Rare syndrome nearly cost Duquesne marksman Micah Mason his career

In 1997, when John and Karen Mason were having their new home built in Natrona Heights, Pa., a half hour northeast of Pittsburgh, they made sure it included a basketball court out back. Though not quite regulation in length or width, the court did provide an ideal outlet for Micah, the couple’s grade-school son and a budding hoops fiend. The boy would spend hours of his youth launching jumper after jumper into the backyard basket as an automated rebounding machine fired the ball back to him, sometimes returning later in the day to undergo workouts designed by his father.

By his junior year at Highlands High School, Micah’s refined shooting touch helped make him a prolific scorer -- he averaged 33.3 points per game -- and a Division I prospect; last year, as a 6-foot-2 sophomore guard at Duquesne, it made him the nation’s leading three-point shooter at 56 percent.

There was a time, however, when merely playing again seemed like an impossibility, and just being at the court was agonizing. In the summer of 2011, not long after he had committed to Drake, a Missouri Valley School located in Des Moines, Iowa, a mysterious medical condition had left 17-year-old Micah skinny, weak and lethargic. While his friends played on the court, Micah would either observe from a nearby picnic table or, unable to muster the physical and emotional wherewithal to watch, lay down inside and direct his mind elsewhere, preparing himself for a life without the game that had once defined him. “It was depressing for him,” Karen says now. “We really felt there would be no way he would do that again.”

The culprit was POTS, or postural orthostatic tachycardia syndrome, a nervous system condition in which blood fails to flow properly when a person changes body positions, namely from laying down or sitting to standing. The syndrome’s most immediate symptom is a rapid fluctuation in heart rate; others include fatigue, nausea, anxiety and disorientation. Prognoses range from permanent debilitation to simply clearing up over time. While there are myriad treatments, there is no cure. Among the potential causes are genetic abnormalities, infections, vitamin deficiencies and mitochondrial diseases.

It has never been determined exactly what caused Mason’s POTS, which came on suddenly in the spring of 2011, at the onset of AAU season. He was tired and dizzy at odd moments, sometimes feeling disconnected from himself. His heartbeat would go so wild during games he could feel it in his head, but afterward it would subside enough that he could shrug it off.

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That changed on an otherwise quiet drive into Pittsburgh for an AAU event. Micah was reclining and listening to music on his headphones as Karen drove when he suddenly shot up and grabbed his mother’s arm, gasping for air. During the ensuing emergency room stay, his heart rate surged at random from 60 beats per minute to 130. There was no initial diagnosis and not enough answers. Blood tests came back normal, and Micah was told to wear a heart monitor. After a few weeks of having the device strapped to his chest, a test determined that when he stood up his heart took more than six minutes to return to its normal state. In most people, that process takes seconds. Finally there was a diagnosis: POTS.

Micah was told to spend his summer at rest, even eating just two meals a day to spare his body the task of further digestion. He added salt to his food and water to maintain blood pressure and avoid dehydration. When he failed to show improvement, his parents couldn’t believe how limited their alternatives were. Karen says doctors recommended a slew of medications, but Micah never used them out of concern for the various side effects and because his family learned how ineffective they were in the case of a local girl who wound up wheelchair-bound anyway.

“It makes you feel like you have to be a renegade, a rebel, to fight for things for your child,” she says, adding she had never disagreed with doctors before. “I’m a real mild-mannered person. It’s hard for me.”

Meanwhile, Micah hardly left his mother’s side that summer, convinced his next cardiac episode would be fatal. Attacks would occur regularly and without warning. As he relaxed in a living room recliner, his veins would bulge out of his neck like twisted tributaries, his heart desperate for blood. He tired merely from playing video games. He lost 30 pounds, dropping under 150. He couldn’t be left alone in case he had another attack, and his family feared he’d be like that forever.

“We were trying to keep him alive at that point,” Karen says. “We were lamenting that he’d never play basketball again, but [we thought] he may never walk around our house safely again.”

Her research grew more urgent. For five hours every day she would run her son’s symptoms through search engines, devouring all she could about causes and treatments of POTS. “I was just a desperate mom,” she says.

Struck by POTS’s seemingly widespread diagnoses, Karen wondered if the cause could be culturally systemic. She thought of the longtime advice one of her doctors had given her to eat as naturally as possible. Out went the frequent McDonald’s stops; in came a head-to-toe organic lifestyle that included not only Micah’s meals but also his shampoo and toothpaste. She also ordered a genetic test that revealed Micah’s sensitivity to gluten, so she took that out of his diet, too.

Karen’s homespun remedy coincided with the results that had eluded them. Soon Micah was cleared to walk laps around the house, then the block, then ride on a stationary bike. A few free throws in the backyard gave way to a day of 50, then 100. Thanks to a 5,000-calorie daily diet, his paltry frame began to resemble its former self. Doctors permitted him to begin running and exercising again, and in September, he was cleared to play basketball again.

