‘One last chance’

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Nine months is a long time to go without driving—especially for someone like Vern Postma, 76, a former car dealer and retired firefighter who loves getting behind the wheel.

Even in his retirement, he worked as the transportation coordinator for a Holland, Michigan, senior living community. Driving is his thing.

But Vern had to hand over the keys in April 2018, when an irregular heartbeat led to a medical crisis that nearly took his life.

Having a medical suspension placed on his driver’s license was a big deal for Vern. But it’s nothing compared to the gratitude he feels for simply being alive.

“They called him the miracle man, everybody that we encountered at the hospital,” said Vern’s wife, Sandy.

Cardiogenic shock

Vern’s odyssey began with shortness of breath and a heart that wouldn’t stop racing. Late one night, Sandy took him to their local hospital, where for two days doctors worked to convert his arrhythmia to a normal heart rhythm.

His heart refused to cooperate and instead went into cardiac arrest.

Though his doctors resuscitated him, they couldn’t prevent the onset of multisystem organ failure. Running out of options, they transferred him to Spectrum Health Fred and Lena Meijer Heart Center.

He arrived in full-blown cardiogenic shock—his heart muscle was so weak that it couldn’t support his body’s demands.

Vern spent the next week on a ventilator and a kidney dialysis machine, as cardiologists and intensive care doctors tried multiple medications to bring his heart rate under control.

This was no ordinary arrythmia.

It was a rare form of ventricular tachycardia, an abnormal heart rhythm sparked by “an electrical tornado in the lower part of the heart,” explained Al Albano, MD, a cardiac electrophysiologist with Spectrum Health Medical Group.

Ninety-five percent of the time, he said, ventricular tachycardia occurs in patients with existing heart damage from a previous heart attack or heart disease.

Vern, however, had a perfectly normal heart. His tachycardia was idiopathic: “We are not sure why this happens in someone with an otherwise normal heart,” Dr. Albano said.

It’s the kind of case he and his colleagues see only once or twice a year.

What made Vern’s case even more unusual is that his racing heart led to cardiomyopathy, or heart muscle weakness, which put him in cardiogenic shock—something that happens in only about 5 percent of patients with idiopathic ventricular tachycardia.

Vern represented 5 percent of 5 percent.

Turning point

By the time Dr. Albano was called to consult on the case, Vern’s heart had stopped two more times. Though scans still showed normal brain activity, the critical care team had reached the limits of medical therapy.

“He was essentially maxed out on what they could give him,” Dr. Albano said.

Typically, patients with arrhythmias can be treated with a cardiac ablation, a catheter procedure in which the doctor burns small areas of heart tissue where electrical signals are misfiring.

Vern, because he was on life support, wasn’t considered a candidate for ablation. His heart function was down to about 5 percent, compared to a normal ejection fraction of 55 to 60.

After a week of unsuccessful treatment, the ICU team cautioned Sandy that she may need to consider withdrawing life support.

“There were a lot of tears and a lot of emotion,” Sandy said.

As she sat in the waiting room with her children, Dr. Albano came in and introduced himself.

“He said, ‘Before you make that decision, I have one other thing to present to you,’” Sandy said. “‘He may not survive, but I’m willing to try.’”

Dr. Albano offered to perform an ablation but added a sobering caveat: The procedure could work only if Vern had an Impella heart pump inserted to support his heart during the procedure. And Dr. Albano had never done an ablation with an Impella in place. He didn’t know whether the pumping device would interfere with his work.

Sandy and her children talked it over and agreed to give their husband and father “this one last chance,” she said.

A few hours later, Vern was wheeled to the cardiac catheterization lab for the high-risk procedure.

When Dr. Albano found the family afterwards, Sandy immediately knew he had good news.

“I’ll always remember, he came out into the waiting room—big smile—and he said, ‘It worked!’”

Not only did the procedure go well, but Vern’s recovery took off almost instantly.

“In a dramatic fashion—I mean right after his ablation, literally hours later—his heart function was pumping at 55 to 60 percent,” Dr. Albano said. “It was probably the most dramatic example of reversal of a tachycardia-mediated cardiomyopathy that any of us have seen.”

In just a few hours, doctors began removing medications.

Three days later, Vern was off the dialysis machine and ventilator, and he began sending signals in response to his children and grandchildren.

“Just to see him wiggle his toes or, like, his eyelashes,” Sandy said. “That is the one thing that we always go back to—just pure joy.”

Strong rebound

Over the next week, Vern steadily regained ground. By month’s end, three weeks after his midnight trip to the hospital, doctors discharged him to a rehab facility.

Over the weeks and months that followed, Vern continued to improve, first with home care, then with outpatient cardiac rehab at Spectrum Health Zeeland Community Hospital.

Though he had a couple of setbacks that required additional ablations in two other chambers of his heart, Vern is well on his way to recovery.

He has progressed from needing a walker to using a cane to walking with minimal assistance.

“Now I use the cane like Fred Astaire,” he joked.

As they approach the one-year mark of Vern’s hospitalization, the Postmas are left with profound appreciation for the support they’ve received from family, friends, pastors, Dr. Albano and the rest of Vern’s medical team.

“You can’t begin to tell everybody the things that happened and how wonderful they are there,” Sandy said.

That message isn’t lost on Dr. Albano.

“Every time I think of him (I remember) the tremendous sense of gratitude that he and his family had,” the doctor said. “He’s given me so many hugs.”

There’s one more thing Vern is thankful for today. After passing a road test in January, he got the green light to drive from his family doctor. He finally has his keys back.

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