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The fatigue started suddenly, remembers Bob
Winkler of Stratford. “In about a week’s time,
I went from feeling fine to feeling completely
exhausted, as if I had been hit on the head with a hammer.
Worst of all,” he continues, “I was constantly fighting
to catch my breath. First I couldn’t walk up stairs without
gasping. Then I couldn’t walk at all without gasping. And
then I couldn’t sleep, because it was too hard to breathe
when I was lying down. Each day became a living nightmare,
just a nightmare.”
Like a recurring nightmare, once Bob’s symptoms began,
they didn’t go away. Initially, he dismissed his fatigue as the
result of too many late nights. But deep down, he knew
something was terribly wrong.
Bob was used to taking his high energy level for granted.
A professional photographer, he depended on his body to
provide him with the stamina to jump into a situation
to capture the next best shot. So when his endurance
plummeted unexpectedly, he was frightened.
But it wasn’t until his arms and legs suddenly swelled that
Bob knew he needed help—fast. He went to a walk-in
clinic close to home, described his symptoms and had a
chest X-ray. Minutes later, the physician sent Bob to
Bridgeport Hospital.
Cardiologist Adam Schussheim, MD, examined Bob in
the Emergency Department (ED) and recognized the
severity of Bob’s condition right away. “It was clear that
he was battling congestive heart failure, or CHF,” says
Dr. Schussheim. “He had many of the tell-tale symptoms:
swelling in his legs, breathlessness and difficultly
sleeping flat on his back. My exam suggested that the cause was mitral valve disease. He had the characteristic
heart murmur and a heart rhythm problem. Diseases of the
heart valves, which weaken the heart muscle, can lead to
congestive heart failure.”
A team from the Heart Institute at Bridgeport Hospital performed
two diagnostic tests on Bob’s heart: an echocardiogram
(a test that creates a video image of the heart from
which doctors can determine how well the heart is pumping)
and a cardiac catheterization (a test during which a thin tube
is placed into a blood vessel and threaded to the heart to help
doctors check for blockages). Chief of Cardiothoracic
Surgery M. Clive Robinson, MD, and Cardiothoracic
Surgeon Umer Darr, MD, read the results and recognized
that the mitral valve and the tricuspid valve in Bob’s heart
weren’t working correctly.
“The valves of the heart allow blood to flow through
the heart in only one direction,” says Dr. Robinson.
“If a valve doesn’t close tightly, blood flows backward—this
is also called regurgitation—and isn’t pumped throughout
the body. People with poor blood flow experience extreme
fatigue and feel short of breath.” Left untreated, valve regurgitation can lead to high blood pressure in your
lungs and eventually congestive heart failure, which can be
life-threatening.
Once Dr. Robinson and Dr. Darr diagnosed Bob’s heart
condition, they met with Bob to discuss his options.
“There are a few ways to fix a faulty mitral valve, depending
on the level of damage,” explains Dr. Darr. “The preferred
method is a mitral valve repair, performed by a cardiothoracic
surgeon (a surgeon who specializes in surgeries of the
heart and chest region), who closes the leaky valve using tiny
surgical sutures (stitches) or sews a surgical ring around the
opening of the valve to tighten it. The benefits of mitral
valve repair over other surgical procedures include longerlasting
results, fewer surgical complications and a lower risk
of stroke and infection.”
Bob agreed that surgery was the best option. “This would
be my first time in the hospital for an operation and, at
first, I was very nervous about having any kind of surgery,”
he says. “But Dr. Darr was so upbeat about my outcome.
His optimism was contagious. Talking to him made me
feel relieved.”
Surgery was delayed for a couple of days while Bob took a
diuretic to help his body get rid of extra fluid caused by the
CHF. “We try to ‘fix’ as many things as possible prior to
surgery,” explains Dr. Darr. “Outcomes are usually much
better when patients go in to surgery with fewer issues.”
On the day of the surgery, a dedicated cardiac anesthesia
team (a physician anesthesiologist and a certified registered
nurse anesthetist) met Bob. This team was responsible
for his sedation during surgery and controlled the
lung machines (ventilators) and breathing tubes. They
also managed Bob’s pain after surgery and determined
when he was ready to leave the recovery room.
Dr. Darr performed the delicate surgery at Bridgeport
Hospital, assisted by Dr. Robinson. Together, they repaired
Bob’s mitral valve and tricuspid valve. With the valves in
regular working order, Bob’s CHF would also clear up on
its own.
One day after surgery, Bob was sitting up. A day later, he
was walking. In less than a week, he was strong enough
to go home.
“I was so impressed with all the people who took care
of me while I was in the hospital, from the surgeons to
the nurses who drew my blood. Everyone in the ICU
was professional, friendly, efficient and very supportive.
You expect that kind of treatment from your friends and
family, so when it comes from someone who doesn’t even
know you, it’s a wonderful surprise.” Even the kitchen
staff made a favorable impression on Bob. “They gave me
advice about what to order and how I could tweak an entrée to make it to my liking. And the French toast?
Delicious!” he remembers.
Today, Bob is thrilled to be back to his regular routine, and
back to his commercial photography work and his photojournalism
assignments. “Dr. Darr had said he could
fix my mitral valve. I was expecting a good outcome
and that’s exactly what happened,” says Bob. He’s had
a few follow-up visits with Dr. Darr and Dr. Schussheim
and will be finishing up some medication in the next
few months.
“Bob is quite lucky,” says Dr. Schussheim, remembering
the day Bob came into the ED. “Many times when patients
already have these severe symptoms, they are left with
impaired heart function even after surgical correction. We
were lucky to be able to identify the problem, repair his
valve quickly and preserve his heart function as much as
possible. His valve is now perfect, his problems are gone
and his heart function is basically normal.”
Dr. Darr agrees. “Bob came in to the hospital profoundly
sick and, after being treated, left profoundly healthy.”
Bob says that since the surgery his attitude has dramatically
improved. “After this experience, realizing that my life
could literally change in a heartbeat, I appreciate things—
especially the little things—more than ever. I also think
about what might have happened if I had continued to
ignore my symptoms or passed them off as just needing
more sleep,” he continues. “If it weren’t for Bridgeport
Hospital, I’d probably be dead. Thank God for Dr. Darr.
Thank God for Bridgeport Hospital!
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