Three Brothers and the Gift of Life
A
Stanford University Medical Centre Publication
Used
by Permission
In
1997, Ronald Westgate was an active 59-year-old living with
his wife Mary in Pleasanton, CA. “My father’s side had a history
of heart failure. My father and grandfather both died of heart
attacks in their fifties,” explains Ron. “I kept in shape because
of that, a lot of exercise, biking, hiking, you name it.” In
the years to come, genetics would prove a stronger force for
Ron and his two brothers, Jim and Chuck, also of Northern California.
By 2006, all three brothers would undergo heart transplants
at Stanford Hospital & Clinics.
Familial
cardiomyopathy, a form of inherited heart disease, often leads
to heart failure. Heart failure affects nearly 5 million U.S.
adults, with an estimated 400,000 to 700,000 new cases eachyear.
In the case of cardiomyopathy, the heart muscle loses the ability
to pump blood effectively. Cardiomyopathy is progressive and
sometimes worsens fairly quickly. While there are a number of
medications that can slow cardiomyopathy’s progression, some
patients require a new heart to survive.
Journey
to a New Heart
In 1998, nearly one year after Ron noticed he couldn’t exercise
as much as he used to, his heart had begun to fail. The year
was spent in and out of John Muir Clinic in Walnut Creek. As
Ron’s condition deteriorated, Dr. Fowler, a cardiologist at
Stanford Hospital & Clinics took over his care. His treatment
included having a defibrillator implanted in his chest to reduce
the risk of sudden death.
“My
heart had become so weak, it was in real danger of stopping,”
says Ron. “The defibrillator would fire—there would be these
storms of it going off.” With the defibrillator doing all it
could to keep Ron alive, it became clear that he would require
a new heart. After spending days at John Muir Clinic, the Stanford
Hospital LifeFlight helicopter was dispatched by Dr. Fowler
to bring Ron to the hospital, where he would wait for a heart
transplant.
“Ron
was the worst,” says Chuck Westgate, one of Ron’s younger brothers.
“He was on a left ventricular assist device for a while, just
a survival situation.” The Westgate brothers rallied around
Ron, and were there when he finally received his heart.
“I
still remember that first breath,” Ron recalls. “My breathing
before the transplant was so shallow; I was too weak. But that
first breath, it was the first time in months that I got a lung
full of ir.” Ron’s condition steadily improved, though he did
experience some rejection of the organ.
All
patients who have a heart transplant are vulnerable to their
own immune system putting up a response to the new organ. Most
require more than one immunosuppressive drug for the rest of
their lives.
One
Recovers, Another Heart Fails
Jim watched his brother recover from his transplant with an
additional level of trepidation. “My heart failure started in
about 1998. I had a minor heart attack. That was an alert for
us,” Jim explains. “I went through the typical process— getting
a pacemaker and defibrillator after Ron had his transplant.
That told us that we were getting pretty close.”
Jim
began seeing Dr. Fowler as well, who put him on the transplant
list in early 2000, hoping to prevent the rapid decline Ron
endured before his transplant. But Jim’s case would have an
additional complication. On his 37th wedding anniversary, while
Jim was undergoing testing for a new heart, doctors had found
a mass on his kidney.
“That
was really our lowest moment,” admits Jim. “More than two years
earlier, I had had melanoma. They thought the mass on the kidney
was a malignant tumor; they had to go in and take it off.”
The
prospect of cancer returning was deflating, not just because
of the obvious risk cancer presents. If Jim lost his kidney
entirely, his body might not be able to handle the immunosuppressive
drugs he would need to take after his transplant. If he kept
the kidney, he would have a harder time beating the cancer,
and would still need to be cancer-free for three years efore
he became eligible for a heart transplant. Jim didn’t have that
kind of time.
Jim
received prayers from across the Christian ministries he’d been
involved with for more than a decade. One week later, those
prayers were answered—Jim’s kidney was spared and the mass on
the organ turned out to be benign. He would be able to go forward
with the transplant. On August 4, 2000, Jim left Stanford Hospital
with a new heart. He credits his successful outcome with the
teamwork the Hospital staff displayed while he was there. “I
never felt like there was just one person making decisions for
me,” says Jim. “I nearly died twice in Fresno because my cardiologist
wasn’t talking to my family doctor and it almost cost me my
life. Seeing how much was done by team was the most comforting
thing for both Nancy and me.”
