleared for high school football.

Now, however, the process is better refined.

Mandates of the Minnesota State High School League require athletes to have a sports physical and to repeat the process every three years. During the non-physical years parents or guardians must complete a questionnaire that addresses the athlete's medical history.

"One of the most important aspects of a sports physical is the (athlete's) history," said Dr. Mark Carlson of Sanford Bemidji Clinic.

Carlson specializes in sports medicine and many of the Bemidji Lumberjack athletes pay him a visit before they head to their first practice sessions.

"Sports physicals usually peak the day after the first day of practice," Carlson said. "But the smart athletes are thinking about having their physicals now."

When the athletes enter the exam room they can expect to be asked a series of questions.

"The actual physical exam tends to be simple," Carlson said. "We look at the heart, the ears and other things but usually we don't find much out of the ordinary. We will also look at vaccination records to make sure they are up to date.

"But we will also ask about the patient's history such as concussions, asthma, heart disease and family history. We want to know if there are any reasons we should be concerned," Carlson added.

Unless there is cause for concern, lab work and extensive testing, including electrocardiograms (ECG), are not part of the customary physical exam, at least not in the United States.

"Should these kids be getting ECGs during the sports physical? That is the world-wide debate right now," Carlson said. "They are mandatory in Italy but in Italy only the best athletes play competitive sports.

"The arguments against requiring ECGs is that they are too expensive and not necessary," Carlson continued.

"During the physical we look for things that can cause death and there are three or four main heart problems that can cause any young athlete to die," Carlson said.

Studies have estimated that there are five million competitive high school athletes and 500,000 competitive collegiate athletes in the United States. The annual incidence of sudden cardiac death (SCD) among these athletes is 1-in-75,000 and the culprit in one-third of the deaths is hypertrophic cardiomyopathy (HCM), a disease which thickens the heart muscle.

The Picnic to Remember | American Catholic Blog

I didn’t sleep late on July 4, 2005. Instead, I awoke early, showered, and put on navy shorts and a red-and-white striped top in celebration of America’s birthday. I ate a bowl of cereal, and then packed a bag with magazines, bottled water, 2 CDs of patriotic songs and greatest church hymns, and my rosary. I kissed my husband goodbye and said I’d call him later with an update. I double-checked to make sure I had my mobile phone in my purse. And then I headed for the nursing home where my Mother lay dying. I knew it would be a long day and not the usual kind of holiday.

When I arrived at the nursing home, the hospice caregiver in Mom’s room greeted me and said that Mom was still hanging on but that she did not think Mom would last much longer. I knew in my head that this was true, but my heart didn’t want to believe what I heard. I had been sitting daily vigil at Mom’s bedside for several weeks, taking turns with my siblings, and had witnessed firsthand Mom’s gradual decline. I’d shed many tears and even spent one very late night at Mom’s bedside, singing softly into her ear all her favorite classic and contemporary hymns from a hymnal I borrowed from my parish church.

On this sunny July 4, I listened to the daily update from the hospice nurse, then called my husband and said I would be spending all day at the nursing home and that he should come over later. I took a CD out of my bag and snapped it into the portable CD player I had placed on the windowsill above Mom’s head. I hit the play button to start the music and then bent over Mom’s bed and spoke into her ear, “It’s July 4, your favorite holiday. Can you hear the Sousa marches playing? I brought the music just for you.” She didn’t stir, and I wondered if she could hear me. I hoped so.

For six weeks, the hospice team had been helping us to look for and understand the physical signs of dying while preparing us for the inevitable death to come. While taking care of Mom in her last days, the team took care of our family too, speaking kindly and gently at all times and telling us the truth about what was happening to Mom’s body as it shut down after 92 years.

Throughout the morning and early afternoon, I prayed the rosary and nibbled on some snacks and tried to read but couldn’t. At 4 p.m., the hospice nurse told me that Mom’s blood pressure was dropping and that I should call my siblings. I did and each said he or she would come immediately. The nursing home chaplain came in the room to pray. By 5 p.m., Mom’s blood pressure dropped very low and her heart rate slowed way down. My four siblings and their spouses and children began arriving, and we gathered in Mom’s room and in the hallway lounge, taking turns sitting with Mom.

Lippincott's Textbook for Nursing Assistants, A Humanistic Approach to Caregiving

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The grace in dying, how we are transformed spiritually as we die

British medical journal, BMJ

Introduction to Tibetan Buddhism