Breathing a Sigh of Relief
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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