Undetected scar on his heart almost cost him his life
Mick Dawson, 65, of Falmouth considers himself to be a “reasonable runner” and somewhat athletic.
He has run the Falmouth Road Race many times, enjoyed cycling and hiking mountains with his friends and has traversed glaciers with his wife, Syrel.
But nothing could have prepared him for the devastating end to a run almost four years ago.
It was a usual day in July 2013 as he took a five-mile run through the woods in the back of his home. He was preparing for the Falmouth Road Race and the run was part of his routine training.
He finished with a walk and slow jog around his neighborhood to cool down. It was then, he realized something was amiss.
“All of a sudden I felt light-headed so I stopped jogging,” said Dawson. “I put my head down between my knees, which didn’t help, so I lay down. I felt for my carotid pulse and couldn’t feel one so I knew that wasn’t good.”
He called for help at intervals and was eventually heard by a neighbor, Susie Cishek, who works at Falmouth Hospital. She contacted his wife and then called 911.
“I thought I had heat stroke,” said Dawson.
“When the EMTs arrived, Mick was awake but he had a dangerous heart rhythm of 280 beats per minute,” said Bruce Levy, M.D. a cardiologist at Falmouth Hospital and friend of the couple.
“The EMTs cardio-verted him in the ambulance, which brought his heart rate down to normal and saved his life,” said Dr. Levy. Cardioversion involves the use of paddles or electrodes attached to the chest and sends waves of shocks to the heart to restore a normal heartrate.
“When my heart slowed down, I felt much better,” said Dawson, who is a retired marine biologist with Associates of Cape Cod, Incorporated.
He was transported to Falmouth Hospital where he was quickly assessed by the staff and Jennifer Ladner, M.D., a cardiology hospitalist at Cape Cod Hospital, who is a former associate of Dr. Levy’s. After Mick was stabilized with IV medications, he was transferred to Cape Cod Hospital, where a cardiac catheterization procedure performed by interventional cardiologist Richard Zelman, MD, FACC, determined the cause of Mick’s arrhythmia.
“Mick’s problem was caused by an undetected virus that left a scar on his heart and he would need more definitive treatment for his rhythm,” said Dr. Levy. “It disrupted the electrical pathways in the heart and triggered the rapid rate. These sort of rhythms are seen fairly often as a cause of sudden death. This is a totally different (problem) than most athletes who usually either have extra heart muscle that can lead to an arrhythmia or they have silent coronary disease.”
Dawson needed an implantable cardioverter-defibrillator, (ICD), a small device placed in his chest that uses electrical shocks to regulate and slow his arrhythmia, which is an abnormal heart rate rhythm.
“His defibrillator does two things,” said Dr. Levy. “The main reason is to shock and cure a rapid rhythm like he had originally, if it happens again. The second part is to back-up the pace-making ability to keep his heart rate from going too slow.”
Peter Friedman, MD, a cardiologist and clinical cardiac electrophysiologist at Cape Cod Hospital, implanted the ICD about a week after Mick’s collapse. During the week in between his collapse and the implantation, he wore an external defibrillator in the form of a vest.
“It was a very scary time,” said Syrel. “My daughter and her wife came down and Mick’s sister flew in to be with us.”
At Dawson’s first appointment with Dr. Friedman after the ICD implant, he asked how Mick was sleeping and he said ‘fine,’ according to Syrel.
“He asked how I was sleeping and I told him not very well, I’m just waiting for the implant to go off,” she said. “He told us if the ICD goes off, it will wake us up. That was reassuring and also knowing that the ICD will prolong Mick’s life.”
Dawson had other questions.
“One of my questions was what can I do and what’s my life expectancy because I hadn’t retired yet,” he said. “Dr. Friedman told us it wouldn’t be any different and my life may be enhanced because I have protection that other people don’t (due to the ICD).”
Dawson is evaluated every six months for medication adjustment and ICD check by Dr. Levy and Dr. Friedman. His ICD has paced his heart rate a few times but has not defibrillated him. He had one scary moment about six months after his implant when he was running and felt lousy, with symptoms similar to (but not as extreme) as he had on the day he collapsed. The ICD did its job, regulated his heart rate without having to administer a shock and he felt better.
“Mick hit the trifecta, he had good luck, good care and a good attitude,” said Dr. Levy. “It started with the EMS who saved his life, the staff at Falmouth Hospital who figured out the problem and stabilized him for the next step. And then the treatment at Cape Cod Hospital, which was on target and successful. It was a good circle of treatment.”
Dawson now has his dream job teaching skiing to children at Stowe Mountain in Vermont. He has retired from his job but continues to do consulting for the company. He and Syrel did a walking vacation in Tuscany, Italy about a year after he received the ICD. He does some cycling, hiking and runs less often at a slower pace. In the past year, he did a combination walking and cycling trip in Europe.
“He is exercising consistently but a little differently and has learned to start more gradually working up to the maximum,” said Dr. Levy.
Dawson said he has become accustomed to having the implant.
“It’s there, I don’t worry about it, it’s just something I know I’ve got,” said Mick. “It’s certainly not a negative or dark cloud hanging over me. I’ve always appreciated life but I appreciate it even more now.”
“I am very grateful to all those who have helped me along the way: our neighbor, Susie Cishek; the EMTs; Dr. Ladner and the ER staff in Falmouth; the ambulance crew who took me to Hyannis; Dr. Zelman and his team who came in around midnight; Dr. Friedman and his team who wired me up, including Sarah Montgomery; Dr. Baggish at Mass General for helping me to get active; Dr. Levy for both his ongoing care and his friendship; and finally, my family, particularly my wonderful wife, Syrel.”