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Pittsburgh Steelers' Ryan Clark Benched For Sickle Cell Trait. What Triggers It?


First Posted: 01/05/12 03:50 PM ET Updated: 01/05/12 05:51 PM ET

The last time Pittsburgh Steelers' Ryan Clark played a game in Colorado, he nearly died, the Associated Press reports, highlighting a series of health scares that led to this week's decision by coach Mike Tomlin to bench the 32-year-old safety during this Sunday's wildcard game in Denver.

"They couldn't tell me 100 percent that 'Nothing is going to happen to you, you're going to play and you're going to be fine' and I think that one percent chance was enough for coach Tomlin to take it out of my hands," Clark told the AP, referring to his battle with sickle cell trait (SCT), which occurs when a person carries a single copy of the sickle globin gene inherited from one parent along with a normal globin gene from the other parent. (Sickle cell trait is different from sickle cell disease, also known as sickle cell anemia.)

According to the CDC, certain conditions can cause flare-ups in people with SCT, including dehydration, low oxygen levels in the air and high altitudes like the one Clark experienced in Denver, causing a "crisis" that eventually forced him to have his gall bladder and spleen removed in addition to losing 30 pounds.

Tomlin reportedly told Clark that if his own son Dino was in the same situation, he wouldn't let him play, a decision he delivered to Clark just one day after former University of Tulsa football player George Clinckscale's death was determined to be the result of sickle cell trait complications.

While many people with SCT don't experience symptoms at all, athletes' intense exercise regimens tend to act as triggers among those who carry the trait, prompting officials, like Tomlin, to take more stringent measures to keep players safe.

On the college level, the NCAA has implemented mandatory SCT screening of all Division I student-athletes. The impact of their initiative was evaluated last month by researchers at the University of Michigan who found that testing alone will help identify more than 2,000 athletes with SCT, but they warned that screening alone will not prevent death.

"In addition to educating athletes and staff, precautionary measures need to be strictly enforced," said Beth A. Tarini, M.D., M.S., lead author of the study and assistant professor in the Department of Pediatrics and Communicable Diseases at the University of Michigan.

The CDC makes the following recommendations for people with SCT who play competitive or team sports:

  • Set your own pace and build your intensity slowly.
  • Rest often in between repetitive sets and drills.
  • Drink plenty of water before, during and after training and conditioning activities.
  • Keep the body temperature cool when exercising in hot and humid temperatures by misting the body with water or going to an air conditioned area during breaks or rest periods.
  • Immediately seek medical care when feeling ill.

SCT is most common among Blacks or African Americans, affecting 1 in 12 Blacks or African Americans in the United States. It can be found, however, among people whose ancestors come from sub-Saharan Africa; the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece, and Italy, according to the CDC.

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The last time Pittsburgh Steelers' Ryan Clark played a game in Colorado, he nearly died, the Associated Press reports, highlighting a series of health scares that led to this week's decision by coach ...
The last time Pittsburgh Steelers' Ryan Clark played a game in Colorado, he nearly died, the Associated Press reports, highlighting a series of health scares that led to this week's decision by coach ...
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06:48 PM on 02/23/2013
SICKLE CELL TRAIT MISINFORMATION & DISINFORMATION: Ignorance/Incompetence/Fraud?
I am flabbergasted that more than 40 years when The Martin Luther King Jr Foundation made me give the Keynote Address at the Award Dinner Ceremony on May 31 1972 in Philadelphia the Centre of Disease Control (USA) appears to be at a loss regarding what Sickle Cell Trait is. With Nobel Laureates Linus Pauling and Max Perutz on the platform together with heavy weights like Roland Scott, Charles Whitten, AC Allison, James Bowman, Bela Ringelhann, Graham Serjeant, Samuel Charache, Helen Ranney, Doris Wethers, and some 10 others who were honoured for "Outstanding research in Sickle Cell Anaemia", the title of my hour-long Lecture was "The Vital Difference Between Sickle Cell Disease and Sickle Cell Trait". CDC officials who were there would never have "acquiesced" to labelling Pittsburgh Steelers Ryan Clark as a Sickle Cell Trait. They would have known from my lecture that the footballer has Sickle Cell Haemoglobin C Disease (two abnormal Haemoglobin genes, not one as in Sickle Cell Trait). CDC needs to wake up, and quantify the abnormal Haemoglobin fractions, and they will find that "C" may be 46%, "S" may be 45%, "F" may be 6%, and A2 may be 3% totalling 100% of Haemoglobin, I directed the largest Sickle Cell Disease Clinic in the world. One wonders how many other Sickle Cell Disease patients are being called Sickle Cell Trait and vice versa. Felix ID Konotey-Ahulu (See www.sicklecell.md)
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HUFFPOST SUPER USER
westcoastsc
Injustice anywhere is a threat to justice everywhe
11:11 AM on 01/13/2012
If you have the trait, you should study the medical research done on it in order to catch problems before they become too great.
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HUFFPOST SUPER USER
Lifeskills
May you be wise and alert in all your responsibili
04:12 PM on 01/08/2012
Thank You we need the understanding of Sickle Cell

Hope & Destiny: The Patient and Parent's Guide to Sickle Cell Disease and Sickle Cell Trait [Paperback] Allan F. Platt Jr. P.A.-C. M.M.Sc. (Author), James Eckman M.D. (Author),
Book http://astore.amazon.com/memandrec-20?node=4&page=2

For the more than 80,000 Americans diagnosed with sickle cell disease, Hope &Destiny provides clear-cut and in-depth information on living with the illness. It offers the latest information on preventing complications, research, and treatment. The knowledge patients and family members need is organized in an easy-to-read format that promotes overall healthy living.

