'Bridge to a transplant': Rainier woman among first to use innovative heart pump

SOURCE: Daily News (Longview,WA)
AUDIENCE: 45,880
DATE: 11-26-2009
HEADLINE:
'Bridge to a transplant': Rainier woman among first to use innovative heart pump

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Thursday, November 26, 2009 12:10 AM PST By Cheryll A. Borgaard 'I said 'That was me three years ago,' " she said recently. 'I want to be that woman again."

An Oct. 28 heart transplant has her back on the path to health. But she wouldn't have made it without an innovative heart pump that made her strong enough to endure the transplant.

Her doctor called the pump 'a bridge to a transplant."

Doctors at Oregon Health Sciences University implanted a HeartMate II in September, making Zieliski the first Oregon woman to receive the device. Unlike most heart pumps, the HeartMate II pushes blood in a continuous stream, rather than in pulses, and is more durable because it has only one moving part. It's been in use since its approval in 2008.

'It's just a steady stream of blood going through you," Zieliski said. 'If you listened, it was just a hum and I had no blood pressure."

Zieliski said she 'hated, hated, hated" the heart pump. She also knows she would have died without it.

'I really didn't want it, but the doctor said it was my only chance," she said. 'I got up to half a mile walking with it, but my body never adjusted to the HeartMate."

'Your body loved it," her husband, Greg, countered. 'Your psychological side hated it."

Losing consciousness

Zieliski's health problems started with fainting spells a little over a year ago. Doctors at St. John Medical Center referred her to OHSU, the local hospital's partner in critical cardiac care.

'But they found I had no blockage, I was clean," Zieliski said.

After she had more bouts of losing consciousness, doctors decided to give Zieliski a pacemaker Oct. 28, 2008.

Then came more doctor visits, more medications, more hospitalizations, more tests. An electrocardiogram in February showed one side of her heart was operating at only 15 percent capacity.

During a hospital stay in March, she saw Dr. Tony Kim. He wasn't her primary cardiologist yet, but he gave her bad news.

'He told me the day I went home, I was probably going to need a heart transplant," Zieliski said.

She said her primary cardiologist wanted to continue using drug therapy for treatment.

'He had a different approach, but I wasn't responding," she said. 'The medications were just making me worse."

Though she said the first doctor 'was good," when he left in June, Zieliski was encouraged when Kim took over her case.

Kim ordered a biopsy of her heart tissue for July 1. After seeing the results, he immediately put her in the hospital, she said. She would be there for the next 50 days, her heart growing weaker and weaker.

'The Michelin woman'

Dr. Tony Kim, 41, came to OHSU in January from the University of Chicago, where he was on the faculty for seven years. Previously, he'd been a fellow at Johns Hopkins University in Baltimore. He brought the HeartMate II to the attention of the cardiology department at OHSU.

'(The HeartMate II) was the newest, and it was a quantum leap from previous ones," said Kim, associate professor at OHSU and the director of its heart failure and transplant program. 'I made a push for our team to acquire it and receive full training."

Zieliski was a good candidate for the HeartMate, but she and Kim kept up hopes for a heart transplant donor.

'We wanted to proceed directly to a transplant, since part of Wendy's desire was to have one procedure instead of two, and we wanted to honor her wishes," Kim said. 'But as she was waiting for a transplant, her condition deteriorated."

Without the HeartMate II, Zieliski had little chance to survive, he said.

'She couldn't even be outside the hospital. By implanting the pump, we were able to get her home and also to rehabilitate," Kim said. 'It was a bridge to a transplant."

Implanting the HeartMate II is 'a big procedure," normally taking two to three hours to perform, Kim said. But for Zieliski, because of complications, she ended up in the operating room three times within 24 hours on July 31, the day of the implant.

The effects of the operation, along with the multiple medications she'd been taking for months, bloated her with 65 pounds of water weight. Her skin was so tight, it was actually starting to break.

'Basically, I was the Michelin woman," she said.

Heart transplant

After the HeartMate implant, the really hard work began for Zieliski -- and her husband of 42 years.

She had orders to walk to lose weight. Greg, 62, was behind her, if not beside her, every step of the way. She was a reluctant walker.

'It was very painful. At first, I couldn't even walk around the couch and I cried because I couldn't breathe," she said. 'Every day, if it wasn't for Greg, I wouldn't have done it. I'd say, 'I'm going to fall.' He'd say, 'Don't worry. I have a chain in the barn, I can pull you back up.' "

'We went through some tough times," Greg said. 'I didn't like myself when I had to push her so far. Her normal inclination was to say no, but we're in a life-and-death situation here."

Zieliski constantly had to wear two battery packs that weighed about 12 pounds to keep the HeartMate working. A football-shaped controller 'with all the bells and whistles" was strapped around her waist. At night in bed, she was connected to a large monitor.

The water weight came off, and she worked up to walking half-a-mile each day.

On the evening of Oct. 27 -- nearly three months after the implant -- they got the call that a heart was waiting for Wendy.

