by Gordon Nary
Gordon: When did your join Holy Name Cathedral Parish and how has the parish contributed to your spirituality?
Dr: Lawless: I joined Holy Name Cathedral (HNC) Parish about 2 years ago, but I have been a lifelong “cradle” Catholic. Two HNC activities, in particular, have contributed to my spiritual growth, the first being the Cathedral Singers (choir), and the second being a small Christian Life Community. The choir is mainly professional, so the quality of the sound is spectacular. The music director, Ricardo Ramirez, and the organist David Jonies are both geniuses. Ricardo is extremely thoughtful in choosing proper songs to fit the gospels and the liturgy. In addition, he is a talented songwriter. The great majority of the Psalms performed at HNC are Ricardo’s own compositions. It is my great honor to sing with such an illustrious group of singers and musicians. When we are making music, I feel transported to Heaven and connected to God.
Connection with God has also occurred through my relationship with other HNC parishioners. In October of 2016, I agreed to facilitate a small Christian Life Community, comprised of 8 women, who gather every other week on Tuesday nights in the Rectory to study the Bible or discuss spiritual inspiring books. Because we focus on print media, we now call ourselves the Media Sisters. Over the two years, we have grown to care for one another and learn tremendously through sharing how God is communicating to us through the written Word. Our current study is St Paul’s letters to the Corinthians. This activity has greatly enhanced my own spiritual growth while fostering community among a small group of amazing faithful HNC women. I’m so glad to be a member of this small group.
Gordon: What interested you in specializing in Sports Medicine?
Dr: Lawless: Sports Medicine was not my first specialty; I found it later in my career. My route to Sports Medicine has been the most unique and not typical at all for those who specialize in it. I spent the first twenty years of my career as a cardiologist, specializing in heart failure and heart transplantation, primarily at Loyola University Medical Center in Maywood IL. However, in 2002 I was asked to become a team doctor for US Figure Skating. I had been a skater my whole life, so I jumped at this opportunity. Being a cardiologist, I was not prepared to diagnose and treat musculoskeletal injuries or concussion, so I decided to formally study Sports Medicine, and did a “fellowship” in it while continuing to practice Cardiology part-time. Then I became the only physician in the United States board certified in both Cardiology and Sports Medicine.
Gordon: What were some of the studies that you had to take to specialize in Sports Medicine?
Dr: Lawless: There is more to Sports Medicine than most people realize. Consider the effect of exercise on all the body’s organ systems. All the organ systems are affected: hearts and blood vessels change their shape in response to chronic increased blood volume; bones and muscles are subjected to constant stress and trauma; athletes need to overcome any psychological barriers to optimal performance. So, I had to study everything from sudden catastrophes on the playing field, to overuse syndromes like stress fractures, to acute concussions and traumatic brain injury, or how to counsel special needs athletes (example: pregnant women). One of the more enjoyable aspects of studying Sports Medicine is the requirement to attend sporting events and/or the training room. I spent Friday nights on the sidelines covering Maine West High School football; and other days providing coverage for University of Illinois basketball. At other times, I covered gymnastics, ice hockey, golf, and of course, figure skating. I would regularly visit the Maine West training room to evaluate athletes with the athletic trainer.
Gordon: Please provide an overview of Sports Cardiology.
Dr: Lawless: I have a unique perspective on Sports Cardiology, having been the one who introduced the concept to the American College of Cardiology in 2011. Physicians, even the ancient Greeks, have been aware that sudden bursts of exercise can trigger sudden death. They have also been aware of and promoted the health benefits of regular exercise since the time of Hippocrates. So the concept is not new. However, in 2004, the International Olympic Committee and FIFA (soccer’s governing body) recommended electrocardiograms (ECG) be performed in all competitive athletes, as a means to find underlying heart disease before it had a chance to harm the athlete. The rise of ECG screening prompted the further development of Sports Cardiology as we know it today. Basic Sports Cardiology competencies include: knowledge of how exercise affects the heart, athletic adaptation to exercise, interpretation of all types of cardiac testing in athletes, knowledge of the diseases that can cause sudden death in athletes on the playing field, use of CPR (cardiopulmonary resuscitation) and the AED (automated external defibrillator) on the sidelines or field, exercise prescription in those with existing heart disease, and knowledge of cardiac training and rehabilitation.
