The heart is a magnificent pumping machine! For most folks, it performs beautifully right up to the moment that a higher power decides it is time to meet Him and discuss the life you have lived. For some of us, the journey through this mortal existence is prolonged by the intervention of superbly trained doctors, who correctly diagnose the signs and symptoms of a pump that is needing maintenance. I am one of those folks. I am sitting at this keyboard because of a team of consummate medical professionals, who correctly analyzed the problems and intervened in a timely fashion. Today, I am enjoying a very active life, with a bucket list that is remarkably short, and I owe this good fortune to modern American medicine.
I had lived with a heart “murmur” for as long as I can remember. It was of no consequence to me as it had no effect on my life, rather was simply noted on every visit with my family practitioner. Fast forward life to a period about 7 years ago when I began to notice odd, strong heartbeats in no particular order. These beats were annoying but not debilitating, however the frequency was slowly increasing. The EKG indicated, during each hookup that was still routine at this point, a little thing called a Premature Ventricular Contraction, or PVC for short. It feels like a missed beat but is really an extra beat involving heart chambers that are not quite full, thus the thumping feeling in my chest. Most folks have one or two PVCs occasionally and they usually are quite benign. My PVCs were increasing, though, and when they became excessive, my physician ordered drugs that tended to even out the heartbeat. These drugs are antiarrhythmics, designed to regulate the electrical impulses within the heart. In the vernacular of a mechanic, my heart was “jumping time”. My physician suggested a cardiologist intervention and I complied. If you are keeping score , I now have two cardiac issues, a murmur attributed to a leaky mitral valve and an electrical problem. The medicines were not doing the job, and my physician then suggested an electrophysiologist, or heart electrician. These are cardiologists that are members of a very specialized sub-specialty that uses a variety of techniques to regulate the electrical system in the heart. I was up to somewhere around 25,000 PVCs a day, making the simple task of establishing a pulse rate nearly impossible. After researching this specialty, we selected the head of the Cleveland Clinic electrophysiology section, Dr. Bruce Lindsay, to evaluate the problem. He did so and I underwent a procedure called an ablation where high frequency radio waves destroy a tiny part of the heart where the errant electrical impulse originates. Dr. Lindsay also ordered an TEE or echocardiogram viewed from the esophagus, giving a much clearer picture of the mitral valve. The valve was determined to be “flail” or virtually non-functional, not at all a good scenario. I was recovering from the ablation, which was successful in eradicating most of the errant beats, when Dr. Lindsay entered the room and described the problem with the valve. He suggested an early surgical intervention, which was necessary if I intended to be around much more than a year. I thought the surgery was a great option. Plans were made and I was wheeled into a thoroughly intimidating surgical suite three days later for an open heart procedure to repair or replace the valve. The surgeon, Dr. Douglas Johnston, was no stranger to these procedures, having among his qualifications, membership on the Massachusetts General Hospital heart transplant team. I have endured several surgeries and thought this might be a little more demanding. I had no idea!
I woke up fighting the tracheal tube in cardiac ICU. The therapist that removed it was my new BFF and the recovery was on. Without being overly dramatic, let me suggest that open heart surgery is not for the timid. I had hoses and lines running out of my body in places that I could not imagine. The pain, carefully controlled with meds, was occasionally very intense, usually near the end of a particular dose’s effectiveness. The discomfort and recovery were managed by what can only be described as a superb medical staff. I was particularly gratified to learn that Dr. Johnston was able to repair the valve as opposed to replacing it, an important consideration as you age. I have recovered nicely and the measure of valve effectiveness indicates it is fully functional. A short time after recovering from this procedure, I found myself back in the ablation laboratory to ablate another part of the heart that Dr. Lindsay had avoided as a result of the proximity to the valve surgical site. I am now virtually PVC free.
As a side note, my mother’s side of the family was consistently plagued by dysfunctional hearts, so heredity may be a consideration in my case. I take nothing for granted and am fully aware that I would be a distant memory for folks who know me had this intervention not occurred. Some countries may enjoy great medicine, but none better than America. My debt to the doctors who have given me the gift of a continued life is great and I would be remiss if I failed to mention them.
Dr. Neal LaPointe, Family Practice
Dr. Jim Tritz, Cardiology
Dr. Bruce Lindsay, Electrophysiology
Dr. Douglas Johnston, Cardio/Thoracic surgeon
Six years later……..and I am having a ball. Thank you doctors.