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#1 Dec 28 2009 at 11:23 AM Rating: Good
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I find these sports issues intriguing - what we do to insure our heroes are all fairly heroic and borglike.....

It seems that the NCAA is debating about requiring screening for the sickle cell trait. Apparently this trait can cause explosive heart muscle breakdown in extreme conditions.

Quote:
Research shows how and why sickle red cells can accumulate in the bloodstream during intense exercise. Sickle cells can “logjam” blood vessels and lead to collapse from ischemic rhabdomyolysis, the rapid breakdown of muscles starved of blood. Major metabolic problems from explosive rhabdomyolysis can threaten life. Sickling can begin in 2-3 minutes of any all-out exertion – and can reach grave levels soon thereafter if the athlete continues to struggle.

Heat, dehydration, altitude, and asthma can increase the risk for and worsen sickling, even when exercise is not all-out. Despite telltale features, collapse from exertional sickling in athletes is under-recognized and often misdiagnosed. Sickling collapse is a medical emergency.


Should colleges, or other sporting organizations be required to screen athletes for the trait?

Should they then ban the students from sports?

If they don't ban a student, and that student should suffer from explosive heart muscle breakdown (usually resulting in death), should the school be liable?

If you were on the path to becoming a sports superstar and you found out you had this trait, would YOU push yourself to the limits in hopes of making the pros if it could also mean an early, but sudden and fairly painless death?

Btw, Sickle cell is not just for Negroes anymore.
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#2 Dec 28 2009 at 11:29 AM Rating: Decent
1. No
2. No
3. No
4. Probably

It's really not all that different from someone with any other genetic disease that puts them at risk. I've known people with heart murmurs, holes in their skulls, and several other medical issues that continued to participate in sport activities despite the pretty obvious risks. It's a personal liability issue, nothing more, IMO.
#3 Dec 28 2009 at 11:29 AM Rating: Excellent
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Sure, I think it's fair to test for the trait. If it's found, the student should be informed and (assuming he/she didn't already know about it) offered counseling with regards to health risks.

If, understanding the risks, he/she is willing to sign a waiver then the school should be off the hook.

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#4 Dec 28 2009 at 11:35 AM Rating: Decent
Samira wrote:
Sure, I think it's fair to test for the trait.


Mandatory AIDS testing too while we're at it? There's a fine line between medical responsibility and invasion of privacy. I hardly doubt anyone will get upset over invasion of privacy regarding sickle cell tests (though I'm sure someone *coughalsharptoncough* will make it out to be a racial thing), but there certainly is the privacy issue when it comes to AIDS, and mandatory testing for the two isn't all that different with regards to policy.

Edited, Dec 28th 2009 11:47am by BrownDuck
#5 Dec 28 2009 at 11:41 AM Rating: Good
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BrownDuck wrote:
Samira wrote:
Sure, I think it's fair to test for the trait.


Mandatory AIDS testing too while we're at it? There's a fine line between medical responsibility and invasion of privacy. I hardly doubt anyone will get upset over invasion of privacy regarding sickle cell tests (though I'm sure someone *coughalsharptoncough* will make it out to be a racial thing), but there certainly is when it comes to AIDS, and mandatory testing for the two isn't all that different with regards to policy.

Edited, Dec 28th 2009 11:42am by BrownDuck
I don't think the Sickle Cell trait is transmittable through infected body fluid exposure.
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#6 Dec 28 2009 at 11:47 AM Rating: Decent
Elinda wrote:
BrownDuck wrote:
Samira wrote:
Sure, I think it's fair to test for the trait.


Mandatory AIDS testing too while we're at it? There's a fine line between medical responsibility and invasion of privacy. I hardly doubt anyone will get upset over invasion of privacy regarding sickle cell tests (though I'm sure someone *coughalsharptoncough* will make it out to be a racial thing), but there certainly is when it comes to AIDS, and mandatory testing for the two isn't all that different with regards to policy.

Edited, Dec 28th 2009 11:42am by BrownDuck
I don't think the Sickle Cell trait is transmittable through infected body fluid exposure.


All the more reason not to test for it? I'm not sure we're on the same page...
#7 Dec 28 2009 at 11:52 AM Rating: Excellent
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We already require screening for college athletes. You have to have had a physical exam in order to compete. What is the difference?

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#8 Dec 28 2009 at 12:11 PM Rating: Good
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Samira wrote:
We already require screening for college athletes. You have to have had a physical exam in order to compete. What is the difference?
Well, mostly it's what do you do with the results. It's easy enough to sign waivers, but when push comes to shove and some coach is harassing a student to run faster, push harder, jump higher...and it's 98 degress out, and the kid falls down and dies....there will be lawyers employed. How much the school knew about pre-existing conditions is crucial.

The flipside being the kid is found to have the sickle cell trait and so not allowed to play a particularly strenuous sport, and then sues.

