Friday, June 2, 2006

Living Heart Foundation’s Shape-a-Life CV Program

Life in the National Football League may be exciting, but it is also physically and emotionally demanding. The Founder and Director of the Living Heart Foundation (LHF), Arthur “Archie” Roberts, MD, played briefly, while going to medical school, as a back-up QB in the mid-1960’s with the Cleveland Browns and the Miami Dolphins. He later became a well-known heart surgeon for over 20 years. During that period, although he personally felt pretty good, trouble was brewing inside his body. He rarely saw his doctor, discovered he had high blood cholesterol, and put on a little too much weight. One day, while speaking to other doctors, he unexpectedly had a stroke. Fortunately, his stroke was mild and reversible. He had a second chance with the rest of his life and is committed to helping players avoid the mistakes that he made. From these life experiences, the players health program or “Shape-a-Life Program” was born.

The LHF, a non-profit entity, founded by Archie in 2001, uses its established nationwide healthcare network to provide technically advanced, voluntary, health screenings for active and retired professional football players at regional participating medical facilities within major geographical areas around the country. The LHF works closely with the National Football League Players Association (NFLPA) to plan and deliver the health screening program. The American College of Cardiology (ACC) and its Chapters, as well as the American Association for Respiratory Care (AARC) assist the Foundation by providing skilled personnel to assist at the screenings and expert medical planning to strengthen program content. A program goal is to offer a CV health screening program designed to improve the early identification of health risk in these former elite athletes, without a financial charge to the players for the screenings. An example of a category of football players who might benefit most from our health screening would include players of very large body mass who would be expected to have, or soon develop, a variety of co-morbidities including hypertension, diabetes, and elevated cholesterol. Such conditions are highly associated with heart disease and stroke. It will also be interesting to correlate such medical co-morbidities and specific health screening findings with the extent of athletic injuries encountered during their careers. Regularly scheduled repeat screening tests will provide the LHF with the ability to define health risk stratification for the players. This knowledge will empower them to learn about ways to limit the impact of evolving health problems that may occur as they actively complete and subsequently age in their lives after football. In some ways, the transitional time from active to retired player, and the subsequent several year period, may be a particularly vulnerable period for many former elite football players.

The LHF medical group will coordinate regional health screenings, health improvement guidelines and specific programs for the player and, if the player chooses, his personal physician. For the retired players, an interactive website and electronic medical record for preventive health information and individual health tracking is also available. Individualized program plans in nutrition, exercise, lifestyle health, motivational guides and general preventive medicine will be available to interested former players. The LHF team provides health guidance and is available to answer health questions that might concern the retired player.

The player also has the option of carrying a health card, which allows the player, or his loved ones, to provide access to his health information as desired. Thus, a healthcare professional, on a 24/7 basis, anywhere in the world that is internet-enabled, may receive health data within minutes. This process supports better medical care for the player. The player initially signs permission forms to participate in the screening and permit inclusion of his data into an anonymous group database that will be analyzed by the LHF scientific group. A confidential preventative health record will be created and given to each participant including direct screening results, as well as medical interpretations of results from echocardiograms, electrocardiograms, pulmonary function tests, blood tests and sleep apnea screening. The findings from the health history questionnaire, nutritional survey, exercise pattern and lifestyle profiles can also be included in this individual health record. In addition, all of the health information will be maintained in the LHF confidential group health record database. That database concept permits tracking and evaluation per individual, as well as outcomes analysis of the collective health for the whole group.

