'I got my life back' — UK patient has new outlook after heart treatment

LEXINGTON, Ky. (April 26, 2023) — “A year ago, I was planning my funeral.”

In October 2021, 45-year-old Ben Allen sat down with his girlfriend and told her what he wanted his funeral to look like. He thought ahead to Christmas, the last one he would spend with his kids.

“I was in a dark place and had already given up on life,” he said. “That was my train of thought.”

Allen was in advanced heart failure. He was worn out and had so little energy that he couldn’t climb a flight of stairs without needing a break. His relationships with his girlfriend and children suffered.

“I was a terrible person to be around,” he said. “I didn’t have a positive outlook. As I got tired or worn down, I’d get meaner and meaner. I was like that from September of 2020 to December 2021. That’s when everything changed.”

***

Allen’s story started on Jan. 11, 2017, in Gillette, Wyoming. He remembers waking at 2 a.m., unable to breathe. His chest was tight. But he wasn’t in any pain, so he figured it was just bronchitis. After all, he reasoned, it’s 25 degrees below zero. Everyone has bronchitis this time of year. Allen went about his morning, drinking coffee and smoking cigarettes. His girlfriend insisted he go to the hospital to get checked out. Sure, Allen said. But only after they the cats to the vet.

Even the vet agreed that Allen didn’t look good. So he drove himself to the hospital, smoking the whole way.

“I walked in the hospital, told them I didn’t feel good, that I thought it was bronchitis, but it could be a heart attack,” Allen said. “In about three minutes, there were 20 people in the room, cutting my clothes off.”

Allen had an anterior ST-segment elevation myocardial infarction (STEMI), commonly known as a widow maker. Blood wasn’t flowing through his left anterior descending (LAD) artery, the vessel that supplies 50% of the heart’s blood supply. He underwent a five-and-a-half-hour surgery to restore blood flow and to repair the damage.

“I survived a widow maker that should have killed me,” Allen said. “Cardiologists told me, the fact that you lived through it is why you’re having the issues you have now. About a third of the left side of my heart is just scar tissue.”

A few months later, Allen and his girlfriend moved to Springfield, Kentucky, and established care with a cardiologist at Ephraim-McDowell Health in Danville. There, he had a surgery to place four stents in his artery. Six months later, he had two more stents placed. It was during that surgery when his surgeon observed something strange.

“The doctor lined the whole left anterior descending artery with stents,” Allen said. “He couldn’t keep it from collapsing. The artery was collapsing every time my heart beat, starving my heart of oxygen. And he’s watching it happen. So they pulled every stent out and sent me to UK.”

Allen was referred to Gill Heart & Vascular Institute at UK HealthCare. Part of the statewide Gill Affiliate Network, Ephraim-McDowell Health and UK HealthCare work together to connect patients with rare, severe illnesses like Allen to specialists for further evaluation and treatment.

On June 4, 2019, Allen underwent open heart surgery to replace the left anterior descending artery with his mammary artery. He followed up regularly with surgeons Michael Sekela, M.D., and Suresh Keshavamurthy, M.D., and started feeling better than he had in years.

“I had energy back,” he said. “I could breathe again. It took some time because it damaged me mentally and physically.”

Allen went back to work as a regional field manager for O’Reilly Auto Parts. He was traveling more than he was home, spending up to four nights a week on the road.

“I was getting beat up every day, but I kept going,” he said. “That led to some issues. I was having some crazy heart palpitations.”

Kristen Ellison, M.D., an electrophysiologist at Gill, placed an implantable cardioverter defibrillator (ICD) in his chest. An ICD is a device that keeps track of the heart’s rhythm and delivers a small corrective shock if it detects an abnormal rhythm. But Allen’s health, energy level and mood continued to decline. By December 2021, he was at his wit’s end.

“There was just so much anger,” he said. “My mental state was just horrible. And it was horrible for my family. No one wanted to be around me, and I don’t blame them. I was doom and gloom. I had given up on life, and was very, very angry.”

At a routine visit, electrophysiology nurse practitioner Mary Czarapata noticed a rising trend in thoracic impedance on his defibrillator, which indicates fluid accumulation.

“I don’t know what she saw,” said Allen. “But she referred me right away to Dr. Vaidya.”

***

“When I met him, he was really frustrated,” said Gaurang Vaidya, M.D., cardiologist and specialist in heart failure at UK HealthCare. “He used to be very active, going to music festivals, taking care of his dogs. But he wasn’t noticing any improvement with his medications. I could really see the frustration he had about not being able to do all the things he used to enjoy doing.”

