The Boston Celtics announced Saturday that the contract of Jeff Green will be voided as a result of the forward being diagnosed with an aortic aneurysm. The 25-year-old will undergo season-ending heart surgery to repair the problem.
This incident is important on both micro and macro scales.
After reporting to training camp on Dec. 9, the condition was discovered when Green failed a stress test during his physical. Several cardiac specialists recommended the surgery that should allow Green to resume his basketball career next season.
According to the Mayo Clinic website, an aortic aneurysm (which can cause fatal bleeding) is described as, “a weakened and bulging area in the upper part of the aorta, the major blood vessel that feeds blood to the body. Because the aorta is the body’s main supplier of blood, a ruptured thoracic aortic aneurysm can cause life-threatening bleeding.”
Green is not the first professional athlete this year who has discovered a life-threatening condition via a team physical.
In October, the Eagles medical staff discovered a brain tumor when running back Jerome Harrison underwent a required physical after being traded by the Detroit Lions to Philadelphia. The Washington Post reported that Harrison told the Eagles doctor he suffered from headaches, prompting the doctor to order an MRI which revealed the tumor. ESPN reported that Harrison’s surgery was successful as doctors removed the entire tumor.
Had Harrison not been traded, or Green not signed a new contract, both of their lives would still be in medical jeopardy, at best.
News of Green’s heart condition elicited sad memories for Celtics fans as the death of Reggie Lewis in 1993 still haunts Boston. The late Celtic died during an off-season practice after having previously shown symptoms of a heart condition (including collapsing during a playoff game) in the months leading up to his death.
Lewis died of hypertrophic cardiomyopathy, commonly referred to as an an enlarged heart, the same condition that took the life of Fred Thompson, an Oregon State freshman football player who died on Dec. 7.
Like Green’s condition, an enlarged heart can easily go undetected due to lack of physical symptoms. According to an Associated Press story about the death of Thompson, “Dr. Karen Gunson said Friday that the 19-year-old had increased thickness of the heart muscle, which can cause an irregular heartbeat during strenuous exercise. She says the condition is a common cause of death in young athletes who seem completely healthy but die during heavy exercise.”
Despite the fact that few people exhibit symptoms of an enlarged heart, some do, and others could if they underwent physical testing, such as the stress test that helped reveal Green’s condition. According to the Mayo Clinic website, “in a small number of people with this condition, the thickened heart muscle can cause signs and symptoms, such as shortness of breath and problems in the heart’s electrical system resulting in life-threatening abnormal heart rhythms (arrhythmias).”
If an athlete exhibits any symptoms, a simple, painless test called an Echocardiogram (ECG) could be administered to diagnose an enlarged heart and other heart conditions. In fact, several countries and the International Olympic Committee now require athletes to undergo screening including an ECG before partaking in sports, according to a story written by CNN’s Elizabeth Landau in March of this year after four high school student athletes died of heart conditions during athletic competition within a two week period.
"There are about 50 to 100 sudden deaths among athletes in middle, high school and college every year, said Dr. Marlon Rosenbaum, associate clinical professor of medicine and pediatrics at Columbia University College of Physicians & Surgeons," wrote Landau.
The same article ( http://tinyurl.com/6nfepto ) cites two differing studies; one of which found mandatory ECG testing did not affect the number of sudden athlete deaths in Israel and another study which previously found a reduction in sudden deaths among athletes after the implementation of mandatory testing in Italy.
While the impact of screening is debatable, that is exactly the point; there should be a debate. I have long maintained that professional athletes (and even college athletes for that matter) should undergo both physical and mental evaluations three times per year. Once during the preseason, again during the season and once more at season’s end.
Why should some football and hockey players suffer head injuries in a game and not be given a concussion test immediately?
Why should an athlete wait to get traded to undergo a simple test that would subsequently reveal a brain tumor?
Why should three NHL enforcers fight mental demons which stemmed from the game and resulted in their deaths?
While Derek Boogaard addressed mental health and addiction issues by going to rehab, he was embarrassed and worried about how his reputation might be impacted ( http://nyti.ms/vvLrZM ). Surely mandatory physical and mental evaluations would simultaneously help to reduce the stigma of weakness associated with health issues and perhaps, reveal life threatening conditions before its too late.
