Boy Drops Dead on Football Field
COOL VALLEY – As Carol Howard plans to bury her youngest son Friday, she still has no clear answers from doctors about why the 13-year-old collapsed and died at football practice eight days ago.
Weeks before his death Aug. 18, her son, Anthony Troupe Jr., had fallen unconscious in the street near her home while tossing water balloons with friends. After the obese boy was revived in the street, he was treated by doctors and released. They chalked it up to dehydration.
On the day he died, Tony had just run a lap at the start of his club team’s football practice on the field at McCluer South-Berkeley High School. It was about 80 degrees outside with cloudy skies. An autopsy on Tony was inconclusive, and officials are awaiting the results of a microscopic examination of his heart tissue.
In an interview at her home Tuesday, Howard said her son always got the routine physicals he needed for sports. “It was a very basic physical, blood pressure, height and weight, they’d listen to his heart,” Howard says. She said he’d been playing football and basketball since the age of 8 and that his coaches never pushed him too hard. She said she has nothing but praise for his coaches.
Soon, after Tony is buried in the St. Peter Cemetery in Kirkwood, Howard said she plans to join forces with the mother of another fallen athlete so they can get the word out someday soon about better screening for heart problems.
Howard is left to wonder if he had a heart defect undetected by physical exams and connected to his father, who collapsed and died at the age of 45 in 2007 after working overnight as a custodian. The father was a big man, too — 6-foot-3, 330 pounds. The death certificate for Anthony Troupe Sr. said he had hardening of the arteries and hypertension. Tony’s aunt, Sharon Beck, said her nephew “had regular physicals and checkups, but it could go undetected.”
Tony played offensive guard and defensive tackle for the Junior Bulldogs, a club team. His coach, Lonnie Jordan, pegged Tony at 6-foot-2 and weighing 358 pounds, but Dr. Mary Case, the St. Louis County medical examiner, said Tony actually weighed about 380 pounds. Case said his size could have played a factor in his death.
“He was a large (young) man and the heart is big but it’s not clear that it’s heart disease,” Case said Tuesday. “The big part here is the microscopic examination,” and it can take two to three weeks for those results to come in.
Tony’s pediatrician didn’t know the circumstances of his father’s death, Howard said. He called the day after Tony died, and Howard told him what his father’s death certificate had said.
Aside from the routine exams, Howard said Tony’s recent trip to the St. Louis Children’s Hospital emergency room only reinforced her belief that doctors had no reason to sound the alarm. Tony collapsed around the corner from his home on a hot summer day while tossing water balloons with friends.
“He was laying on the ground unconscious, and someone got a wet beach towel and patted him,” she recalls. “By the time they got him in the ambulance, he was conscious and knew his name, knew who the president was.”
At St. Louis Children’s Hospital that day, he underwent an examination and “all kinds of tests,” including an electrocardiogram, Howard said. The nurses gave him intravenous fluids and let him guzzle two bottles of Gatorade. The doctors determined he had suffered from dehydration and sent him on his way.
Tony will be buried Friday in a new Bulldogs team football jersey emblazoned on the front with his nickname “Big Ant” and number 56.
Howard didn’t want Tony in a suit. A football jersey is, after all, what people got used to seeing him wear, she said.
So even though the Bulldogs season was so new and they didn’t have any team jerseys yet, a print shop hurried to finish this one so the funeral home could have it in time for the open casket viewing at 9 a.m. Friday at Friendly Temple Missionary Baptist Church, 5544 Martin Luther King Drive.
ATHLETES SCREENING
Dr. Keith Mankowitz, director of the athletes screening program at Washington University, said more could be done to try to reduce the sudden deaths of athletes. About 75 athletes between the ages of 13 and 25 die every year in the United States, most during or immediately after exercise. The deaths are usually a result of unsuspected heart disease.
A week before Tony’s death, Mankowitz had offered a free conference to area school officials and coaches to educate them about the risks involved with exercise, teach them what they can do to avoid athletetes’ injury and death and talk about ways to resuscitate the kids who collapse. Mankowitz sent out about 2,000 letters for the free program, which was sponsored by Barnes-Jewish Hospital. To his surprise, it was poorly attended with only about 30 people showing up. “I’m prepared to do it again,” he said this week. “I would like some way to get to the athletic directors, the school principals.”
