Proactive prevention

BY GUERIN EMIG World Sports Writer
Wednesday, August 05, 2009
8/06/09 at 1:44 PM

NORMAN — Before Curtis Lofton became an All-American linebacker at Oklahoma, and the starting middle linebacker for the Atlanta Falcons, he spent a frightening amount of time in hospital emergency rooms.

"Back in high school, I'd be on the bus after a game, and I would cramp up so bad I'd have to be rushed to the hospital," Lofton said. "I was always wondering, 'I know I can't be in this bad of shape.' I'd be running sprints in practice and think I was in great shape and it would happen again. I'd get tired and all the other kids were fine. I was like, 'What's wrong with me?'"

It took until Lofton reported to OU his freshman season of 2005 to find out: He had sickle cell trait, a condition affecting one in every 12 African-Americans in which red blood cells tend to sickle, or misshape, from their typically round form.

How serious could this have been?

"In the last decade, exertional sickling, where athletes with the sickle cell trait overexert, has been the leading cause of death among NCAA football players," said Dr. Brock Schnebel, an Oklahoma team physician.

"The red blood cell is normally round and carries oxygen that it unloads to muscles and organs," explained Scott Anderson, OU's head athletics trainer. "That red blood cell with a sickle shape takes on properties where it can stick to cell walls. What creates a problem for athletes with sickle cell trait is that with exertion, those cells tend to clump and stick and logjam in blood vessels. Then you have the prospect there's going to be a loss of blood supply and, therefore, a lack of oxygen. If that progresses, it releases toxins into the bloodstream and produces kidney failure."

According to a CBSSports.com report, the NCAA has acknowledged seven deaths associated with sickle cell trait this decade. One occurred in 2006, a day after Rice's Dale Lloyd II collapsed during a workout. Lloyd's family sued the university, naming then-Owls coach Todd Graham in the process, and the NCAA before settling last June.

The NCAA now recommends that its member schools test for sickle cell trait. Rice had no such testing in place three years ago, and could not detect Lloyd's condition.

Lofton was luckier. OU has been at the forefront of sickle cell trait detection as long as Anderson can remember.

"My first year was 1996, and we were having day-one conditioning tests for our athletes," he said. "We had an athlete withdraw complaining of low back pain, cramping, spasm types of things. We made a natural yet erroneous assumption that it was heat stress. We excused him, gave him fluids and put him in a cooler place. That provided some relief.

"The following day he was a little worse in some ways, so we referred him for a follow-up with the team physician. He wound up being hospitalitzed for observation.

"About that time, Randy Eichner joined our staff as an internist. We reviewed the case with him, and he said it was sickle cell trait, that the athlete was suffering from exertional sickling. Dr. Eichner had been writing on the topic for a number of years, and he began to have awareness of its presence in sports."

Thus, so did the Sooners. Anderson said for the next couple years, OU advised its athletes of the trait. Then it began mandatory screening, with a simple preseason blood test.

"We were leaving too much to chance," Anderson said.

Since then, Anderson says his staff has detected 19 cases. OU keeps 18 of those identities private. Lofton, who hopes the NCAA will go from recommending to requiring testing, is a willing spokesman.

"It's crazy," Lofton said. "How many players have to die before they realize it needs to be mandatory?"

After discovering he carried the trait —like all but two of OU's cases, he had tested positive as a child but was unaware of his condition — Lofton had his workouts monitored.

"If you have the trait and you don't give your body enough rest and air, the next thing you know is you're sickling," Lofton said, "and that's how people die. The good thing about OU is they have coaches and trainers aware of your problem. Anytime during the workout I was feeling I couldn't go on or needed to stop and rest, they pulled me out and let me get some air.

"During practice I was fine because it was stop-and-go, stop-and-go. Games weren't a problem because I could rest while the offense had the ball. The only time it affected me was during training."

How did he know he needed a break?

"Say after 15 wind sprints, the normal person is fine. Tired but fine," Lofton said. "Fifteen for me, my calves and lower back would tighten up. My blood flow would become irregular and get blocked in my arteries. I'd get less oxygen to my extremities, and that would cause cramps. I can't really explain how the cramps feel, I just know I'm getting them."

"It's not so much that they feel winded or exhausted," Anderson said. "They're just fatigued to the point they can't go any further. 'I'm not tired, I just can't go on.'"

It is a tricky, dangerous situation, but one OU has been on top of over the past decade. Of the 19 sickle cell trait cases, Schnebel said: "We haven't had any scares."

"The key thing is to communicate," Anderson said. "Not only do we inform the athlete, we inform my staff, the head coach, position coach and strength coaches. So everybody knows and understands, so there can be accommodations made."

"The university has been very been aggressive with this problem," Schnebel said. "Scott and Dr. Eichner have been co-chairs of a task force for NATA (National Athletic Trainers' Association)."

They have been consultants for staffs of countless other schools. Their wish, like Lofton's, is that the NCAA be so aggressive.

"It makes no sense for us to not know any piece of health-care information," Schnebel said of the NCAA's recommended, not required, testing policy. "Why would I not want to know that before we embark on something as strenuous, and potentially dangerous in this case, as sports?

"Knowledge beats ignorance anytime."

Guerin Emig 581-8355
guerin.emig@tulsaworld.com

Associated Images:

Former OU linebacker Curtis Lofton suffers from sickle cell trait, the leading cause of death among NCAA football players in the past decade. Stephen Pingry/Tulsa World file