Copyright 2003 The Atlanta Journal-Constitution
The Atlanta Journal and Constitution

September 7, 2003 Sunday Home Edition

SECTION: Sports; Pg. 10D

LENGTH: 1195 words


HEADLINE: PLAYING WITH DANGER: Policies, finances put high school athletes at
risk: The roundtable: 'If it was your child, what would you do?'



A five-member panel representing the high school sports community met
recently at the Journal-Constitution to discuss how to keep athletes from dying.
At issue: The merits of a thorough heart screening, like the one being given by
a local group for $58, and whether it should be mandated for all Georgia

Dr. David Marshall: Often sudden cardiac death cannot be prevented. There is
nothing on a physical exam that is a red flag. There may or may not be something
in the medical history of the athlete or the family history that might have
pointed to a red flag. . . . The cardiogram or the ultrasound to the heart hasn
't shown to be valid for a first-time screening tool. It hasn't been shown,
because the illness that we are looking for is a needle in a haystack. Just
based on incidences and statistics, you're going to have to screen 200,000 kids
to find one who is at risk of sudden death.

Tom Vardase: If it was your child, what would you do?

Marshall: That's the pure science data collecting part of me. But from a
parent . . . side of me, I think [the physical that is being conducted locally]
is a great thing.

Alison Findlay: Ryan [Boslet] had no symptoms. If someone had offered me a
$58 test and it could have found [his problem], I would have done it.

Vardase: It would seem to me that if you could find one HCM [hypertrophic
cardiomyopathy, a heart abnormality that affects about 1 in 200,000, and is the
leading cause of sudden cardiac deaths], it is worth it. We are fortunate to put
this together, because it is a multiple screening. Meaning it's not one child
walking into a doctor's office. They're at the school, and you can do 40 or more
[exams] with one echo unit. From a financial standpoint, I've talked to a parent
and she's talking about $1,500 [for a single private screening ]. . . . It's a
tremendous opportunity for $58 because [some families] are paying $125 for a
pair of Nikes.

Marshall: Is the test worth it? In my opinion, if you have to screen 10
million to find one [student-athlete] who is going to die, it does mean it is
worth it. But purely from a statistical standpoint, it is not a very
cost-effective test. . . . However, from a team doctor and parents standpoint,
it is worth it.

Findlay: I've had parents who actually said to me, "Well, what happens if you
find a problem with my child's heart?" I said, "Well, they're going to recommend
you to take him to a cardiologist, and he may lose the right to play." And they
actually would say, "Well, what about that scholarship he's been looking at?"
And, I would say, "Well, you can bury him when he's 18 or you can have him when
he's 35 and you have grandkids." And they would say, "Oh yeah, you are right."

Charlie Henderson: It's not a lot of money for me and anybody else at this
table, but when you're talking about kids, immigrants from another country, that
is a lot of money. The $58 . . . we have got to figure out a way to have
insurance pay for it.

Ralph Swearngin: From our position, I have to think about Dade County to
Camden County, from Rabun County to Seminole County, and all parts in between. I
've got to think about the urban, the suburban, the rural and the extreme rural.
The GHSA does not mandate any kind of procedure that would work against any one
part of our society. If we mandate that every student must take a medical
screening, we know that a certain segment of our state cannot afford it. It
would be foolhardy. . . . I get a little bit concerned when we say these forms
or screenings will stop this problem. It won't. If we can find one, then it's
worth it. But I just don't see us in the position to mandate it and have any
hope that every kid in this state will have access to these kinds of things.

Vardase: It is up to the mom and dad.

Findlay: And that's education. . . . We also realize that some people cannot
afford [the screenings]. But some kids can afford school lunches and some others
cannot, and we figured that problem out. There has to be a way to say
financially, if you can afford the $58 test, we are going to recommend it. If
you can't afford it, we are going to find a way if you have a history that looks
suspicious. Would it be impossible to say the GHSA is mandating that if your
child is going to participate in high school sports, one parent or a legal
guardian must attend an information session?

Swearngin: I would be concerned about a mandated thing. Who is going to be in
charge? We've got 390 schools. We've got all the sports, so we would have to do
it all the way through the spring. Maybe if we were able to provide to the
schools an information letter for the parents, instead of having a meeting per
se. In other words, any athlete who was going to have a physical test [would
have to] take this letter home. Is that a reasonable substitute?

Findlay: Can we get the parents to sign and send it right back?

Swearngin: I don't know.

Findlay: And know that they read it. Do you know how many letters come home
and go right into the garbage can?

Swearngin: This leads to another philosophical question. But I use another
illustration. I just got back from a wonderful trip in Wyoming and Montana. We
were in a rest stop area and this group came in on motorcycles. They were from
the Midwest and we told them that we were from Georgia. They said they hated
Georgia because when they go through Georgia, they have to wear helmets. They
went on a tirade about the government protecting us from ourselves. I buy that a
little bit. I think we've gotten into this situation where we are shirking our
individual responsibilities. . . . I think if we can make information available,
then I'd turn to you and your cohorts to compose such a letter that explains why
it's important. What I can say to you is the GHSA will make sure that every
school will have the letter before they get their physicals done. So the school
's responsibility is that every student is going to have a letter sent home. We
would cooperate.

Marshall: I think that's a great idea. . . . The education audience is really
three different groups. One is the parents. How we educate the parents would be
about taking your child to the right doctor, someone who knows how to take care
of athletes. Another level is the physicians. Not the orthopedic surgeons and
the pediatricians who are interested in sports, but the pediatricians who are 75
years old and getting ready to retire. The other level is the athletic trainers,
the ADs, the coaches. They need to be educated, not just on sudden cardiac
death, but overuse injuries, like running bleachers or running hills, heat, how
to manage a concussion on the sidelines.

Findlay: I think it still would be a good idea to have a spokesman who will
look these parents in the eyes.

Swearngin: But who is going to do it in Homerville or do it in Jesup?

Findlay: You find a parent. You bring somebody in the school who cares, and
you bring them to a training session. It is a three-minute conversation. It took
me three minutes to convince 70 people [at Chattahoochee High] to have the

GRAPHIC: Photo: Dr. David Marshall; Photo: Tom Vardase; Photo: Alison Findlay;
Photo: Charlie Henderson; Photo: Ralph Swearngin; Graphic: THE PANEL
Ralph Swearngin has been executive director of the Georgia High School
Association since 2001. He has been with the GHSA for 11 years.
Charlie Henderson is director of athletics for DeKalb County Schools. He made
several policy changes after one of his athletes, Shai Owens, died last August.
Dr. David Marshall specializes in sports medicine at Children's Health Care of
Atlanta at Scottish Rite. He was instrumental in getting the GHSA to adopt a
more thorough physical form.
Alison Findlay is vice president of communications with the Chattahoochee High
School PTSA and is active in the booster club. She handled public relations for
the school after Ryan Boslet's death.
Tom Vardase, producer of the Prep Sports-Plus TV program, was instrumental in
putting together a $58 echocardiogram physical for the state's high school
ME: Part 1 of a 3-part series about the dangers that high school athletes risk.

LOAD-DATE: September 8, 2003