Six hours into open heart surgery last March, doctors attempted to restart Douglas Barense’s heart.
It lay almost lifeless in his chest, quivering like gelatin in a moving bowl. But not beating. Not pumping blood. Not sustaining life.
Barense had been easily weaned from the heart-lung machine, but a dangerous heart rhythm had developed.
“They couldn’t get the heart beating (properly) again,” Barense said. “It just sat there. They tried the paddles on it.”
Ed Murphy, MD, a Spectrum Health Medical Group cardiothoracic surgeon, took Barense’s heart into his hands, quite literally.
“Dr. Murphy massaged it by hand, trying to get it going,” Barense said. “Finally, they got it going. He said of all the surgeries he’s had, he’s never had a heart that he couldn’t get going (in a regular rhythm) like that.
“Finally they got it going, but it was all over the place,” Barense said. “It was going crazy.”
His once-steady rhythm had morphed into unpredictable discord. Dr. Murphy and the cardiac surgery team placed Barense back on the heart-lung machine and used a temporary pacemaker to help stabilize the rhythm.
Barense went home from the hospital six days after surgery, but his heart remained in atrial fibrillation—a fast, non-rhythmic pulsation.
During cardiac rehabilitation, his heart finally slipped back into rhythm.
Heading toward healthy
The retired builder could finally start rebuilding his life. In a new way. A healthier way.
He smoked cigarettes for 45 years. He blames them for his heart issues.
“It’s important to have a healthy lifestyle,” said the former Zeeland High School and Central Michigan University football player. “You’ve got to keep fit. It’s good for your mind and it’s good for your body. I wake up in the morning and I think, if they didn’t catch this, I’d probably be dead.”
In some ways, he’s never felt more alive.
Barense walks for an hour every morning and 45 minutes at night. He lifts light weights for 45 minutes in the afternoon. He rides a stationary bicycle twice a day.
“I always liked to exercise, even before the operation,” Barense said. “I like to keep myself fit.”
Barense has built more than 1,300 homes, but a bad back forced him to hang up his hammer eight years ago.
“I wish I could still do construction work,” he said. “I can only do it around the house for an hour or two.”
Barense seemed born to build. He learned the craft from his father, also a carpenter.
“When I was a little kid I was always around the job site,” he said. “I was like a beaver in heat.”
In the genes
Besides their common love of building, Barense would later learn that he and his father had something else in common: heart trouble.
His dad died of a heart attack at 80. His grandfather perished from the same at 57. His older brother? Fatal heart attack at 65, Barense’s current age.
“It was in my genes,” Barense said. “I was getting awful tired when I was doing stuff around the yard. I’d get short of breath and have to sit down.”
For the last two years, Barense had been experiencing what he thought was acid reflux. A stress test last March revealed deeper issues.
Barense was referred to Spectrum Health’s heart team, which uses a multidisciplinary approach to managing patients with complex cardiovascular disease.
Typically, about 20 specialists, including cardiologists, cardiothoracic surgeons, anesthesiologists and other experts meet every Tuesday morning from 6:45-7:45 a.m. to discuss each patient’s situation and determine the best plan of action.
Richard McNamara, MD, a Spectrum Health Medical Group cardiologist, said multidisciplinary team involvement is critical in complex cases.
“With the multi-specialty group, about 20 doctors get together once a week and go through these patients’ (cases),” Dr. McNamara said. “As I tell patients, you get a chance to have 20 different second opinions. We discuss six to seven patients a week and individualize a cohesive care plan for each patient. It’s an indispensable part of our caring for these patients.”
In Barense’s case, it took all multi-specialty hands on deck to navigate a successful outcome.
“When I went for my stress test … halfway through they knew something was wrong,” Barense said. “I had a heart cath and they found two vessels blocked.”
In retrospect, there had been signs. While vacationing in Belize in January, he experienced angina for about 90 minutes. A month later in a Florida hotel room, it happened again for about three hours.
“Dr. McNamara later told me the first time was one of my blood vessels shutting down and the second time was the other blood vessel shutting down,” Barense said.
A pre-operative evaluation revealed an aneurysm of the aorta and aortic root.
Besides double bypass surgery and replacing Barense’s aortic valve with a pig’s valve, Dr. Murphy replaced the aortic root and ascending aorta.
“It was a complex surgery,” Dr. Murphy said. “His own coronary arteries had to be disconnected from his aneurysm and reconnected to the polyester graft that was used to replace his aneurysmal aorta.”
Barense’s wife, Judy, said nurses came out to the waiting room to give her updates.
“At 7 p.m. they said everything was complete and everything looked real good and they were going to close him,” Judy said. “She said it would be about another hour and he would go into recovery.”
But the hour passed. Then another. A nurse explained the unexpected trouble in restarting Barense’s heart.
Dr. Murphy came out at about 11 p.m.
“He said he didn’t know why that happened,” Judy said. “He explained how they had to go in and do some hand massaging to get it going.”
By 9:30 a.m., Dr. Murphy told her that her husband would likely be fine. His heart rhythm had remained stable through the night and he was making the expected postoperative progress after a complex heart surgery.
“He’s probably in better health than he was before,” Judy said. “We can’t say enough about the cardiac team. I was so grateful to all of them. Their expertise is unbelievable.”
“(Dr. Murphy) had my husband’s heart in his hand,” she said. “That’s not something everyone can say. It’s just amazing.”
A perfect normal
Judy and her husband are resuming normal life these days.
They are, in a sense, holding each other’s hearts, grateful to still be together.
“Until you go through it, you don’t realize it,” Judy said. “It’s quite a journey. They told him he was very fortunate to be here. We are very thankful to all our friends and family who prayed and were there for us. We give all the glory to God for the healing.”
Barense is back to taking care of his garden, tending to beans, peas, corn, tomatoes and radishes.
He relishes the moments.
And he knows if it weren’t for the heart team, he might not be here.
“If you have just one person, you hope he was pretty good in his class,” Barense said. “When you have all these people working together, it’s very comforting. They were pretty sharp tacks. I was really impressed with their knowledge.”
Dr. Murphy said Spectrum Health’s thoracic aortic clinic will follow Barense for life, but he is confident in long-term success.
“I am delighted with Doug’s progress after his surgery,” Dr. Murphy said. “He recovered beautifully and he has done all of the right things to ensure continued success. …He and Judy can be confident that in the unlikely event that any further aorta problems arise, we will be here for him.”