At 87 years old, Angelo C. likes to stay on the go. The Winthrop, Massachusetts resident attends church every day, goes to the mall and grocery store once a week, and likes to hang out downtown. His motorized wheelchair and heart condition don’t slow him down. Angelo, who has congestive heart failure, regularly sees Cardiologist Dr. Joseph Carrozza at St. Elizabeth’s Medical Center. As part of his treatment plan, Angelo is benefiting from the state-of-the-art CardioMEMS™ System, which features a miniature wireless monitoring system that is implanted in the pulmonary artery during a minimally invasive procedure to directly measure pulmonary artery pressure. What make this system unique is it allows Angelo to transmit pulmonary artery pressure data from his home to his health care team allowing for personalized and proactive management to reduce the likelihood of hospitalization so he can continue to enjoy his lively lifestyle. “Angelo was a perfect candidate for CardioMEMs,” says Dr. Carrozza. “I explained to him that the greatest benefit of having the implanted monitoring system is that it will keep him out of the hospital.” On March 20, 2016, Dr. Carrozza performed the hour-long, painless procedure to insert the monitoring system using a catheter into Angelo’s pulmonary artery. He was awake throughout the whole procedure and following the procedure, he had to stay still, without moving, for six hours. During this recovery period, the cardiac catheterization lab nursing staff cared for him. “The nursing staff was fantastic and went above and beyond to help me,” says Angelo.“I use The Ride to get back and forth to St. Elizabeth’s. When the driver arrived to take me home after the procedure, my six hours wasn’t up and they left. I had no way to get home. One of the nurses said ‘I’m going to take care of you.’ She arranged for an ambulance to take me home, as well as confirmed my insurance would cover the transport. She and another nurse stayed well after their shifts ended to make sure I was taken care of and got me into the ambulance. They didn’t go home until I got home.” Nowadays, back at home in the early afternoon, Angelo takes a break from his daily activities to hook himself up to the CardioMEMS™ System for his reading. His fastest reading was three seconds, and the longest was 15 seconds. He feels the time it takes for a reading all depends on the positioning of his body. “It is amazing that I am here, at my home, and my doctor, in Boston, can receive my exam and know if I am okay or if I need something, like an adjustment in my medicine,” says Angelo. “This is such a benefit to me, the patient. It is like having a doctor in my house everyday giving me an exam. What more could you want?”
When routine care turns into specialized care. More than 52 years ago, Debbie A., of Arlington, Massachusetts, delivered all three of her children at St. Elizabeth’s Medical Center and has been receiving routine care at the hospital ever since. Recently, this routine care changed for the 75 year old after she was diagnosed with reoccurring breast cancer. In November 2014, Debbie had a screening mammogram at St. Elizabeth’s Center for Breast Care and it showed a lesion on her left breast. Then, a biopsy confirmed cancer. Working with Jan Rothschild, MD, a breast surgeon at St. Elizabeth’s, Debbie had a mastectomy on her left breast in December. She had already had a mastectomy on her right breast when cancer was detected in 1989. "I am the sole caregiver for my 47-year-old daughter who has multiple sclerosis and was diagnosed as a teenager,” says Debbie. “I’ll do anything to be here for my children and I knew when I first met Dr. Rothschild, whose smile beamed right through me, that I wanted her to be my doctor through this journey.” Debbie’s recovery went well and she takes anastrozole, a chemotherapy medication, for further treatment. In addition to the care she received from Dr. Rothschild and her medical oncologist, Leslie Martin, MD, Debbie was also overseen by a nurse navigator who was her guide, mentor and advocate before, during, and after her treatment. “All of the staff at the Center for Breast Care was wonderful and my nurse navigator, Cheryl, was unbelievable,” explains Debbie. “From day one, she made me feel that everything was going to okay. Knowing this made me feel good and confident.”
For the past 50 years, engineer Manuel G. has routinely worked seven days a week and played racquetball and competitive soccer. About 18 months ago he began needing naps to get through the day, doubling over to catch his breath while playing sports and experiencing heart palpitations. “I felt like an old man. I didn’t have any energy,” Manuel, 71, of North Dartmouth, Massachusetts, said. In May of 2014, he was diagnosed with persistent atrial fibrillation, a condition where a patient has a sustained heart rhythm disorder for more than seven days. A procedure called a cardioversion got his heart beating normally again, but only for a few days. A second one lasted about a week. His cardiologist then reached out to Dr. Michael Orlov, director of the Electrophysiology Laboratory at St. Elizabeth’s Medical Center. He underwent a third procedure called an ablation where Dr. Orlov used radiofrequency to produce scar tissue on Manuel’s heart to block abnormal electrical signals that cause his rhythm disorder. In less than two weeks he was back in atrial fibrillation and by the end of the year he had undergone a second cardioversion and another ablation, however, in his case, they did not correct his condition. “I really, really, didn’t want a pacemaker,” he said. “That was out of the question for me.” On the advice of Dr. Orlov, Manuel met Dr. Stanley Tam, a cardiac surgeon who had recently joined St. Elizabeth’s Medical Center from the University of Massachusetts Memorial in Worcester where he had served as chief of cardiac surgery. After consulting with Dr. Tam and Dr. Orlov, Manuel decided to undergo an ablation procedure called the “Convergent Approach” where the cardiac surgeon and electrophysiologist work as a team to perform a cardiac ablation. Using a minimally invasive approach with a small incision in Manuel’s abdomen, Dr. Tam performed an ablation across the backside of his heart. Dr. Orlov, the next day, threaded an ablation catheter through Manuel’s femoral vein in the groin to reach the inside of his heart to ensure the lesions were completed and connected, and then used electrophysiology diagnostics to confirm the abnormal electrical signals were interrupted. “I’ve been in normal sinus rhythm since,” Manuel said. “I’m feeling the best I have felt in two years.” Manuel, who has been married for 50 years and is a father and grandfather, is doing just that. In the summer heat and humidity, he was building a patio at his house and is once again playing racquetball. “I’m really thankful to my doctors for giving me back my life,” he said.
Last year, when Lucy M. began experiencing problems with her breathing, she chalked it up to complications stemming from her asthma. She followed up with her pulmonologist who adjusted her medications. When the breathing problems persisted, she consulted with her primary care physician who referred her to a cardiologist. A heart catheterization revealed a narrowed heart valve, a condition called aortic stenosis. In June of 2015, Lucy, 84, underwent a transcatheter aortic valve replacement (TAVR) at St. Elizabeth’s Medical Center. The procedure is one in which the technology allows physicians to replace a severely narrowed aortic valve due to aortic stenosis without a conventional chest incision or having to be placed on a bypass pump. In this much less invasive approach, a new valve is implanted either through a catheter that is inserted through the vein in the groin area and then carefully passed up into the heart, or through a tiny incision in the chest wall and implanted directly into a patient’s heart. “I feel good, really good,” Lucy, of Haverhill, Massachusetts says. “I’m surprised I feel as well as I do.” Without the TAVR, she faced an uncertain future and is pleased she underwent the procedure. “I’m 84 years old. I felt either it’s going to do good for me or it’s not going to do good for me, so I thought I would take the chance,” she says. “I want to prolong my life. I still feel young.” She encourages others who need this procedure to give it a try. While she misses working, she doesn’t miss her commute. Faced with several other health issues, Lucy is content to spend time with her adult son and daughter and do “ordinary things,” including grocery shopping, laundry and cooking. “If anyone has the opportunity, regardless of what age they are, they should take the chance. Always take a chance,” she says.