At about 1:45 Wednesday afternoon, Rennie Matthews’ heart stopped.
Fortunately for the 46-year-old builder, he was on the table in Wise Regional Health System’s’ cardiac catheterization lab, surrounded by doctors, nurses, technicians and millions of dollars’ worth of high-tech medical equipment.
The heart stoppage was a test. Cardiologist Dr. Trieu Ho had just implanted a bi-ventricular defibrillator in his chest.
Big-screen monitors recorded the chaos as Rennie’s heart rhythm was disrupted. An instant later, the device administered an electrical shock that caused his body, although sleeping, to bounce on the table. His heartbeat resumed – and just like that, the procedure was over.
After an overnight stay in the hospital for observation, Rennie and his wife, Dale, went home the next day.
“Home” for Rennie and Dale is actually the island of Grenada, in the far southern reaches of the Caribbean just above Trinidad. They came to Decatur for the procedure and will return home a few days after Christmas.
The surgery, the implanted device, the hospital stay and even their room and meals while they’re here are all complimentary – an early Christmas gift from Wise Regional, some dedicated doctors, St. Jude’s Hospital, Candlewood Suites and a few other generous people.
The story that links Grenada and Decatur starts with Dr. Jason Finkelstein, a partner of Dr. Ho and several other physicians in Advanced Heart Care here. Dr. Finkelstein, a native of Long Island, N.Y., went to medical school at St. George’s University on Grenada and for years has participated in a program that brings graduates back there for a week a year to do free cardiac care.
“I’ve been doing this since 2008, myself and about 12 other doctors,” he said. “We see patients there on a volunteer basis because there is no full-time cardiologist on the island.
“During my time down there, the citizens were nice to me. I just wanted to try and give back to them.”
Grenada is a tiny island, 21 miles long and 12 miles wide, with only about 105,000 people. Originally a French colony, they have a democratic form of government and an economy that relies heavily on tourism.
Most of the people speak English, but converse in a French creole patois. The temperature seldom gets below 80 or above 90.
Rennie’s wife Dale, a fifth-grade teacher, said it was November 2012 when her husband started complaining of shortness of breath. A local doctor said it was asthma and gave him inhalers, but he still had a hard time making the walk from the main road up to his house, about 120 feet.
“When he’s coming up the hill he would complain that he’s still having the shortness, and at work he couldn’t do anything much,” Dale said. “He would have to lie down and give orders.”
On Dec. 5 last year, they went to see Dr. Johansen Sylvester, coordinator of the adult cardiology program at St. George’s University.
“They admitted him, took his blood pressure, did an EKG, and then the doctor said it was really bad,” Dale said. “His heart was beating about 1 percent.”
They sent him home, planning to bring him back for further tests – but on Dec. 9 he suffered a heart attack.
“At about three minutes past six, I heard someone struggle to call my name,” she said. “When I look I saw him, so I rush him to the casualty. He was on drips, oxygen, in and out of hospital for about two or three weeks.”
In January, a doctor from Maine did an angiogram on Rennie – the first angiogram ever done in Grenada – and it revealed his heart muscle had been damaged by a virus.
“They said with a pacemaker, if he gets one in there, he would feel much better and be able to return to an almost normal life,” Dale said. “So we started working on that.”
Dr. Finkelstein wrote a letter to the U.S. Consulate in Grenada to help them get visas, and once those were secured he started organizing everything for the trip. The only thing Rennie and Dale had to pay for was their travel to the U.S. – and they took a loan from Dale’s credit union for that.
By that time, with the right combination of medications, his heart had improved to about 50 percent.
“He got about halfway there,” Dale said. “It appeared that he would be in shape to take a nice little surgery to implant the pacemaker. Dr. Finkelstein insured that everything would work smoothly – he dotted every i and crossed every t.
“Had it not been for him, this would not have been possible,” she added.
A DEFIBRILLATOR INSIDE
Those AED’s – automated external defibrillators – that hang on the wall in schools and most other public buildings are similar to what Dr. Ho placed inside Rennie’s chest, although Rennie’s device does more and is much smaller – about the size of a small garage door opener.
To use the AED, the rescuer places electrode pads on the patient’s chest which sense the heart rhythm and determine if a shock is needed. If it is, the machine calculates the correct voltage and delivers it.
In Rennie’s case, the electrode now resides inside his heart, on a lead connected to the device which is under the skin, just below his collarbone. The pacemaker senses problems with the heart’s rhythm and corrects them. But if the heart stops, the device senses that, too, and becomes a defibrillator, administering a shock.
That’s what happened during the test.
The device was donated by St. Jude’s Hospital, delivered to Decatur by Jeff Cole, who worked hand-in-hand with the physician in operating and testing it during surgery.
It’s a procedure Dr. Ho does about 10 times a month here – but it would not be possible in Grenada.
“To get that care down there, they would have to travel to Barbados or Trinidad,” Dr. Finkelstein said. “These devices can cost $40,000 or $50,000. If they have to pay that out-of-pocket, it’s like seven or eight years’ salary for some of these people.”
Those in the cath lab wear lead suits because x-rays are taken throughout the procedure, to make sure the probe goes to the right spot in the heart. They insert it through a vein just below the left clavicle, and once it’s in place, they implant the device.
The only thing that’s visible is about a one-and-a-half-inch scar.
“The device is about half microchips and half batteries,” Cole said. He said the batteries should last eight to 10 years, and visiting cardiologists in Grenada will be able to test them when they’re down there. If he needs a replacement, he will have to come back to the U.S.
It’s a piece of equipment that will make his life better on a day-to-day basis, and save it if he has another heart attack.
“That heart stoppage we just saw, if it happened at work or on a ballfield, would be fatal 99 times out of 100,” Cole said. “With the device in place, it is survived 99 times out of 100.”
GRATEFUL FOR LIFE
Dr. Finkelstein said he expects the procedure to improve Rennie’s heart function and quality of life. The day after the surgery, it was apparent that was already happening.
“He said he feels like he’s 16 again,” Dale said on Thursday. “Every time when he wakes up he says, ‘I feel like when I just met you.’
“I’m just so glad that Rennie will be able to live again. If we hadn’t been given this opportunity, I don’t think he would be with us much longer. Since he is the main breadwinner for our family his illness had been very hard.”
Rennie and Dale have two children, a son who is 21 and a daughter who is 15. The trip falls during Dale’s Christmas vacation from school, so she doesn’t miss any time at work. School starts again Jan. 6.
“I have prayed for my kids and left them in God’s hands, so I’m not worried,” Dale said. “I get to say hi to them at least once a day.”
She’s delighted Rennie will be able to start 2014 on the road to recovery and extremely impressed with the hospitality they’ve seen in Decatur.
But they’re not huge fans of the weather.
“Everyone in Texas has been very nice – but it is a bit colder than home,” Dale said.
Warm hearts, however, make a big difference.