Patient EXPERIENCE- Heart Failure

Biventricular Defibrillator
iv

Before I suffered from Dilated Cardiomyopathy, LBBB condition, I had no previous hospital admissions. In June 2013, I had an ICD implantation (three wire).
Two years previous to this procedure I had climbed Kilimanjaro. Approximately six months after the climb I noticed a change in my breathing, when I cycled up a specific steep hill, I struggled and this stuck in my mind as I had not experienced breathing difficulties. Shortly afterwards, I began to experience shortness of breath when playing a vigorous game of tennis. I went to my GP who carried out various blood tests and lung tests. I was given the all clear. Subsequently after my GP visit, I became tired more easily and my fitness level continued to deteriorate even though I was pushing myself harder while playing sports. I used to do a lot of water skiing but stopped because my extremities would get cold. Towards the end I struggled walking up a slope.
My symptoms continued and my son was getting married in Sicily in a week. I decided to visit my GP again and told him due to the way I was feeling I had no interest in going to the wedding. He arranged an Echocardiogram in the
This revealed an “Ejection Fraction” of 15%.
I was taken to the “Intensive Care” section where Dr. Maheshwar Pariah and his team made the assessment and started the treatment. By the way, I made my Father of the Groom’s wedding speech from the hospital bed via Skype. (The staff in the Bon Secours Hospital in Cork hospital were outstanding in their support.).
I came out of hospital after two weeks and started my recuperation. My drugs were slowly increased to the desired level.I began exercising and building myself up. This included six weeks rehab at the Bon Secours Hospital which consisted of 1.5 hours of rehab twice a week. I continued the program at home.
I am now back playing tennis, cycling, walking vigorously and feeling great. As a matter of fact I pinch myself with the quality of life I have. My Ejection Fraction has improved, my breathing is great and my fitness levels are to the same level that they were before I had the procedure. I feel so good, I forget about the ICD for long periods of time.
In conclusion I would like to stress that through all this experience I never had any pain even though my heart was so close to failure, the whole thing was so passive it is frightening. It was my first time in hospital and the staff and doctors made my stay a pleasant one to look back on. I return for check-ups and have become very friendly with them all.

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Biventricular Pacemaker

Mr. Patrick Tierney
Midleton, Co. Cork

To Dr. Maheshwar Pauriah
Consultant Cardiologist
Mater Private Hospital, Cork

Thank you for your letter received today informing me of your career move to the Mater Private. All I can say is that I wish you well and continued success. The Bon Secours loss is certainly the Mater’s gain.

I was a very active person until the summer of 2013. Pains in my knees made it very difficult to get up from any sitting position, though I could walk perfectly once I got to my feet.

It was diagnosed that I was suffering from Polymalgia Rheumatica (PMR) BPH. However while this was been treated Dr. Maheshwar Pauriah discovered I was also suffering from Bradycardia/NSVT and atrial fibrillation.

He said it required immediate treatment and that meant that same evening. I rang my family and tried to be as brave as possible.

In the arte-room to the operating Theatre Dr. Maheshwar sought my consent to the insertion of pacemaker with dual-chamber pacing. He explained the risks of the procedure. He explained that my heart and the fact that I was a Warfarin patient made the procedure more serious. He obviously saw the fear in my face and quietly took my hand. “Have no fears”, he said, “I shall treat you as if you were my father”.

Already I felt I was a different person. I realised I was in the hands of a medical genius who was still a very human compassionate and caring surgeon in whom I had a 100% trust.

Less than 2 hours later my family received a phone call from me as they were driving in to see me after the operation. They could not believe how calm, lucid and happy I sounded as I phoned them from my bed. Two days later I was home and in good form.

Dr. Maheshwar’s concern did not end there and he continued to check on my progress. He judged after 3 months that the pacemaker was working at optimum level and suggested that it could be updated to a CRT (Cardiac Resynchronization Therapy Device) which has an extra leads. I agreed and placed myself once again in his caring hands, entering hospital on 10/12/2013 and was discharged on 23/12/2013.

It was certainly a very happy Christmas for me and 2014 and 2015 have allowed me to return to a very active life for someone who has passed the 3 score and ten many years ago.

I thank God and Dr. Maheshwar Pauriah.

An optional extra.
As you know I have 2 interests in life, gardening and music.

This spring I had one of my best displays of spring flowers. Still I honoured the dictum on no heavy work such as digging. I responded by using dozens and dozens of pots with daffodils, tulips, hyacinths, primulas etc. It gave me hope and pleasure.

I still play piano and my CD+LP collection. The song lyrics to songs have got a whole new meaning.

