Changing strategies of treating heart disease in Kentucky

COVID 19 along with other respiratory diseases remain a priority in Kentucky. But, it’s heart disease that is still the number one cause of death in the Commonwealth. There are several aspects to prevention, treatment, and aftercare.

In 2018, at age 57 and in the midst of a stressful time with company business, Lexington resident Mark Meade had a heart attack while walking through the Blue Grass Airport parking lot. He didn’t recognize it as such, but later, at a relatively slow pace during a subsequent stress test, Meade had a complete system failure and was thrown off the treadmill. He said if he had the event on the walkway outside the hospital, he would have died.

“If I have it on a sidewalk next to a fire station..there’s a fire station across the road. If I have the event there and I have the EMT on me immediately, I don’t survive. There’s only one place I can go down and it’s in the middle of Gill Heart and it still took a heroic effort by 18 people for ten hours to bring me back,” said Meade.

Meade has a family history of high cholesterol and was identified with high levels himself 50 years prior to the main event. Medications in more recent years had done much to keep him in check.

“Over the last 10, 15 years my cholesterol, my lipid profile has been near perfect. The problem was, it was that first 35 years where the damage was done,” said Meade.

“Ok, we’re gonna head this way. It’s a busy time of morning so there will still be lots of hustle bustle outside of the rooms.”

Natasha Crain led the way to a room inside UK Hospital, just like the room where Mark Meade received care six years ago. Crain is operations manager of ECMO at UK HealthCare. ECMO stands for Extracorporeal.

“beep-beep-beep…Takes a minute. This is one of our ECMO machines that we have here at UK. And if you can kind of hear, you can definitely see like the water starting to rush,” said Crain.

Crain said ECMO is used for heart and lung patients. It draws blood out from a vein, supplements the blood with oxygen, removes CO-2, and then puts the blood back into the body. It can be a difference maker.

“A lot of patients that I have seen in the time that I have been here..the time that I’ve been involved with ECMO who I walked into their room and I knew..you know…I just knew in my heart they were going to pass away and through the persistence of their family or what they would have wanted, we’ve been able to weather those storms and they have survived and they have come out on the other side,” said Crain.

It was during Meade’s ECMO treatment that he had a third heart-related incident. He went into lethal cardiac rhythm and Crain said he was defibrillated-or-shocked back into the right rhythm. Meade spent six days with ECMO flow and emerged, ready for cardiac rehab. That was after four stents were inserted into his heart.

Crain said ECMO got heavy use during the COVID pandemic, but it was another prior significant health challenge where the machine also ran a lot.

“You know if we didn’t have this technology during the H1-N1 we would have lost a lot more patients. That was the biggest surge where they had seen the use of ECMO. And then when COVID came along they went back to the research they had done during H1 N1 to see how beneficial it was and then COVID happened and we started seeing how many patients we were saving,” said Crain.

The nursing manager noted 40 to 50% of patients on ECMO still die, often because they are so sick at that point. Crain added during COVID about 75% of patients were on it for respiratory reasons and now it’s about 75% for heart conditions. She said why there’s been a flip-flop in cases is being studied.

Dr. Vincent Sorrell is chief of cardiology in UK’s Gill Heart Institute. He said Kentucky suffers like many other states with heart disease, but at a slightly higher level. Sorrell said two people in Kentucky will die of a heart attack in the next hour. He said more and more, medicine is the approach with less surgery.

“You look over just the last decade, we have become smarter by during clinical trials showing how effective medicine is…therefore we’ve been more comfortable holding back from needing the stent of the by-pass as quickly or urgently as we might have recommended it,” said Sorrell.

Sorrell said medicines are given more time to work and patients are told there may be some chest pain before the medicines have the desired effect. The head of cardiology said heart specialists have taken a tip from those physicians working in cancer care.

“Our colleagues in oncology have done a fantastic job of lowering the mortality rate of by coming up with your body’s own immuno-targeted therapies. We’re trying to do that in cardiology as well to come up with these type of newer therapies,” said Sorrell.

Dr. Sorrell said a plateau of sorts has been hit with this treatment method in heart cases, adding he thinks more needs to be done with prevention.

That would include 30 minutes of moderate exercise five days a week and in the diet area, Dr. Sorrell said cutting out sugar, moderation, and portion control all seem doable.

The American Heart Association has been probably THE longest-standing advocate for improving heart health. Andrea Ooten, executive director for the AHA central and eastern Kentucky chapter said she’s optimistic about the future, based on collaboration of many groups pushing in the same direction. One example is making checking blood pressure easier through public libraries.

“You know working with the libraries in the different communities, especially in rural areas to provide blood pressure cuffs that you can come in and check out and take home with you to monitor your blood pressure, so you have this opportunity and access so that you don’t have to go out and spend 35 dollars that you don’t have on a blood pressure cuff. You can go check it out from your local library,” said Ooten.

Ooten admits changing lifestyles to achieve better heart health can be an uphill battle, but she’s hopeful seeing so many people working on these issues.

Mark Meade, the now 63-year-old Lexington man who’s lived with a near-death heart condition, said it’s important to evaluate where you are with your health. Meade said he mentors others at Gill Heart. He said sometimes he hears from patients' who have immediate worry about missing out.

“You know I had this significant event. I was on ECMO. I lived a very physical life. I probably won’t be able to do that anymore. My advice to them is why would you give up on anything at this point. You’re in the early days of recovery. Listen to your doctor. Do what they say. Go to cardiac rehab. Take it seriously. And then, you and your doctor figure out what you can and cannot do,” said Meade.

Another way to put it, according to Meade, is to focus on a little bit of improvement every day and make tomorrow a bit better than today.

Interview with Mark Meade:

Interview with Natasha Crain:

Interview with Dr. Vince Sorrell:

** WEKU is working hard to be a leading source for public service, and fact-based journalism. Monthly supporters are the top funding source for this growing nonprofit news organization. Please join others in your community who support WEKU by making your donation.