Gordon: You are team physician to the United States Figure Skating World Teams, What are the most common figure skating injuries, how are they treated, and how can they be prevented?
Dr: Lawless: By far, overuse injuries are the most common injuries in figure skaters. A young skater must do the same tricks over and over to gain the skill necessary to do that trick consistently in competition. This leads to overuse injuries, typically stress fractures or tendonitis/tendinopathy. Most of these occur in the lower extremities. The best prevention is to limit the number of times a trick is repeated daily. Strength and conditioning help make a skater stronger, and symmetrical in strength; both significantly reduce the chance of overuse injury. Nutrition is also key, as poor nutrition or lack of calcium leads to osteoporosis and soft bones. Also common among skaters are acute injuries like concussions and lacerations. Skate blades can come into contact with one’s own skin (grabbing a blade during a trick), or that of a partner (dance or pair skating) or a teammate (synchronized skating). The same preventive measures apply. When traveling as a team doctor, one must remember that musculoskeletal injuries may not be the only issues encountered on a trip. Skaters can get colds, influenza, bronchitis, jet lag, urinary infections, and upset stomach. The team doctor must be prepared to evaluate and treat all of these conditions. Team doctors may also be responsible for other members of the team, such as coaches, judges, team leaders, and parents. I’ve personally treated influenza and fever in a pair skater, migraine headaches in a coach, hypertension and angina in a judge, kidney stones in a team leader, and indigestion in parents.
Gordon: How can Sports Medicine help improve performance?
Dr: Lawless: Sports Medicine can improve performance by preventing and treating injuries and illnesses as quickly as possible, and making thoughtful determinations as to whether an athlete can stay in the game, or has to be pulled from competition. Here are some examples: At the World Figure Skating Championships in Tokyo Japan in 2007, one of our pair skaters came down with a fever of 103 degrees F, nausea, and vomiting. She had influenza, or “the flu.” In my team, the medical bag was Tylenol, IV fluids, Tamiflu (antiviral used to shorten the course of flu), and Zofran (medication we use to treat nausea in cancer patients receiving chemotherapy). I started an IV and isolated the skater in her room so that illness could not be passed to other teammates. Her roommate (a female ice dancer) had to be moved to another room and also treated with Tamiflu as a preventative measure. After 12 hours of these treatments, the pair skater had no fever and felt so much improved that she was able to skate a perfectly clean pair short program with her partner. We continued the same treatments for the next 24 hours, and she was also able to do her pair long program. Then she got to rest. She ended up in 12th at the Worlds, which allowed her to get an additional $25,000 in training money from the US Olympic Committee, and a world ranking. Turns out, this was to be her one and only Worlds, which allows her to say she was 12th in the World rather than “DNF.” So in this case, prompt recognition and treatment of illness allowed the pair skater to perform to the best of her ability, thereby earning her additional training money and a World Ranking. Prompt medical treatment also kept her roommate ice dancer in the World Championships, performing at her highest level. This is only one example, but there are many others, especially when treating musculoskeletal conditions.
Gordon: What is overuse syndrome?
Dr: Lawless: Overuse can be defined as repeating a movement over and over again so much that rather than leading to enhanced performance, the repetition results in stress injury. Examples include stress fractures and tendinopathies. Overuse is not confined to sports; it can also occur in musicians, singers, and dancers.
Gordon: There has been an increasing controversy of letting high school students play football. What is your recommendation?
Dr: Lawless: This is an individual decision for every parent and athlete to make. While it is true that American football has the greatest number of sports injuries, football governing bodies at all levels are striving to make the game safer through promoting safe pre-season practices, better-performing helmets, and enforcing rules changes. Some athletes and parents are opting for sports that are less risky, but just as personally satisfying.
Gordon: Thank you for a great interview. In closing, here is a video interview on sports cardiology.
Sports and Exercise Cardiology: Boom Times for CV Specialists and Athletes