I give you a perfect example.
Listen to Michael Buble or Harry Connick Jr
Sing “I’ve got you under mu skin,
Deep in the heart of me……..”
Sing on
“Zing go the strings of my heart”

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cs
My heart problems became obvious in 1994, when I was 64 years of age.

I had severely blocked arteries and had multiple by-pass surgery carried out by Mr.Tom Ahern.
This was very successful subsequently,I continued to lead a very active life, which also involved a great deal of travel.

In 2005, I suffered a heart attack. I was hospitalised ( Bon Secours) and had two stints inserted.
Stents were also put in on another occasion. I was at that time under the excellent care of Dr. William Fennell.

In 2014, I found I was felling very tired and struggling to continue my active life-style (at the ripe old age of 84!)
My G.P recommended I go to see Dr. Maheshwar Pauriah, which was the best decision I could have made.
I had the usual stress test and echocardiogram.
Dr. Pauriah advised me of the advantages of having a pace maker implanted, which was duly done on 19th of November 2014.

The procedure was painless and without complications. I feel much more energised since it was done.
I walk briskly and climb hills without stress or breathlessness and I strongly recommended the procedure to those who need it.

Dr. Pauriah inspires great confidence and his open and friendly manner and excellent communication skills contribute in no small way to the well-being of his patients

Dr Pauriah’s comments: Biventricular pacemaker can make a huge difference to the lives of selected patients. You are never too old to feel good.
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Jim Hayes

My name is Jim Hayes and I am 76 years old. Over the years, I have experienced a number of medical problems, but my heart had always been fine until this year (‘perfect’ I used to joke!). From the early part of 2014, I started to feeling increasingly tired and very short of breath. This breathlessness reached a point where ,by March of this year I was barely able to put one foot in front of the other at home without feeling worn out and in need of a rest. I was hospitalized twice, in a pretty bad way, suffering from fluid filled lungs, caused by the inefficiency of the heart. By the summer, with a diagnosis of a damaged heart, functioning atless than [30%] efficiency, things were looking bleak and my quality of life was not great at all. It was also very difficult for my family looking on and not being able to do anything.

In July of this year, whilst in the Bons under the care of the Cardiology Team, I was referred to Dr. Maheshwar Pauriah, Consultant Cardiologistand Electrophysiologist at the Bons Hospital in Cork. I was told that the plumbing of my heart was working but that the heart muscle was not functioning properly and I had atrial fibrillation.They said Dr. Pauriah was the man for the job. My family and I were so relieved that there was a possibility to improve my condition and some chink of light at the end of a bleak tunnel.

On 28 July 2014 I had a triple lead,combined pacemaker and defibrillator fitted and I immediately started to feel a bit better. Since then I have made what I consider to be a remarkable recovery from the problems I had before the device was fitted. The functioning of my heart has increased from 40% to 90% of the pumping capacity ( Ejection fraction increased from 20 to 50%) and I have regained much of the energy that I used to have before this year. My family and I are enormously grateful to Dr. Pauriah and all his team at the Bons, Cork,for the work they carried out and the great result that has been achieved. I am so glad that I was referred to this specialist team.

To finish my year out, I went for a walk on St. Stephen’s Day with ten of my children and grandchildren through Colligan Woods, near where we live in Dungarvan, Co. Waterford (see photo above). Three of my children and their families were home on holiday from faraway, so it was even more special to be able to share in this Hayes family tradition, a walk in Colligan Woods at Christmas. I walked three miles with ease, which I thought in the summer I would never be able to do again. For my family and I a thrilling end to this year which is down to work of Dr. Pauriah and the team at the Bons.

Jim Hayes
30th December 2014

Dr Pauriah’s comments: Mr Hayes had a Biventricular AICD for heart failure and has done very well with near normalisation of heart function. Part of the improvement can also be attributed to the maintenance of sinus rhythm.

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MK- Ablate and Pace: “My name is Maureen and I am 57 years old. I have had chronic lung problems and abnormal heart rhythm for a long time. I have been very breathless and it was all put down to my lung problems. For the abnormal heart rhythm, I was on a combination of medications that were giving me significant side effects. On one of the occasions when I was admitted, I was seen by Dr Pauriah for the first time.

He suggested that although my breathing was bad, the atrial fibrillation was probably a part of it. He went through the various treatment options including the use of a pacemaker and a simple ablation so that my heart rate will not go up.

