Oh, and welcome to the Gifted Life Podcast, where we have conversations about organ tissue and I know nation. I'm Roy Steel. I'm Joey Bujro. I'm Sarah Blakemore.
What's up today, Joe? Today, we'll be talking about heart diseases and what might cause one to need a heart transplant. Yeah, lots to delve into. Here we go.
All right, guys, here on the Gifted Life, we love to hear from you. That spurs new ideas, new conversations. We partner with new experts. Thanks to you, you are our partner.
We received a voice mail from a Jack Gilroy and we want you to take a listen. Hey, guys. My name is Jack Gilroy. I'm listening to your podcast right now, which I really like.
I'm a big fan of. As a matter of fact, I'm actually a heart transplant survivor. I'm 20 years old. I had a heart transplant when I was seven.
I was diagnosed with dilated cardiomyopathy and I actually just finished listening to Matthew Kutcher's podcast and I know he had cardiomyopathy as well. So I was able to connect real well with that. In May 26 is my heart birthday and it'll be 14 years since my transplant that I had in May 2006. So I just wanted to call and reach out.
I just want to do as much as I can. So I hope all is well and thank you guys for your time. First of all, Jack, thank you. We love when people call in and just by calling in, Jack, you could be a great one.
We created this specific episode for us. You helped to inspire us. Yeah. So you guys just heard Jack Gilroy and we've done quite a bit of podcast focusing on kidney donation, liver donation, even diabetes and pancreas donation from time to time.
But we realized we hadn't really focused a ton on heart donation. So in this episode of the gift of life, we'll explore the disease process of cardiomyopathy and explain what the disease does to a heart causing the need for a transplant. Yeah. We went out and we found an expert at Ashen or medical center, one of our partners, Dr.
Daniel Morin joins us here on the gift of life. Hey, doctor. You're having me. We appreciate your time.
We know that you're a cardiac electrophysiologist. I'm going to start out. What is that? Explain.
Right. So a cardiac electrophysiologist is a cardiologist or a heart doctor who specializes in the heart and rhythm disorders, of course, some of which are related to cardiomyopathy, some of which aren't. But in general, we take care of anything that has to do with the rhythm of the heart. So of course, working in the transl...
or actually in the donation world, we understand that a lot of the transplant recipient's potential recipients suffer from what's called cardiomyopathy. Of course, you know, one of the ways that someone can develop cardiomyopathy is through rhythm issues. But can you tell us a little bit about cardiomyopathy and just the different ways of developing it? Sure.
So we can, of course, concentrate on cardiomyopathy in general, and I'll be sure to sprinkle through the rhythm issues as we're talking, because that is my area of particular expertise. But cardiomyopathy, in general, you know, it's a long word, and people don't often think about this. But just think about the word. It's cardio.
That's the heart, right? And myo is the muscle and pathy is disease. So this is a disease of the heart muscle. And that can result in the heart muscle to become weaker so that it doesn't pump blood forward.
It can also make it become enlarged or thick, especially sometimes it becomes so thick that it impedes the blood flowing through the heart, you know, through the various chambers of the heart, or sometimes the heart can become abnormally rigid so that it's not able to relax and accept the next load of blood that it needs to pump forward. And of course, if it can't relax in order to fill, then it certainly can't pump forward, you know, it can't squeeze to pump forward either. So is this the primary cause of someone needing that would need a heart transplant? It's a big reason.
That's for sure. So of course, as a heart gets weaker, or if the heart has problems with pumping the blood forward, that can make it such that the blood doesn't get around the patient's body so well and they develop what's called heart failure. And that of course makes people feel very short of breath and being winded all the time, not having any energy. And in addition, it puts you at risk for dangerous, fast heart rhythms, which can lead to sudden cardiac arrest and suddenly dying.
That is oftentimes when I come in as an electrophysiologist to try to prevent those bad rhythms that can cause sudden death. But one of the main reasons, of course, for people to require a transplant is a weakening of the heart, especially that the heart can't do its job and thereby the patient requires a new heart. Dr. Maureen, could you please share with us what the symptoms for cardiomyopathy are?
Sure. So sometimes, amazingly, people don't have any symptoms at all from their cardiomyopathy. They may have a heart that is very significantly weakened. But because of their youth and otherwise doing pretty well, and they may have no symptoms, we have patients who have cardiomyopathy and are able to play basketball and maybe only come through our attention because of an EKG that they have done or an echocardiogram that they have.
