“The first thing I heard when I woke up was ba-bump, ba-bump, ba-bump,” said heart transplant recipient Roger Browne, thumping his right hand against his chest as his eyes welled up with tears.
The sound of a beating heart was something he hadn’t heard for many years.
Roger’s heart arrived New Year’s Eve. Yet, because of a misplaced phone, he nearly didn’t get it.
Here’s a great example of highly reliable care. Last Dec. 30, Sarah Witthoefft, the on call Ventricular Assist Device (VAD) coordinator, received a phone call from work that Roger, a heart transplant candidate, wasn’t answering his phone.
Saul Benitez, Jr., the transplant advanced practice nurse who called Sarah, said they had just 30 minutes to get Roger to the hospital.
Both nurses, who are with the Seton Heart Specialty Care and Transplant Center, knew about Roger’s history and heart candidate status – first on the transplant list. All of the center’s care team did. Each week, a group of cardiologists, surgeons, social workers, administrators and heart transplant and VAD coordinators discuss their patients’ status and information such as habits and living situations.
“Everyone needs to know a little bit about each patient,” said Sarah, so they can better address patients’ needs – a key for positively affecting their outcomes.
Sarah reached out to Roger’s social worker, Shay Rogillio, for help.
“I was at home and didn’t have his parents’ phone number, but I knew enough to Google them,” Shay said.
She found the number and reached the Brownes in Colorado, and they quickly contacted Roger’s ex-wife Meredith, who lived in Roger’s neighborhood.
“Thank God for internet,” Shay said.
While Shay and Saul made phone calls, Sarah jumped in her car and drove to Roger’s house.
“I wasn’t going to let him miss his heart because he couldn’t hear his phone,” Sarah said.
From Procurement to Transplant
Time was not on their side. Organ procurement and transplant is a delicately orchestrated process that engages dozens of people in several locations under a tight timeline. For optimal results, a heart should not be outside a body for more than four hours. This includes time to transport the heart and prepare the recipient for surgery.
The cascade of processes begins the moment a heart is identified. The organ procurement organization, the Texas Organ Sharing Alliance, alerts its affiliate network. Factors such as geography (how far away the heart is from the hospital) and blood type are considered for determining a match. The Seton transplant team logs into the website, assesses the factors and calls upon the surgeon and cardiologist to discuss the quality of the match.
“You have to move very fast with organ donation. To keep it viable, a heart can’t sit on a table for hours,” said Pam Combs, clinical nursing manager of Mechanical Circulatory Support.
“It was a perfect heart, a beautiful heart and our team accepted it quickly,” Pam said.
Clock is Ticking
Roger knew about the time critical nature of a transplant and always kept his phone on the loudest ringer settling.
But unbeknownst to him, his phone had fallen into a fold of his comforter while he was taking a nap, muffling the sound.
So instead of a phone call from the Seton Heart Specialty Care and Transplant Center, it was a pair of unexpected visitors who delivered to him his life-saving news.
Someone at the front door was pressing the doorbell incessantly. Roger thought it was his 14-year-old daughter.
But when he opened the door he found his ex-wife on his front step, waving her arms and repeating, “They’ve got a heart! We’ve got to go!”
Roger was in such disbelief, he didn’t know what to do and credits the second visitor, Sarah, for focusing him on getting to the hospital.
“Sarah arrived a few minutes later, calmed me down and got me on my way,” he said.
In the nick of time, Shay got a call from Roger as he made his way to Seton Medical Center Austin.
“The first thing I said to him was, ‘You better be on the way to the hospital.’ And he says, ‘Yes, and I can hardly breathe, I’m so excited’,” Shay said.
A Different Nursing Philosophy
When asked how working with transplant and advanced heart failure patients is different than other clinical experiences, Sarah replied, “They say in nursing school, ‘Don’t get too attached, don’t get too emotional.’ That’s pretty much impossible to do here.”
“The truth is, we go through all of these efforts with all of our patients. These are very complicated patients. You have to have a teamwork approach,” she said.
Just like Sarah, Shay also said that the team was going to do everything to make sure Roger got his heart.
“These are peoples’ lives. This is what we do.”
“If people knew how many people were waiting (for transplants), they might be more open to organ donation,” said Dr. Mary Beth Cishek of Seton Heart Institute and Roger’s cardiologist since he was identified for transplant, “because sometimes the best thing to come out of a traumatic situation is that there is another life saved.”
Roger, 56, developed a type of heart congestive failure called non-ischemic cardiomyopathy 15 years ago when a virus weakened his heart. Until 2013, he controlled his disease with prescription medicine and a defibrillator.
When his condition worsened last year, Roger was implanted with a VAD, also known as mechanical heart, in May 2013. He received his heart transplant on Dec. 31.
Today, he is back at his Austin home doing the things he loves – cooking, painting and making jokes.
Other members of Roger’s medical family:
• Mim Luetje, RN, BSN, Roger’s primary VAD coordinator
• Nichole Jones, RN, MSN, CNS, Roger’s primary advanced nurse practitioner
• Dr. Paul Roach, Seton Heart Institute and Roger’s cardiologist for 15 years
• Cardiovascular surgeons Dr. William Kessler and Dr. Eric Hoenicke of Cardiothoracic and Vascular Surgeons