A
Family at Risk
Chuck Westgate was there for his older brother Ron’s transplant,
and again for his twin brother Jim’s. As Ron and Jim got back
on their feet, Chuck knew he needed to keep a close watch over
his own heart health. Three years passed without incident, and
it seemed like Chuck might avoid the troubles his brothers endured.
“I
saw Ron go through it and then Jim went next; I thought I would
go through the same thing, says Chuck. “The help for me was
that I’d seen what they went through, it prepared me.”
In
2003, Chuck was in Poland on a mission trip with his church.
Like his brothers, Chuck has a very strong spiritual side; he
has been a pastor for 37 years. During the second week of the
trip, Chuck experienced heart failure. He was treated in Poland,
and had a defibrillator implanted when he got back to the states.
Two years later, Dr. Fowler added Chuck’s name to the transplant
list.
“Mentally,
I was ready to accept a heart. I knew that yes, I would,” Chuck
says. He knows what a difficult decision it is to accept a transplant.
Many recipients deal with guilt after a transplant. Stanford
Hospital provides support groups for transplant patients where
they can discuss their feelings. Additionally, a team of social
workers meets with patients and their families, facilitating
the difficult emotional process each side experiences.
Celebrating
Life
Chuck, just over a year out from his transplant, is still benefiting
from the follow-up care he receives from Stanford. “I have a
terrific follow-up nurse. She answers questions and chews me
out when she needs to,” admits Chuck. “You need that at times;
you need a kick in the pants. All of us have a great appreciation
for her and everyone at Stanford Hospital, we give them an A+,
that’s for sure.”
In
the fall, Stanford Hospital will welcome heart transplant patients
and their loved ones to a celebration of life at the annual
heart and lung transplant patient reunion. The tradition began
20 years ago when Stanford Hospital social worker Mary Burge
arranged a potluck dinner for about a dozen patients who’d received
transplants and an equal number of people on the transplant
waiting list. Since that time, the reunion has grown. This year
the Hospital expects to host 200 people at the reunion.
40 Years
and Looking Forward
Forty years ago, a 54-year old American steel worker spent the
final two weeks of his life with a donated heart pumping in
his chest. The first successful adult heart transplant in the
U.S. had been completed by Dr. Norman Shumway and his team in
the cardiothoracic surgery division at Stanford Hospital. The
event was the culmination of more than a decade’s worth of research,
finally translated into a therapeutic option for patients with
end-stage heart failure.
In
the 20 years that followed that first procedure, researchers
and clinicians at Stanford continued to make steady progress
in all areas of heart transplant, including efforts to increase
the donor pool, improve organ preservation and heart biopsies
and advance development of drugs to prevent rejection of the
transplanted organ. In late 1980, the Stanford team was the
first to introduce cyclosporine for heart transplantation. The
availability of this immunosuppressive drug, which is still
in use today, was a giant leap forward for the field.
“The
first successful heart transplant in the country took place
only 10 years after Stanford Hospital opened in Palo Alto,”
said Dr. Robert Robbins, current chair of the Department of
Cardiothoracic Surgery at Stanford who trained with Dr. Shumway.
“As Stanford Hospital looks to the future with the construction
of a new facility, patients in Palo Alto and beyond will benefit
from the discoveries Hospital clinicians will make in the years
to come.”
Copyright
2001-2008 Stanford Hospital & Clinics. All rights reserved.
Used by Permission
Stanford
Hospital & Clinics is
known worldwide for advanced treatment of complex disorders
in areas such as cardiac care, cancer treatment, neurosciences,
surgery, and organ transplants. Ranked #15 on the U.S.
News and World Report annual list of “America’s Best Hospitals,”
Stanford Hospital & Clinics is internationally recognized
for translating medical breakthroughs into the care of
patients. The Hospital is part of the Stanford University
Medical Center, along with the Stanford University School
of Medicine and Lucile Packard Children’s Hospital at
Stanford. |
