By Liz Torrey

Dammien Mason is so committed to making the perfect taco that he nearly died while doing it.

Mason is an owner and operator of RVA Street Foodies, a collective of food carts that serves the Richmond metro area and offers hungry customers meals from a set of nine different menus, from rice bowls to “wraps and stacks.”

While serving up tacos at a recent late-night event, the alarm on Mason’s left ventricular assist device — LVAD for short — started to sound.

“You only get 18 hours on the battery charge,” he explained. “This event was so noisy, we couldn’t hear the battery alarm going off. Almost died selling tacos.”

An LVAD is a mechanical pump that is surgically implanted into the chest; it assists the left ventricle of the heart in pumping blood when the heart is too weak to do so on its own.

Mason had his LVAD implanted by a collaborative team from VCU Health’s Pauley Heart and Hume-Lee Transplant centers in 2021 after experiencing his second cardiac arrest in five years. His wife saved his life by performing CPR following the first cardiac arrest; the second occurred the day Mason’s mother passed away in late January 2021. During the next 104 days in the hospital, he was diagnosed with dilated cardiomyopathy, a condition in which the chambers of the heart become enlarged and stretched, causing the heart’s muscle tissue to thin and weaken.

I tried another hospital at one point and it just wasn’t the same concern, the same care, the same touch. The VCU Health doctors just seemed more informed and proactive and willing to answer all my questions. So that’s why we decided to stay right there with it.

Dammien Mason, VCU Health patient

“Dammien had a severe cardiomyopathy when we met him,” said Keyur Shah, M.D., chief of heart failure at VCU Health Pauley Heart Center. “His heart was large and weak; his valves were leaky; and he was developing symptoms of end-stage heart failure: fatigue, shortness of breath, intolerance of activity, edema [swelling caused by fluid retention in the body], poor appetite, loss of muscle — that was all happening.”

Perhaps most alarmingly, noted Shah, “Dammien had a history of sudden death from arrhythmias.” As Mason’s heart became weaker, he was experiencing a recurring deadly arrhythmia called ventricular tachycardia, a dangerously fast heartbeat that occurs in the lower chambers of the heart and can lead to cardiac arrest. To help control his ventricular tachycardia, Mason had an implantable cardioverter-defibrillator (ICD) placed in his chest after his first cardiac arrest in 2016.

“I’ve been shocked by my defibrillator at least 27 times,” Mason said. “You could say I’ve actually had 27 cardiac arrests, not two.”

“His heart was too weak to respond to the typical treatments for arrhythmia, like ablation,” Shah said. “Essentially, his heart was barely pumping. At that point, we started having conversations about heart transplant.”

Mason, however, was not keen on the idea of taking immunosuppressant medicants for the rest of his life — the required course of action for all heart transplant patients.

“That was when Dr. Shah and a few others mentioned that I might be a great candidate for LVAD,” Mason recalled.

A lifesaving option for heart patients

LVADs are often considered for patients when other treatments for heart failure, such as medication or lifestyle changes, have not been successful. LVADs are used either as a bridge to heart transplant, while a patient awaits a donor, or as a definitive therapy for those who are not transplant candidates.

“The hope for many patients with advanced heart failure is to get a transplant, but the beauty of the LVAD is that they don’t have to live their life waiting,” said Kathryn Abernathy, MS, RN, ACCNS-AG, CHFN, manager of transplant services for the VCU Health Hume-Lee Transplant Center.

Surgeons connect the LVAD to the left ventricle and aorta. It draws oxygen-rich blood from the ventricle and pumps it into the aorta, which then distributes this blood throughout the body. The device is controlled by an external power source that must be worn on the body, usually near the waist.

Since 2006, VCU Health surgeons have implanted more than 400 LVADs in patients.

“Dammien opted for the LVAD and he did wonderfully,” Shah said. “His breathing improved, he’s gotten his muscle back – it took him a few months to build himself back up, but he’s fully functional now.” 

What to know about left ventricular assist devices (LVADs)

Mason notes he’s been with his Pauley Heart and Hume-Lee care teams almost since “day one.”

“I tried another hospital at one point and it just wasn’t the same concern, the same care, the same touch,” he said. “The VCU Health doctors just seemed more informed and proactive and willing to answer all my questions. So that’s why we decided to stay right there with it.”

That said, Mason acknowledges that his road to recovery was not an easy or a linear one.

“I came out of the hospital and now [I’ve] got this big apparatus on me that I don’t know how to carry,” Mason said. “I went into a little bit of depression at that time.”

“I’m a hustler,” he continued. “I like to run, I like to move, I’m never in town. I felt like the LVAD would totally stop everything — because everything had to be changed up.”