I underwent pacemaker implantation on 13/08/2014, and it took less than 30 minutes for the complete procedure. I underwent ablation on 10/09/2014 and immediately all my cardiac medications were stopped ( except warfarin). I realised how much better I could feel. This procedure changed me completely got rid of half my problems eliminated tablets, totally different person colour in my cheeks even.
I wish I could have seen him before and have this treatment.”
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ANDREW FOGARTY : “In June 2013 I suddenly found myself in the Bon Secours hospital in cork suffering from heart failure with an ejection fraction of 15%. I had been very strong and active all my life and involved in sport. Earlier that same year in march I started to become breathless and had a persistent cough. This breathlessness became gradually worse until I could only walk a few hundred metres at any one time. I also found myself waking during the night gasping for breath but had put this down to possible worsening sleep apnoea. I presumed these symptoms were due to the fact that I had been a lifelong heavy smoker and I therefore self-diagnosed a respiratory or lung disease.

I spent three weeks in the Bon Secours where my heart failure was diagnosed. One of my main arteries was 95% blocked. Initially I was due to undergo a bypass but this was eventually deemed unsuitable due to the severe damage to my heart muscle. I felt complete despair and my future seemed uncertain at best. Luckily I was treated by Dr Mahesh and his team. He told me he could make me well again but obviously there were no promises or guarantees as to what extent I would improve. Immediately I felt hope again. Dr Mahesh was very positive and I felt he personally cared about my well-being. This was of huge importance to me and an invaluable aid to my recovery. I was put on various medications and had a stent and ICD inserted none of which had any negative impact on my health.

After leaving hospital I very quickly began to feel better. Walking was a big part of my recovery as was stopping smoking, lifestyle changes and a positive attitude that I would recover my health and strength. That positive mindset was fostered by Dr Mahesh and his team while in hospital. Obviously there were down days and difficult adjustments to make but not many.

Looking back there were other symptoms, maybe what I thought had been a muscular injury may have been a minor heart attack. At the time of writing this – January 2015 I am back to full health. I am strong and active and can work again. I actually feel better and more energetic than I have for many years.

Andrew Fogarty, Tipperary
Age 51”
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Thomas Wilkinson, Aged 79: In May 2014 I visited my GP to discuss my latest dizzy spell, having previously been treated for suspected vertigo. On this occasion she diagnosed a serious issue with my heart rhythm and sent me to the Bons Secours Hospital immediately. The next day I was operated on by Dr. Maheshwar Pauriah who fitted a pacemaker. The benefits of the procedure were immediately apparent as my health, balance and fitness all improved significantly. Within weeks I was walking several miles daily along a beach in Mayo and now walk my dog every day and live a full and active life. It’s hard sometimes to believe I have a device in my chest regulating my heart as there’s no sensation from it or outward sign of it. I’d like to extend my thanks to all the staff in the Bons Secours Hospital for their excellent care and professionalism.

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C T – Pacemaker: After living such an active life style all my life, I was very distressed
to find myself in a position where suddenly breathing was difficult,
walking was tiring and basic everyday tasks were almost impossible.

I sought help. I was advised to attend consultant cardiologist Dr.
Maheshwar pauriah’s clinic at the Bons Secours Hospital, Cork. After
thorough testing, Dr. Pauriah informed me that I was a suitable candidate
for a pacemaker. Initially, I was anxious however Dr. Pauriah soon put me
at complete ease by explaining the simple yet life changing procedure.

The whole procedure took 15 minutes to do and I haven’t looked back
since. The effects were instantly felt. It is absolutely wonderful to be
active again. Golfing, walking and socialising are now as they once were,
pleasurable. I hope that this will help people who have been advised to
undergo the procedure of getting a pacemaker.
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Christine Twomey, age 75 years. I retired from nursing five years ago due to shortness of breath. I had an angiogram and I needed a stent to my right coronary artery. I had same. It was unsuccessful. Re-stented failed. I had to have bypass operation and also mitral valve repair.
I went to Dublin Mater Private Hospital “Too risky for C.U.H.” in March 2010.

I had an ICD implanted at the Bons Secours hospital but the third lead proved very difficult due to the way my mitral valve was repaired.
I was in and out of the Bon Secours Hospital with heart failure. Finally, I was seen by Dr. Maheshwar Pauriah in October 2014. He was able to insert 3rd lead via a different route.
Since then I have a new lease of life. I am able to do all my home work, walk 1-2 miles daily, look after the horses and drive the tractor etc. As I did before without being breathless.

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FN- Biventricular ICD
My story starts with going to funeral where there were about 100 steps up to the church and when I got to the top after some breaks / stops along the way I knew that I was in trouble.

Within a few days I made an appointment to see Dr Conor O’Shea a cardiologist in the Bons Secours Hospital where I then went for tests and where I met Dr Maheshwar and it was decided to have a cardoversion but this only worked for 24 hours and then it was a few days later where I had a biventricular ICD implanted in February of 2015. I am back walking and cycling and a lot of lost energy has come back to me.

If anyone is in the same position I would strongly recommend that they have this implant or even have a check with a Cardiologist Now.