Other people do show signs as the disease progresses oftentimes as they get older and maybe not quite as strong as they were when they were 20 years old. And as the heart weakens, they may develop shortness of breath or fatigue. Sometimes if the heart is unable to pump the blood forward, it backs up, the lungs back up with fluid and blood and therefore that causes the shortness of breath as well. Sometimes depending on the types of cardiomyopathy, those patients can either develop lightheadedness or dizziness as a result of narrowing of their heart valves or from the development of arrhythmias or abnormal heart rhythms where the heart goes way too fast and that makes it sort of like the heart is not pumping any blood forward at all.
And that can cause people to pass out or if those arrhythmias last even longer, that can result in sudden cardiac arrest and sudden death unfortunately. And that's part of where we come in as electrophysiologists because as people develop their cardiomyopathy, that is a sign that they're at higher risk for developing bad, fast heart rhythms that have not treated immediately, that could potentially cause sudden cardiac arrest and sudden death. And under those circumstances, then oftentimes we will recommend that we implant an implantable cardiabertor defibrillator or a defibrillator for short. That's a device that can help to protect people from sudden cardiac arrest.
I have one more question. So now after working with LOPA4, I don't know, 17, 18, whatever years, I am terrified every time I have a simple cold and it's crazy because my first thought goes straight to, oh my goodness, I hope I don't have somehow developed a viral cardiomyopathy. So how does that happen? It seems like something that's so benign causes so many, of course I'm looking at it from this end, but so many needs for heart transplant.
Sure. Well, you know, obviously it's not the case that every time somebody gets cold, they develop cardiomyopathy, otherwise we'd all be in real bad trouble. But sometimes as you're pointing out, when people have viral illness and especially with certain viruses, it does affect directly the heart muscle. And I don't think it's completely understood, otherwise we would be able to maybe detect that and treat it.
But oftentimes what we do find is the first time that someone comes to our attention as having cardiomyopathy, we find out that maybe a week earlier they had flu symptoms for no apparent other reason. And maybe their flu symptoms improve, but maybe their shortest of breath doesn't and the swelling in their legs doesn't. And that leads us to think, well, you know, maybe there's a problem going on with their heart and we'll get an echocardiogram. And if we find then that they have a cardiomyopathy, well, then we take very close attention to that patient, give them the appropriate medications to help them to recover.
And then if their squeezing function of their heart remains depressed for a number of months afterwards, well, then we start going down the line of treating them appropriately for a long-standing cardiomyopathy. Well, not have gotten everyone else just as paranoid as I am all the time. I appreciate that. Yeah.
So a lot of times I've been a nurse just to give you my background. I've been a nurse for about 23 years or so. And you know, I've had quite a bit of conversations about heart donation and then in that oftentimes a lot of people get confused with like bypass surgery. And they think immediately, well, if you've got bypass, why didn't you get a transplant?
But can you tell us a little bit about the differences with those two? For sure. So people undergo bypass surgery when they have blockages in the arteries that feed their heart. If there's a blockage in the arteries that feed the heart, then of course the blood can't get to the heart muscle and that causes people to have chest pain, have heart attacks, for example, and also to have bad rhythms.
And a bypass surgery is just what it sounds like. It bypasses those blockages by putting a new blood vessel from the source of where the blood comes from, which is usually the aorta, the very large blood vessel that comes out of the heart and plugs it into the artery that feeds the heart, thereby bypassing or getting blood past the blockages that occurred within the artery itself on the surface of the heart. Now in contrast, of course, the heart transplant is removing the entire heart and replacing it with another heart, which has come from a donor. So with hard bypass, of course, you know, as you said, you can tie in a vessel and the heart's still a good functioning heart at that time.
And whereas, you know, someone with cardiomyopathy, it's not that easy to just resume the previous function. So I guess basically, you know, that's, that's the big difference is what I'm hearing. Right. So that, you know, a person with, with cardiomyopathy might have that cardiomyopathy or weakness of the heart muscle because of a number of different reasons.
And only one of them, probably the most common one, of course, is coronary artery disease and heart attacks, which can cause the heart to weaken over time. But there are lots of people who have cardiomyopathy or weakening of heart because of a bunch of different reasons. Sometimes people just have high blood pressure over a long period of time. And that causes the heart to wear out because it has had to pump against that very high blood pressure.
