Mike Grieselding is glad to be alive. The 53-year-old Holland man was on the brink of death in January after suffering a massive heart attack.
“He flat-lined, and they called Code Blue over the intercom, ” said his wife, Celine.
“His heart stopped. He had no circulation,” said Dr. Mark Bonnell, a cardiothoracic surgeon and assistant professor of surgery at the University of Toledo Medical Center, the former Medical College of Ohio.
Dr. Bonnell said Mr. Grieselding technically died that night in the emergency room, but he was brought back to life through cardiopulmonary resuscitation and the use of a temporary pump system called an ECMO, which stands for extracorporeal membrane oxygenation.
There are 5 million new cases of heart failure diagnosed each year, Dr. Bonnell said.
“It’s a huge problem. It's the number one expense for Medicare in this country,” he said.
Not everyone needs a heart transplant, but by conservative estimates there are at least 50,000 people nationally who could benefit from one — including Mr. Grieselding, said Dr. Bonnell.
The road from heart failure to heart transplant, however, is long and arduous.
“There are about eight to 10 thousand people waiting for hearts, and we do about 2,000 [transplants] a year,” Dr. Bonnell said.
The first step is being approved for the heart-transplant waiting list, which itself is a daunting task, said Dr. Robert Higgins, director of the Ohio State University Wexner Medical Center's comprehensive transplant center.
Dr. Higgins, also a past president of United Network for Organ Sharing, said two hospitals in Ohio and two in Michigan are approved by the national organization to perform heart transplants: the Ohio State hospital and the Cleveland Clinic, and the University of Michigan Health System and Henry Ford Health System in Detroit.
“A patient will have to get into one of these programs. Someone in Toledo can be referred if their doctor thinks they are a candidate for transplant,” Dr. Higgins said.
Dr. Bonnell said Mr. Grieselding is a good candidate for a transplant, and he plans to refer him to either OSU or UM.
After a lengthy examination and evaluation process, only 3,000 people are placed in the national registry for heart donation each year. The typical wait time is up to six months, said Dr. Higgins.
The Grieselding family knows the odds are long but they still hope he will be one of the few chosen to receive a donor heart.
“You can’t predict who will get a heart. I just want Mike to have a phenomenal rest of his life. I want him to be with our kids and to see them all graduate from college and watch them all get married and we have to be grandparents yet. I have this fear all the time that something else is going to happen,” Mrs. Grieselding said.
Her fear is understandable, considering the painful ordeal he and the family have been through over the last six months.
Mr. Grieselding worked in several Toledo-area drugstores during his 27 years as a pharmacist, his wife said.
“I think [the heart attack] was a combination of a lot of things. I think he was stressed out. I think he was working too much. I think he was not taking care of himself and Mike never exercised,” she said.
He spent 70 days in intensive care at UTMC, much of it in a coma, and was eventually fitted with an implanted blood pump called a left-ventricular assist device.
The current LVAD model, smaller and lasting years longer than the original, was approved for use in the United States in 2010. Dr. Bonnell has implanted the mechanical heart in some 24 patients since 2011, when he started Toledo’s only program of its kind at UTMC.
“It’s designed to take over the function of the left side of the heart — the part of the heart that pumps blood to the body,” he said. The device can pump up to 12 liters a minute.
“It was quite a leap of faith and a very very high-risk decision to do this,” Dr. Bonnell said about implanting the LVAD in Mr. Grieselding. Although he miraculously survived his heart attack, his health was still poor and several of his organs also were supported by machines.
Mr. Grieselding was released from the hospital in early April and seemed to be on the road to recovery when he had another setback.
LVAD implant recipients have a 5 percent chance of suffering a stroke, Dr. Bonnell said, and Mr. Grieselding fell into that group, suffering a massive episode just one month after returning home.
It affected the entire right side of his body, and while he can hear and understand speech he has trouble forming words, Mrs. Grieselding said.
“I want to come home from work and have him say, ‘?How was your day.’? And we don’t have those conversations,” she said.
Mr. Grieselding is not giving up. “I’m here, ” he said.
For now he and his family tackle the complications of life with the LVAD, which include never being able to immerse his body in water, carrying extra batteries everywhere he goes, and enduring stares from people who may fear his mechanical heart’?s battery pack is a bomb.
“Dr. Bonnell’s thoughts right now are, ‘?Let’s just let his mind recover and we will see where he is in another month.’? If there was no stroke, we would be on a little bit smoother road right now to getting a heart,” Mrs. Grieselding said.
OSU’?s Dr. Higgins said the stroke will not disqualify him for a new heart, but it will be considered by a team that decides which patients get on the transplant list.
Deciding who gets a heart is very complex, Dr. Higgins said. It's based on a patient’?s height, weight, blood type, and severity of illness. Patients with an LVAD “are the sickest of the sick and need a transplant sooner,” he said.
Mrs. Grieselding views the mechanical heart as a bridge device to keep her husband alive until he can receive a new heart. Dr. Bonnell said that was the original intent, but technological advances combined with the numbers of people surviving heart failure is creating a new dynamic in the heart transplant field.
He said last year the number of patients implanted with a LVAD eclipsed the number of heart transplants. There were 2,000 transplants and 2,700 LVAD surgeries nationally.
“I think a mechanical device like this is going to be the only available answer for a lot of people, because the donor pool is so limited, we can’t possibly treat everybody that has a need for heart assistance with a transplant,” Dr. Bonnell said.
By Marlene Harris-Taylor - The Blade, Toledo, Ohio (MCT)
©2014 The Blade (Toledo, Ohio)
Visit The Blade (Toledo, Ohio) at www.toledoblade.com
Distributed by MCT Information Services