By outward appearances, Allen’s heart looked functional. On an echocardiogram, his heart pumped at an ejection fraction of 45%, with normal being over 40%. He had not developed any new heart artery blockage either. However, his symptoms were much more severe than suggested by the evidence thus far. Given the disproportionate symptoms, he underwent a heart catheterization to measure the actual amount of blood that his heart was pumping when it beats. This is known as  cardiac output. Vaidya could tell that Allen’s body wasn’t getting the amount of blood it needed.

“Every time his heart squeezed, it wasn’t providing as much blood as his body needed,” said Vaidya. “He’s a tall a guy, so you can measure how much blood his body would need, and his heart wasn’t providing that.”

In advanced heart failure, often the only options are a heart transplant or the implantation of a left ventricle assistive devices (LVAD) to mechanically pump the blood. But Vaidya had another idea.

Milrinone is an intravenous drug used to treat heart failure by increasing heart muscle strength and widening blood vessels. It is administered through a peripherally inserted central catheter (PICC) line, which allows the drug to be administered through veins close to the heart.

“Dr. Vaidya saw me in December and wanted to admit me right away to get me started.” Allen said. “I fought with him, because I realized I was dying, and this was going to be my last Christmas with my kids. So he said, ‘Okay, come in on Dec. 27.’”

Allen spent 15 days at the University of Kentucky Albert B. Chandler Hospital, not just getting the PICC line placed, but also getting evaluated for a heart transplant.

“That was on the 28^th,” he said. “On the 29^th, I was up moving around, walking on my own, feeling pretty decent. I had newfound energy. I actually walked so much that I didn’t run out of breath. My legs had turned to Jell-O because I hadn’t walked that much in forever.”

Allen was discharged and continued to get stronger at home.

“It was the first time in two-and-a-half years that I could walk up my stairs and not have to stop when I got to the top,” he said. “That was the first thing I noticed.” A month later, he was able to walk his six dogs to their dog run at the top of the hill on his property. Allen returned to work as a manager at Wal-Mart, walking more than 20,000 steps a day and supervising 40 people. It was at work when Allen’s newly restored stamina was put to the test.

One of Allen’s coworkers collapsed – Allen knew right away it was a heart attack. He instructed another coworker to call 911 while he hurried across the store to help.

“My instincts were to get over there immediately,” Allen said. “I full-on sprinted. A year ago, that would have flat-out killed me. It was probably the first time in five years I sprinted. When I got over there, my heart felt good. My knees felt like crap.”

“He told me he had tears in his eyes when he got there, when he realized what he had done,” Vaidya said. “He ran for a few minutes when a year ago, he couldn’t walk the same distance without having to stop.”

Allen was feeling so good on the milrinone that Vaidya wondered if Allen had recovered enough of his heart function to discontinue the medication. After three weeks of stopping the medication, Allen felt as bad as he did before he started milrinone. His symptoms returned to the point where he couldn’t make it through a full shift at work. He resumed the milrinone treatment and was back to his normal self in just a few days.

“People can stay on the medication, but it’s a means to get somewhere – it’s never the end,” Vaidya said. “At some point, he will need a heart transplant or an LVAD. But he’s not ready to think about that because he feels his life at this point in time is exactly where he wants to be.”

***

Allen considers Vaidya and his heart failure coordinator Krista Lewis to be close friends. He looks forward to his follow-up visits with them every three months and knows that if he ever has any issues, they’re just a phone call away.

“Dr. Vaidya’s funny,” Allen said. “He likes to laugh, he cracks jokes. That’s some bedside manner that some other doctors need to learn. Talk to your patients if you’re going to be this intimate with them. He’ll ask me about the dogs. He’ll remember other things going on in my life, like how my daughter’s band did in competition. We have a good time.”

Allen is back to work full-time while also enjoying spending time with his girlfriend and his daughter. Weekends are spent at car shows and festivals. When his family is tired and ready to go home, Allen is just getting started.

“I wish you could see the change in me,” Allen said. “Dr. Vaidya and Krista have seen it. They’ve seen the positivity come back to my attitude. I’ve dropped 30 pounds and gained a ton of muscle. I’m healthier, I’m fitter. I feel better than I have in over a decade. I didn’t feel this good before the heart problems started. I’m fully confident that if we went to the Smoky Mountains, I could hike the trails again. I haven’t been able to do that in a very long time. Not without wanting to die halfway through it.”

A year ago, Allen wasn’t thinking about his future – because he didn’t think he would have one. Now, he still isn’t giving the future much thought, but that’s only because he’s enjoying the present. He credits Vaidya with giving him a second chance to spend time doing the things he loves with the most important people in his life.

“I smile a lot all the time now,” he said. “I run around joking with people. Dr. Vaidya didn’t just prolong my life, he gave me my life back.”