Health & Wellbeing

The RPA has launched a new Men's Health service to its Members where you can get physical and emotional advice and support. Contact Phil Hopley at LPP Consulting, the RPA confidential counselling service on 020 3219 3080. This service can help Members with a number if issues including:

• Coping with injury
• Player Burnout
• Career transition
• Alcohol and drug problems
• Gambling
• Financial Worries
• Relationship issues
• Bereavement
• Anger Management
• Sports Psychology
• Stress, anxiety and depression

The RPA has also established a health service for its members and their families with 108 Harley Street. The range of services available at 108 Harley Street and its partner clinics in this service are:

• Gilmore's Groin and Hernia
• GP, Travel and Sexual health services
• Moles and Skin Cancer screening and general dermatology
• Colo-rectal from haemorrhoids to malignant bowel problems
• Plastic surgery including treatment of cauliflower ears etc
• Prostate and urology problems
• Thyroid problems
• Breast problems

More information is available from Hamish Millar, Commercial and Financial Director 0207 563 1234 / 0789 418 969 / hamish@108harleystreet.co.uk or from the website at http://www.108harleystreet.co.uk/

If you have questions or need advice and support on any of the above issues then don't hesitate to contact your PDM or the RPA office on 020 8831 7930.

Premiership Rugby Cardiac Screening - Summer 2010

All players across the Premiership will undergo cardiac screening in July. The screening campaign has been agreed and is supported by the RPA, the RFU and Premiership Rugby. Below is a brief Q&A introduction to the reasons for screening players, and what will happen during the screening process.

Once you have read the Q&A, if you still have any queries or questions, please contact Alex Anderson at the RPA on 07710 468 190

What is CRY?
CRY stands for Cardiac Risk in the Young. It was founded in 1995 to raise awareness of conditions that can lead to Sudden Cardiac Death

What is Sudden Cardiac Death?
Sudden cardiac death can be simply defined as a sudden death from a cardiac (heart) problem within 12 hours of witnessed normal health.
Sudden cardiac death is sometimes referred to as SADS in the young (under 35). SADS stands for Sudden Arrhythmic Death and this is part of sudden cardiac death

What causes Sudden Cardiac Death?
There are several conditions which, if undetected, can lead to Sudden Cardiac Death These conditions include thickening or abnormal structure of the heart muscle and irregularities of the electrical impulses that upset the natural rhythm of the heart.

Why get tested?
If an individual that plays sport harbours a condition that's capable of causing sudden cardiac death, then sport is three times more likely to kill that individual
The European Society of Cardiology (ESC 2005) and International Olympic Committee (IOC) recommend cardiac screening for any young person taking part in competitive sport. Sport itself does not lead to cardiac arrest, but can trigger a sudden death by aggravating an undetected cardiac abnormality.
There is a simple way to diagnose most cardiac abnormalities. This is by having an ECG (electrocardiogram) test.
If a disorder is identified, there is considerable amount that can be done to help young people who have been diagnosed as having a cardiac abnormality, and this can prevent deaths.

Do I have to be screened?
YES: All EPS, Saxons, & 7s - U16, U18 & U20 It's an IRB requirement
NO: All other Guinness Premiership Players

Do I need to bring anything with me for the test?
This screening programme involves filling out a health questionnaire so it's important to bring details about your GP (doctor), and any relevant medical conditions that you may have. You also need to supply information about any medications that you may be taking: you need to be aware of what they are or bring them with you. It is extremely important that you fill in the questionnaire to the best of your ability. Do not guess on history you don't know

What is the ECG test and how long will it take?
The CRY screening programme comprises of a health questionnaire and an ECG test. The health questionnaire will ask you if you have experienced any of the cardinal (primary) symptoms of cardiac diseases and also importantly asks about family history of cardiac conditions, because most conditions that cause sudden death in young people are hereditary.
That is usually followed by a 12 lead ECG test which looks at the electrical conduction pathways around the heart. Small stickers known as electrodes are placed on the client's chest and the wires connect to an ECG machine whilst you lie still. A printout of the hearts electrical activity is obtained and will then be evaluated by a cardiologist. This test is painless, non-invasive and will take about 5 minutes to perform.

How are the results analysed?
After the ECG has taken place it is reviewed by a CRY doctor on the day. The doctor reviews each individual with the personal and family history questionnaire you would have completed prior to examination. The screening programme is supervised by CRY's consultant cardiologist Professor Sanjay Sharma, who is Professor of Inherited Cardiovascular Disease and Sport Cardiology at St George's Hospital, London, the Virgin London Marathon Doctor and a leading expert in the field.

What happens to the information following my test?
When you fill out your consent form, you will be asked to confirm you agree to consent to the test, and to the results being shared with:
• Your GP
• Your Club Doctor (optional - but advised!)
• RFU/PRL Programme Medical Managers (anonymous)
This is to ensure efficient case management i.e. further testing is followed up on
Following the test, you will receive a letter. In the majority of cases, this will state that no abnormality has been identified, but sometimes patients will be invited to attend an appropriate Hospital for further cardiac testing.

What are the chances of having something wrong?
About one in 100 people would be identified with something. This could range from mild abnormalities that require nothing more than monitoring or caution in terms of lifestyle, to very serious conditions which need a lot of treatment or input medically

What happens if something is found on my ECG?
If the test does identify an abnormality then the cardiologist would recommend further investigations. Most commonly this will be in the form of a cardiac ultrasound (sometimes called a heart scan), and sometimes patients are also required to have a 24 hour ECG and an exercise stress test.

What will happen if I am found to have a condition?
If a condition is identified, you will be advised to withdraw from training. A formal referral will be required from your GP to CRY Centre in Cheshire or SW London. You will be referred to a CRY cardiologist that has experience in managing conditions that cause sudden death in the young or managing individuals who play a lot of sport.
You may just need nothing more than advice on lifestyle modification, some people may need medications and a small minority may require surgery or implantation of a defibrillator to prevent sudden death. The aim would be to treat the symptoms if there are symptoms; to identify serious conditions that can cause sudden death and ensure that fatalities don't occur; and to screen your first degree family members, as most of these conditions are hereditary

Will I have to stop playing sport?
This depends on what condition has been identified. There are some conditions that can be diagnosed and cured so that the individual can start exercising again as normal. However, most conditions that cause sudden cardiac death in young individuals are not curable. A very small number of people who are identified with serious conditions that can cause sudden death are recommended not to perform any type of exercise that involves moderate to severe strenuous exertion.
It will be the opinion of CRY cardiologist that dictates whether you continue playing or not. If you are deemed unfit to play, appropriate counselling will be facilitated.
The NHS will cover costs of further tests required to confirm if an abnormality exists.

I've heard that if something is found, it can affect insurance or mortgages
It must be emphasised that if a diagnosis of a cardiac condition is confirmed it can have serious implications with regard to Life Insurance and Mortgage Application for the individual. Any diagnosis of a serious condition that can shorten life span will almost certainly have an important impact on insurance premiums.

Who do I talk to if I have concerns?
If you have concerns, pre, during or post screening you can talk confidentially to any one of the following:
• Your GP
• Club Doctor
• CRY Cardiologist
• RPA Independent Medical Advisor. In the first instance call Alex Anderson on 07710 468 190
• RPA Confidential Counselling Service, LLP Consulting on 020 3219 3080

If you would like to find out more about CRY, Sudden Cardiac Death or the screening process, visit the CRY website at www.c-r-y.org.uk/ If you have any further queries or questions, please contact Alex Anderson at the RPA on 07710 468 190