Steve Hoffelt reunited with two old friends — a 1964 drum set from his father and Gary Camp, an old-time college bandmate – about a decade ago.
The reunion ignited his soul. He hadn’t played music for 30 years, but when he ran into his old friend again, he delighted in his good fortune.
Now 70 years old, carrying his 10-piece drum set from his truck to his basement after playing gigs at area nursing homes left him terribly winded. Hoffelt didn’t pay too much attention to it, even though he also was experiencing occasional lightheadedness and short blackouts. At his age, he figured, he should be a bit tired.
“I was in denial,” Hoffelt said. “I figured that’s what it is to get older. I didn’t want to think I was losing something. I wanted more, not less.”
But then he fainted and had “the big fall” — the one that, a few days after, sent him to his primary care office in Greeley because of ongoing wrist pain. He could not have imagined what lay ahead, that a simple checkup with his doctor would lead to him to experiencing the magic of medical innovation, nor that he’d be the first person in Colorado to have the procedure.
Before all that happened, though, there was the nagging wrist injury to contend with.
“He was found to have a wrist fracture,” said Dr. John Ebens, who sees patients at UCHealth Internal Medicine in Greeley and Loveland. “We discussed the situation, and were concerned about the unprovoked syncopal spell.”
Ebens referred Hoffelt for a cardiac consultation with Dr. Matthew Purvis, an interventional cardiologist with UCHealth Northern Colorado. An echocardiogram at UCHealth Heart Center at Medical Center of the Rockies showed Hoffelt’s heart was strong. But what Hoffelt had failed to reveal during his first visit to the center was that he’d had several “episodes” before — times where he almost blacked out or had crippling chest pain. When Purvis learned of this, he ordered more tests, including a nuclear stress test and then a cardiac catheterization, which showed a 99 percent blockage in the left anterior descending artery.
“That’s part of the business,” said Purvis. “You really want to investigate as deeply as possible to make sure you are looking at all the possibilities. You need that history from the patient to see if there are any red flags.”
There are three main arteries that supply the heart with blood, but the LAD artery supplies the entire front wall of the heart and much of the side wall, and it’s the reason a blockage here is called “the widow-maker.”
“This is a good example of the importance of not ignoring and not downplaying symptoms that could represent an underlying potentially severe medical condition,” Ebens said. “Symptoms of a possible underlying heart condition include chest or arm discomfort, shortness of breath, a change in exercise or activity tolerance, lightheadedness, and unprovoked passing out. Early diagnosis and interventions can be lifesaving.”
There are a few ways to address a coronary artery blockage. Sometimes medication can fix the problem, but other times a stent is needed to open the artery, or there may also be the need for bypass surgery. Hoffelt’s still-strong heart, as well as the length, location and size of the blockage, qualified him for a stent, a small tube placed inside a narrow or weak coronary artery, allowing it to again efficiently channel blood. When placed in the artery, it does a great job of keeping the passage open for blood to flow, with only a 5 percent closure rate within the first year.
To implant a stent, a cardiologist uses a catheter that has been inserted into an artery in the wrist or leg and guides the device to the coronary artery. The patient is under conscious sedation during the procedure, which typically lasts about 60 minutes.
“If you break a bone, you get a cast, which allows you to heal as you should,” Purvis added. “A stent is like a cast in the artery, but because it never comes off, you really never restore the natural function of that artery.”
This can lead later to blood clots as scar tissue begins to grow around the stent, he said. Because of this, patients with stents are required to be on medication and take aspirin every day for the rest of their lives.
That is, until now. Recently, the Food and Drug Administration approved Abbott’s Absorb bioresorbable vascular scaffold — a stent that dissolves when it’s no longer needed.
“The Achilles heel of a metal scaffold is that some cause clotting later because the body sees it as a foreign object,” Purvis said. “The benefit [of a dissolvable stent] is that you open the vessel just like you would with a typical scaffold, but over time, the material dissolves and there is no metal in place. Long term, that’s good for the patient.”
Cardiologists don’t know if a patient will be able to receive the dissolvable stent until they get into the artery, which must be in a certain size and length range. So before the procedure, Hoffelt only knew that it might be an option for him.
Just as he did when he stumbled upon his University of North Dakota bandmate 30 years later in Loveland, Hoffelt feels like he got lucky once again as he became the first person in Colorado to receive the dissolvable stent after it was approved by the FDA.
“You think about those circumstances in life — how things had to work out to get you where you are,” Hoffelt said. “I’ve been married for 46 years, have nine wonderful grandchildren. … I’ve been lucky, but I was worried that I’d not be so lucky this time.
“Again, I kept thinking about the circumstances in life that put me here in this moment — how I ended up in a place where I could get this [dissolvable stent],” Hoffelt said. “It’s a blessing and a gift because in different circumstances, it could have not ended as well.”
Hoffelt was back playing his drums for a local assisted living center only three days after his procedure.
“The hardest thing has been looking at myself and seeing that I’m getting older,” Hoffelt said. “But for me, playing the drums is like breathing, and I’m not ready to give that up yet.”