THE recent increase in the number of sportsmen who collapse and at times die, is a source of concern to sports and exercise enthusiasts. If it could happen to young people who are supposed to be fit, then anything can happen to those who are struggling to achieve fitness, many reason. Is their collapse and death not making nonsense of the widely believed claims that exercise can help prevent heart problems' EBERE AMEH spoke with the Head, Medical Unit, Nigerian Institute of Sports (NIS), Lagos, Dr Sam Ogbondeminu on the issue.What do you think is responsible for the recent spate of sudden collapse and death of sportsmen'They call it sudden death because it occurs suddenly. If you have somebody who is ill and eventually dies as a result, of course you are prepared for it, it's not sudden. In the case you are talking about, we assume that somebody who will go to the field to play is fit and healthy but when they suddenly fall down and die, it is a kind of sudden death. Though some of them do not die, it is on very rare occasions that they are revived.What are the causes' Could it be congenital malformations, heart issues, some other sickness or just fatigue'Some of them had sudden cardiac arrest, so to say. The heart suddenly stops, but with proper personnel on ground and equipment, or appropriate intervention, some of them have been brought back to life. Where things are done the right way, people go for check-ups before they start active participation in sports. Basic tests and evaluations which will help to ascertain the health and medical history of the individual are conducted. With that, those who are free to participate in sports directly are known. Some would have to go for more sophisticated tests or even go to other specialists for further evaluation to determine if they are fit to participate or not. Some are told outright that rigorous physical activity is not for them.You hear that football players, when they are moving from one club to the other, go for medical checkups. You hear the manager of the new club say that they will sign them in so far as they certify their medicals. During those medicals, they are subjected to a lot of medical evaluation and most importantly, the state of their heart is determined because the heart is the engine that powers the body. By so doing, some things are detected early enough, which are adequately taken care of.However, even with the evaluation, somebody who is fit today may not be fit the next year. That is why at intervals, possibly before they start their pre-season programmes, they subject them to evaluations that would be able to detect some problems early enough. A typical example is our man, Nwankwo Kanu. It was when he was about to move for a major contract that they detected that he had a heart condition which was promptly attended to. Assuming he didn't go through that, nobody knows where he would have been today. And there are so many athletes even in this country that have collapsed suddenly and we lost them.Nevertheless, the problem is not in the medical, or the sports field alone but the general decadence in the country. We don't care about our health. Yes, it is not only on the field of play. We have heard of people who though looking healthy suddenly collapse in the midst of a meeting or in their offices. You hear adults boasting that 'in the last 15 years, I never stepped into any hospital, I never took Paracetamol.' I always tell them to thank God for their lives. The fact that you are going to the hospital for check up does not mean your health is affected in any way. But if you don't go there, you may not know if you have hypertension or one underlying ailment or the other. Without the instrument to check BP, nobody can just come out to tell you that you have it.What I would want us to take from here is that our attitude to medical or personal care in the country is poor. As an adult, there are times you go for your regular check-up and from there, you are able to know your individual health needs and what to do. These emergencies won't tell you that they are coming but they will always come. So when they come, how prepared are you'In football emergency, you need well prepared medical team. In some of the cases of collapse, even the opposing medical team come to join in the resuscitation. In such cases, what are needed immediately are not ambulances; there are some things you need to do right where it happened. That is why in developed countries, the citizens are taught how to do some basic resuscitation so that even if you are a cleaner and somebody collapses beside you, you should be able to do the basic things to keep the person alive before the ambulance arrives.Exercise has been portrayed as being so good that it helps improve heart health and general wellbeing. How come this is happening to sports people'It is not your build up alone that makes you to fall down and die. Just as I said earlier, the medical evaluation matters. As human beings, we all can fall sick. Even if the body is a machine, it can break down. It is however less with those that exercise. That is why we say that in addition to exercise, carry out a regular check up to be in top form.Is it still advisable for normal people who are not sportsmen, to still indulge in rigorous exercise to lose weight or keep fit' Are the odds are higher for them'The answer is yes, they should keep exercising. The problem associated with not doing exercise far outweighs the fear of collapse. There are a lot of illnesses such as obesity, which itself is as a result of sedentary lifestyles; accumulating and eating so much and not burning the calories. However, it's not like 'hey, I've not been living an active life' and just one time you run 10 kilometres. One of the things I would recommend to the general populace who are not into sports is a moderate level of regular exercise.Obesity, hypertension and even some forms of cancer and some psychological problems can be overcome when you do regular, moderate exercise. If you are already up to 40 and have not been living an active life, you are expected to see your doctor for check up to tell you what level you can go when you start exercising. You graduate according to your age and level of fitness. Someone who is recuperating wouldn't do the same exercise that a healthy person of the same age would do. You also may not have to go to the field to exercise. Some routine actions can be turned to real exercise. Taking the stairs instead of the elevator, trekking to the supermarket instead of driving and even sweeping your house are all forms of aerobics on their own and would help you burn some calories.Can sudden collapse also affect children during school sports, for instance'Just like I said, in children, congenital malformation can plague children in early childhood. However, it is always discovered at that time. Children start manifesting some symptoms that make you know that yes, something is wrong with this child.At every stage of sport, be it school or professional sport, there is supposed to be some kind of medical evaluation to ascertain their fitness. Most children just go from house to school, from car to bed, Monday to Friday and so are not opportune to get involved in intense play. With little or no practice, they go from a private school with no playground to the stadium for inter-house sports. Their bodies have not gotten acclimatized to exercise. Some of them even come to run on empty stomachs and with that, when the level of glucose that is supposed to supply the brain to keep it moving falls, some of them go down and collapse. Of course, it can be as fatal as the one you see among the trained athletes. Oxygen supply to the brain can also be compromised in that way.Some schools have started doing some kind of medical evaluation. It is good to do that and also to make sure that trained medical personnel are on ground to attend to emergencies. Some of them may even have underlying heart conditions that have not been treated or which the parents have not been observant enough to discover and treat. It is usually at that early stage, at that school level, that most of these things are detected before they start real active participation in sports.These can be part of the policy issues that government should be looking at. Government should insist that there be playgrounds in all schools so children can play. It will help them to overcome childhood obesity that is getting rampant among Nigerian children. They need to exercise and not just bringing them for a one day showmanship they call inter-house sports.After the incidence in London involving footballer Fabrice Muamba, we heard that the Nigerian Football Federation (NFF) is talking about taking measures to make sure the right things are done. At the national level, the people in charge are already putting machineries in place to take care of such emergencies. When you talk about sports in Nigeria, the highest organ that will advice the government is the Sports Medicine Centre. I know that there are competent people there who would be able to bring about the policies which we need to deal with sudden death in sports.
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