After eight years on a ventricular assist device, a heart transplant surprise

June 9th, 2020
family takes a selfie at a rockies game after Cliff went from a LVAD to a heart transplant and was feeling better.
Good times at a Rockies game for Cliff, with Nichole, Terrell and Karrissa. Photo courtesy of Karrissa and Cliff Phillips.

For the past decade, Cliff Phillips spent a good deal of time taking long shots. He fixed his eyes in the distance, gripped a hand-sewn, one-pound bag, and flipped it underhand in a soaring arc toward a goal some 30 feet away. More often than not, it reached its mark, landing with a thud on a sloping board and often sliding toward and disappearing into or teetering on the edge of a small hole cut into it.

The game is cornhole, and Phillips achieved respect and notoriety among his many fellow players around the Denver area and the state for his competitive fire. Since he started playing the sport in 2010, he built his own boards, made his own bags with scraps of jeans filled with corn, kidney beans or fiber pellets and honed his toss touch with regular practice. He eventually joined the leading players in Mile High Cornhole, the largest group of players in Colorado. He became a tournament fixture, known by regulars as “Clutch Cliff,” or “Coach Cliff.”

“I pressed myself to get better so I could challenge anybody who threw,” said Phillips, now 67.

LVAD lifesaver when heart transplant not an option

He put that determination to good use when it came to answering challenges to his health. Phillips suffered a heart attack in 2002. He survived with stents placed at UCHealth University of Colorado Hospital on the Anschutz Medical Campus and had a defibrillator implanted to regulate his heart’s electrical activity. But congestive heart failure gradually weakened him so severely that in July 2011 he needed a left ventricular assist device (LVAD) to feed his blood-starved organs. The lifesaving mechanical pump served him well. He had it for eight years without a significant complication, a record for the Advanced Heart Failure Program at UCH, said its medical director, Dr. Larry Allen.

“Most patients who receive an LVAD and intend to move on to [heart] transplant are able to do so in months to a few years,” Allen said. Phillips stayed with the pump year after year, partially because he had peripheral artery disease (PAD), which narrowed the blood vessels in his legs and increased his risk for a heart transplant, but also because he did so well with the mechanical pump.

In September 2019, though, a series of events scrambled Phillips’ and his family’s lives. For a time, he went from taking long shots with the bags to fearing he was a longshot to live. His story illustrates that in the health care world, the line between life and death, hope and despair is often razor-thin.

family stands together at a park after grandpa went from a LVAD to a heart transplant in order to return to his life.
Cliff Phillips with his family, all of whom supported him through his challenges of a LVAD to a heart transplant. Front row, left to right: daughter Karrissa, Cliff, son Cliff Jr., granddaughter Bella. Back row, left to right: grandsons Jake and Brock, daughter Nichole, granddaughter Desi, and daughter-in-law Marci. Photo courtesy of Karrissa and Cliff Phillips.

Pump (LVAD) problems

The roller coaster ride began with a routine checkup at UCH. Phillips felt fine, but a blood test revealed an abnormality that turned out to be blood clots in his LVAD that threatened the device’s viability. The clots gum up the bearings of the pump, making it work harder than it should. They can also cause hemolysis, or shearing of oxygen-carrying red blood cells, said Dr. Jay Pal, a cardiothoracic surgeon and surgical director of the Mechanical Circulatory Support Program at the University of Colorado School of Medicine. The threats didn’t end there, Pal said.

“A little bit of a clot can break off and go somewhere else and cause a stroke,” he said.

The news of the pump problems was a rude surprise, especially because the LVAD, up to that moment, had so effectively reversed Phillips’ steep health decline, said his daughter, Karrissa Phillips. She was there, along with her older sister, Nichole, and younger brother, Cliff Jr., when her father was rushed to UCH in 2011 on death’s door. She’d watched him change from the active guy of her childhood who boated, swam, and played ball. She remembered as a kid watching him do cannonballs off a diving board during a vacation in South Carolina, going for the biggest splash he could make.

“It was hard on all of us,” she said of his congestive heart failure. “He stopped doing any of those activities because he was tired all the time.”

The toll of heart failure

Years before Karrissa was born, Cliff excelled in football, basketball and baseball at Highland High School in Thornton. He was all-state at two positions in baseball and made it to spring training camp in Bradenton, Florida in 1971 as a righthanded pitcher with the Pittsburgh Pirates – a team that went on to win the World Series that year. After facing him in batting practice, Hall of Fame right fielder Roberto Clemente told Phillips that he threw two sharp-breaking pitches he’d never seen before.

“[Clemente] told my roommates if they want to learn to throw a curveball, watch me,” Phillips recalled.

Cliff enjoys an outdoor outing with Karrissa and grandsons Brock and Terrell after going form an LVAD to a heart transplant. Photo courtesy of Karrissa and Cliff Phillips.

His baseball career ended prematurely with a freak accident that severely lacerated the thumb on his pitching hand. Phillips returned to Colorado to drive trucks, get married, have kids and raise his family. But he stayed active, playing in summer softball leagues until he was 50. The 2002 heart attack and heart failure, though, gradually drained his energy and stamina. He was frequently hospitalized and had to quit truck driving. He took a job painting houses with an uncle’s company, but was eventually too unstable to climb ladders.

“I thought, ‘What’s happening to me?’” Phillips recalled. “My legs ain’t as strong. I can’t do anything I used to.”

