Thursday, April 18, 2013
When it comes to grateful patient stories, Chris Eckhart’s sounds fairly typical. Man discovers he has a heart condition. Man finds physician at the University of Maryland who can perform the operation he needs. Afterwards, man makes donation to the School of Medicine as a way to say “thanks.” End of story.
But, as Eckhart tells it, there is one key ingredient that makes his story uniquely atypical, both in terms of his medical condition and his decision to make a financial contribution: his age.
“I’m a young guy -- I was 32 at the time of the operation -- and otherwise extremely healthy,” says Eckhart, who discovered he had a heart condition while visiting his primary care physician in December 2008. “I tell my story as a way to alert young people -- and I’m talking about people in their 20s and 30s -- to make sure they visit a doctor regularly, in case they have a condition they don’t know about.”
He also tells his story as a way to encourage other young people who have received medical treatment, particularly those who are just starting careers and may think they don’t have the means to make a contribution, to consider giving back financially to the institution.
“Most of the photos I’ve seen of charitable donors are older people, people who have reached a stage in their life where they can afford to make a financial contribution or are at a point where they are thinking about getting rid of their fortunes,” says Eckhart, who makes a donation each year on the anniversary of his surgery. “I know that, to do this at a young age is unique. Maybe it will serve as an inspiration for others.”
‘I don’t have a heart murmur’
Eckhart’s story began, as many do, with a routine physical. Aware that hypertension and heart disease run in his family, Eckhart had taken the precaution to get regular, twice-annual check-ups with his family physician. He had received a clean bill of health for years, including his appointment in June of 2008. But his second visit that year became anything but ordinary.
“My doctor asked me, ‘We’ve talked about your murmur, right?’” Eckhart says. “And I said, ‘What murmur? I don’t have a murmur.’”
As it turned out, Eckhart had developed a heart murmur in the time between his two visits, and he was sent to a cardiologist for a full work-up. All the test results were normal, but the cardiologist confirmed there was a heart murmur. And not just any murmur, a severe one -- caused by mitral valve prolapse -- that, without treatment, could prove fatal.
To be safe, Eckhart sought a second opinion from three other cardiologists, and the one who would see him the soonest was James S. Gammie, MD, Professor and Chief, Division of Cardiac Surgery at The University of Maryland School of Medicine. Dr. Gammie also proved to be the only one that Eckhart wanted to see.
The University of Maryland Heart Center specializes in the surgical treatment of valvular disease, including mitral valve repair surgery, which is used to treat regurgitation, or leakage, problems (like Eckhart’s), as well as other conditions affecting the mitral valve. Traditionally, surgeons have treated mitral valve disease by removing the affected valve and implanting an artificial one. These days, Dr. Gammie and other cardiac surgeons at Maryland are leading the way in mitral valve repairs. In fact, about 92 percent of patients at the Center have their valves repaired instead of replaced -- a rate nearly twice the national average.
Among the advantages of this approach are improved long-term survival rates and reduced risk of stroke, and freedom from long-term treatment with blood thinners.
In addition, Center surgeons routinely perform mitral valve repairs using a minimally invasive procedure on the side of the chest, rather than through an incision in the breastbone, that allows patients to return to everyday activity sooner than traditional surgery.
“I chose Dr. Gammie because he could see me within 2 weeks and, after that first consultation, I felt comfortable enough that this was the guy who was going to do the work,” Eckhart says. “Dr Gammie’s demeanor [is] what appealed to me. He showed me what was going to be done and told me that he’d done thousands of repair procedures. His staff also had a lot of compassion and made me feel at ease and comfortable. So that’s a great combination.
“I felt like it was more of a partnership, as opposed to an ‘I’m the doctor, you’re the patient, and I know better than you’ relationship,” he adds. “And that’s a huge deal.”
Another important aspect of this “partnership,” Eckhart says, was the fact that Dr. Gammie involved him in the decision-making about the choice of treatment: to repair or replace the valve.
“I was involved in the discussion, with Dr. Gammie, and it was a detailed conversation,” he says. “After looking at the test results, he felt he could repair the valve and that was my preference. I describe it as wanting to keep my original equipment.”
Although no one, including Dr. Gammie, could say for certain what transpired between June and December of 2008 that had caused Eckhart’s heart condition, the result was clear: the chords that normally serve to close the two curved “leaflets” that comprise the valve were gone, causing the valve to prolapse, or improperly close. Thus, there was nothing to prevent the blood flowing into the left ventricle from flowing backwards through the abnormal valve into the left atrium when the heart contracted. If left untreated, this regurgitation of blood back into the atrium can cause irregular heart rhythms, heart enlargement and weakness, and/or cardiac arrest.
Dr. Gammie’s procedure involves placing a stabilizing ring around the opening of the valve, to help maintain its shape, and resuspending the prolapsed leaflets with synthetic chords to restore the function of the mitral valve.
“Even though my condition was considered ‘severe,’ Dr. Gammie gave me the confidence that, based on the number of these procedures he does a year, if anyone could perform a repair on my valve, rather than the more dramatic replacement, it was him,” Eckhart says, adding that, other than experiencing some initial pain after the surgery, everything from pre-op to post-op went extremely well. In fact, his recovery was so smooth that he was cleared to return to work within four weeks -- about half the time recommended for a patient undergoing traditional open-heart surgery.
However, perhaps the most exciting outcome of the procedure for Eckhart (aside from experiencing a full recovery, of course) may have been the “souvenirs.”
“One of the things that Dr. Gammie and his staff accommodated me with was that I wanted pictures, lots of pictures, of the heart and the surgery, at different stages,” Eckhart says. “Although I work in the information services sector now, I have always considered myself a scientist. I studied geology and worked in a lab as an undergrad, so I understand and like scientific discovery. Whereas most people are grossed out by such a thing, I’m ecstatic about learning which areas are which and being able to identify them easily. I mean, how many people have a picture of their own mitral valve? I do!”
A desire to give back
All of these factors -- from Dr. Gammie’s demeanor and reputation as a surgeon to the ease of recovery from, and the science behind, his surgery -- contributed to Eckhart’s desire to give back, in the form of an annual financial donation, to the University of Maryland School of Medicine.
“I know that, from my days as an undergrad working in a lab, you have to always work hard for your money. And it’s not fun,” Eckhart says. “So, in a certain sense, if I can make things a little bit easier [for Dr. Gammie and staff], then I’m willing to do that.”
Each year, to mark the anniversary of his surgery, Eckhart makes a donation to support Dr. Gammie’s research and teaching efforts.
“I will never have a building named after me -- I don’t think I’ll ever make that big of a donation,” he says. “But, if I can give a modest donation, something that might help out in the classroom or in the lab, that’s great.”
Eckhart says he’s also interested in supporting the ways science continues to grow and change.
“I know from the stories he’s told me, Dr. Gammie has already evolved his process from the way it was 3-4 years ago. He thinks he could eventually do surgery through little holes and not even make the kind of incision that I have. That’s incredible to me, that he can do that,” Eckhart says. “So, for me to be able to help in some way that advances the science that directly impacted me, that’s my goal.”
Eckhart explains that his overall rationale for giving -- and it’s the one he discusses with his peers -- is simple: it helps the next person.
“At some point prior to my surgery, someone donated money to get Dr. Gammie, and anyone else like him, up to speed to be able to do what they do,” he says. “That money has to come from somewhere to keep that going.
“My methodology at this point is to give what I am willing and can afford to give, and doing what will make a difference.”
For more information about the Maryland Heart Center and the Division of Cardiac Surgery, and how you may contribute, please contact the University of Maryland School of Medicine Office of Development at 410-706-8503.