Early in 2008, Bill was diagnosed with severe
heart failure. With the help of Dr. Joseph Casella, our family doctor, and the
specialized knowledge and outstanding care of Dr. Marc Goldschmidt, Bill
recovered enough to regain a full and active life for a time. But his disease
progressed, so in 2010 Dr. Goldschmidt sent Bill to see Dr. Zucker, who heads
the heart transplant program at Newark Beth Israel Hospital. From that time
until his death, his medical team worked together to provide a quality of
treatment for Bill that I have never seen or heard of anywhere else. Bill could
not have survived as long or with as good a quality of life as he did without the
very special care he received from these extraordinary people.
As Bill's heart failure progressed his doctors tried
a Primacor infusion pump, which wasn’t enough. So the medical team fitted Bill with
an LVAD (Left Ventricular Assistance Device), a type of heart pump, while he
awaited a heart transplant. We opted to be a part of an experimental group of
patients using the Duraheart LVAD--the newest pump available, and Dr. Camacho,
a team surgeon, implanted the LVAD in November 2010.
To compound his medical issues, on January 31st
2011, Bill had a stroke, the first of three he would have in a period of two
weeks. Bill appeared to completely recover from the first two strokes and was
partially recovered from the third, but his LVAD had filled with blood clots
and needed to be exchanged. When Dr. Simsir, a surgeon on the Newark Beth
Israel transplant team, told me what was needed, he also said such surgery, was
risky. Undergoing open heart surgery is not normally done until at least six
months after a stroke. But, when Dr. Simsir told me that he would opt for this
surgery if his own loved one were in this position, and knowing that no one on the
entire team disagreed, we were confident that the surgery was the right choice.
So, Dr. Simsir performed the surgery on February 13th and replaced Bill’s
Duraheart with a Heartmate II LVAD. Dr. Simsir discovered then that the strokes
were caused by a failure of the device and not by a failure of Bill’s body.
There was a kink in a flow tube that pooled blood which created the clots. It
was a chance happening. Over the next two days, further surgery was required to
remove blood clots from Bill’s chest. These were not easy surgeries, and the
recovery was complicated, but they saved Bill’s life.
Following the LVAD exchange, Bill spent nearly
two months at Newark Beth Israel, during which time he was paralyzed on his
left side and had dysphagia which prevented him from swallowing thin liquids.
He aspirated and was fitted with a feeding tube. He barely spoke. He regained
movement slowly, first in his leg and then his left arm moved ever so slightly.
After his discharge from the hospital he spent another month in inpatient rehab
at JFK Johnson. While he received treatment, I learned how to transfer Bill in
and out of his wheelchair, so I could care for him at home.
Bill came home a week before his 70th birthday,
and despite my training, I needed help caring for him at home. Friends came
over to help me carry him up and down the outside stairs in his wheelchair when
he went to the doctor and three therapists and a nurse came to our home for
four months. Then in July, Bill aspirated and Dr. Casella and I agreed we
wanted him to get Vitalstim Therapy which was only available as an outpatient. At
this point, Bill was able to use his walker with assistance and to climb the
outside stairs at our house. So, he began another round of rehab as an outpatient in Newton, going five days a week for
three therapy modalities. When Newton felt he couldn’t progress beyond walking
with a walker, and I disagreed as I saw he was ready to begin working on his
balance, I switched his treatment to Kessler Rehab in Chester.
During the time that Bill was receiving treatment
for balance at Kessler, he began to blossom. In addition to the outpatient
therapies, he worked a lot at home. To make this easier, we turned our living room
into our own rehab center. We had a NewStep recumbent cross-trainer stepper
with 10 levels that Bill used most days, and he progressed from level 1 for 15 minutes
to level 4 for an hour. We had parallel bars, which he used to practice walking
hands-free. We were preparing to install a partial weight bearing rig so that
Bill could start walking freely and safely on a treadmill. And we had just
received his new center-positioned walker which would have allowed him to walk
alone. With all his effort, Bill’s balance was rapidly improving, and he was
beginning to do standing activities, like washing and drying his hands. With
these improvements in his abilities, he was also becoming very confident and
strong.
On Friday, November 25th, Bill graduated from
speech therapy, where he was being treated for swallowing--he was able mostly
to swallow thin liquids again. We went
out to celebrate this milestone in his recovery, and he wanted to eat at a
sushi restaurant. We almost chose another place; we almost just went home to
eat and watch a cooking show. We almost avoided what happened. Bill even second
guessed me and almost picked Mexican. I almost let him; but he really wanted
sushi. The food turned out to be tainted. I only got a little sick, but Bill
became severely sick as a result of where and what we ate, and in a cruel twist
of fate, a severe bout of food poisoning did what heart disease and stroke
couldn’t do, which was defeat this strong and wonderful man. His indomitable
spirit was not enough to fight the effects of the poison on his weakened body,
and we lost Bill.
In another cruel
twist of fate I got a letter in the mail the day after Bill’s death telling us
that he was approved by his insurance company to receive a heart transplant as
of November 18th. Dr. Zucker must have reinstated him on the active
list of patients scheduled to receive a heart transplant. He spared me that
knowledge in the hospital. The one consolation I feel is knowing that the heart
that would have been Bill’s will go to another needy person and another family
will get to experience the relief and joy we had hoped for.
***
A week before Bill
died, I happened across the song by Spanky and Our Gang called Sunday Will
Never Be the Same. I remember thinking how I wanted to just get it out of my
mind. But it got stuck, you know, how that sometimes happens? I hummed it and
sang it and Bill remarked, "You have such a pretty voice." And then
on Sunday he left us. Sunday may never be the same for me. But none of us will
be the same for having known Bill. Bill changed us all.
Special thanks to Barbara Klipper for her editing.
I remember Sunday morning
I would meet him at the park
We'd walk together hand in hand
'Til it was almost dark
I would meet him at the park
We'd walk together hand in hand
'Til it was almost dark
Now I wake up Sunday morning
Walk across the way to find
Nobody waiting for me
Sunday's just another day
Walk across the way to find
Nobody waiting for me
Sunday's just another day
Sunday will never be the same
I've lost my Sunday-song,
He'll not be back again
I've lost my Sunday-song,
He'll not be back again
Sunny afternoons that make me
Feel so warm inside
Have turned as cold and grey as ashes
As I feel the embers die
Feel so warm inside
Have turned as cold and grey as ashes
As I feel the embers die
No longer can I walk these paths
For they have changed
I must be on, the sun is gone
And I think it's gonna rain
For they have changed
I must be on, the sun is gone
And I think it's gonna rain
Sunday will never be the same
I've lost my Sunday-song
He'll not be back again
I've lost my Sunday-song
He'll not be back again
I remember children
Feeding flocks of pigeons
I remember sunshine
And you were mine
Feeding flocks of pigeons
I remember sunshine
And you were mine
Sunday will never be the same
I've lost my Sunday song,
He'll not be back again
I've lost my Sunday song,
He'll not be back again
An interesting article in AARP Bulletin regarding the Thoratec LVAD:
ReplyDeletehttp://www.aarp.org/health/conditions-treatments/info-12-2011/heart-pump-helps-those-with-heart-failure.html
LVAD Article
ReplyDelete