By Staff
Coaching Management, 9.8, November 2001, http://www.momentummedia.com/articles/cm/cm0908/bbbreathe.htm
The August 3, 2001, death of 22-year-old Rashidi Wheeler, strong safety at Northwestern University, brought the medical care and safety of asthmatic student-athletes to the forethoughts of coaches nationwide--at least momentarily. And while all the details of the player's death have yet to be determined, some facts of the case have been established: 1) Wheeler was a known chronic asthmatic; 2) The postmortem toxicology report states that his blood contained no trace of his prescribed asthma medication albuterol, indicating that Wheeler either failed to take his dose that day or that his inhaler was faulty; and 3) Cook County Medical Examiner Dr. Edmund Donoghue said the safety died of a "classic case of exercise-induced asthma."
The shock of a player collapsing during customary sport activities will jar any coach to question his own situation. This case may leave coaches wondering: "How many of my players have asthma? Could this have happened on my team? Can something like this be prevented? What is asthma, exactly?" For those coaches, here's some information on asthma, as well as things they and their staff can do to help their athletes.
Asthma is estimated to affect around 18 million individuals in the U.S. Asthma is a condition of the airways characterized by constriction and inflammation of air passages which inhibits, and can even block, breathing and thus, the transmission of oxygen to the lungs. According to the Asthma and Allergy Foundation of America, asthma is the only chronic disease besides AIDS and tuberculosis with an increasing death rate. And exercise is one of the disease's most common triggers for an attack.
While coaches can do nothing to cure athletes of this affliction, their understanding of the disease and their influence over athletes may help ensure the safety of these players. First, make sure all medical staff and coaches know which players are asthmatic. But simply asking athletes if they are asthmatic during preseason physicals may not be enough. Dr. Christopher Randolph, a privately practicing allergist/immunologist and Chair of the Sports Medicine Committee of the American Academy of Allergy, Asthma & Immunology, says athletes aren't always forthcoming with their health histories.
"Denial is a major problem in athletes, particularly teenagers," he says. "And the more high performance the athletes are, the more likely they will be in denial. They suppress any health concerns, unless they're overwhelmed by them, because they're afraid they'll be discovered and booted off the team, or they'll have to take medications they don't want to take."
Fortunately, there are tests that medical professionals, including athletic trainers, can perform to identify athletes who may have asthma. Once asthmatic athletes have been identified, coaches can also improve their care by becoming vocal advocates for the players' regular use of medication. Physicians say this is necessary because many athletes are reluctant or unwilling to take their medication as directed.
Asthmatics are generally treated with two medications simultaneously. The first, an inhaler, provides a quick fix when taken within an hour of exercise and will keep airways clear for two to three hours. This should be used to avert exercise-induced asthma. A second long-acting anti-inflammatory medication controls the root of airway inflammation and should, like antibiotics, be taken as directed regardless of symptoms.
Randolph feels that the positive reinforcement and influence of coaches and athletic trainers can help counter players' resistance to using their medication. "An athletic trainer has a tremendous amount of power over athletes that no one else has," he says. "Clinicians don't have that kind of power because athletes view them as an impediment. But if the athletic trainer tells them to do something, athletes will listen because he or she is viewed as the expert in yielding outstanding performance."By the same token, the authority coaches have and the respect they engender in athletes may encourage some athletes to be more fastidious in taking care of their own medical needs.
"Athletes who have asthma can compete at high levels," says Randolph. "However, in order for these athletes to remain healthy and competitive, they must be diagnosed with asthma and take proper steps to control their condition."