Call 281-633-8600 for an appointment. This article discusses medical conditions that can be deadly under the stress of athletics. It’s based on an episode of the Dr. Jay Show broadcast on AM 1560TheGame in Houston, TX. Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Physician serving patients from Katy, Fort Bend County, Metro Houston and Southeast Texas from offices in Sugar Land, TX.
The special guest in this episode is Dr. Terence Chang, a family practice physician Board Certified in Sports Medicine from Physicians at Sugar Creek in Sugar Land, TX. Bob Lewis, from 1560TheGame, is also participating.
Here’s the transcript of the first portion of the Show:
DR. J. MICHAEL BENNETT: Good morning Houston, welcome to Saturdays with Dr. Jay, coming at you live from 1560 the Game in Houston. This is Saturdays with Dr. Jay, your sports medicine wellness show. If this is your first time tuning into the show, our purpose is to update and inform you, to clarify some of the misunderstandings, myths or misconceptions regarding sports medicine and wellness. Our main goal over here is really to just make sure you’re an informed consumer because I really do believe that patients should approach medicine as a product and research their physicians and their procedures. And put as much effort into that as you would in buying a new TV or a new car and realize that you always have options no matter what people tell you.
Especially in orthopedic surgery, you always have options and if that physician does not go over those options with you, then you have to start questioning that. There’s not any time where it’s 100 percent that you have to do this, unless it’s an open fracture or something along those lines. But for the most part, when it comes to elective surgery and orthopedics, you always have an option.
We’ve got a great show for you today, once again we have Bob Lewis here from 1560, he’s our patient advocate, and we’ve also got Dr. Terrence Chang, he’s actually a family practice sports medicine specialist and he also did his fellowship in sports medicine but it was after a family practice residency whereas I did mine after orthopedic residency. Dr. Chang is here from the Physicians of Sugar Creek. We’re glad to have you here and this is a really important show, it’s something that you hear about a lot in the news but there’s really not a lot of explanation why it happens and it’s a devastating thing that occurs when it does. I think this really is an important show for anyone out there that has a child that does play a sport or any young athletes out there that are playing sports.
The topic today is deadly conditions in sports medicine and though it gets a lot of big media coverage when it happens nobody really understands if it was a heart defect or it was an irregular rhythm or something like that, when these athletes fall down and die in the middle of a game. I don’t know if it’s because it’s just the age of information and there’s more information out there and people are hearing more about these stories, but it seems like these incidents are becoming more common and we’re hearing about them at least three or four times during the year. And this is obviously just a horrible devastating injury that can be avoided. There’s different things that you need to take into consideration, particularly here in Houston because it’s so hot here, and you’re out there and you’re running your drills and everything and so not only should you take into consideration things about the cardiac issues, the heart issues, but there’s also fluid and dehydration issues and heat issues and we’re going to talk about a lot of that here today. So if you have any questions call us here, 281-633-8600.
I’ll go into my particular issues with this and then we’ll go over to Dr. Chang and see what he has to say about it. Really, what every athlete or parent should know regarding these type of conditions, I just want to go through a few things here. First off, every athlete is required to have a physical exam to participate in a sport. Now those physical exams, just like anything else, are not created equal. There’s the physical exam that is done by the “Team Doc” of the school, who may be an orthopedic surgeon, may be a physical medicine rehabilitation doctor or may be a family practitioner. I’ve even seen places where the Team Doc is just a trainer who is working for the doc who can’t be there. So the physical exam is a key part of this but it’s got to be done appropriately and that means that you do not get a physical exam by an orthopedic surgeon doing everything. You know, I don’t feel comfortable listening to somebody’s heart and telling that patient that they do not have arrhythmia or an abnormality in that heart. Yes, I went to medical school and I did study arrhythmias and I did study abnormal heart rhythms but it’s been about 25 years since I’ve done that and I think that that is not necessarily fair to the patient or the family that you’ve got an orthopedic surgeon clearing them based on their heart and lungs. I mean you’ve got to have the orthopedic surgeon evaluate the orthopedic issues, look at the joints, look at the legs, arms, shoulders, all that, and saying that’s okay. But then get an internal medicine doc, get a family practitioner, get somebody that listens to these rhythms everyday and can pick up these little bitty differences in the heartbeat because all it takes is what they call a flutter, or a murmur, which is an abnormal little swoosh when the heart beats, and that sets off bells and whistles and believe me, their ears are better tuned to hear that than say, you know, an orthopedic surgeon. So I mean I would definitely take that into consideration. And if they do pick that up, sometimes they need to do an EKG, an electrocardiogram, and additional tests to make sure they don’t have this genetic abnormality or anything going on with the heart that actually puts them at risk for developing anything serious which can actually lead to death. Am I right Terrence? Is there something else you can add to that regarding the physical exam? I know Dr. Chang and I have been doing physical exams together in the past; we have it worked out where I do the orthopedic evaluation, look at the joints and the muscles and everything, and Dr. Chang will do the cardiac evaluation.
DR. TERENCE CHANG: You want to get somebody who’s used to listening to the heart, I mean, that’s what they do on a day-in, day-out basis, and not only just for adults, but you also want someone who is used to listening to kids and the pediatric population as well as the adolescents because as kids grow, as people get older, their hearts sound differently and you want someone who is familiar with what that is going to sound like. One of the things that we do notice, though, is that a lot of times, parents view the physical exam as a sort of formality, that they have to come to a physical exam, that there’s this huge line, there’s paperwork to be filled out, and so they sort of rush through the whole thing. And sometimes those settings may not be the most ideal settings to listen to the heart. You want it to ideally be as quiet as possible so that the doctor can actually hear those little subtleties in the heart but even more important than that you want to have someone who is familiar with the history, and part of the history you gather from the physical exam form so the parents and the athlete really need to be filling out those forms together and be honest about what’s going on. If they view it as just a formality and check “no problems” all the way down, that’s the information that the doctor relies on and so you’re going to get bad information if you give the doctors bad information.
BENNETT: That’s completely true and parents, you are the guardian of that child and you really are representing that child and you need to make sure you’re filling out those pieces of paper and putting on there if there’s any history of cardiac disease in your family, if any people in your family have died suddenly in the past, if your son or daughter has had issues with dizziness, loss of consciousness, shortness of breath, any kind of abnormal chest pain or anything like that because those are key indicators. If we’re talking to a 12-year-old and we’re saying, do you have this, this, and this, half of them don’t even know what palpitation or dizziness is or feels like and they really don’t get the question. They’re just looking at trying to text the whole time or get out of there so they can go and see their movie or whatever. So it’s up to the parents to really be an advocate and fill out those sheets as accurately as they can. So please, just make sure that you’re doing your due diligence with that. Secondly, you really want to make sure that as far as the sudden death thing at an early age is concerned, if there’s somebody in your family that did die quickly, you’ve really got to let us know and we’ve got to know in the physical exam. But anyway we’re going to go to a quick break right now.
If you’d like to schedule a physical examination with Dr. Bennett for your child, please call his office at 281-633-8600.