Sometimes valve abnormalities within the heart overload the heart because of the need for the heart to pump harder and pump faster and pump more. In addition, sometimes people get viral infections that inflames the heart muscle and can weaken that either on a short term and the heart can get better. But sometimes that weakening continues over months and years afterwards, such that the cardiomyopathy persists and continues onward. There's other things along the lines of very heavy alcoholism, obesity and diabetes that can also lead to various kinds of cardiomyopathy as well.
So in your time and of course in studying the transplant world, what are the biggest changes? What are the biggest improvements that have been made over the last 10, 15 years that have allowed people to maybe even live further along without the heart transplant or to help speed up heart transplant possibilities? Right. Well, that's a really good question.
Heart transplants have been around for decades and are becoming more and more frequent. We are always behind in terms of the number of organs that are available, of course. There are lots of people who need a heart but don't have one yet. So luckily, the medications that we have are able to unload the heart somewhat by decreasing the blood pressure.
We can fix valves in order to make it easier for the heart to pump forward, the blood around the body. In addition, when the heart gets too weak even despite those therapies, another thing that we've been doing more and more frequently is actually implanting a little pump that plugs into the heart. It's an implantable pump called a left ventricular assist device or LVAD which actually sucks a little bit of blood out of the main pumping chamber of the heart and then puts it through a pump and pumps it out into the aorta, the large blood vessel that comes out of the heart. So it's sort of like having an extra heart that's mechanical attached to your heart because your own heart is failing.
And that is often used as a what's called bridge to transplant, meaning putting that pump into position so as to allow that patient to survive long enough until the heart becomes available for them. So you're not listed here as a transplant surgeon, so I want to kind of bring it back to what we do. So how did you get involved in transplant? Well, as a cardiologist, of course, we're always associated with people at all levels of disease from when they are completely asymptomatic, maybe they're having no symptoms and are just at risk for developing problems down the line to when they do have symptoms and their heart is getting worse over time.
And then as we move on to people who get further towards the end stage and may have to be considered for an LVAD or a transplant or some of the electrical therapies that we use, including in resynchronization devices, which are sort of like they are pacemakers that work to synchronize the two sides of the heart in order to improve the function of the heart on a day to day basis as well. So outside of the work world, are you tied to transplants in any specific way? Well, I am, unfortunately. My little sister, who's two years my junior is currently awaiting a transplant.
She herself has one of these LVADs that I was just talking about. She's up in Boston and boy, we hope that she gets hard sometimes soon. You're working hard, certainly on Irene, I can tell you, you know, to spread the word, of course, that's why we've got the podcast out so more people can hear, understand, donation, and then of course, ultimately say yes so that she, among others, can get that transplant. Right.
Thank you for your work. Yeah, and absolutely. It sounds like you're an advocate for donation on the clinical side and now on the family side, unfortunately, but we're so happy that you're here and that you're spreading the word. Thank you.
Well, we appreciate your knowledge. You're taking the time to bring it down to a level where we can all understand. We have a lot of folks who are going into the medical world who use this as a learning tool. So, doctor, that you gave us your talents today.
We certainly appreciate the visit. Oh, it was my pleasure. Please call whenever I can help. Good.
And then we will continue to think about your sister and any updates. We'd like to have you back on the gift of life just to kind of follow that journey as well. We use this as an educational tool. So if there's any opportunity, we'd like it.
Sure. So maybe after she gets her transplant, maybe you'd like to talk to her as well. We'd like that. Thank you, Dr.
Moran, with Ashener Medical Center. Here on the podcast, we take a moment for mental health with Sarah. Yeah, we're continuing our conversations on self-care and today's focus is on mindfulness, which is the opposite of what my wife says about me. Yes, it's all in the delivery.
So we're going to talk about mindfulness. So first of all, what is mindfulness? I think a lot of times people think meditation, which is really impossible to do unless you're a guru. Right.
So a really easy way to simplify meditation is to practice mindfulness, which is a state of active, open attention on the present. So essentially what mindfulness is is being totally focused on what you're doing, the thoughts you have, the emotions you're feeling in the moment. So put my phone down. So put your phone down.