'I had just been to the clinic and we had been saying it would be another two to three months out," Zieliski said. 'We get this call, and they said they're in the process of accepting a heart for me. They said they have a heart, this perfect, perfect heart. It was such a good match, it could have been (an) identical twin."

It was an emotional time, Greg Zieliski said.

'On the way down (to OHSU), I actually turned and said, 'Are you ready to go through this?' A few seconds went by, and she said 'yes,' " Greg said. 'We got to the hospital, and she was a different person, more chipper. The previous year had been very hard on her."

Wendy Zieliski said she did feel like a new person when she woke up from the heart transplant on Oct. 28 -- exactly a year since she'd gotten that first pacemaker.

'I knew the minute I woke up I had a new heart," she recalled. 'I can't describe how my body said, 'Oh, we have a heart beat.' "

Since her old heart was removed, it has been under study at OHSU to figure out why it started failing so rapidly. That remains a mystery.

'We don't know exactly the cause of Wendy's heart problems, other than the fact that all of her heart tissue was dying rapidly. It's unusual for heart tissue to turn that quickly," Kim said. 'We think there might have been an inflammation process that was affecting her heart. It's not that common."

'They told me there was no heart left -- just scar tissue," Zieliski said.

A great gift

Because of the better condition her body was in with the aid of the HeartMate II, her recovery from the transplant has been better than expected, she said. Thinking she would be in the hospital a minimum of four to six weeks, she was home in two weeks after the transplant.

'And I cooked a meal the next day. I hadn't cooked in 10 months."

Zieliski said getting the HeartMate likely saved another life in addition to hers.

'My doctor said that I saved a person's life the day I got the HeartMate, because if I'd taken a heart at that time, I would have died and taken that good heart with me -- one that someone else could have used."

Zieliski said she knows a little bit about the donor, but she declined to share. 'It's a very emotional and private thing. They gave me a great gift that day."

The Zieliskis both tear up, recalling the generosity of Wendy's donor and his or her family.

'I've got a second chance for some reason," she said. 'I don't know if it's for one of our grandkids or some other heart patients. You choose the paths that are out there. We figure there's something guiding us."

HeartMate II

In 2008 the U.S. Food and Drug Administration approved HeartMate II for 'bridge to transplant" -- short-term use in patients awaiting a heart transplant. The device assists a heart's failing left ventricle to improve circulation. The left ventricle of the heart pumps blood throughout the body. Unlike other heart pumps, HeartMate II doesn't use pumping action. Instead, it has a spinning rotor that builds continuous pressure.

About 150,000 Americans have advanced heart failure that could be treated with a transplant, but only about 2,100 donor hearts are available per year.

Thoratec Corp., the maker of the device, hopes to receive approval from the FDA for 'destination therapy" sometime next year. Destination therapy is when the device is intended to be used for the rest of a patient's life.

l-town mom wrote on Nov 26, 2009 5:18 AM:" What a wonderful story--especially on Thanksgiving. Not only does it demonsrate how much Wendy and Greg have to be thankful for, it reminds me of all I have to be thankful for. Thanks for sharing. Best wishes and prayer are sent your way, Greg and Wendy. "

justareader wrote on Nov 26, 2009 7:18 AM:" Prayers for continued good health! What a wonderful reason for giving thanks this season.

All the members of my family are organ donors. When we are gone, let nothing go to waste. If someone needs it to live and we are already gone, have at it. They really do mean "give the gift of life". "

Pasta wrote on Nov 26, 2009 8:03 AM:" Wendy, I am so happy that you are on the path to recovery! It has been a trying time for you and your family. With the last year being so hard there sure is a lot to be thankful for this year and the years to come. Wonderful to hear you are doing so well. "

columbian wrote on Nov 26, 2009 11:18 AM:" GOOD LUCK GAL DONT GIVE UP NOW AND HAVE A GOOD TURKEY DAY. "

gramsn'me wrote on Nov 26, 2009 11:59 AM:" Hey this is Wendys Grandson Jeffrey Hamar. We are all so blessed to have her still. I am so verry greatfull to all of the doctors at OHSU hopital, They really worked hard to fix her. Now i think that we are on the home strech to recovery. "

NJGZ wrote on Nov 26, 2009 12:19 PM:" My mother-in-law and father-in-law are one(two)in a million. I couldn't wish for a better family to be married in to. They are gracious parents and wonderful grandparents. Thank you, everyone, for your kind thoughts and prayers...it is truly appreciated. "

kalama kow wrote on Nov 26, 2009 1:52 PM:" Well done Wendy and Greg. You have demonstrated for your family and friends a level of perseverance seldom seen. Its been a tough year but NOW you get to look at decades of future life with abundant energy.

There are several of us in this area that also went the LVAD and transplant route and understand the emotions and life transformation. Stay up on those immunosuppresion drugs and heart tissue biopsys. Help us promote organ donations in this area...it is a way of paying back. Good luck to you both for speaking out about this new therapy. "

NYFamily wrote on Nov 26, 2009 2:57 PM:" We're so thankful for this miracle, and will be forever grateful to the donor's family. Love to you on this BEAUTIFUL Thanksgiving Day from your family in New York. "

Highlights: HeartMate