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Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”

“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”

“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”

“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”

“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”

“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”

The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”

Change of Pace

January 30, 2015

Michael Schwimer is little known to us in Michigan. He was a 6-8, 240-pound relief pitcher out of the University of Virginia who was drafted in the 10th round by the Philadelphia Phillies in 2008.
In his minor league career, Schwimer earned 20 wins against 10 losses with a respectable 2.51 ERA. He struck out an eye-popping 12 batters per nine innings.
When Schwimer made his Major League Baseball debut for the Phillies in August of 2011, he served up a game-tying home run to the first batter he faced. He was traded to the Toronto Blue Jays in February of 2013, and was released by the Blue Jays the following August. You might say Schwimer majored in the minors. That’s where he peaked as a professional baseball player.
As a player, Schwimer made few waves. He wasn’t a “game changer.” And yet, he may still be known as one who helped to change the game itself.
Schwimer is widely reported to be the first MLB player to use a glove that was made of synthetics, not leather (which weighs twice as much), and was made using a plaster cast of his hand. It was a custom-made, form-fitting glove.
The result looks almost like a toy glove, fit for T-ball; but MLB gave it a “thumbs up” in December of 2011. MLB players have been warming to the glove, although very slowly.
To which Schwimer responds: “It takes forever for any change to occur. But when change happens, it happens really fast.”
That almost sounds like something Yogi Berra would have said – like, “it takes forever for change to occur, and then it doesn’t.” But experience very often teaches us the truth of this sentiment.
As the MHSAA reprocesses two of its toughest topics ever – out-of-season coaching rules and 6th-graders’ roles in school sports and the MHSAA – it seems like there is no progress toward change. And no change is the possible outcome of both long journeys.
But it’s also possible that, for one or both topics, the time will come when wisdom and will combine to create constructive change, which then seems to be occurring almost overnight.
My hope is that we find that formula before a rash of problems causes a tipping point that results in a rush toward solutions that are poorly conceived and/or politically imposed by outside entities.