- Associated Press - Saturday, December 1, 2018

YANKTON, S.D. (AP) - A local man risked a dangerous, life-saving surgery to be able to have more time with his family.

Jim Robinson of Yankton recently underwent a dangerous surgery to have a heart assist device implanted in his failing heart.

He has a condition called cardiomyopathy, in which the heart muscles weaken to the point where they no longer function. Robinson has been aware of the condition for some time and said that his doctor told him that his heart muscles were at 17 percent when he had the surgery.

Ultimately, people with cardiomyopathy will need a new heart, but a device can be installed surgically to help the heart along until a new one can be implanted.

“They put an LVAD in me - that’s ‘left-ventricular-assist device,’” Robinson told the Yankton Daily Press & Dakotan . “The doctor, Dr. Timothy Irwin (a cardiologist at Yankton Medical Clinic), started talking about one of these three years ago because of the way my heart was deteriorating. I didn’t want to do a heart transplant because I was too old, so he started talking about one of these. I started looking on the internet and it scared the hell out of me.”

Robinson explained that cardiac issues run in the family.

“It’s genetic. I had a brother that had it, too,” Robinson said. “My dad, he had bypass surgery back in the ‘70s and I had a brother, my oldest brother, he did have a heart transplant and he lived for 20 years. My other brother, who is still living, he is 80 now, he had to have bypass surgery. So our father left us with bad hearts.”

Robinson was referred to the Nebraska Medical Center in Omaha, and Dr. John Y. Um.

Robinson went through all the regular testing and some additional testing to see if he qualified for the newest, third-generation LVAD.

“It’s quite a procedure,” Robinson said. “When I went down for testing, I went through three days of different testing, and if there’s a test I didn’t do, I don’t know what it is - maybe a test for pregnancy.”

Robinson qualified for the surgery and the newest model LVAD.

“They said, ‘Now’s the time. You’ve got to make up your mind whether you want to do it or not because you don’t want to wait,’” Robinson recalled. “They said, ‘If you wait until you get sick, and they have to bring you down in an air helicopter or an ambulance, your chances of making it would be about 10 percent.’”

The doctors also said there was no guarantee Robinson would even make it through the surgery.

“I told my family that I would rather die on the table trying than not try at all,” he said.

If Robinson survived the surgery, the doctors warned him of a difficult and painful recovery.

“‘But, before you decide,’ they said, ‘you’ve got to realize up front that this is going to be the toughest thing you ever did,” Robinson said. “You just can’t imagine how tough it’s going to be and you are going to have to fight like heck to get through it.’ And they were right.”

An LVAD comes in two pieces and is attached to the heart much the way a grommet is attached to fabric - installing it involves cutting out and removing a piece of the heart.

“They had to open me up and then take a piece of my heart out, insert one end of that (LVAD) in it and the other down at the other end of the heart,” Robinson said. “Having a bypass surgery is like having a hangnail taken off compared to this.”

He explained that most cardiac procedures involve breaking the ribs and chest open to expose the heart, which can make recovery quite painful.

“I know a lot of guys that have had that done and they said they’d scream with the pain when they cough or something. That was the least of my pain,” Robinson said. “They busted my chest wide open, and honestly, I never knew it was there after the surgery was over with.”

Robinson’s wife and family were in the waiting room during the surgery. They later told him there were 17 doctors and nurses in the operating room during the procedure.

“When I woke up, they said I would have a breathing tube in me and I wouldn’t be able to talk for a few days,” Robinson said. “When I woke up from the surgery, I felt like I had a heart attack, because the pain was so bad in my chest. I couldn’t talk because of the breathing tube and I couldn’t move my hands because they had those tied down. I started kicking my feet to get their attention, so they tied my feet down.”

After a few days, medical staff removed the breathing tube and Robinson was able to speak with the doctor.

“I said, ‘Doctor, I think I’m having a heart attack,’” Robinson recalled “‘He said, ‘Well, you don’t remember, but they had to take a piece of your heart out to get the LVAD into it, and that is what your pain is.’ It hurt like a brand; it was not fun.”

There was really no way to alleviate the pain, except to live through it and get better, Robinson said, which took about 10 days.

During his recovery, Robinson said he had to do physical therapy to increase his strength, but also occupational therapy to learn how to perform everyday tasks, like showering, while wearing the device, which is connected by a cable that runs from the heart to a battery pack outside his body.

“There’s a tube coming out my side that fits into a controller that controls the LVAD and there’s a battery pack on each side which fits into the controller,” Robinson said. “At night, I take both batteries off and plug it in to the wall.”

He also has a dressing that covers the port where the cable to the LVAD enters his chest cavity. The dressing prevents infection and must be changed a couple of times a week.”

“I am a hybrid,” he added. “I actually am living off of electricity. That’s the only thing that keeps me going. If I didn’t have electricity, I’d be dead.”

Because the batteries, or controller, can theoretically fail at any time, Robinson must keep backups with him.

“I have a bag that looks like a camera bag and I’ve got to take it with me everywhere I go,” Robinson said. “It has two extra batteries and another controller in it. So, wherever I go, I’ve got that bag. But you think of the alternative, which is, you know you don’t want to think about that.”

Despite the inconveniences of having the LVAD, Robinson does not think he wants to go through with a heart transplant.

“I’m 75 and I don’t think I want to go through that, after going through this,” he said. “If I can get another 10-15 years out of this, I’ll be happy. It’s possible with this. I’ve got a lot of grandkids and I’ve got things to do. I am not ready to give up yet.”


Information from: Yankton Press and Dakotan, http://www.yankton.net/

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