About the Author
Allan Platt, PA-C graduated with a BS in Health Systems Engineering from the Georgia Institute of Technology in 1977, a BS in Medical Science from the Emory University School of Medicine, Physician Assistant program in 1979, and a MMSc in Career Physician Assistant from Emory in 2006. From 1984 until 2004 he was Program Coordinator, and Physician Assistant at the Georgia Comprehensive Sickle Cell Center at Grady Health System, the world's first dedicated 24 hour emergency center for sickle cell patients. Allan is co-inventor of the MPS - Multidimensional Pain Score. The MPS is a new documentation tool for patients and clinicians to communicate about pain. He is co-author of Overcoming Pain from Hilton Publishing published in September 2006 and author of Evidence Based Medicine for PDAs
BOOK LINK
http://astore.amazon.com/memandrec-20?node=4&page=2
12:50 PM on 01/10/2012
I do not know much about Sickle Cell because some in our family have the trait. Our doctor says it protects the body from Malaria in tropical countries. I hope everyone who has this illnesss gets cured.
11:33 PM on 01/06/2012
Good for the coach for caring more about the health of his players than the impact on the game! I hope other coaches follow suit!
HUFFPOST COMMUNITY MODERATOR
dengal
09:32 PM on 01/07/2012
I agree - not many coaches are willing to do the right thing instead of the winning thing
HUFFPOST SUPER USER
mukTech
Prince of Congo
12:41 PM on 01/06/2012
Coach Tomlin made the right decision. I applaud him for that. I have SCD. While SCT is not as severe as the disease, when symptoms start showing, this needs to be taken very seriously, especially in the NFL or other sports where physical activity is very extreme.
08:10 AM on 01/06/2012
I have SCT. I work out regularly but I am not an athlete. As mentioned by others, I have had issues with dehydration, but otherwise no complications that I'm aware of.
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HUFFPOST SUPER USER
Lifeskills
May you be wise and alert in all your responsibili
04:48 PM on 01/08/2012
OBEY YOUR THIRST

It is critical that the volume (Amount) of plasma be maintained by regular ‘Water’ intake.
“About two-thirds of your body is water, and it is one of the most valuable nutrients in the body.” Obey your thirst. Milk, Coffee, and Juice are not a substitute for water. It is recommended that we have 5-8 classes of water a day. Parents need to ask the kids if they want water, and give it to them after a long walk or activity. Kids need to be able to reach a class and school water fountain need to be working with proper pressure. A class of warm water in the morning, 'water' stimulates the system. “Water working with blood inside the blood vessels deliver vital nutrients, oxygen, and other chemicals to the CELLS of your vital organs, (kidney, liver, brain, ect.,) and carries the waste out.
PLASMA (A fluid) the red blood CELLS and platelets flow along together inside the blood vessel with the plasma, which is 92% water. That mix contains, electrolytes, (IONS) potassium, chloride, sodium, etc., they help regulate the electrical charge and flow of water molecules over the CELLS membrane (Cells outer surface). It is critical that the volume (Amount) of plasma be maintained by regular water intake.”
07:27 PM on 02/24/2013
Dear Uchenna: Please read my comment above on Sickle Cell Trait Misinformation and Disinformation. Never ever assume that what you have is Sickle Cell Trait (One Normal Haemoglobin 'A' plus one variant Haemoglobin 'S' making you 'AS' phenotype, when in fact what you probably have is Sickle Disease (Two Haemoglobin variants ''S' plus 'C' making you 'SC' phenotype. To call 'SC' phenotype with no Normal Haemoglobin a Sickle Cell Trait is not only genetic heresy but quite dangerous. Linus Pauling who discovered the molecular pathology of Haemoglobin 'S' was sitting on the platform in Philadelphia when I gave the Keynote Address on "The Vital Difference between Sickle Cell Disease and Sickle Cell Trait" when, with some 18 others we received the Martin Luther King Jr Foundation Award for "Outstanding Research in Sickle Cell Anaemia" in Philadelphia on 31st May 1972. If over 40 years since I showed clearly in a Lecture in front of Nobel Prize Winners, how to distinguish Sickle Cell Disease ('SC' phenotype) from Sickle Cell Trait ('AS' phenotype) doctors in the USA (including those at Centres for Disease Control) are confusing the phenotypes then God help us! See www.sicklecell.md or www.konotey-ahulu.com Felix Konotey-Ahulu MD(Lond) FRCP DTMH Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast, Ghana and Consultant Physician Genetic Counsellor, 9 Harley Street, London W1G 9AL, England.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
10:19 PM on 01/05/2012
I had no idea how serious the situation had been for this man and was shocked reading his history. You would presume he had access to oxygen during that game or some assistance. I feel sorry for the guy missing the game but I think all concerned should err on the side of safety with the man's life at stake. Hope he gets a chance to play a meaningful PS game -- just not this one.
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HUFFPOST SUPER USER
Claude Hosch
A single bracelet does not jingle
10:10 PM on 01/05/2012
I've lived 62 yrs with SCT, and blessed to not have any complication. I sometime wonder if one trait is worse than the other.
09:47 PM on 01/05/2012
I have Sickle Cell Trait. I also have a problem with dehydration but I never linked it to that. Wow. I guess I need to do a lot more research on it as well.
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HUFFPOST SUPER USER
Anabelle Whitepaws
The UNITED States of America Has Spoken #TeamUSA
05:51 PM on 01/05/2012
WOW... I have the SCT and have NEVER known of any of these complications. Better get off HP and do my homework. I also have two children that have the SCT. WOW... Just WOW...