Jim Whalen is no stranger to physical labor. His career in construction has had him installing fences for many years - including the fences he had installed in various locations around the hospital where he had open heart surgery.
Jim - known to his friends as "Jimbo" - has been told that even though he's approaching 74 years old, he barely looks 60. "I dig holes - by hand sometimes. Knock on wood, I'm in good physical shape," he says.
Just A Little AFIB
So when a routine electrocardiogram (EKG) before a colonoscopy procedure in 2010 revealed that Jim's heart in an irregular rhythm (a condition called atrial fibrillation, or AFib), he wasn't concerned.
About a year later, Jim's new primary care physician, Dr. Dawn Thornton, performed an EKG as part of Jim's initial physical. It showed that he was in AFib. Since Jim wasn't having symptoms, Dr. Thornton told him to go to the ER to see the cardiologist on call. Jim felt fine, and had a job scheduled for the rest of the day, so he figured it could wait. He told Dr. Thornton that he would see a cardiologist that week if she would make the appointment for him. Dr. Thornton scheduled an appointment for Jim with Donna M. Reed, DO
, for a few days later.
Dr. Reed immediately put Jim on a treatment plan of heart medication and annual monitoring. But about 9 years later, in early 2019, an EKG showed that Jim was in AFib again. It also revealed that Jim's heart was not as strong as he'd been telling himself, and he needed to do something about it.
The Diagnosis: A Leaky Heart Valve
The echocardiogram showed that Jim's heart function was lower than normal. Dr. Reed suspected Jim had at least one leaky heart valve and referred Jim to Steven J. Weiss, MD
, Chief of Cardiac Surgery at Chester County Hospital, to assess his heart and advise Jim on treatment options.
Dr. Reed and Dr. Weiss treat patients together all the time, which gave Mary and Jim "a good sense of comfort," she says.
Dr. Weiss ordered a cardiac catheterization - inserting a thin, hollow tube, called a catheter into the blood vessels that supply his heart - to make sure the arteries which supply blood to his heart muscle were in good shape.
The catheterization revealed some good news - Jim's coronary arteries were open, meaning the blood supply to his heart muscle was very good.
However, it also confirmed his physicians' suspicion that he had a condition called valve insufficiency, or regurgitation. This meant that when the heart tried to push the blood back to the rest of the body, the valves leaked and the blood went back into the heart. His heart had to work harder than normal to push blood back out to the body.
Because this could put him at a higher risk of blood clots and stroke, Dr. Weiss told him that the leakage had to be corrected.
Mary and Jim's confidence in Jim's care team was especially important when they were informed that he'd need open surgery because the two valves were involved.
"They didn't just give us a spiel and then walk out of the room. They waited for our reactions, and they gave us time to come up with questions and ask them," Mary says about Jim's care team. "Dr. Weiss and his team wanted to make sure Jim and I understood everything."
April Fool's Heart Surgery
Jim wasn't planning on having heart surgery that March - or any month. "I'm going on a cruise in a few weeks," he told his physicians, "and I have jobs to do before then."
But he was open to listening to his team who were all in one room, ready to explain the next steps to Jim. They talked with him about cardiac ablation, which is a procedure used to scar small areas of the heart that are causing problems.
Dr. Weiss told Jim that the surgery wasn't going to give him just another 40,000 miles on his life. "He told me it was going to give me 200,000 more miles," Jim says.
When Jim walked out of the room that day, he understood exactly how Dr. Weiss would repair the two leaky heart valves, as well as how he would perform the cardiac ablation - and he was convinced that he needed to listen to Dr. Weiss.
"He encouraged Jim to get the surgery as soon as possible because his heart was only going to get worse," Mary says.
When Jim scheduled his surgery for April 1, 2019, some of his care team teased him about scheduling it on April Fool's Day. But Jim knew it was no joke, and he was ready to have his heart health back.
A Collapsed Lung, But An Easy Recovery
Jim's recovery from his heart surgery was initially very smooth, and for the first full day, he was in good shape. On the second day, he was still having some trouble breathing - and his team noticed that Jim wasn't perking up as they expected him to.
"Dr. Weiss' team knew I should have been a little perkier than I was. I kept falling asleep, and when they monitored my breathing, they immediately knew something was wrong," he says.
Jim had a collapsed lung, which is not uncommon for heart surgery patients. His care team acted right away, and the lung collapse only added one day to his recovery. "They put the tube in to re-inflate the lung right there while I was in bed, and I felt better right away. I couldn't believe how instant everything was," Jim recalls.
When Chris, one of the physician assistants, asked Jim if the student nurses - who were out in the hallway at the time - could come in and watch him insert the tube into his lung, Jim was on board. "They can't learn nothing out there," he had said.
Calm, Cool, and Collected
During her husband's surgery - and the lung collapse afterward - Mary found the team's relaxed demeanor to be particularly comforting. "The nurses in the cardiac care unit are unbelievable. I was nervous when I saw all those IVs in Jim, but they were so relaxed. The nurses explained everything to both Jim and myself, and were so encouraging," she says.
On the third day of post-op - after the breathing tube had been out for about half a day - one of the physician assistants, Chris, entered the room. Chris noticed Jim admiring a beautiful flowering cherry tree in full bloom just outside his window, looking a little wistful. He asked Jim if he was ready to go home, and was met with a resounding "YES!" from Jim.
Mary was sitting there, and agreed. "I'm ready for him to come home anytime," she said. Since Jim was medically stable and able to move and walk on his own, Chris started the paperwork for discharge to home.
Jim's nurse (also named Mary), made sure he was good to go on his 13 medications for that evening. Now, Jim is down to just a handful of pills, including aspirin, along with regular blood work and monitoring.
Despite his strong physical health, Jim still had some recovering to do. He was anxious to get back to work, but was told he had to wait at least 6 to 8 weeks. One of his physician's assistants, Jennifer, put his recovery in words he could relate to. "She told me it's like concrete - you just can't hang something on it right away," Jim said.
So Jim followed the post-operative instructions from Dr. Weiss and the rest of his care team - down to the letter. Jim was prepared to let that concrete dry.
Once discharged, Jim wanted to bring his care team a fruit basket to thank them for all they did for him. When he walked in, everyone said, "Jim! Dr. Weiss told you not to drive for a few weeks!"
"Don't worry," Jim responded. "I had Mary drive me."
As for his chest, Jim says it's healing nicely. "If someone saw my chest," the 73-year old says, "they wouldn't even know they cut me."