Meadville Tribune

February 19, 2013

Heart procedure helping Hadley man find normalcy

By Keith Gushard
Meadville Tribune

SHEAKLEYVILLE — He has a failing heart and can’t do everything he once did, but these days Brian Palmer considers himself a walking medical miracle.

“I love it. I’d recommend this to anybody in the same condition,” Palmer, 52, of Hadley, said during a work break as he tapped the battery pack around his waist that powers a high-tech pump for his heart.

In October, doctors at UPMC Passavant Hospital in Pittsburgh implanted an LVAD, or left ventricular assist device, in Palmer’s heart. Palmer has cardiomyopathy, a weakening of the heart muscle and has COPD, or chronic obstructive pulmonary disease, which is a lung disease that makes it hard to breathe.

The LVAD is a battery-powered mechanical pump that helps send blood from his heart’s left ventricle, the main pumping chamber of the heart, to the rest of his body. The LVAD takes over the function of the diseased left ventricle by using an electric motor to drive a small rotor, similar to a propeller, to push blood into the aorta and out to the body.

The LVAD is connected to his heart and its power cords were surgically implanted through his skin to connect with a small battery pack and controller he wears around his waist. The battery packs are good for about a five-hour charge, he said.

The pump has Palmer feeling so well that in November he was able to return to work as an auto detailer at Lakeland Livery Services, a limousine and hearse service based in Sheakleyville.

“I don’t get tired like I did before (implantation of the LVAD),” he said. “Cleaning and detailing one of the cars took 90 minutes to do before; now it’s 45 minutes.”

Palmer has been plagued by serious health problems for more than 15 years.

In 1998, he had a heart attack when he was an employee at the former R.D. Werner Co. ladder plant in Greenville.

In 2006 he suffered a stroke while working as head of maintenance at White Cliff Nursing Center in Greenville. His health rebounded, but not enough where Palmer was able to return to full-time employment.

In December 2011, Palmer contacted Bob Snyder, the owner of Lakeland Livery and Sheakleyville’s funeral home, about a job preparing the funeral cars.

Palmer wanted to do it in order to have something to pass the time and also because of his love of automobiles and making them shine.

“I’ve been cleaning cars since I was 16 years old,” Palmer said. “I really enjoy doing it. You see what you’ve accomplished when you’re done.”

“I knew he had health issues, but I was looking for some help part-time,” said Snyder, who was doing the vehicle prep work himself.

“He’s a great guy to have around,” said Snyder, who went back to prepping the vehicles himself while Palmer was hospitalized for the LVAD operation. “He does a fantastic job. He’s got an easy-going personality. He’s eager to please and conscientious.”

Palmer’s road to an LVAD implant began in late summer 2012 when Palmer knew he wasn’t feeling right. It was taking him much longer than normal to prepare the vehicles for their next use.

After visiting his primary care physician in late August, Palmer was sent to heart specialists at UPMC in Pittsburgh on Sept. 12, 2012. “They put me in bed a half-hour later and said ‘You’re not going anywhere,’” he said.

Surgeons implanted the LVAD on Oct. 9, 2012, and Palmer was able to go home from the hospital on Oct. 20, 2012. Palmer resumed working for Snyder on Nov. 1, 2012, and has rebounded enough that Snyder now has Palmer also taking over scheduling of the vehicles.

Palmer did have a setback on Nov. 15, 2012, when his battery pack had a malfunction and he ended up being flown by helicopter ambulance to Pittsburgh.

Palmer was at home when the pack malfunctioned and he couldn’t get it to reconnect nor could his wife. The emergency medical technicians from the ambulance crew called to his home had never seen the device before and as Palmer put it, “didn’t want to mess with it.”

Taken to UPMC Horizon in Greenville, physicians there also had not dealt with the device before. Emergency room physicians contacted UPMC in Pittsburgh, which led to a heart team being flown by helicopter from Pittsburgh to Greenville to whisk Palmer back down to Pittsburgh to remedy the situation. He was able to return home after just a couple of days of observation.

“It turned out a connector pin for the battery pack (to the controller) broke so it couldn’t get hooked up,” he said. “I knew what to do and so did my wife, but with the broken pin, it wouldn’t connect and nobody realized it had broken.”

The use of the LVAD may or may not be a long-term solution for Palmer. He can be placed on the list for a heart transplant, but Palmer must use the LVAD for at least six months before he’s put on the heart transplant list.

But Palmer’s not certain if he wants to go through a heart transplant operation.

“This was tough enough,” he said with a smile. “It was several hours and when it was over I really hurt and had 11 to 13 tubes running out of me.”

Despite the pain he endured from the LVAD operation, Palmer said he’s grateful to the doctors and nurses involved in his care, but others as well.

Palmer singled out the Rev. Randy Keeling of Reash Community Church of Cochranton, who also works part-time at the livery service as a driver, and The Rev. Tim Bowser of Sheakleyville United Methodist Church for helping restore his faith in God.

“Everybody in the community really has helped me,” he said.

There have been fund-drives held throughout the community to help Palmer and his family with expenses since he’s on disability income because of his previous health issues.

The LVAD operation cost about $65,000 and the November helicopter flight was another $15,000. Medicare paid $46,000 of the approximate $80,000 tab, he said.

“I just can’t thank people enough,” he said. “I’m very lucky.”

What are VADs?

Implantable ventricular assist devices, or VADs, are used mainly for people who are waiting for heart transplants or as a long-term solution for people who can’t have heart transplants, according to the National Heart, Lung and Blood Institute of the Nationial Institutes of Health.

According information on to the National Heart, Lung and Blood Institute’s website a VAD has several basic parts.

A small tube carries blood out of the heart into a pump. Another tube carries blood from the pump to the blood vessels, which deliver the blood to the body.

A VAD also has a power source that connects to a control unit. This unit monitors the VAD’s functions. It gives warnings, or alarms, if the power is low or the device isn’t working well.

The two basic types of VADs are a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD). If both types are used at the same time, they’re called a biventricular assist device (BIVAD).

The LVAD is the most common type of VAD. It helps the left ventricle pump blood to the aorta. The aorta is the main artery that carries oxygen-rich blood from the heart to the body.