Coronary Disease: Special screening uncovers potentially fatal problem in a ‘healthy’ young executive
Joel DeBoer could have been a model for a fitness ad. The tall, slender 46-year-old was an active father of three teenagers. He felt great and enjoyed biking, hiking, skiing, and rock climbing with his family. The vice president at Burns & McDonnell expected to sail through an executive health screening that his company offered.
And he might have, had he not gone to Saint Luke’s Mid America Heart Institute. The doctor who examined Joel noticed a small heart rhythm hiccup during a stress test. “I wouldn’t expect to see this pattern in someone who’s as fit as you look,” the doctor said. Joel’s father and two uncles had heart disease, so his doctor ordered a nuclear stress test. This involved injecting a radioactive substance that showed how the blood flowed through his heart while Joel exercised. The test revealed narrowing in his arteries.
Joel would need an angiogram to confirm whether plaque was decreasing blood flow. Kenneth Huber, M.D., an interventional cardiologist, threaded a camera through Joel’s arteries. Joel imagined the worst-case scenario would be needing stents to open pathways.
No one expected the situation to be as grave as it was.
The last artery
Dr. Huber diagnosed severe coronary disease. Three of Joel’s four arteries were between 98 and 100 percent blocked. A single artery was supplying blood to his entire heart, and it was 80 percent blocked. If it closed, the result would be a fatal heart attack.
“Although people with heart disease commonly have symptoms, there’s a small percentage who don’t,” said Richard Lustig, D.O., director of Saint Luke’s Executive Health Management Program. “An ordinary physical by someone not familiar with the disease process likely would not have detected Joel’s problem.”
Sanjeev Aggarwal, M.D., a thoracic surgeon enlisted by Dr. Huber, recommended emergency bypass surgery. “We’re not sure how you’re functioning,” he told Joel.
Joel asked for some time to process this news. “It was hard to accept that I wasn’t as healthy as I looked or felt,” he said. He went home on a Wednesday and researched his condition. He also asked people he trusted to recommend the best hospital for bypass surgery. Their responses? Saint Luke’s was a premier option. So Dr. Aggarwal scheduled Joel’s surgery for Friday.
Joel made arrangements with his co-workers, did a refresh of his will, and set up a temporary Twitter account to keep family and friends updated on his condition.
@KCJoelScoop: It’s game day. Feeling a little anxious, but ready to get this done went out to his 189 followers on the day of his surgery.
During the five-hour surgery, Dr. Aggarwal grafted clean arteries from Joel’s chest wall and leg veins to bypass the blockages in those that supplied his heart. Joel spent the first 12 hours after surgery in intensive care.
His nurses had warned him, “The first day it will feel like you got run over by a truck. The next day, it will be a small car. Day three will be a bicycle.” That was accurate, Joel recalled. But what made it better was the outstanding care. “My wife and I could not believe the level of compassion, concern, and empathy of the caregivers,” he said. Joel even tweeted about Amanda, the angiogram nurse who brought him a get-well balloon after his surgery.
@KCJoelScoop: Who does this?...Spends $ she earned caring for us to encourage us even more? Staff here, even lunch servers, have been amazing.
Joel also got an education. Dr. Aggarwal told him plaque would start to clog his arteries again, but lifestyle modifications could slow or even stop the process.
Joel went through Saint Luke’s Cardiovascular Rehabilitation Program. He started walking three miles a day and bought a FitBit to track his steps. He went on statins (cholesterol-lowering drugs), aspirin, vitamin D, and fish oil. He also cut back on sugars and refined starches, replacing them with more vegetables and whole grains. As he felt stronger, his tweets became more playful.
@KCJoelScoop: Ever wonder what it costs for a little open heart surgery? Got this bill yesterday. LOL! No worries—I had a Groupon.
By Thanksgiving, four months after surgery, he closed the account with parting tweets of gratitude for his doctors, family, friends, and his company for its robust wellness program.
“This screening literally saved my life,” Joel said. Now, he’s doing his part to stay healthy. His bad cholesterol dropped from 174 to 58. And taking the stairs instead of the elevator to his third floor office is part of his daily routine.
“I used to let my weight and shape influence my perception of health,” he said. “Now I know better.”
While Joel still looks like the picture of health, now his arteries do, too.