The value of a good sports physical

Our office has been busy the last few weeks pounding through our annual rush of school and sports physicals.  I really enjoy this time of year, because it gives me a chance to catch up with kids who've been healthy over the past 12 months and haven't been in to see me.  It also gives me an opportunity to really dig through any issues they may have had over the past year, especially any red flags for sudden cardiac death.

About 1 in 100,000 students will die from sudden cardiac death every year.  Every time I hear or read about a student athlete who died suddenly, I think to myself "Somebody cleared that kid to play sports".   There is no way we can prevent every case of sudden cardiac death in youths, but we can definitely prevent a few of them by doing a comprehensive annual exam.

These exams focus particularly on obtaining a thorough history from the student and their parent(s).  We ask questions about chest pain, lightheadedness, and shortness of breath, either at rest or with exertion.  Other important parts of the history include fainting, almost fainting, decrease in exercise tolerance and updating the patient's family history regarding any family members who have died suddenly.  The encounter also give us a chance to talk about concussions, physical and emotional development, academic successes and family life.  On physical examination, all patients require a thorough cardiac exam and evaluation for conditions such as Marfan's syndrome, which can lead to sudden cardiac death.

There is no possible way to do this type of clearance exam on a child/adolescent  in 5 minutes.  Unfortunately, there are parents who utilize this type of sports physical to clear their child to participate in sports.   There are walk-in clinics just up the street from my office who offer these "convenient" exams for $30.  I implore all of you to avoid this.

Take your child to his or her physician for a full well-child exam.  It only takes about 15 minutes.  The exam will  reinforce your child's relationship with their physician, and it will give you peace of mind that a trained professional has determined your child is safe to participate.

One child dying from a preventable condition is one too many.

The burden of dying

I discharged a 20 year old patient of mine from the hospital a few weeks ago.  He's the second college aged kid I've cared for with a malignant brain tumor.  T passed away in March after a 4 year fight.  T's tumor was operable, thank goodness, so we were able to buy him some good time.  K's unfortunately isn't.  His recent stay was for a complication of his cancer, and he required 2 major surgeries. It was really awful.

At one point during K's recovery, he looked like a beaten kid.  He was exhausted.  I asked him how he was doing, and he curtly said "Fine".  I said "No you're not.  I wouldn't be either".  After I checked him over, his mom followed me out of the room.   She asked me a few questions, and went back in to be with her son.  She was smiling, engaging, uncomfortably upbeat.  Throughout his stay, she didn't show a single crack in her emotional foundation.  Her matter of fact approach to her son's illness has made me realize that she hadn't had the opportunity to wrap her emotions around what her son was going through.  She needed to be strong for him, even when he wasn't.

T was the first young person I had ever diagnosed with cancer.  I remember the night I diagnosed him like it was yesterday.  Each experience he and his family went through was a new experience for me as well.  It was a privilege to watch him battle.  He was beyond inspirational. Out of all those experiences, the most surprising was how T's mom responded to her son's illness.  Even when he was done fighting, she kept him going.  It was an amazing thing to watch.   The last time I saw him, he said, "I'll see you again, don't worry".  His eyes said something different.

You could see the burden on him.   He knew his days were numbered.  As much as he wanted to wave the white flag, he couldn't, because his mom wouldn't let him.  Her ability to fight for her child was the most instinctual thing I've ever witnessed.  It came from the depths of her DNA.  This ability, to fight till the end for her child, had to be unbelievably difficult on her.  I can't imagine either of their burdens.

K hasn't stopped fighting.  But when he does, I don't think he's going to have the heart to ask him mom to stop fighting.  T couldn't.  T's love for his mom allowed him to carry her burden as well as his own.  Who knows how many other people's burdens he put on his broad shoulders?  Maybe his ability to carry the extra weight was also buried somewhere deep in his code.  Then again, maybe it came from above.  Either way, he carried the weight with incredible dignity.

Being part of these kids lives has given me such an appreciation for the strength of our bonds to one another.  Keep both of these families in your prayers.

Let's get together, and feel all right

Happy 4th of July everybody.  It's a beautiful morning here in Chicago.  I got up early to see my patients in the hospital, and now I'm home.  Kids are up, and the house is getting busy.  Life is grand.

Looking through my expansive iTunes library, I decided to stream Bob Marley "Legend" to my stereo while I worked around the house.  This album is beyond reproach.  There are few artists who's songs can elicit emotion in people from all walks of life.  The human race is better because he blessed us with his gift.

Not many people know how Bob Marley died.  Most assume it was drug related.  He actually died of melanoma at the age of 36.  He injured his toe playing soccer, and when it didn't heal, he had it biopsied.  Once he was diagnosed, the toe was amputated, but by that point, the melanoma had spread.  Within 6 months, he was gone.

All those years in the Jamaican sun, shoeless, with the tops of his feet pointing skyward took its toll. So this sunny 4th of July weekend, wear your sunscreen.  Everyone.  I don't care how dark your skin is.  Protect yourself.  It will allow you to enjoy life to it's fullest.

God Bless!