Athletes with sickle cell must be cautious

Two years ago, Ryan Clark of the Pittsburgh Steelers nearly died after playing in Denver. He required emergency surgery to remove his spleen and gall bladder. Ryan, along with one in 12 African-Americans, has sickle cell trait and must be cautious about competing at high altitudes.

Sickle cell disease affects the ability of red blood cells to carry oxygen. It is an evolutionary adaptation that provides resistance to malaria and is found in people who come from areas where malaria is endemic like Africa, the Middle East, South America as well as the Mediterranean, Caribbean and other areas. The decreased oxygen-carrying ability of hemoglobin results in damage to a variety of organs including the brain, lungs and spleen.

Sickle cell disease differs from sickle cell trait. The trait is found in those who have both a normal and a sickle component to hemoglobin. During intense exertion, dehydration or conditions that decrease oxygen, red blood cells change their shape and clog blood vessels throughout the body.

The condition can also result in a potentially lethal breakdown of muscle known as acute exertional rhabdomyolysis.

While it is generally safe for athletes with sickle cell trait to compete, certain precautions must be followed:

• Athletes from at-risk groups must be tested before participation.
• When competing at high altitudes, sufficient time must be spent adapting to the new environment.
• Adequate hydration is crucial.
• Symptoms of fatigue, shortness of breath and abdominal or leg pain are often a hallmark of impending crisis.
• Workouts in extreme heat must be modified.

There is some controversy that finding the gene may potentially adversely impact an athlete’s financial value in professional sports. While this is highly unlikely, it must be weighed against the potential loss of life.

Boxing needs safety measures

Last week, HBO viewers and those attending championship boxing at the XL Center in Hartford witnessed one of the most horrific knockouts in recent memory.

In the third round of the co-feature match between Harry Joe Yorgey and Alfredo Angulo, it became apparent that Angulo was the dominant fighter. Yorgey was rendered unconscious, and reminded all present of the brutality of this sport.

In an age when awareness of head injury in sports has been heightened, something must be done about the sport of boxing where the only way to score points is to neurologically impair the opponent.

Attempts to ban boxing have been misguided and have failed miserably. Boxing is a not just a sport, it is part of the American cultural fabric. Boxing can represent a vehicle for young men to gain respect in their communities while avoiding negative peer pressure.

Safety measures must be instituted nationally to reduce permanent neurological injury to boxers:

• Every professional fighter (both boxers and mixed martial artists) must have a complete annual neurological examination.
• Exposure to head blows must be limited during a fighter’s career. This can be done by regulating the number of rounds fought, the total number of fights and/or age of the fighter.
• A system of national regulation must be put in place similar to other sports. The current statewide commission system offers too much variability and federal regulation may be cumbersome.

This week, the Connecticut Boxing Hall of Fame will induct new members at the Mohegan Sun Casino. As at most similar affairs, there will be a lot of discussion about “the good old days.” Wouldn’t it be great if the legacy left behind by these brave men was to make their sport safer?

Athletes have make-up to overcome physical and mental challenges

The 2009 baseball season has officially closed. After a season filled with late-inning comebacks and walk-off home runs, a World Series champion has been crowned.

Two stories of baseball comebacks deserve some extra attention while we await the spring arrival of pitchers and catchers:

• In August, Jerry Remy returned to the Red Sox broadcast booth after an extended illness. He was diagnosed with lung cancer the previous fall and underwent surgery. An infection followed but after going through appropriate treatment, it was depression that crippled him. Remy then stepped forward to make people aware of the scope of the problem. He now openly encourages those suffering from depression to get help in the form of medication and psychotherapy. His bold admission helps remove any stigma associated with psychiatric diseases.

• Aaron Boone underwent open heart surgery in March at the age of 36. The surgery repaired a chronic problem with his aorta that included replacement of the aortic valve. He impressively returned to major league play in September with the Houston Astros. His recovery included standard cardiac rehabilitation in addition to extensive work aimed at regaining his baseball skills.

Both stories highlight some essential personality traits necessary for success in athletics. Athletes do not fear challenges, even in the face of insurmountable odds. Successful athletes have a dedication to training that distinguishes them from others. The burden of not trying to return far outweighs any embarrassment associated with being unsuccessful in that effort.
Aaron Boone may never play another major league game and Jerry Remy may still have to deal with depression, but both know that their stories have helped many others face physical and mental challenges.

UConn homicide shows how athletes cope with loss

Grief, bereavement and mourning are terms that define the intense feeling of sorrow over the loss of a beloved person. While these sentiments are apparent in many situations, the loss of a favorite athlete or performer seems to attract great attention.

Two weeks ago, tragedy struck the University of Connecticut football team when Jasper Howard was murdered. The response to this event by players, fans and opposing teams is what makes this situation remarkable.

In 1969, Dr. Elisabeth Kubler-Ross described the five stages of grief:

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

Every individual works through these stages at a different pace and uses a variety of mechanisms to deal with each. Athletes tend to revert to what they know best by immersing themselves in athletic competition while dealing with their loss.
Two goals of grieving involve finding a way to cope with loss and living on in the face of that loss. Sports are a very physical and instrumental way of coping for many people. Some prefer other outward signs such as dedication to a cause, starting a charitable foundation or even wearing a tattoo.

“Grieving helps meet the challenge of resuming life in the face of loss; we must respect the different ways people cope with loss,” said Dr. Kenneth J. Doka, a professor at the College of New Rochelle and consultant to the Hospice Foundation of America. Death of a teammate is no different than any other death in the workplace. It must be recognized and all involved should be supportive in continuing on.

Jasper Howard’s death has brought so many people together to mourn and hopefully work together to stop the senseless violence that ended his life too soon.