|Ocala, FL - |
Published in Ocala.com Thursday, February 21, 2013 at 1:07 p.m.
Dr. Robert Feldman, interventional cardiologist and medical director of Munroe Heart Cath Lab, instructs his team during a catheterization of a patient on Tuesday morning.
Loren Eastmer, 63, was born with a bad heart during a time when doctors didn't have the technology to fix it.
Despite the condition, the retired teacher from near Buffalo, N.Y. lived an active life and ran marathons. But he also knew it was only a matter of time before problems from his heart's defective valve would catch up with him.
“On the fifth of January I went out for a run and I couldn't (make it) 200, 300 yards. I was gasping,” Eastmer recalled.
The same thing happened in Daytona a few days later. For five hours after his failed attempt at a jog, his heart was still racing.
Lucky for Eastmer, medical technology has changed significantly since doctors diagnosed him as a 7-year-old boy. Also lucky for Eastmer, Munroe Regional Medical Center has created what it recognized as one of the best heart programs in the United States.
Dr. Robert Feldman was one of the pioneers of the program, Munroe Heart, which this year celebrates its 25th anniversary.
Feldman performed a catheterization on Eastmer's heart in January. The procedure showed the extent of the trouble. The Ocala retiree became one of more than 75,000 patients who has benefited from the heart program.
Feldman told Eastmer there was no blockage in his heart, but he did have a ruined valve that needed replacing. Eastmer was taken into surgery to install a state-of-the-art valve two weeks later. More than 25,000 patients before him had benefited from open-heart surgeries performed through Munroe Heart.
Five days after the valve was successfully installed, Eastmer was back home. He wasn't jogging, but his mile-long walks each day were a good start toward recovery.
The Munroe program that began with two heart doctors and 18 support staff in 1988 has come a long way. It now has an office in The Villages and has branched out, offering services not even contemplated when the program began.
With a support staff of 300, Munroe Heart also includes 28 community cardiologists who work with the hospital's program; five interventional cardiologists such as Feldman, who perform catheterizations, angioplasty procedures and install stents; a cardio electrophysiologists who works with the electrical impulses of the heart; four cardiothoracic surgeons; and five cardiovascular anesthesiologists.
Carol Floyd was a nurse in Gainesville who quit her job to work for Munroe's new heart program in 1988. She said she had faith in Feldman and Dr. Michael Carmichael who, like her, had come from Shands at the University of Florida to start the program.
“I was staff nurse at the time,” Floyd said. “But I knew they were going to have a successful program, and the challenge of building a new program from the ground up was very exciting to me.
“I had a gut feeling it was going to work,” said Floyd, who is now Munroe's director of cardiovascular services.
“The team from Day One hit the ground running. It jelled from the beginning,” she said.
Pam Michell, one of Munroe's vice presidents and its chief nursing officer, remembers that the level of heart technology was vastly different before the heart program got underway.
If someone had a heart attack in Marion County, he or she was typically transferred to Orlando or Tampa.
In 1980, up to 10 percent of patients who had angioplasty procedures would still need more invasive procedures to fix their problems, Feldman recalled. Twenty-five years ago that dropped to about 2 percent or 3 percent. Today it's only one or two people per 1,000 patients.
Before Munroe's program and recent advancements in heart treatment, following a severe heart attack, a patient's odds of fully recovering were not good, Feldman said.
Michell said Munroe's data shows that, even 15 years ago, if a patient's heart stopped beating, the chance of he or she leaving the hospital without series injury to the heart and some brain damage was no better than 15 percent.
Now, with procedures such as cooling the patient's body to slow its metabolism and giving doctors more time to fix the heart, the chance is more like 50 percent.
Along the way, Munroe has been among a handful of heart programs breaking medical ground. Its cardiac electrophysiology program was only the fourth of its kind in the United States. In 2012, Munroe Heart opened the doors to its hybrid operating room, allowing surgeons to conduct minimally invasive procedures, but with the flexibility to perform complex and open heart procedures if the need arose.
And since Munroe Heart began its interventional cardiology program, patients' family members have been invited to watch the procedures next door through glass windows and closed-circuit monitors as staff explain the process.
Munroe is also working to get patients with heart problems diagnosed and treated quickly. The average time it takes to get a Munroe patient once he or she enters the emergency department into a catheterization lab and have the procedure underway is 46 minutes.
The national average: 63.1 minutes.
The program also offers a cardiac rehabilitation program, which is medically supervised to focuses on helping patients with cardiovascular and pulmonary disease.
Munroe Heart has branched out to The Oaks at 138th in Lady Lake, where patients can meet with Munroe Heart doctors for evaluation.
Before the heart program, Feldman said, individual heart doctors in the Ocala area specialized in their own fields, but as a result could only offer patients the services they were most familiar with performing.
Under Munroe's program, heart doctors don't compete for patients, but transfer them to the doctor with the appropriate specialties, Feldman said.
Dyer Michell, who was Munroe's president at the time the heart program began, said Ocala Regional Medical Center also offered cardiac services, and still does, but the community gradually put its support behind Munroe.
“But we didn't know for sure, from a financial standpoint, how the program would do,” Dyer Michell said.
But given the area's demographics, the program was a logical move for the now 421-bed nonprofit hospital, he said.
And the top-notch program also served to raise the standards of all the hospital's other programs, Dyer Michell said.
Eastmer wasn't familiar with the full history of Munroe Heart when he went there last month. He can only measure its quality of care by how he feels now.
“They did a very good job. I have no complaints,” he said. “It was handled first rate.”
Eastmer hopes his story, and that of Munroe Heart, will encourage others with heart problems to get the help they need.
“I know people can be scared,” he said, “but when all is said and done, it may be something you need to do to save your life.