Initially, Mason was worried about how the LVAD would affect every aspect of his lifestyle, from what he should eat, to how he would dress, to whether he would be able to get a job.

Soon, however, Mason met and conquered his first challenge: coming up with a way to wear the LVAD’s external power device, which is about the size of a large paperback book. Many LVAD patients carry the power device in a bag.

“I figured out a way to put the battery pack on me without actually having the bag on me,” he said. “I got my mobility back out of the desire to be comfortable. I can move, I can play basketball, I can drive.”

It was at this point that Mason started considering his next steps, both personally and professionally. Mason also quit smoking, quit drinking and even adopted a dog.

“I knew that I had to eat right,” he said. “I started learning about ‘food as medicine,’ and juicing, fasting, going to bed on time, walking, exercising, breathing, everything.”

Adopting a lifestyle focused on healthy food became Mason’s passion – one he now shares with others.

Connecting healthy food to heart health

RVA Foodies was originally founded by Malcom Andress, MDiv, in 2010, as an expansion of Soul Ice, a locally loved water-based frozen dessert made with pureed fruit that was Andress’s first foray into the Richmond street food scene.

“When we launched RVA Street Foodies, I had a whole food truck at first,” Andress said. “But then I realized that carts would be an easier onboard for employee workforce development. ‘Healthy heart carts’ is what we call them.”

What makes an RVA Street Foodie meal healthy is also one of the things that makes its business model unique. Whenever possible, Andress and his franchisees source food from small Virginia farmers.

“Most of us don’t know where our food comes from,” Andress said. “The current food supply chain goes from farm to production facility to grocery store.” 

Malcolm Andress and Dammien Mason run RVA Street Foodies, a collective of food carts in Richmond. Mason is a heart patient at VCU Health and recently had a procedure to install a left ventricular assist device (LVAD). (Enterprise Marketing and Communications)

Andress notes that during this supply chain journey, food is often processed in ways that isn’t great for our bodies.

His solution? Create an alternative supply chain that brings fresh, locally grown produce direct to consumers who may not otherwise have access to it.

“We have to really look at giving ownership back to cultures and allowing people to feed themselves,” Andress said. “Black and brown people don’t have ownership on the distribution side of the food supply chain – we’re always relying on another culture to feed us. And when you look at what food is available in Black neighborhoods, it is predominantly unhealthy."

The draw of unhealthy, ultra-processed foods is that they are typically inexpensive, non-perishable, and often require little or no time to prepare. Research shows that people facing financial challenges may eat more ultra-processed food, with those having limited or uncertain access to adequate food sources are even more likely to eat ultra-processed food. Ultra-processed food manufacturers have also been shown to explicitly and disproportionately target certain racial demographics when marketing their products.

Within the city of Richmond, more than 20% of residents experience food insecurity, and more than 30% of Black Richmonders are living below the poverty line.

For households with tight budgets, it can be difficult to turn away from the affordability and accessibility of ultra-processed foods. But studies indicate that the more people consume ultra-processed foods, the greater their risk for heart disease and serious cardiovascular health problems. According to the American Heart Association, Americans living with heart disease are significantly more likely to experience food insecurity.

Andress says he sees the connections between the health care system, food supply chains and an individual’s “personal needs.”

“This is where our carts come in — they’re a mini farmer’s market meets healthy fast food,” Andress said. “There are not always enough hours in the day, [so] we want to make this kind of food directly and immediately available.’” 

What are your options after being diagnosed with advanced heart failure? Listen to Keyur Shah’s interview on the Healthy with VCU Health podcast

Mason and his wife had known Andress for years, and had long considered going into business together, but it wasn’t until Mason began pursuing a healthier lifestyle post-LVAD that everything “clicked” for the three partners.

“I had to take control of what I wanted,” Mason said. “I could talk about the food insecurity problem all day and it’s still going to be there. This business right here made me a part of the solution.”

At first, Mason served as manager of his fleet of carts, but was hesitant to step behind the grill and cook — until one of his employees didn’t show up for a shift, and he had no choice.

While working the grill, a new energy comes over Mason. His heart pumping strong with help from the LVAD, he’s able to enjoy the sight of happy customers devouring every item on his menus.

“They’re like, ‘This tastes so different,’” he said. “I know what the difference is: you’re not used to eating fresh food.”

“It was literally like a magic wand got waved over him,” Andress said. “I watched him regain his spirit and it was no longer about the LVAD.”

That’s because for Mason, the work is not just about a job – it’s about a new healthy lifestyle.

“If you ain’t smiling when you bite into that taco, I didn’t do it right,” he added. “And I get a smile every time. Every time.”