Click here to read Elizabeth Landau’s article on how teen athlete deaths can be prevented: http://tinyurl.com/6nfepto
Click here to read “Punched Out: The Life and Death of a Hockey Enforcer,” a fascinating 3-part series about Derek Boogaard by John Branch of the New York Times: http://nyti.ms/vvLrZM
When Jahvid Best went down with yet another concussion, I’m sure Detroit Lions back up running back Jerome Harrison felt ready to seize the opportunity of getting on the field and contributing, as all competitors do. Surely, Harrison’s spirits took a nose dive when shortly after, he found out he was being traded to the struggling Philadelphia Eagles (where he spent part of last season after being traded from the Browns) for Ronnie Brown. Little did Harrison know this unwelcome move by the Lions would be a blessing in disguise.
While we don’t know the details yet, a brain tumor is a brain tumor… you don’t want one, no matter what kind it is, and that, unfortunately, is what 28-year-old Harrison, in his sixth NFL season has. Eagles team doctors found the tumor while giving their new running back a physical exam which nullified the trade. Now Brown will stay put in Philly and Harrison is having the tumor treated. Hopefully we will get more information about his exact medical condition soon.
ESPN’s Adam Schefter writes, “The trade might have actually saved Harrison’s life, the sources said. Without the deal being made, Harrison would not have undergone a physical.”
If you have read my previous blog post about head injuries, concussions, depression and player suicide, you can guess where I’m headed here.
For many years, I’ve believed every player on a professional team should undergo three physical (including blood work, body scans) and psychological exams per season. Once before the season starts, again at mid-season and a third time at the end of the work year.
While I know my ideal is just that, an ideal (for many reasons such as cost, and teams surviving on “what we don’t know can’t hurt us” in regards to their players), imagine the impact such care could have in terms of both physical and mental health.
Hank Gathers. After collapsing during a game in December, 1989, the Loyola Marymount University basketball star was checked out and diagnosed with an exercise-induced abnormal heartbeat and prescribed medication. Gathers was fortunate to survive that first episode, but we all know how this story ends. Gathers had reportedly reduced his dosage of medication or perhaps stopped taking it all together because he felt it adversely affected his play on the court. Just a few months later, he collapsed at a West Coast Conference Tournament game and died shortly after.
Michigan high school basketball player Wes Leonard wasn’t as lucky as Gathers, never getting that initial second chance at life. The first collapse, which came after Leonard and his teammates celebrated his game-winning shot, would be his last. Shortly after his death in March of this year, the medical examiner said the 16-year-old died of cardiac arrest brought on by a condition called dilated cardiomyopathy. According to an LA Times article by Eryn Brown, “people with dilated cardiomyopathy have enlarged and weakened hearts that cannot pump blood through the body efficiently. The American Heart Association has advised that children with dilated cardiomyopathy should not play competitive sports ‘because of the possibility of a sudden collapse or increased heart failure.’”
The last sentence suggests that such ailments, like Gathers’ condition, can be diagnosed by a doctor, certainly, before death.
Unfortunately, the idea of such screenings is a bit of a mixed bag. Famed Chicago Bears running back Brian Piccolo passed a full physical, including a chest x-ray in July heading into the 1969 football season. Four months later, the 26-year-old was diagnosed with cancer after a grapefruit-sized tumor was discovered in his chest cavity. Piccolo died less than a year later.
David Epstein provides more details on the pros and cons of screening athletes in his Sports Illustrated column:
"A study published last year by doctors at Massachusetts General Hospital reported on a program that screened 510 Harvard University athletes. That study identified 11 athletes with heart abnormalities that had not been previously identified, and three of those athletes ultimately had to be restricted from sports…At the same time, about one in every six athletes was given a false positive result that required follow-up, begging the question of whether a mandatory nationwide screening program would be effective from a financial and emotional standpoint, given current diagnostic tools."
Clearly this discussion opens up a massive can of worms and perhaps there is no easy or obvious solution to the problems faced by athletes, athletic institutions and medical providers. But it’s still a discussion worth having. Just ask Jerome Harrison.
Read more of David Epstein’s story about athletes and heart conditions: http://sportsillustrated.cnn.com/2011/writers/david_epstein/03/08/enlarged.hearts/index.html#ixzz1bLkr1kLY