A Patient's Story -- Frederick Vierling
Frederick Vierling came down from the skilled nursing unit of Regional Hospital of Scranton in a wheelchair on June 29 and walked to his daughter's car. He was being discharged from the hospital after an emergency admission, a life-saving heart procedure and a spell in telemetry and skilled nursing. A man of few words, Mr. Vierling said he felt "good" and "I'm ready to get out of here."
That he could walk at all was nothing short of miraculous considering that his heart was barely working when the ambulance brought him to Regional almost three weeks earlier. He had been short of breath and had no strength, said Lucy, his wife of 62 years. And when he would try to walk with the help of his cane his legs would buckle. "His legs were swollen and he hadn't walked any distance in a long time," Mrs Vierling explained.
Looking back, Mr. Vierling had been an active man his whole life. "He's a good man and a wonderful father," said Mrs. Vierling. "All our daughters were in 4-H and he would do so much to help them. He used to haul horses with no trouble." The Vierlings, who live in Lenox, Pa., have five daughters, nine grandchildren and three great grandchildren. They have also operated Lucy's Corner Cabinet, an antiques shop specializing in depression glass and china for more than 40 years.
Mrs. Vierling recalls that her husband's father and grandfather died in their 60s. "But his mother lived into her 90s, so we took for granted that he wouldn't have any problems," she said. Even so, Mr. Vierling, now 83, made twice yearly doctor visits.
Suddenly his health deteriorated and the problems began in earnest. Daughter Ann Marie Jennings, a labor and delivery nurse at Moses Taylor Hospital, insisted he go to the doctor, who after an examination sent him by ambulance to Regional's emergency department.
It turns out, the shortness of breath and leg swelling were related to his poorly functioning heart. His heart's ejection fraction, an important measurement in determining how well his heart was pumping out blood was at 10 percent. Normal is 55 to 70 percent.
"He was in cardiogenic shock; he was very sick," said Sridhar Sampath Kumar, M.D., an interventional cardiologist from Great Valley Cardiology Associates (GVCA) at Regional Hospital of Scranton. Mr. Vierling's blood pressure was decreasing and his heart was beating way too fast.
A heart catheterization revealed that he had life-threatening heart blockages and the pumping function of his heart was very poor. Coronary artery bypass surgery, or open-heart surgery, where a blood vessel from elsewhere in the body is redirected to bypass a blockage and improve blood supply, was considered high risk due to his age and heart function.
So, Dr. Kumar and Cardiology Section Chief Christopher Dressel, M.D., decided their aim was to open the blockages with coronary angioplasty, where a thin, soft, flexible tube or catheter with a balloon at its tip is threaded through a blood vessel to the affected artery and then inflated to compress the plaque and restore blood flow. However, Mr. Vierling's failing heart needed support to move his blood through his arteries and organs.
While Doctors Kumar and Dressel prepared Mr. Vierling for a procedure which would take over the blood pumping action of his heart through a percutaneous, or tiny needle puncture of the skin, his five daughters rallied around their mother.
"They were trying to prepare me," Mrs. Vierling said. "We weren't at all sure that he would make it."
Meanwhile, Mr. Vierling was wide awake while the device was inserted into a blood vessel through his groin and into the left ventricle of his heart. The device, called a percutaneous left ventricle assist device VAD, took up the heart's pumping action and the doctors were able to perform a rotoblator procedure, where the plaque in his affected arteries were cleared. Finally, stents were placed which slowly release a drug to prevent reblockage.
Altogether five stents were inserted in his arteries through the same tiny opening in his groin and Mr. Vierling sailed through the procedure. "It was great, he had no significant symptoms, and he was able to walk shortly after," Dr. Kumar noted.
The percutaneous left ventricle assist device is increasingly being used in high risk coronary procedures, but this was the first time in our area, said Mark Mileski, director of Regional's cardiac catheterization lab. The closest hospital that is using the device is in Chester County, northwest of Philadelphia.
"What this device means for our patients is they can be treated succesfully right here, in their own community," said Dr. Kumar. "And in many cases they can avoid surgery," said Dr. Dressel.
What it means for the Vierling family is total joy. Lucy has Frederick back home. The girls have their beloved Dad and the grandchildren have Grandpa to tell them stories about when he was in the hospital.
And daughter Ann Marie is thrilled that it all happened in one of our community hospitals. "I am so proud to be a member of Commonwealth Health," she said.