Issue 8 Stories

Sentara RMH Heart Team Swings into Action

Harrisonburg Man Thankful for Wide Range of Available Cardiac Services

Paul McFarland’sheart was in good shape—or so he thought.

An avid tennis player who has no family history of heart problems, McFarland, 64, never considered himself at risk for a cardiac episode. What happened on the morning of Feb. 7, 2017, however, changed all that.

As usual, McFarland showed up at the tennis courts in Bridgewater at 5:30 a.m., and finished playing about an hour later. His tennis buddies asked if he wanted to play a bit more.

“I opted out because I was having some breathing problems,” says McFarland, a retired director of rehabilitation services for Friendship Industries in Harrisonburg. “My breaths were shallow, and I couldn’t seem to fill my lungs.”

McFarland drove himself home. “Probably not the smartest move I could have made, in retrospect!” he says. When he explained his condition to his wife, Johna, she took him to the Emergency Department (ED) at Sentara RMH. He was admitted right away, and the decision was made to evaluate his coronary arteries.

Cardiologist Stewart Pollock, MD, performed a cardiac catheterization, which revealed that McFarland’s arteries were 90-95 percent blocked, and that he would need cardiac surgery to correct the condition.

His heart surgeon was Jerome McDonald, MD, who has served as director of the Sentara RMH cardiothoracic surgery program since 2013. Dr. McDonald explains that although a 90-95 percent blockage doesn’t necessarily cause people to have a massive heart attack in the short term, it really depends on whether there is disease elsewhere in the vessels of the heart.

“Some people who have vessels with disease in multiple locations can experience a heart attack,” says Dr. McDonald, “and certainly the kinds of blockages Paul had were potentially dangerous. Clots can cause a major heart attack, and having clogged coronary arteries does increase the likelihood of dying of heart disease in general.”

Due to the degree of disease in multiple vessels, Dr. Pollock and Dr. McDonald recommended quintuple bypass surgery, which McFarland underwent just two days after his visit to the ED.

Although the surgery was a success, McFarland wasn’t yet out of the woods. Following the procedure, his heart rate was abnormally high, so several medications were administered in an attempt to bring it down. None of them was effective, so Dr. McDonald then prescribed a mild shock treatment, which worked like a charm for about 30 minutes. After that, McFarland’s heart rate shot back up again.

At that point, Dr. McDonald suggested that McFarland undergo a heart ablation, a procedure that is widely used to treat heart conditions—especially rhythm disturbances known as arrhythmias, according Robert VerNooy, MD, the electrophysiology specialist at Sentara RMH who performed the ablation. The procedure is performed through small tubes that are inserted through the arteries or veins of the leg and passed up to the heart. Ablation works by scarring or destroying tissue in the heart that is causing an abnormal heart rhythm.

“Atrial fibrillation, a common type of irregular heart rhythm, is common after cardiac surgery, occurring in 30-50 percent of cases, and is probably due to an inflammatory response to the effects of heart surgery,” says Dr. VerNooy.

The flutter, or fibrillation, could have been dangerous to McFarland had it not been corrected, he notes.

“It was an added stressor for Paul. If left uncorrected, the fibrillation could have led to blood pressure problems or congestive heart failure,” explains Dr. VerNooy. “It may even have put him at a high risk of stroke.”

Thankfully, the ablation procedure lowered McFarland’s heart rate to normal, and he was able to go home after an eight-day stay in the hospital.

“After that, I underwent rehab for six to eight weeks,” says McFarland. “To date, I have had no recurrence of my heart problems. I try to exercise each day, either by walking or riding my recumbent bicycle. I limit my salt intake and take my meds. It’s not just a matter of having the surgery and then going back to normal—you have to work at it and always be aware that you need to do whatever you can to facilitate good heart health. As a result, I am back to living an active and normal lifestyle—including my tennis game!”

Uncovering a Sleep Disorder

However, McFarland did have one other problem that needed to be addressed. One of the first things Dr. VerNooy asked McFarland during his initial examination was whether he snored or had trouble sleeping. He confirmed that he did regularly experience those issues, so Dr. VerNooy suggested that McFarland visit the Sentara RMH Sleep Center.

The center, which provides evaluation, diagnosis and treatment of sleep disorders, determined that McFarland was experiencing a significant loss of oxygen at night—a condition known as sleep apnea that occurs when a person’s breathing starts and stops during sleep. The condition can produce exhaustion during the day and also contribute to a wide range of health problems.

After an all-night sleep study, McFarland was prescribed a continuous positive airway pressure (CPAP) machine, which eliminates snoring and breathing cessation by providing a steady stream of air throughout the night.

“In terms of the energy I now have during the day, the CPAP has changed my life dramatically,” he says.

Doing Well, and Happy with Sentara RMH

Today, McFarland has a checkup with his general practitioner twice a year, and he sees his cardiologist once a year.

Looking back over his experience at Sentara RMH, McFarland says he is “incredibly happy” with the services provided, and with the comprehensiveness of the care he received.

“Sentara has been very proactive in supporting my health,” he says. “I believe Sentara RMH has a deep interest in my well-being—not only in providing the procedures I needed, but also in helping me learn how to stay healthy on a day-to-day basis.”

In addition to praising the skill and efficiency of the heart team at Sentara RMH, McFarland notes how Sentara also assisted him when his insurance denied him coverage for a portable defibrillator.

“The defibrillator, which my doctor suggested I use for a few months, is covered by Medicare and Medicaid—but I have Blue Cross/Blue Shield, which doesn’t cover it,” says McFarland. “The hospital has been helping me appeal that decision. We’re now at the final appeal, and Sentara has supported us at each step of the way and helped provide Blue Cross/Blue Shield with the information they need to evaluate what they will and will not pay for.”

McFarland is thankful for the care he has received at Sentara RMH.

“I truly believe that Dr. McDonald and the other members of the heart team saved my life, and I will always be grateful for that.”

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