Life at 9200 rpm's: Waiting and Living

     What does an LVAD do while waiting for a heart?  I can't answer for anyone but me.  I'm enjoying the fall weather in Fargo and at Detroit Lakes.  

     Today I helped build and load a firewood rack with about a cord of wood.  The house fireplace is gas operated, but we have a chiminea that seems constantly in use.  A chiminea is an outdoor fireplace made of earthenware shaped like an upside-down fat light bulb.  It sits on a wrought iron stand and the narrow part is the chimney.

     The dogs, our four and a visiting fifth, romp in two feet of oak leaves.  Their coats smell slightly of wood smoke.

     It is overcast this afternoon and the lake is flat.  A few late season muskie fishermen ply the waters several hundred yards off shore.  I've heard that a few monster fish have been caught, photographed, and released this year. There a size limits for keeping these fresh water sharks.  

     Mounting them using a taxidermist has become prohibitively expensive.  The preferred method is to use photos to recreate a plastic resin model that replicates the fish.  That way someone can catch Mr. Muskie again, if he knows what he's doing.

     Frank Vacek, a Canadian lodge owner and guide, took a crew of us out on Lake of the Woods from Sioux Narrows, Ontario, one June in the early 70's.  Our boats all had 15 horse outboards on them.  

     As we fished along trying for walleyed pike, Frank caught sight of a muskie closely following the propeller of one of our boats.  He called out to keep the boat steady until Frank signalled to cut the engine.  It took less than a minute for all this to happen.

     Frank cast a muskie lure that must have been 10 inches long between the boat's propeller and the following fish.  He timed the cast well and called out to cut the motor.  At that point, Frank cranked the muskie lure away from the stopped boat propeller and enticed the muskie to follow.  Despite his skill, Frank couldn't tempt the big fellow to strike but the whole spectacle was worth it.

     Later, back at the lodge, Frank said he once had a muskie attack an outboard propeller.  The prop had teeth marks on it but the engine won the battle.

    My HeartMate II gives me the chance to be with family and friends.  It is the lifeline that allows me and other LVADs to wait and live.

     I read that the International Society for Heart & Lung Transplantation has data that show that about 60 percent of heart transplant recipients age 70 and over live at least six years from the time of transplantation.  About 80 percent of patients getting new hearts because of damage caused by coronary disease survive at least six years.

    The same data show that about 70 percent of LVADS survive about the same length of time after receiving a new heart.  The data involve transplants between 2002 and 2009.

     Research has shown that being on a waiting list for a heart transplant with an LVAD, has reduced the mortality rate.  My heart surgeon at the University of Minnesota in Minneapolis, Dr. Ranjit John, has been quoted as saying that mortality has been reduced for LVADs into the single digits.

    LVADs account for more people than heart transplants.In the United States about 3,000 ventricular assist devices are implanted yearly compared to about 2,500 heart transplants.  The transplant rate has not increased since 1994.


     Having an LVAD can keep a wait listed transplant candidate alive for several years.  That fact was not always the case.

     Fewer hearts are available for donation because car air bags and the use of helmets by those engaged in high risk sports have reduced the number of fatal head injuries in young, healthy men--the most common source of donor hearts.

     I am alive today because I got an LVAD.  It has been reported that as many as a third of those receiving heart transplants have a similar mechanical circulatory assist device.  What the LVAD has done for me is to underwrite my exercise and conditioning to be better prepared for a transplant, if one occurs. 

     My HeartMate II LVAD manufactured by Thoratec Inc. of California cost about $80,000.  Installation is extra.  I had my chest opened three times in 11 days to implant the pump and stop bleeding.

     A Duke University study on the cost effectiveness of LVADs cost $360,407 over five years.  A study of treatment to that former Vice President Cheney received showed the yearly cost was $167,208 for every year of life saved. 

    How does anyone assess the cost effectiveness of such treatment?  One cost effectiveness figure showed that $50,000 was acceptable with a range up to $100,000 per year of life. A European study in 2011 showed a cost of $414,275 per year of life saved.

     At 68, I'm three years younger than Cheney.  My overall health is excellent.  My LVAD has forestalled a life count down as the Society for Heart & Lung Transplantation suggests.

     I am grateful for the opportunity to be living and waitng.