Tuesday, August 19, 2008

A miracle, a mystery, and a transplant

With a dynamic personality and a quick-witted tongue, Deborah Heffernan has all of the traits of a great story-teller. She uses vivid language, quirky humor and total honesty to get her point across, especially when telling her greatest story - the story of a personal comeback.

This story begins in a Cambridge yoga class, where Heffernan experienced her first heart attack caused by a spontaneous dissection of the left anterior descending artery. Of all places, this personal comeback began in yoga, a class devoted to renewal. Right on the floor, Heffernan experienced her first heart attack from a spontaneous dissection of the left anterior descending artery.

Medical personnel rushed her to a local hospital to stabilize her condition for two days before sending Heffernan to the Massachusetts General Hospital Heart Center.

A Miracle and Mystery

Called “the miracle and mystery of Mass General Hospital,” Heffernan arrived at Mass General unconscious, bloated with fluids from acute heart failure, and her tongue was black and fat as a fish from an emergency intubation. “And that’s how I met Mass General’s heroes. They were up all night long,” says Heffernan.

Near midnight, cardiologist Marc Semigran and surgeon David Torchiana, assisted by Dr. Tom MacGillivray called a family meeting. The team needed a family decision. There was so much damage to the heart that Heffernan actually needed a heart transplant, but there was no time to find a match. Torchiana recommended a high-risk bypass operation.

“My husband Jack stood up in front of my 80-something dad and told the doctors that I have ‘gone for it’ my whole life and so now he would speak for me,” says Heffernan. “And Jack told them, ‘Operate immediately.’”

Adjusting, Surviving

The operation was a brilliant success. Nonetheless, Heffernan left Mass General a month later with half a functioning heart and a deadly arrhythmia, for which she received an implantable defibrillator from Dr. Jeremy Ruskin. For 10 years, Heffernan lived at her home on a lake in western Maine with her defibrillator firing occasionally and slowly adjusted to living with a failing heart. She exercised every day, and she slept most of the afternoon. It was an imperfect situation, it but became tolerable, she says.

“I learned to thrive within my corral. Sometimes illness is a teacher. I learned from my heart attack and lived more deeply, more fully with restrictions than I had when I was free, healthy.” says Heffernan.

In 2002, she wrote the best-seller, An Arrow Through the Heart, where she detailed the story of her heart attack and first year of recovery. Using humor and a compelling love story, the book also invites readers to look critically at their own heart health. Heffernan and her husband donate all sales proceeds to Mass General Hospital, the American Heart Association, and other cardiovascular disease research initiatives.

Not Again…

Nine years after that heart attack and content in her corral, Heffernan never expected to have a second heart attack. She was young, fit, and had no family history of heart disease. She exercised and ate healthy, as she had her whole life. On her way to a routine massage in February 2006, she took a brief moment to remember how lucky she was to be alive.

“It was like someone had grabbed me by the shoulder and told me to look up into the clear blue sky, through pine bows heavy with fresh white snow, and I said out loud to the universe, ‘I’m so lucky to be alive on this beautiful day,’” reflects Heffernan.

Two hours later, as she drove home along a country road, she experienced a second heart attack. Somehow she managed to keep on driving through the snow to her local hospital where MedFlight took her directly to the Mass General Hospital cardiac catheterization lab. This time, her right coronary artery had dissected, and Joseph Garasic, MD, used stents to save her life.

“And you want to know why I love the Heart Center? Those are just the beginnings of the story,” says Heffernan.

The Transplant

She was alive, but as time went on Heffernan became weaker, slept more, and struggled to walk to the garage. It became apparent that she needed a heart transplant to survive.

Right when she was about to plummet, and possibly begin living on a machine, Heffernan received the unforgettable call that it was time for her heart transplant. Luckily, she and Jack were already in Boston. Her husband was going to a Red Sox-Yankee game and Heffernan was heading back to their hotel for her afternoon nap.

“I collapsed to the pavement because as much as I had prepared, nothing prepares you for the call,” says Heffernan.

At Mass General Hospital, doctors and nurses that had been caring for her for 10 years visited to wish her well, and cardiac surgeon Arvind Agnihotri, MD, led the transplant team.

“It was the best send-off party anyone could have,” smiles Heffernan.

Still a Journey

Her journey isn’t over, but Heffernan’s ability to participate in life has completely changed. She can now garden, snowshoe, hike, and cross country ski.

Fifty-six this summer—almost two years after her transplant—Heffernan has adjusted to taking around twenty drugs a day, to monitoring her symptoms for any sign of rejection, to multiple hospitalizations for infections. Her 15 grandchildren give virtual hugs to prevent her from catching any of their many childhood diseases, cheerfully following her example of resilience and gratitude. Every day to Heffernan is both precarious and precious.

“Some family lost a loved one, and in the midst of their profound grief, had the courage and generosity to give me, a complete stranger, another chance at life. They must be very special people. I am deeply grateful to my donor family—and to everyone in this story,” says Heffernan.

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