“I’m happy to do free lectures to sports athletic directors if we can get to them,” Mankowitz said.
A doctor listening for a heart murmur should listen as the child is laying down, standing up, squatting, then standing again. But Mankowitz said some heart conditions are not detected by routine screening measures. The most important step is to do a thorough family history and ask the child if he or she has had any dizziness, chest pains or trouble breathing. That would require a more extensive evaluation by a specialist if something abnormal is detected.
And coaches and staff need to be trained in what to look for on the field. “If a child is complaining of chest pain, dizzyness or shortness of breath, that means the heart may not be getting enough blood,” Mankowitz said. “What they need is recognize the kids who may be in trouble and stop the kid from exercising further and send them for evaluation.”
They also need to have someone who is supervising the sports have basic training in CPR. And they need to have a defibrillator, Mankowitz said. Mankowitz, who started the Washington University Hypertrophic Cardiomyopathy Center in 1997, also pledges to help St. Louis area schools find donors to purchase defibrillators.
Dr. Edward Geltman, professor of medicine in the cardiology division at Washington University, said the screenings need to find out from the athlete: “Do you have a history of chest pain, irregular heart beats or palpitations, do you have more shortness of breath than your peers, do you have a family history of heart problems?”
A child who collapses might also have a profound electrolyte abnormality. “It doesn’t happen often, but particularly with a kid who is very overweight, they are more prone to an overheating injury.” Obesity is also an issue when a doctor is trying to listen for a heart murmur. “If the kid is 300 pounds, may be hard to hear. Layers of fat can muffle the sounds of the heart,” Geltman said.
A big hint for coaches, Geltman said, is to watch for heavy breathing among the athletes. “A certain amount is fine, but when the play is over, and they’re still breathing heavy several minutes later, something is amiss. If they stop sweating or have shivering when it’s 90 degrees, you’ve got a problem.”
MOURNING TONY
One of the mourners who came to comfort Carol Howard in her Cool Valley home was the mother of Damien Nash, who grew up in St. Louis and played for the Denver Broncos. Nash died in 2007 after playing in a charity basketball game in St. Louis County. The cause of Nash’s death was not determined, as several other underlying heart conditions can cause sudden death. But HCM (hypertrophic cardiomyopathy) is the culprit in 36 percent of sudden deaths among athletes 35 and younger. A standard physical usually is not enough to uncover the condition.
Howard said she and Nash’s mother talked about teaming up someday soon. “We’re going to promote awareness about this,” Howard said.
Tony’s aunt, Sharon Beck, said: “Every kid probably can’t afford a heart screening or EKG. It should be a requirement.” She said the town in New Jersey where she lives conducts free clinics where cardiologists volunteer their time to screen all high school athletes.
Howard said she vividly recalls the last day with her son. He came home from school and plopped down to play video games. She asked about his homework. “Done it, mama,” he replied. She asked him to vacuum the living room, and he did. Then, when it was time for football practice, he came to her in the kitchen and stood face to face with her. In his usual joking manner, he told her, “You’re short.” After some playful back-and-forth, he was out the door.
Friends, strangers and people who barely knew Tony have been flooding the family’s home with cards, donations and condolences since news spread about his death.
Workers at several offices and schools took up collections to help the family pay funeral expenses. Howard lost her job a few weeks ago and does not have insurance. Donors big and small stopped by. Three schoolgirls, no older than 12, brought a handful of coins.
The Rams organization is giving Tony’s teammates tickets to see an NFL game. Offers came in from no fewer than three strangers wanting to donate burial plots for the boy. A local church passed the collection plate and raised more than $300 last Sunday. And the Berkeley school teachers and staff have brought a constant flow of food to the family, from cakes to roasted chicken.
Tony’s classmates at Berkeley Middle School busily made banners and asked the funeral procession to drive by the school early Friday. They decorated his locker with balloons. The students told a social worker, Beckie Baum, who is helping console them, that for now they wanted Tony’s chair and desk left where they were in each of his classrooms.
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