(Pictured above): Standing with her surgeon Dr. Georg Wieselthaler, Janice Chapman holds a mechanical heart device similar to the one that's implanted inside of her.
At 75, Janice Chapman figures she is one of the oldest patients to receive an ventricular assist device (VAD), a device implanted in her chest that takes over the work of her heart's left chamber. Powered by an external power supply, the device pumps blood through the chamber to her aorta, the major vessel that delivers blood to the body's arteries.
When Chapman arrived at UCSF Medical Center last fall, her heart, as well as other organs, were failing. Doctors told her she qualified for "destination therapy," which provides mechanical devices for patients who are not candidates for a heart transplant. Indeed, they said it was the only option that would save her life. Though she was scared by the prospect of open-heart surgery, she knew she had to take the risk — not just for herself, but because she is taking care of her 13-year-old grandson. While staying with friends to recover from the surgery, she talked about her experience:
How did you discover you needed a left ventricular assist device (LVAD)?
It started when I couldn't breathe. I would run out of breath and my heart wasn't beating regularly. My doctor put in a defibrillator in January of 2012. I thought that would fix everything but it didn't. I still couldn't breathe. Still I was kind of in denial for quite a while. I've never been sick. I've never even been in the hospital. So I didn't believe it when my cardiologist told me I had congestive heart failure, liver failure and kidney failure. He showed me articles on ventricular assist devices and said I need to have one put in. I said, "What happens if I don't do this?" because it was very scary. He said "you'd have about a year." But he said if I got the LVAD, it's possible I would have seven or eight more years. I'm raising a 13-year-old, so I have to be here.
So you came to USCF?
Yes. My doctor called UCSF and made an appointment for me. Since I live in Chico, it was a four-hour drive. I met with Dr. [Liviu] Klein, did an interview with him and found out I was a candidate for an LVAD.
Did you have to go through tests?
I had a bunch of tests done. I had EKGs and treadmill tests and breathing tests. I also had a right ventricular catheterization [to see how well the right chamber of the heart is working]. Then when I got a letter saying I was approved for the LVAD I came in and met with Dr. [Georg] Wieselthaler. I love that man. I told him I didn't want to do anything over the holidays, so we scheduled the surgery for January 7.
How did you feel after the surgery?
At first I was totally out of my mind, babbling incoherently. I was in the ICU (Intensive Care Unit) for about five days. Then I got moved to a regular room. I was very weak at first and it was a big question whether they could get my kidneys working again. But by God, Dr. Wieselthaler did get them working through medications. I also suffered some short-term memory loss, which I am still suffering a bit six weeks later. I don't know if it's from the anesthetic or the surgery. But I had excellent physical therapists and nurses who treated me well so now I feel great.
How long were you in the hospital?
Three and a half weeks.
How has it been adjusting to the LVAD?
It's kind of scary. I have to carry batteries for power, I have to be hooked up to one or the other forever. And I have to have my dressing changed every day, and that's hard to do. It's right under my breast and I can't reach it. I have to have somebody do it now; hopefully eventually I can do it myself.
Is the LVAD comfortable?
It's an adjustment wearing all this stuff. The two batteries are very heavy and the system controller is very heavy. And unfortunately I've lost so much weight in the last few years that I'm weaker than I used to be.
Are there any restrictions on what you can or can't do?
I can't drive or take a shower right now. But that should change. There's a plastic case that I'll be able to wrap around the system controller when I'm allowed to take a shower. Hopefully in a few months I’ll be able to drive. Dr. Wieselthaler said that long term the only thing I won't be able to do is take a bath. I can live with that.
Can you feel the device inside you?
I can feel it pumping. Sometimes it pumps harder than other times. If you put a stethoscope to my chest, you can hear it.
Are there things you can do now that you couldn’t do before surgery?
I can breathe. And walk. The friends I'm staying with right now took me walking through the park and shopping so I can get some exercise. I don’t even use my cane anymore. It is awesome.
Interviewed by Susan Freinkel.
Photo by Tom Seawell.
Advanced Heart Failure Evaluation and Therapies Program
400 Parnassus Ave., Sixth Floor, Suite A-6110
San Francisco, CA 94143-0118
Phone: (415) 353-4145
Fax: (415) 353-4166