Tuesday 11 April 2017

Medical Miracles

Family historians do not think too much about medical advances of the past. Certainly they notice how their ancestors may have died or what illnesses took them down. There are many stories of how communities were affected by epidemics that ravaged them and how local doctors and others reacted to treat the afflicted.

We know that great advances in medicine have been made in the last 200 years, for example with the introduction of vaccines which over time, at least in the western world, helped to eradicate many diseases which caused so much death in so many areas. Modern techniques in surgery have also allowed physicians to prevent or reduce the risks of death from many ailments. Late in the 20th century, non-invasive procedures meant that patients could go home the same day they underwent operations. We have now moved into a time when mechanical devices can reduce suffering and prolong life.

Less than 100 years ago some treatments and techniques would have been thought of as belonging to science fiction. Two or more centuries ago things such as artificial lungs, kidney dialysis machines or organ transplants were completely unthought-of.

The idea of medical miracles has become commonplace.

One device we learned about in my own family was the Left Ventricular Assist Device (LVAD) or Heartmate II®. In early 2011, my oldest sister was suffering with a failing heart, and was near death. Other ailments, her deteriorating health and her age, made her a very high risk patient for a heart transplant. But there was an option available at the Mazankowski Alberta Heart Institute in Edmonton, Alberta, Canada, where she was admitted. They were a world leader in cardiac care and had been developing the skills and experience associated with the Heartmate II.

The LVAD is a pump that connects directly to the heart and is powered by batteries carried outside the body. An online description describes it as “a mechanical device that helps people when their heart is too weak to pump blood. An LVAD doesn’t replace the heart. It assists the heart in pumping oxygen-rich blood throughout the body so that the organs and muscles can function properly. The LVAD system has parts that work inside and outside the body. Inside, a heart pump is attached to the left side of the heart. Outside, a controller, batteries, and driveline help to power and control the heart pump.
Diagram of the Heartmate II system
Within days of the surgery, and after the shock and pain of the process had subsided, Lynn was alert and back to her smiling, happy self. There was, of course, the normal recovery period that patients who have had open-heart surgery face, but within a few months she was home and resuming most of her daily activities. My brother-in-law, Roy, was a real trooper in making sure her batteries were charged and the wound constantly cleaned, being available to drive her wherever she needed to be and doing whatever other tasks needed to be done around the house to alleviate any stress.

Lynn was 70 when the Heartmate II was implanted, at the time apparently the oldest female patient to have the procedure. In the words of her husband, “She was chosen for her youthful attitude and will for quality of life which she strived for.” Many others to receive the new pump eventually went on to have heart transplants. Because of her general physical condition, Lynn was not to be afforded that option.

The fact this procedure was available was particularly notable in our family as our little brother had died in 1950, at the age of two, of a congenital heart defect. I wrote about him on a post, My Brother Jimmy… Within a few years of his death, open heart surgery was available, something that might have saved his life.

Lynn became a poster-girl for the system, often presenting her experiences about the life-saving process to others. It had some unique properties, among them, a constant flow of blood such that patients did not exhibit a normal periodic pulse but rather a sound like flowing water. Her words were especially valued by concerned people with heart problems and who would be candidates for the new pump – even children.
Lynn with Muskaan Grewal – At the time the photo was taken in 2013 they were the oldest and youngest females in the program. At the age of six years, Muskaan was the youngest person in the world to receive a heart pump.
The new heart pump did not prevent Lynn from travelling but when she did local hospitals had to be alerted to her visit, so that if anything went wrong they would know how to treat her. You can imagine the questioning looks she got going through airport security with her implanted mechanical device and the battery pack strapped to her waist. She could even dial up the pump rate in case she wanted to do a little jogging (Not!).

Eventually she went back to performing with her seniors group in their musical stage productions. Most importantly she got her happy disposition rekindled.

Following are the results of a study done in 2015, Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devicesThe mean age of our LVAD recipients was 59.3 years (range 17-81), 76% (152/200) were males, and 49% were implanted for the indication of bridge to transplant. The survival rate for our LVAD patients at 30 days, 6 months, 12 months, 2 years, 3 years, and 4 years was 94%, 86%, 78%, 71%, 62% and 45% respectively. The mean duration of LVAD support was 581 days (range 2-2595 days). Short and long term survival for patients on LVAD support are excellent, although outcomes still remain inferior compared to heart transplantation.

Lynn lived another five years with her Heartmate II, and enjoyed every minute of it. And the family were all blessed for having the extra time with her. In the end, it was not her heart or the pump that failed. The LVAD never faltered; it continued to function as it had been intended. Other complications ended her life. With other parts of her body failing, the pump had to be shut down and unplugged. We appreciate what a life-saving and life-extending device the Heartmate II was.

It is interesting to speculate what changes in our family trees might have occurred if many of the procedures and treatments had been available centuries ago – or even just decades ago – things we seem to take for granted today. There is no doubt that future families will have different outcomes as a result of the medical miracles we are now witnessing.

Wayne Shepheard is a retired geologist and active genealogist. He volunteers with the Online Parish Clerk program in England, handling four parishes in Devon, England. He has published a number of articles about various aspects of genealogy in several family history society journals. Wayne has also served as an editor of two such publications. He provides genealogical consulting services through his business, Family History Facilitated.