Also, once tested for and found - the individual now has a pre-existing condition. How this might effect the rest of his/her life is questionable. Currently, it's not routine to test for the trait.
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#9 Dec 28 2009 at 1:55 PM Rating: Decent
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Samira wrote:
What is the difference?

A big one. Letting some strange dude stare at and fondle your junk isn't an invasion of privacy. Blood testing is, and can you imagine how embarrassing it'd be to have other people find out you have a genetic disorder?
#10 Dec 28 2009 at 5:44 PM Rating: Good
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Allegory wrote:
...can you imagine how embarrassing it'd be to have other people find out you have a genetic disorder?


You mean like being black, that is a genetic disorder right?

#11 Dec 28 2009 at 6:19 PM Rating: Good
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Sports physicals should be left to just the physical part (lumps, hernias, etc.), and the urine. From what I remember of high school physicals, that's all it was, make sure you didn't have hernias or other types of external conditions that were dangerous. And the urine. (Drugs are bad, mmmkay)

Why test the blood for disorders? Should they start testing cholesterol levels too? Make sure you don't have any heart conditions that might make you more likely to have a heart attack?

It's pretty obvious that if they started banning athletes with sickle cell that organizations would start screaming racism. The disorder (or disease, what ever you want to call it) affects African Americans the most.
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#12 Dec 28 2009 at 6:53 PM Rating: Excellent
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Quote:
Make sure you don't have any heart conditions that might make you more likely to have a heart attack?


Yes?

For adolescents and young adults this would usually entail a doctor with good hearing listening for a murmur.

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#13 Dec 28 2009 at 6:56 PM Rating: Good
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Samira wrote:
Quote:
Make sure you don't have any heart conditions that might make you more likely to have a heart attack?


Yes?

For adolescents and young adults this would usually entail a doctor with good hearing listening for a murmur.



A far cry from drawing blood and screening it.

I was thinking more along the lines of cholesterol levels, etc.
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#14 Dec 28 2009 at 7:05 PM Rating: Good
Sickle cell is only "cured" through gene therapy, and the procedures are still experimental and expensive.

Since there is a health risk for student athletes, I think that routine testing should be administered, but I don't think students should be banned from the sport. Since they are now aware of the condition, they can possibly seek treatment for it.

BTW, the reason the mutation is so prevalent is that it confers a high level of resistance to malaria when it's a heterotype - when one parent gives the offspring the gene, but the other parent doesn't.

Because of this, it's part of the recommended blood screening for potential parents, along with the RH factor. Two carriers will have a a 1/4 chance of a child with the condition, a 1/2 chance of a child being a carrier, and a 1/4 chance of the mutation not being passed on at all. So it's important to know if two carriers are reproducing, since the disease can be deadly.
#15 Dec 29 2009 at 10:49 AM Rating: Good
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Allegory wrote:
Samira wrote:
What is the difference?

A big one. Letting some strange dude stare at and fondle your junk isn't an invasion of privacy. Blood testing is, and can you imagine how embarrassing it'd be to have other people find out you have a genetic disorder?

Sickle cell anemia is a genetic disorder. Possessing one sickle cell gene is a mutation that grants immunity to malaria, but carries other health risks. So long as there are health risks involved, athletes should be screened for them at some point, although not necessarily as part of their annual sports physical. However, the presence of this specific defect worries me much less than adopting a meaningful concussion policy at all levels of organized sports, especially football.

Here's a curveball for you: while we're screening blood for genetic abnormalities, should we throw in a test for HGH, steroids, and other dangerous substances?

I'm guessing that you meant to be sarcastic, but I can never tell since you're always wearing a "SRS BSNS" hat.
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#16 Dec 29 2009 at 11:00 AM Rating: Good
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Do you guys have the "Blood Rule"?

In Australian football, if any of the players starts to bleed on the field, they are immediately sent off to be treated/bandaged and the substitute comes in. That was a new rule instituted after HIV. Before that, it was up to the player if he got knocked enough to bleed, whether or not he came in for treatment.
#17 Dec 29 2009 at 11:02 AM Rating: Good
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Aripyanfar wrote:
Do you guys have the "Blood Rule"?

In Australian football, if any of the players starts to bleed on the field, they are immediately sent off to be treated/bandaged and the substitute comes in. That was a new rule instituted after HIV. Before that, it was up to the player if he got knocked enough to bleed, whether or not he came in for treatment.


I know in High School Football, we were not allowed to have any exposed blood.
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#18 Dec 29 2009 at 11:04 AM Rating: Good
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Aripyanfar wrote:
Do you guys have the "Blood Rule"?

In Australian football, if any of the players starts to bleed on the field, they are immediately sent off to be treated/bandaged and the substitute comes in. That was a new rule instituted after HIV. Before that, it was up to the player if he got knocked enough to bleed, whether or not he came in for treatment.

Hockey players are not allowed to be on the ice while bleeding, and cannot wear a jersey that has blood on it.

I assume there's a similar rule for basketball.
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