“Three months of an awful life went by,” Micah says. “Then everything started moving forward.”

Not that the clearance kept his parents from being the bleachers’ most conflicting jumble of pride and nerves. “We would sit in the stands and wait for him to collapse or something,” Karen says, “but he didn’t.”

Micah, who averaged 28.7 points per game as a senior at Highlands, encountered a new set of problems once he arrived at Drake in the summer of 2012. (Then-Bulldogs coach Mark Phelps had promised to honor Mason’s scholarship regardless of his health.) When an allergen-free meal plan through the school’s cafeteria proved unsustainable, Micah scrambled to feed himself. Without ample time available between his basketball and class schedules, cooking was not much of an option; without the ability to eat convenient, calorie-rich foods like pizzas and sandwiches, he struggled to get enough calories to support his active lifestyle, dropping 14 pounds.

Enter mom – again. Karen and John, who owns a dozen Verizon stores in Pennsylvania, had already discussed purchasing a home in Des Moines where they could stay when in town to watch their son’s games. Instead Karen, who does not work, moved to the house -- a two-bedroom “shack,” as she called it, that was a stone’s throw from her son’s dorm -- full-time to serve as his chef (John had to stay back for work but visited as often as he could). Though Micah describes his mother’s locality as “the last thing I wanted” and the need to ditch team meals to eat with his mom as “awkward,” he was thankful for her help, and relished the steak, potatoes and salads she made that fueled him. And Karen, for her part, tried to stay as invisible as possible, making exception to attend just one soccer game with a friend of hers.

Micah’s freshman season was easier on the floor -- his 50.6 three-point percentage led all Missouri Valley shooters with at least 50 attempts that season – than off it. Road-trip diets remained tricky, prompting him to ignore his restrictions and pay the price in the following days, in which he was physically fatigued and in a mental fog. And upending his mother’s entire life to suit his needs felt selfish and unnecessary. At the end of the season, he told Karen and his coaches that he had had enough and would seek a transfer to a school closer to Pittsburgh.

“I didn’t want my mom living out in Iowa for three years just so I could eat right,” says Micah, whose mother rented her Des Moines home to Drake players last year and is now selling it. “I loved Drake, the people there. I just wanted to come home and make everything more normal.”

After postseason surgeries on both hips (his fourth and fifth in five years, which were unrelated to his illness), Micah transferred to Duquesne, roughly 25 miles from home. It was even closer to his older sister, Mackenzie, with whom Micah would live in an apartment just up the hill from Duquesne’s downtown Pittsburgh campus. Mackenzie, who worked from home, assumed her mother’s chef duties -- albeit with the aid of Karen’s regular visits and frozen-food deposits. After a summer of practicing set shots as his hips recuperated and awaiting an NCAA medical hardship waiver to be eligible immediately, Micah was back on the court when the Dukes’ season tipped off in November.

By his fourth game he had become Duquesne’s starting shooting guard (though he missed the next five games with a broken right hand) and ended up averaging 10.6 points in 28.4 minutes per game while becoming the country’s preeminent marksman. In the highlight of the Dukes’ 13-17 season, Micah keyed an upset at then-No. 10 Saint Louis on Feb. 27 with 22 points on 4-of-5 outside shooting. He also started eating better on the road: Choosing meat, vegetables and fruit from the team spread, and ordering off a gluten- or allergen-free menu when the team went out to eat.

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Now both healthy and well-fed for the first time in four years, Micah is poised to take on additional responsibilities on the court. He will be back as the starting shooting guard, and he will be shifted to the point when starter Derrick Colter is out. It’s a task he seems well-suited for -- he was one assist shy of leading the nation in assist-to-turnover rate last season -- but with the larger burden must come increased attention to his physical state. “The biggest thing is the constant line of communication,” says Dukes coach Jim Ferry. “We need to know where he’s at, what he needs.”

Micah says the heart palpitations are now rare and brief, blips he has learned to tolerate as the rest of his POTS symptoms have mostly subsided. Because it is a nervous system illness, he still visits a local chiropractor to check his spine, just as he’s done since the onset of the disease. He never had to go back to the heart monitor and still doesn’t use medications, choosing instead to manage his disease with his diet, the same way he has for three years. He is expected to be fine as long as he keeps eating right.

That represents another new challenge for Micah this coming season. Mackenzie moved to Philadelphia this summer, leaving her brother to cook for himself in an apartment he will be sharing with a walk-on teammate this year. His parents remain a half hour away at the home with the backyard hoop, where John still concocts practice routines for his son’s visits. Micah may not have any more free time than he did as a freshman, but he’s better prepared to keep himself healthy after a few years of dealing with the disease. It’s all part of an existence he happily describes as “pretty much normal,” a vast improvement over what he’s known for most of the past three years.

“I definitely look back and I’m like, wow, I’ve been through a lot of things, in a physical way,” he says. “It just feels good to be able to play again."