Back to life with LVAD

By the time of his last hospitalization in 2011 before the LVAD surgery, Phillips had so much fluid buildup from his failing heart that he looked nine months pregnant, Karrissa said. Providers at UCH worked him up for a transplant before deciding his severely damaged heart and unstable health made an LVAD the only available choice. The severity of her father’s heart damage was a shock, Karissa said.

“My face was as white as the wall,” she recalled, but she and her siblings quickly understood that without a heart transplant, an LVAD was their dad’s only available lifeline.

Phillips was close to his old self after the LVAD surgery.  “He sprang back up,” Karrissa said. He walked a day after the procedure, had a short intensive care stay and was home in a couple of weeks. Soon he was throwing footballs and having dart gun wars with Karrissa’s kids.

“The only thing he couldn’t do was swim,” she said. “The difference was night and day.” It wasn’t long before he was a regular again at cornhole competitions.

Phillips adapted so readily to maintaining his LVAD that he became a go-to source of information at UCH for patients getting the device. “I told patients my story as to why I chose it,” he said. “I told them I got the thing. I know what it’s doing.”

Surprise heart transplant decision

In 2019, Phillips and his family were being told the lifesaving device was failing, raising the difficult prospect of a surgery to replace it. But then came another surprise. His providers at UCH believed that Phillips’ best chance for long-term health was a heart transplant. “The equation changed” with the discovery of the blood clot in the LVAD and the risk that posed, as well as the fact that Phillips’ PAD had stabilized, Allen explained.

“We felt that transplantation was really his only chance for ongoing survival’” he said.

Phillips’ family readily agreed with the assessment. “We were all okay with a transplant,” Karrissa said. “Anything to save our dad’s life.”

With that, the whirlwind intensified. Phillips met with the transplant team on Tuesday, September 24. On Thursday the 26th, he was on the transplant list. One day later came the stunning news that he had a heart from a donor in Texas. The following day, Saturday, September 28, Phillips lay in an operating room at UCH, where Pal, Dr. Jessica Rove and their team transplanted his new heart.

four family members sit on the couch for a photo, which was their christmas card in 2019 after one of them went from a LVAD to a heart transplant.
After going from a LVAD to a heart transplant, Cliff celebrated Christmas 2019 with his kids, left to right, Karrissa, Nichole and Cliff Jr. Photo courtesy of Karrissa and Cliff Phillips.

Heart transplant troubles

The drama, however, was far from over. Phillips did not wake up, other than a few eyelid flutters, for a week after the surgery. It was another week before he became fully cognizant of his surroundings. As it turned out, he’d had three small strokes, apparently from clots dislodged from the LVAD.

“I’m lucky I survived that,” Phillips said.

Karrissa, watching anxiously with her brother and sister, remembers urging her father to fight through that challenge. “My family are fighters,” she added, noting that Cliff is a “spitting image” of his father Joe, still kicking at age 85.  “I said, ‘Dad, you can’t give up. You’re a Phillips,’” she recalled.

Phillips did fight back. He finally left the hospital and returned home, where the three kids rotated shifts to care for him 24-7. He recovered steadily, but in January of this year he suffered a series of setbacks, including blood clots in his right leg, a urinary tract infection, dehydration and falls. He was rehospitalized and struggled into February. He had great difficulty walking and was so fatigued that simply getting up from the toilet required a big effort.

“At times I thought I was maybe close to dying,” Phillips said.

Bouncing back after a heart transplant

But later that month, his providers stabilized his medications and Phillips began another surprisingly rapid recovery. He asked for more physical therapy and wanted to know why he couldn’t have his cornhole boards brought into the hospital so he could practice throwing bags. He complained about not being allowed to drive (he will be, provided his recovery continues to progress).

Now back at home in his apartment in an assisted living facility in Arvada, Phillips said he’s regularly walking up and down the halls, doing everyday tasks like laundry and cooking without help, and of course getting ready for some cornhole competition.

“His momentum has kicked into overdrive,” Karrissa said.

Managing LVADs and heart transplantation

For Pal, Phillips’ case is a reminder that managing LVADs and heart transplantation is “an evolving field.” Eight years before his transplant, his providers thought that “he was getting an LVAD and that would be it for the rest of his life,” Pal said. “But people surprise us. The LVAD allowed him to work on his other health issues so that he ultimately was a transplant candidate.” Today, he added, Phillips can now expect a nearly normal life span.

The expertise of his large team of providers at UCH and their support was crucial to his recovery. “We swear by University Hospital,” Karrissa said. But Phillips himself deserves a large measure of credit, Pal said.

“He was incredibly motivated and committed and took care of himself,” Pal said. “That helped to keep him going all along.”

His children, who have been at his side throughout his ordeals, see more and more of the feisty father they remember. Karrissa believes Cliff has turned a corner. His cornhole-playing friends should beware, Phillips added.

“I’m going back into it and I’m going to get back to the top where I used to be,” he said. “I never give up.”

 

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About the author

Tyler Smith has been a health care writer, with a focus on hospitals, since 1996. He served as a writer and editor for the Marketing and Communications team at University of Colorado Hospital and UCHealth from 2007 to 2017. More recently, he has reported for and contributed stories to the University of Colorado School of Medicine, the Colorado School of Public Health and the Colorado Bioscience Association.