When 58-year-old Don Whitson arrived at UCHealth’s emergency room about a year ago, his lips were blue and his nurse could hardly find a pulse.
It didn’t take long for doctors to realize he was showing symptoms of heart failure.
“Quite honestly, I thought he was going to die,” said Dr. Tristan Dow, a cardiologist with UCHealth Heart and Vascular Clinic – Medical Center of the Rockies.
Not normal function
A normal heart pumps blood out of its left ventricle at about 50 to 70 percent — a measurement called an ejection fraction, according to the American Heart Association.
“Don was at 10 percent, which is basically a nonfunctional heart,” Dow said. “When a heart is pumping at only 10 percent, a person can die very easily. They go to sleep or pass out and don’t wake up.”
After stabilizing Whitson in the emergency room, Whitson followed up with Dow, who also works with the UCHealth Heart Failure Program in Loveland. The program has a multidisciplinary team of cardiac-specialized nurses and doctors who provide individualized care to evaluate symptoms of heart failure and address specific concerns of each and every heart patient.
Symptoms of heart failure
“Heart failure is complicated, and usually these patients have multiple issues that are contributing to their condition,” said Dr. Lance Richards, a cardiologist working with Dow in the program. “They need more than just medication or a procedure — they need personalized care.”
Whitson’s symptoms of heart failure were not a result of blocked blood vessels, as often is the case with heart disease. And there then was the issue of his atrial fibrillation — an irregular heartbeat, also called arrhythmia, that if not controlled can lead to blood clots, stroke, heart failure and other heart-related complications, according to the AHA.
Having only recently retired from 30 years on the police force, Whitson thought most of his symptoms of heart failure were simply the result of just living, as he’d been feeling them for years. And he partially blames his inability to accurately describe how he was feeling to doctors for how bad his condition had become.
In the months leading up to his admission to the hospital, Whitson was experiencing a bloated stomach, swollen feet and an upset stomach most of the time. Despite not being able to keep food down, he was gaining weight and reached 250 pounds — about 65 pounds over his healthy weight level, he said.
“In hindsight, I didn’t really understand how sick I really was,” he said. “But mentally, I was so tired of being sick that I didn’t have the mental or physical ability to do anything about it — I was just surviving.”
In fact, Whitson found himself mostly chair-bound, as any basic activity, such as walking up the stairs, made him breathless.
A collaboration of experts
”Because of how sick he was, I contacted Dr. Amrut Ambardekar (at UCHealth Heart Failure Program – Anschutz Medical Campus),” Dow said. “That clinic coordinates with us when we are very worried about a patient needing advanced treatment, such as an LVAD (left ventricular assist device) or a transplant.
“That’s how sick Don (Whitson) was,” Dow continued. “I wanted to get him in the pipeline in case things didn’t turn out like they ultimately did, and Don did need those advanced therapies.”
Ambardekar coordinates with the UCHealth Heart Failure Program – Loveland, seeing patients there once a month, while his colleague, Dr. Andreas Brieke, sees the same type of high-risk patients at UCHealth Heart Failure Program – Colorado Springs.
“UCHealth is able to leverage our different geographic campuses to provide advanced care across our regions,” Ambardekar said. “Like with Don, I can see patients and follow along with their care, which offers a safety net if our interventions with medications and lifestyle changes don’t work for a patient. We hope for the best but plan for the worst.”
In Whitson’s case, the best happened.
One lucky man
“It’s a patient-to-patient situation, but fortunately for Don, he had towed the line perfectly,” Dow said. “The cornerstone of treating a guy like Don is, number one, medications, and number two, getting the patient on board with the stuff they need to do with their life.”
For Whitson, this meant focusing on his health and diet. Salt restrictions were put in place, as well as an exercise plan. His wife also put a few restrictions in place, such as no coffee, soda or alcohol, he said. And he had to pay close attention to how he felt with each medication he was taking.
Following his medication regimen and reporting exactly how he was feeling were key to Whitson’s success, Dow and Whitson both agreed.
Taking it seriously
Whitson had this advice: “If I could say anything to anyone in a similar position, it is to follow the doctor’s instructions specifically and absolutely because they are dealing with some very critical factors, and if you don’t, then you are making their job harder. It can throw everything off and take longer to figure out the best treatment.”
Dow said this attitude from Whitson was crucial in the changes they saw.
“When you really get the person to understand why they are taking their medications and what their situation is, they really buy into their treatment and it makes them do better and their heart do better,” Dow said. “That is what we are able to do at our heart failure clinic. We are able to educate them and their family on the symptoms of heart failure and fill them in on the situation.”
Support system vital
Whitson said he relied heavily on his support system at home — something he admitted was hard for him — in able to be so compliant.
“My wife took control of my daily activities, doctor appointments, diet, exercise and everything I did throughout the day,” he said. “If it were not for her, I would not have been able to follow what was happening to me since I was so sick. You have to listen and rely on your family or friends to support you as it is hard to do this on your own.”
Whitson’s heart failure program experience was intense, including multiple appointments a week for such things as blood draws, tests and medication changes. But he’s alive today because of them, Dow said.
Whitson couldn’t agree more.
“Given my condition, I don’t think I would have survived if I didn’t have those doctors and if I hadn’t followed their directions to a T,” he said. “I don’t think any of us expected this great outcome, but the best way I can describe it is that I feel better than I’ve ever felt in my adult life.”