Correct. Stop waiting to talk. Absolutely. So you're doing this on the moment.
Listen. Listen. Right. And so, you know, there's a lot out there that shows that if you can practice mindfulness, the more you practice being totally focused on what you're doing in that moment, the happier you'll be because you're more focused, your mind's not in three different places at once, and you're able to give the attention that you need and that others need for you.
Well, now I get it because my attention is three ways at one, two, five. Yes. And in that moment, my wife says, stop being mindless. Talk to us.
So what it amounts to. Got a lot of stuff going on. And then I have children everywhere. Everywhere.
And so I take time with each one. When you're with them. And, oh, you know. Right.
Or when you're with them, you're thinking about what do you have to cook for dinner? Or what do you have to do for this? And I'm just not cleaning or cooking. And that's the sound goes.
Yes. Order. Yeah. Sorry to your husband.
But essentially it's, you know, it's impossible to do this all day, every day. Yeah. So picking maybe one or two things a day that you can be totally mindful. A lot of, I know you said Joey Mindless, but a lot of activities that are mindless.
Let's rephrase and think of them as mindful. So when you're cooking and you're chopping vegetables, it can seem pretty boring or mindless, but instead think of it as mindful and give your total attention to the thoughts you're having, what you're doing in that moment. Sounds very zinnish. I feel like I'm going to need some help with that.
Is there an app for that? App? There's an app for everybody. Yeah.
The apps I like, one is Headspace. Well, yeah. Yeah. It's good.
Get ahead in that space. So another one too is even if you just listen to relaxing melodies, there's an app called Relax Melodies. If you just put on a certain melody while you're doing something and focus on that or focus on, it's just getting you in that space of calm being mindful of what you're doing. I have to do that before bed.
Like I need to stop everything, slow everything so this brain can shut down. It's hard. These things we're talking about in self care, they're not easy. This is difficult.
But if you can give three minutes a day even, I know another practice for mindfulness is when you're eating, totally focus on your eating. Don't have your phone out checking emails, making your calls. It's be totally famous. It's like it's done.
I know. But if you can do 20 minutes a day when you're at lunch, you just focus on taking a bite, chewing, doing it. That's mindful practice is that you can do every day. I like to watch cute puppies.
I'm running around having fun like that comes. I was thinking, well, every time I sit down to eat, I think my coworkers realize, okay, he's sitting down to eat, so I get barrage for the next 20 minutes. Sorry about that. Sorry about that.
Good tips though. It's all about learning and you know, a new me. Yeah, better than yourselves. Be more successful.
You. All right. Sounds good. Thanks, Sarah.
In every episode of the Gifted Life, we honor a hero. Today's hero, Chloe Escabel. We learn about Chloe from her family. Chloe registered as an organ donor because it simply made sense to her.
She was my sweet daughter and although I miss her terribly, I'm happy for the three recipients that are able to live on because of her. She was only 25 years old when she gave them this amazing gift a person could give. Now we pause and say thank you to Chloe for the gift of life. In our question and answer segment today, got one from our own team.
So we heard from Dr. Moran earlier about a bridge to transplant. So I'm wondering, Joey, if you can tell us what that means. Well, in this situation, a bridge to transplant, it's not a permanent solution.
He talked about the LVAD, the left ventricular cyst device, which can be implanted. And what this has enabled in the transplant world is a lot of heart patients, the hearts decompensate quickly. And in the past, these patients didn't make it. And what this changes is that you hook them up to the LVAD and it can extend their life at least for a period of time until their perfect match arrives.
That way they can then get the heart transplant and live for up to 25, 30 or beyond. We're always learning here on the gift of life. Now listen, we want to hear from you. You can email your questions to us info at thegiftedlife.org or you can do like Jack did.
Give us a call at number 5046483477. And like Jack, we may even play your message here on the podcast. And that's episode 112 of the Gifted Life. Yeah, happy heart birthday to Jack.
Yay. And we're going to be pulling into the podcast. And also thanks to Dr. Daniel Morin for explaining a little bit about cardiomyopathy and the need for heart transplant.
You can find out more about what we do here at the Gifted Life.org. Listen there and find links to listen on Apple Podcasts, Google Podcasts, Spotify or anywhere you listen to your podcast. If you do listen on Apple Podcasts, please leave us a five star rating. It really helps others find our podcast.
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