Ron Rutland Ron's New Trail

First post: 7/10/2017 Latest post: 10/13/2017
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This story began in 2004 when Ron thought he had a bad case of 'heartburn' that turned out to be a major heart attack.  He had a couple stents put in, but did have damage to the heart muscle. In 2012, he was diagnosed with heart failure and had 3 bypass grafts. In early 2013, one of the vein grafts closed, and they opened it with a stent. In 2014, he had a defibrillator/pacemaker implanted because his lowered heart pumping capacity made him more susceptible to A-fib and sudden cardiac arrest. In 2015, he developed A-fib and had a cardioversion to bring his heart back to a normal rhythm. Through all of this, Ron continued to live a pretty active life - mowing, taking care of the yard work and pool, walking - he even did a Color Run with his family a couple years ago! 

Ron really wanted to go backpacking on the Appalachian Trail.  He prepared by buying all the 'cool' equipment he could find - for him, preparing for the trip is as much fun as the trip itself!! He also walked the neighborhood - with and without his backpack. In April, he and Dan did a trial hike on a trail near Holtwood Dam. Ron was ready!

On May 20th, Ron, Dan, and Karla set off to Pine Grove Furnace to start the hike. They had hiked about 4 miles and were going to stop to find a camping site when Ron started having chest pain. Karla stayed with Ron while Dan ran about 1 and 1/2 miles til he got phone reception and called 911.  After a ride in a pick-up truck, an ambulance, and a helicopter, he arrived at York Hospital where a stent was placed in the same bypass graft that had closed in 2013.  Because his heart was damaged before, this time his heart was weakened to the point that it couldn't pump enough blood to his major organs, and he ended up with a balloon pump inserted to help his heart rest and recover and IV heart stimulating medication to give the heart some extra squeeze. After a few days, he recovered enough to have the balloon pump removed. He was weaned off the the heart-stimulating drug, and spent  a few more days in the hospital and went home on May 29th, just in time for his birthday! Unfortunately, by June 4th, he was short of breath again, and he was admitted back to the hospital for a couple days and returned home on June 6th.  His heart was very weak, and they had to increase the diuretics to help with the heart failure. From June 6th to June 27th, Ron had good days and bad days - we felt that he was getting a little stronger each week, but progress was very slow. He had a lot of doctor appointments,visits to the lab and got connected with the Heart Failure Clinic, but he also got to attend a couple family events.  

On Tuesday, June 27th, he started having jaw pain followed by chest pain. We called 911 and took an ambulance ride to York Hospital. They admitted him and scheduled him for a heart catheterization on Thursday. By the time they took him down to the cath lab, his breathing was very labored.   Dr. Harvey, the cardiologist that did the cath, told us that the stent they had put in the vein graft on May 20th had closed, and they needed to get a stent in his native artery since the graft was not holding up. His collateral arteries were supplying just enough blood to the heart to prevent a full blown heart attack, but his heart was not pumping enough to keep fluid from backing up in and outside of his lungs.  Ron needed to have his chest tapped to remove the fluid outside the lungs, have higher doses of diuretics (water pills), and be started on an IV of a heart stimulating drug to keep the  fluids off so they could do the long and more complicated procedure to open a totally blocked artery and get a stent placed. For the next 6 days, he was on a roller coaster ride of days where he could breathe and days when he was filled with fluid and struggled to breathe. Treating heart failure is a balancing act - diuretics drain the fluid, which lowers the blood pressure, but if the blood pressure gets too low that's not good either!  Finally, on Wednesday, July 5th, everything lined up that Ron was 'dry' and the cardiologist was available to do the procedure. It took five hours, but when we got to go back and see Ron, he was breathing well, and Dr. Harvey was very pleased that they had not only opened the native artery, but had also opened another branch of an artery that was diseased! He felt confident that with better blood flow to the heart, that eventually his heart might recover to the point where the pumping action of the heart would improve and the heart failure would improve! 

Ron came back to the cardiac floor after the procedure and had a good night!  His breathing was good and we both slept well.  He was still receiving the heart stimulating drug, and needed to be weaned off of it to see how his heart reacted.  In order to go home with an IV of this medication, they have to prove that you need it!  They slightly lowered the medication around 9 am Thursday, and within an hour, Ron's breathing slightly worsened. They increased it back to the level it was before, but he continued to get worse. By mid afternoon, he was struggling to breathe. His blood pressure was getting so low, they couldn't give him more diuretics.  The heart failure cardiologist, Dr. Malik, who had been working with us during our time at home in June had left for vacation, but the heart failure nurse was checking on Ron continually and contacted him  by phone - Dr. Malik made the call to get Ron back to the cath lab and have a balloon pump inserted.  Dr. Harvey was in the cath lab (Thank the Lord) and took Ron right in and got it done.  He was taken to critical care afterward.  When the dust settled on Friday morning, and Ron was stable in the coronary care unit, we found out that even though the new stents were working to get blood flow to the heart, Ron's heart 'pump' was so weak that it couldn't do it's job.

Ron's best option at this point, is to have an LVAD (left ventricular assist device) implanted in his left ventricle to mechanically push the blood out of his heart to supply oxygen to his organs. This would be used as a bridge to a possible transplant.  He could also live the rest of his life with the LVAD (he could even recover if his heart gets stronger from the stents doing their work, but that doesn't seem very likely).  Everyone assures us that he is a good candidate for a transplant.  His heart is sick enough to need one, but he is healthy enough otherwise and young enough to fit the criteria for a transplant.  We  had briefly discussed the LVAD and possible heart transplant with the Heart Failure nurse and Dr. Malik, but had been thinking that would be an option for the future.  It seems the future is now - we have already talked to the LVAD coordinator, the heart surgeon, and a few other people about the benefits and risks of the LVAD. It is a different kind of lifestyle and has risks and side effects, but it is pretty much Ron's only option for life.  It is open-heart surgery, and the hospital stay afterwards could be up to a month long.  While he is recovering, we will start the process to get into a transplant program.

This is not the trail Ron and I and our family thought we would be on at this time in our lives, but it is the trail we ARE on, and we know we are unbelievably blessed to have these options available!  We also know that God is with us on this journey.  He has provided us with awesome family and friends who are supporting us with their love and prayers and offers of help.  We will need that support in the coming days, weeks, and months, and we thank you for being on this trail with us!





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