Life after laser heart surgery

by Betty Heffron

Editor's note: When Mrs. Heffron shared her story with us in 2001, she was 48 years old, had one son and two grandchildren, and lived in Ellsworth, Wis. She was a social worker until she stopped working because of her health problems.

I'm about to celebrate the two-year anniversary of my TMR (transmyocardial revascularization) laser surgery. I've been virtually pain-free since I had TMR, which is amazing considering what I went through during the years before.

I'd call it a miracle because I'd pretty much given up. I'm now taking care of my home and my husband, and I can do things with my grandchildren. But to understand how amazing this is, you'd have to know what happened to me.

My first heart attack and triple bypass

I had my first heart attack when I was 29. I had been struggling with high blood pressure and high cholesterol, which is a problem in our family. My cholesterol was between 300-400; normal is about 200.

It was back in October 1980. My boyfriend and I had been out raccoon hunting late at night. I was very tired and had been under a lot of stress.

While in the woods, I thought I was experiencing very bad heartburn, an ulcer or something like that. I chewed up a whole bottle of Gaviscon®.

When we returned home, I lay down and took a valium®. But it did nothing.

We finally went to the hospital, where they didn’t suspect a heart attack until they did some blood work. My blood pressure was out of sight when I came in, but they didn’t assume young women had heart attacks in those days. I spent seven days in intensive care and then they sent me home to recuperate.

Back then, they made you wait 30 days before you could have an angiogram. They wanted your heart to heal. In November, I had an angiogram, and in January, I had my first triple bypass surgery.

My weight and cholesterol

By the summer of 1989, my health had deteriorated further. My weight had ballooned to 193 pounds (I’m only 5 feet tall), and my cholesterol level was still rising and hit an all time high of 565.

I was okay for a while, but then I started having serious medical problems again. The cholesterol and weight posed such an added risk to my heart that my cardiologist suggested I have a gastric bypass coupled with a partial ileal bypass. The bypass of my stomach would lower my weight. And the bypass of my small intestine would reduce my absorption of cholesterol. I had both surgeries at that time.

A turn for the worst

In 1993, I was starting to have chest pains again. I also had a lot of esophagitis, very intense gas and pain in my stomach. My heart problems were getting worse and worse, and so was my stomach. I was just physically very bad.

The combination of two gastric surgeries brought my cholesterol down into the low 200s and dropped my weight to 78 pounds. I now had malabsorption syndrome. I needed to feed myself through an IV, and I was maxed out on heart medication. My health had gotten so bad that no doctor wanted to do anything concerning my heart.

My family had even pretty much given up on me. I didn’t think I was going to make it.

That's when my husband and I decided to take a trip to Las Vegas. I had been so sick that we just decided to get away and do something different. During the flight, I read in one of the magazines about a clinic that specialized in heart treatments. So, I called them and went in for an evaluation.

When I returned home, I sent them a copy of my last angiogram. They sent me a letter saying they were sorry, there' nothing they could do. Between all the rest of my health problems, and my heart history, and the fact that I’m a small person, there just wasn’t anything they could offer. They didn’t want to do bypass again, and another angiogram or stents just weren’t options for me.

That was a tremendous blow. It was so incredibly depressing. Here was a heart clinic that had a reputation for being one of more aggressive clinics for heart procedures. When they said they wouldn’t be able to help me, I didn’t think anybody would. I was very, very down.

My second triple bypass

As we knew it eventually would, my angina reach a point where it was unbearable, and my cardiologist brought me in for yet another angiogram. They found what was expected: more blockage. But the surgeons felt the risk of surgery outweighed any relief they could give me.

It just so happened that my cardiologist talked to Dr. Robert Emery at United Hospital in St. Paul, Minn. and reviewed the angiogram films with him for a second opinion. Dr. Emery had done a lot of heart surgery on children and diabetes patients with small vessel problems such as mine and was willing to try another bypass on me.

In January of 1994, I had a triple bypass by Dr. Emery. It was a very long recovery because my other health problems made it slower.

I was okay for a while, but my heart gradually got worse again, and the heart medications started adding up.

A heart transplant?

By 1998, I was on four different nitrates all the time. I talked to Dr. Emery about a transplant and went to the Mayo Clinic for their screening program.

I went through a work-up for a transplant and took the anti-rejection medications to see how my body would react. Because of the gastric and ileal bypasses done to control my cholesterol, my body couldn’t absorb the medication I would need to take if I had a heart transplant.

I felt this was an ironic twist. What helped keep me alive once would now stop me from a life-saving transplant.

Time for my miracle

I was depressed and in serious, everyday pain. It was like a tightening in my shoulder and my neck, and a cramp in my chest.

That's how I was when I got a call from Dr. Emery’s office about TMR (transmyocardial revascularization) laser surgery. It was just approved for use by the FDA (United States Food and Drug Administration) and he felt it could greatly benefit me.

He said I'd be the first person he performed it on outside of the test study group. I said I was fine with that and was looking forward to the opportunity to find relief from some of my pain.

In April 1999, I had TMR and was in the hospital for five days. Dr. Emery told me he had "lasered" 37 holes in my heart and that he’d left an area of my heart alone that he could use again if we need to.

I went through the first week after surgery using medication to control the incision pain. But I had stopped taking all of the four nitrate medications for angina.

It's hard to believe. But after all that time, the angina pain had gone away.

Pain-free for two years

Almost two years later, I'm still on heart medication, but not for pain -- nothing for pain. It's fantastic.

My life is normal in a way I never thought it would be again. My weight is stable at 120 pounds and has been for more than a year. I watch what I eat, but I have a fairly normal appetite and diet.

Recently, my uncle, who is in his 60s, just had TMR, too.

Other people definitely need to know about this. I called up my doctor and told them to make me a poster person for TMR (transmyocardial revascularization) laser surgery.

I've heard people talk about this being a placebo effect. All I know is that I felt the effects right away. I didn't have this much relief after I had my second bypass. I'm off nitrates and I had never been off them for years, even after the second bypass. If this is a placebo, well, fine. I’ll gladly take another placebo like this one.

An update from Betty's husband

By David Heffron

Betty did benefit greatly by this surgery. But as with all cardiac patients, the disease is not escapable, and it’s eventual outcome fatal. On Dec. 17, 2002, Betty died of a heart attack while at home.

Though the outcome was not what was hoped in years, the quality of life definitely was! That value cannot be over emphasized.

Betty believed that the journey through life is not always an easy one. She believed that by taking all opportunities to explore new medical advances, she made her life here on Earth a better one and could help the journey those after her would face.

Her hope was to help others through sharing her own experience. Thus, I would like to keep this article available for those who are facing the same types of decisions in their lives.

Betty's uncle who underwent the same surgery by the same surgeon is still doing quite well.