Craig Cunningham lost his leg and his career as a professional hockey player. He almost lost his life, too.
But through that difficult, life-changing experience, the 27-year-old Cunningham also found something: a sense of purpose and a cause – one that could create a lasting legacy of epic proportion.
"I feel like I can't make a difference on the ice anymore," Cunningham said, "but I can make a difference for a lot of other people. I can do something else. That's what I'm going to do now."
That something else is save a life. Maybe many lives.
Cunningham is teaming up with the world renowned cardio-thoracic surgeon, Dr. Zain Khalpey, who literally saved Cunningham's life after the Tucson Roadrunner captain collapsed on the ice last Nov. 19 due to sudden cardiac arrest (SCA). Together, Dr. Khalpey and Cunningham intend to revolutionize the screening process that could greatly aid in prevention of SCA.
"After Craig was discharged from the hospital," Dr. Khalpey said, "he said to me, 'I need to make a difference. I lost my leg, I lost my career. I don't want this to happen to anyone else.' He's not going to be an ordinary survivor. He's going to be iconic.
"There's no doubt in my mind this can be a legacy for Craig Cunningham," Dr. Khalpey added. "It's important for Craig to have a voice to champion this cause because we have Craig Cunninghams happen every day. It's important to know it can happen to anyone at any time. We can save more lives. That's why I'm teaming up with Craig. This can be so powerful. Craig can put a face and a name to [the battle against SCA]."
One thousand people die each day from sudden cardiac arrest; on Nov. 19, 2016, Craig Cunningham was nearly one of them.
Lining up for the opening faceoff in the Roadrunner's American Hockey League game that November day, Cunningham collapsed on the ice. Using a revolutionary medical process pioneered by Dr. Khalpey – Cunningham was only the third person ever to undergo the procedure – he was able to be saved though he ultimately had to have his leg amputated below the knee.
This incredible story – the special young man and athlete that Craig Cunningham is and the extraordinary efforts of Dr. Khalpey to save his life ¬– is chronicled in All Heart, a TSN documentary that will air on Wednesday. Produced by Josh Shiaman and fronted by TSN hockey analyst Ray Ferraro, who is a close family friend of Cunningham, here is the trailer for a remarkable piece:
Cunningham is embarking on an off-ice hockey career as a pro scout with the Arizona Coyotes, but he's also dedicating himself to the fight against what almost killed him.
Hockey has, unfortunately, become all too familiar with SCA.
Windsor Spitfire captain Mickey Renaud collapsed at age 19 and died in February of 2008; New York Ranger first-round draft pick Alexei Cherepanov collapsed and died during a KHL game in October of 2013.
In November of 2005, Detroit Red Wing defenceman Jiri Fischer collapsed and had his life saved by the quick work of Red Wing team physician Dr. Tony Colucci. A similar situation played itself out in March of 2014, when Dallas Star forward Rich Peverley collapsed but was saved by the use of an AED (automated external defibrillator). In July of 2012, Phoenix Coyote prospect Brett MacLean collapsed during a summer on-ice workout in Owen Sound, Ont., but quick action by those on the scene saved his life.
The diagnosis for each varied. Renaud and Cherepanov were found to have hypertrophic cardiomyopathy (HCM), an abnormal thickening of the heart wall. Peverley was diagnosed with atrial fibrillation (A-Fib), which is an electrical irregularity in the beating of the heart.
For Cunningham, there is still no specific diagnosis of why his heart stopped beating that day in Tucson. It's still a mystery.
"We found scar tissue on the back of Craig's heart," Dr. Khalpey said, "but we still don't really know what caused his sudden cardiac arrest."
There are many reasons why a well-conditioned hockey player can have cardiac arrest and, if not treated quickly and properly, die from it.
But Dr. Khalpey said better screening for heart irregularities – not just in athletes but all people – is imperative and major breakthroughs in convenience and cost are at hand.
Historically, when an athlete underwent his preseason physical, the extent of screening for heart problems was a standard ECG/EKG (electrocardiogram). The problem is that many athletes who have heart irregularities can still pass a normal EKG with flying colours. The reality is it's not nearly a good enough screening tool in and of itself.
Dr. Khalpey said it's imperative that "dynamic EKGs" are performed. That is, doing an EKG before and after the patient athlete has exerted themselves just as they would in the sport they play.
Even that, by itself, isn't enough, Dr. Khalpey added.
In the English Premiership, the top British soccer league, players are also given a preseason ultrasound of their heart, which is the best method for detection of HCM, the thickened heart wall that caused the death of Renaud and Cherepanov. But many leagues eschew ultrasounds for every player because of cost.
Dr. Khalpey isn't buying the cost explanation. He believes every professional athlete should and could undergo a new-age, four-prong heart evaluation screening regimen that would cost no more than between $1,000 and $2,000 per player.
"It's bull----, really," Dr. Khalpey said of the cost argument. "A thousand dollars is chump change when you're talking about million dollar athletes."
Dr. Khalpey did make a presentation to the NHL and NHL Players Association in the off-season. He would have liked to have seen his four-part heart screening test put into place for the NHL's 2017 training camp. And while he was "encouraged" by his meeting with the league, the NHL/NHLPA medical group did ask him for additional "science" on some of what he's proposing.