The LHF program does not end with health screening and the delivery of results to players. The players will be tracked by the LHF and individual health trends are discussed with them as their health data is studied. The retired athletes are shown the LHF health programs and guidance will be offered when particular health needs are identified. The LHF group is willing to communicate with the retired player’s personal physician, if the player desires such interaction. At all times, the LHF would respect the patient- physician relationship that exists between the ex-player and his doctor. The LHF would function as a health resource and a scientific study group helping to provide understanding related to health outcomes in retired football players. The LHF believes that preventive health efforts are long-term and involve lifestyle changes and self-motivation. In the retired player, this may be accomplished through a joint effort involving the LHF, the retired player and his personal physician. Such teamwork will go a long way in improving health and reducing future medical expenses for these former players. The health screening program is administered by the LHF in Monmouth County, New Jersey. The Foundation utilizes dedicated volunteers, regional area doctors, nurses and hospital healthcare technicians and hospital partner facilities for the regional health screenings. A LHF network physician is also present at each regional screening.

The health screening team training center is located at Monmouth University, in central New Jersey. The health database center and the Institutional Review Board (IRB) approval for the LHF program is situated at the Penn State Medical School in Hershey, Pennsylvania. The LHF utilizes its network of medical advisors and practicing physicians to oversee the screening procedure, education, tracking process and data analysis. Physicians licensed in each state also actively participate in the review of the health testing information gathered in their state. As part of its mission, the LHF also establishes public relations efforts, including participation in community-based and scientific meetings to promote the importance of health prevention, early identification of health problems, and institution of lifestyle health programs to minimize adverse health outcomes. A LHF team objective is to work with the active and retired players to increase the public’s awareness of proactive health measures and preventive wellness. The Foundation has formed a close association with the Center for the Study of Retired Athletes ( CSRA ) at the University of North Carolina which joins LHF at each screening event. The LHF has also entered into a cooperative agreement with the National Football League Players Association (NFLPA). The NFLPA has agreed to champion players’ health and supports the LHF in its effort to improve health outcomes in players. Together, these three organizations form a nurturing triangle which encourages players to participate in our regional CV health screening program

A recent cooperative effort couples the actions and dedication of active and retired players who participate in our health screening program with community health efforts organized by the LHF and its Sponsors. Such outreach efforts should help us to acquire financial support from new sources in communities across the country. Joint fundraising efforts, including golf tournaments and outreach to regional companies by the NFLPA and its local Chapters, will enable our health programs to expand to new areas and include more current and retired players. The LHF and the players will also influence younger elementary, high school and college students, including minorities, to learn more about their health and how they can maximize the quality of their lives as they prepare for the future. Together, the NFLPA, its players, CSRA and LHF provide a powerful tool to raise awareness about the dangers related to cardiovascular disease. Our collective organizations have identified childhood obesity and minority health disparity, including conditions affecting African Americans and Hispanics, as outreach programs demanding our special interests in the upcoming year. We plan to educate, screen and develop follow-up plans in communities to minimize the health gap among racial groups in this country. Together, our groups, in conjunction with hospitals and universities around the country can and will make a difference.

Currently available LHF health screenings include:

  • Electrocardiograms (ECGs)
  • Echocardiograms (ECHOs)
  • Carotid vascular ultrasound
  • Pulmonary function tests (PFTs)
  • Blood sugar, cholesterol profile,
  • Blood liver enzyme, triglycerides
  • Body mass index and body fat
  • Blood pressure and pulse analysis
  • Sleep Apnea (overnight home sleep)
  • Cardiac risk assessment
  • Health history questionnaire
  • Nutritional health status
  • Exercise performance
  • Lifestyle motivation profile

Although the Living Heart Foundation’s state of the art, computerized screening equipment provides some immediate, on-the-spot findings to be discussed with the player; electrocardiograms, pulmonary function tests, echocardiograms, carotid ultrasounds and sleep apnea studies are sent electronically to our MD specialists for analysis and reports. These results are returned confidentially to the individual player within four weeks of the screening event.

The LHF began delivering this coordinated health program in the summer of 2003.Our organization is fortunate to have had Pfizer as the initial Sponsor for the Foundation’s CV Health Screening Program for active and retired professional football players. The LHF and its partners are also now expanding Sponsorship participation as the program grows and the number of player’s and communities participating in programs around the country increases dramatically.

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