On August 1, 2014, Firefighter Robert Macias, a 30-year-old Iraq war veteran, was working on a structure fire at 2 a.m. in the Las Vegas summer heat. It was the second fire he’d been on in two days. He was feeling under the weather and taking sinus medications. Suddenly a massive wave of steam from water sprayed on the fire enveloped him and he collapsed.
Olivia, Robert, and their children.
“I couldn’t catch my breath,” Robert recounts. “I turned white as a ghost, and my crewmates had to help me out of the building.”
Once he’d cleared the building, his team ran an EKG and got the puzzling message that his condition might be Brugada Syndrome, an extremely rare genetic disease found primarily in Southeast Asians. The diagnosis seemed odd since that wasn’t Robert’s heritage. Robert was rushed to a local hospital where a cardiologist bluntly delivered the diagnosis, told him he was in danger of dying in his sleep, and said he needed to have a mechanical defibrillator installed immediately and wear a vest to protect himself from sudden death until he could get the operation.
This ratcheted Robert’s stress level up to the point where he couldn’t sleep at night for fear he wouldn’t wake up. It also affected his wife, Olivia.
“I had to be strong through this and try to manage what was happening to him and to us both,” Olivia says. “The stress of the situation was so hard.”
When news of Robert’s condition got to his workplace, he was told the defibrillator would keep him from continuing to work in the field as a firefighter, which he’d done for two years in California and five years in Las Vegas.
“It felt like my career and my dreams were being crushed,” Robert says. “The diagnosis made me feel so depressed.”
During this difficult time, Olivia reached out to a friend who was the daughter of Sherri Allen, Intermountain Nevada’s senior partner in compliance and ethics. Sherri referred Robert and Olivia to Dr. Stephen Portz, Intermountain’s chief of cardiology for Nevada, who had authored several professional papers on Brugada Syndrome. Dr. Portz rearranged his schedule and brought Robert in first thing the following morning. In the meantime, Dr. Portz reviewed Robert’s mandatory stress tests, medical background, and family history.
When Robert arrived at his appointment, Dr. Portz shook his hand and informed him he could ditch the supposedly lifesaving vest. He told Robert the erroneous EKG message aside, what he’d experienced was severe dehydration due to working two fires back-to-back for the better part of two days in heavy protective gear, coupled with side effects of the sinus medication. The result was a massive electrolyte imbalance. The unexpected blast of steam was the last straw, causing him to suddenly feel incredibly weak.
“We couldn’t believe it,” Robert says. “I went from being misdiagnosed with a life changing rare disease that could kill me instantly to being diagnosed and treated with simple changes such as watching my fluid intake and being aware of the impact of medications, caffeine, and other stimulants.”
“It was a miracle that Dr. Portz was an expert on this rare disease,” Olivia says. “He treated Robert with respect and understood the impact of this misdiagnosis on us.”
Robert’s career is now back on track. He moved into working as a paramedic and loves his job. And he was recently promoted to captain of his team. Robert makes a special effort to be empathetic and help his patients stay calm in the face of a life-threatening prognosis because he knows his words and attitude have a profound impact on their health and wellness.
“I remember how Dr. Portz helped me deal with my situation, and how he saved me from having that defibrillator installed—a procedure that could’ve had profound implications on my health.” Robert says. “If I can help somebody else like that, it’s all worth it.”