"I had very good meetings with Dr. Winne Meeuwisse [co-chair of the NHL-NHLPA Joint Health and Safety Committee] and other [hockey] doctors," Dr. Khalpey said. "They want a more formal presentation of the data and the science behind it. So that's what we'll do.
"It's all hearsay until we prove otherwise. If the NHL says they need to see the science, then we will do that and get that to them."
Dr. Khalpey is working with the U.S. Military and Department of Defense on a pilot project with elite soldiers to get that data the NHL is looking for.
Dr. Khalpey did, however, work with the Coyotes in training camp to ensure that every player underwent a dynamic EKG and also had a heart ultrasound. He was encouraged by the Coyotes' willingness to do that, but wants the entire NHL to take their heart screening to the next level.
Dr. Khalpey’s four-prong approach not only includes dynamic EKGs and heart ultra-sounds for every player, but cutting-edge blood tests and a new heart monitoring app that the doctor's wife, Amina Hamzaoui, has created and developed and that will soon be widely available to any person who wants to download the free app.
"Every player should have a [dynamic] EKG and an ultrasound," Dr. Khalpey said. "But getting the blood work is so important. One of my specialties is metabolomics. It's important that the blood tests are done before and after exercise. There are 200 pathways and 4,000 molecules that can be studied in that blood and we have the ability to pinpoint the [heart] abnormality from those pathways and molecules. The genius of the blood pathway is that fixing the [heart] irregularity could be something as simple as taking a pill. We have the tools to do this."
The fourth element of Dr. Khalpey's screening regimen is his wife's app, known as RhythmCor, which is part of her company Ai-Cor. The alpha testing for the app has been done. Cunningham is one of many who will be part of the beta testing now that they're entering that phase (anyone can sign up to be part of beta testing by going to ai-cor.com and registering there). For now, the app is available for those using only Android programmed smart phones or watches. Dr. Khalpey said an iOS app will follow in a couple of months.
"By simply wearing a [smart] watch and having this app on your phone, you will be able to detect abnormal cardiac rhythm, see heart rate variability trends and be able to archive your heart rate data and send it in to be analyzed," Dr. Khalpey. "This is the real thing. It's not some bull---- app. It will have the ability to highlight [heart] irregularities not just in professional athletes, but any person."
Dr. Khalpey fervently believes that between a dynamic EKG, heart ultra-sound, metabolomic bloodwork and the RhythmCor app, every NHL player could be screened for between $1,000 and $2,000 per player and that the screening would catch many heart irregularities/ailments that would otherwise go undetected.
"This is what Craig and I are teaming up to do," Dr. Khalpey said.
The good doctor isn't content to win over the NHL. He believes there's a widespread application for every person in the world, a screening process he's currently dubbing NHL Lite. Dr. Khalpey said that everyone should have a dynamic EKG and get the RhythmCor app and those two measures alone would greatly enhance identification of potential heart problems that could prevent SCA.
"The app my wife has come up with will be free," Dr. Khalpey said. "No one is trying to make money off this. We're trying to save lives. This can be Craig's legacy."
Cunningham and Dr. Khalpey are in the process of establishing a foundation. There is much business and legal work to be done on that, but they're committed to getting it done.
In the meantime, Dr. Khalpey and Cunningham are meeting with other heart related foundations. What you have, Dr. Khalpey said, is a lot of smaller foundations that were originated after a family lost a loved one to SCA or someone survived SCA and started their own foundation.
As an example, Dr. Khalpey and Cunningham will be meeting soon with Kim Ruether, a mother who started Project Brock after her 16-year-old son Brock died of SCA in May of 2012 while playing high school volleyball in northern Alberta. Ex-NHLers Fischer and Peverley have their own foundations that raise funds and awareness for making AEDs more accessible.
"These individual foundations are great," Dr. Khalpey said, "and they're very important to the people who started them, either in memory of someone close to them who died or because they survived (SCA). But they all deal in the treatment of SCA. The foundation Craig and I are starting will be aimed at prevention. Treatment is great; prevention is better. That's what I'm able to do."
Dr. Khalpey and Cunningham realize they're just getting started, that there's much work to be done, but Dr. Khalpey is bursting to make it happen because he absolutely believes he’s in possession right now of science that can save lives and Cunningham is perfectly suited to make an impact in the game.
"I want to do this for other hockey players but I want to raise awareness for everyone," Cunningham said. "I'm lucky to be in four or five per cent who survived [SCA]. I want to do this for some 16-year-old kid who doesn't even know he has a heart problem."
"I believe this is a force that cannot be stopped," Dr. Khalpey said. "Craig is a special person. This experience I have had with Craig, I have really come to like Canadians and hockey people. They're very tribal and Craig cares very much about his tribe. I see Craig Cunninghams every day, people leading average lives. I performed the same procedure I did on Craig on a bus driver and he walked out of the hospital, the same as Craig did. This has to be for everyone, not just hockey players. We can do this, Craig and I, together."