‘It was urgent’ | health beat
Last spring, when a routine referral led Jim Boismier to undergo a cardiac catheterization procedure to examine his heart closely, he saw little cause for alarm.
He has had issues with intermittent chest pain in the past, but nothing that has caused major concern.
Boismier suffered a cardiac catheterization procedure March 9 with Cardiologist Spectrum Health Gregory Bernath, MD.
Dr. Bernath threaded a catheter deep into the chambers and blood vessels of his heart, evaluating him for coronary artery disease, valvular heart disease and congestive heart failure.
Although Boismier may not have been involved in the procedure, the results of this test changed everything.
“The (catheterization) test revealed that one artery – the one associated with a type of cardiac event called widowhood – was 95% clogged,” Boismier, 78, said.
Widowed refers to a severe blockage of the left anterior descending artery of the heart.
That same day, Boismier received a referral to meet with Spectrum Health cardiothoracic surgeons to discuss coronary bypass surgery.
To keep Boismier care near you, John Heiser, MDhead of division of cardiothoracic surgery, organized a visit to the office of the new Specialized care clinic in Muskegon, Michigan.
There, on March 17, Boismier underwent an echocardiogram and surgical evaluation with Dr. Heiser, who determined that open-heart surgery would be the best treatment option.
“It was urgent,” Dr. Heiser said. “With this type of lesion and no symptoms, it is likely that he would have no warning when the blockage caused a heart attack. And he would probably die at home before he could get treatment.
The team scheduled Boismier’s surgery for March 24.
They also set up a virtual appointment on March 18, giving Boismier the opportunity to meet with a cardiothoracic surgeon in advance. Justin Fanning, MD. The team also ordered preoperative labs and chest x-rays, which were done at the Integrated Care Campus just down the road.
Boismier also had a pre-op training appointment virtually with Cardiothoracic Surgery Nurse Educator Heather Bolhuis, RN, who provided important information on what he should do the night before surgery and what to expect during and after surgery.
It was all done with remarkable speed, Dr. Heiser said.
Boismier went from test results to surgery in 13 days, with appointments taking place either virtually or at care campuses near his home.
Surgery and rehabilitation
Dr. Fanning performed Boismier’s operation at Spectrum Health Hospitals Fred and Lena Meijer Heart Center in Grand Rapids.
Boismier underwent coronary bypass surgery, in which Dr. Fanning used the left internal mammary artery to bypass the blockage in the left anterior descending artery. The team also placed a pacemaker in Boismier to help regulate his heart rate.
Boismier was impressed with how quickly he moved from testing to surgery. But afterwards, he also felt surprised at the pace of recovery and the rehabilitation process.
“Even that first day, I was safe and able to walk a bit,” he said. “I could use the toilet myself and take a few steps down the hall.”
Patients typically stay in the hospital for five to seven days after open-heart surgery, gradually increasing their daily activity.
“After the hospital stay, we send them home with a step chart that we want them to progress,” said Bolhuis, who helped care for Boismier.
Once heart surgery patients go home, “we like that they have someone to stay with them for the first week, 24/7, in case of any complications,” Bolhuis said. .
The progress of each patient should be carefully monitored.
“The visiting nurses will come to the patient’s home for three days in the first week to make sure they are healing as they should, two days in the second week and one day in the third week,” she said. “The fourth week, they will follow up with their surgeon.”
At that point, Boismier moved on to the next phase of the rehabilitation process. This crucial element of recovery is also offered in Muskegon, which spared Boismier the trip to Grand Rapids.
There he trains several times a week with rehabilitation specialists, using a stationary bike and a treadmill under the watchful eyes of team members.
Such local care likely leads to better outcomes for surgical patients, Dr. Heiser said.
“The more convenient we can make rehabilitation, the more likely the patient will be able to follow through and recover optimally,” he said.
Team members are always aware that patients undergoing major heart surgery may be at higher risk for depression.
Boismier, who has a doctorate in psychology and retired as an engineer at General Dynamics in 2007, knew this.
And he had a plan.
First, he drew on the support of his wife, children and grandchildren. He has also long believed that an active life and many interests are the key to emotional resilience. He is a passionate photographer.
After the operation, he had some tough times.
“There were two or three occasions where I thought I might fall into something like depression,” he said.
He bends over his photography, taking pictures of butterflies and dragonflies, his favorite subjects. He likes to edit the digital images on his computer, but he also looks forward to getting into nature.
“I go out into the field a lot, in beautiful natural spaces, with flowers and ponds,” he says.
Bolhuis helps families understand that there is a component to psychological recovery after surgery that many do not expect.
“The best thing to do is to let the patients go through all these emotions,” she said. “After all, they had contact with their mortality. But if it persists, it’s important to talk to their primary care physician. They may need medication or other treatments to feel better.
A more likely effect is that they are much happier.
“Often people didn’t realize the impact the lockdown had on them,” she said. “After surgery, they have better blood circulation and feel so much better, especially when walking or exercising.”
‘In good health’
The most important thing a person can do is seek medical attention whenever they have concerns about symptoms, including chest pain and pain in the jaw, neck, back or arms, a said Dr. Heiser.
Although Boismier’s symptoms weren’t pronounced, people generally know they have problems, Dr. Heiser said.
“They should be tested and worked up until they know what’s causing the symptoms,” he said.
It would be hard to overstate the importance of heart health awareness.
Heart disease remains the leading cause of death in the United States, taking about 659,000 lives annually.
If surgery is necessary, there are plenty of reasons for optimism. The recovery is discouraging, but the success rate is impressive.
About 95% of these bypasses remain effective 15 years later, Dr. Heiser said.
“People do very well in the long run,” he said.
He is fortunate that Boismier received much of this life-saving care at a location near his home.
“We want to make it as easy as possible for patients to stay healthy,” Dr. Heiser said.