For Better Health
THE NEWTOWN BEE, FRIDAY, OCTOBER 13, 2017
C-ONE
Lifesaving Transplant Comes After Decade-Long Struggle With Heart Failure By Alissa Silber Dan Krauss is a father, husband, community member, and — as of this year — a heart transplant recipient, who up until 11 years ago was in good health. In 2006, at just 30 years old, Mr Krauss contracted a virus that changed the course of his life forever. Looking to remedy what he originally thought was a simple cold, he went to his primary care doctor and received antibiotics. Upon finishing the medicine, he felt a little better but not great. He was put on a second round of antibiotics to treat the lingering effects, but this time when he finished them he became alarmingly sick. Instead of receiving a different prescription when he returned to his doctor, he was informed that he needed to go to the emergency room right away. Mr Krauss’s wife, Betsy, with their infant daughter, immediately picked him up and brought him to Danbury Hospital. When they arrived, he was pumped full of fluids, suspecting he was suffering from severe dehydration. Shortly thereafter, a nurse came in and told everyone to stop what they were doing. Unsure what was going on, Mr and Ms Krauss were approached by a doctor who began to tell them it was not a case of dehydration. The doctor explained to the young couple that Mr Krauss had congestive heart failure, brought on by the virus. “We were totally shocked,” Ms Krauss said about hearing the news. “That was the furthest thing from my mind that a 30-year-old could have heart problems.” Mr Krauss agrees, saying, “I nearly fell of my gurney when they told me I had congestive heart failure.” Neither had much experience with anyone they knew having the life-threatening disease, except for Mr Krauss’s grandmother, who only lived three years after being diagnosed with it. “I thought I was dying,” Mr Krauss said. After the diagnosis, he was out of work for six weeks and put on a drug regimen of ACE inhibitors, beta blockers, and diuretics. Despite constant fatigue, he explained the medicine allowed him to start feeling well enough to return to work and go back to a relatively normal routine. Every three to four weeks, though, Mr Krauss would see the cardiologist his
father recommended, Dr Ulrich Jorde. He would have his heart’s ejection fraction measured to see the percentage of blood that was leaving when his heart contracted and relaxed. “Most people pump out like 60 percent of the blood in the heart, and I was at 15 percent,” Mr Krauss explained. That blood count can cause serious problems, as it essentially starves all the cells in the body of crucial oxygen and nutrients. Six months after being diagnosed with congestive heart failure, his ejection fraction rose to 35 percent giving the Krauss family a false sense of ease before it took a turn for the worse and plummeted back down close to 20 percent. Testing And Waiting In November 2008, Mr Krauss had surgery at Danbury Hospital to place a defibrillator inside his chest with a lead attaching into his heart. By the following spring, both he and his wife began being evaluated to see if Mr Krauss was eligible to be put on the organ transplant list for a new heart, as one of the most important features of the assessments was to make sure Mr Krauss had a good support system in place. Together they had to meet with a cardiologist, psychiatrist, social worker, financial person, and nutritionist — just to name a few — to see if he would be a good transplant candidate. Mr Krauss also went through multiple physical and mental tests to ensure the rest of his body was healthy enough to receive the organ. “It was two of the most draining days that either one of us had gone through at that point,” Ms Krauss said. He passed the tests and was able to be put on the transplant list with the intention that he was going to need a new heart sometime in the next few months. Over the following years, however, Mr Krauss received countless calls about possible matches from the transplant organization United Network for Organ Sharing (UNOS), but each time Columbia Presbyterian Hospital, where Dr Jorde worked at the time, determined Mr Krauss was too healthy and turned him down. Throughout those years Mr Krauss tried to not let waiting for a heart consume him and went back to work, doing family activities, and finding anything to
in the afternoon to restore a semblance of energy in him. “He went in for testing one day on the defibrillator,” Ms Krauss said, “and they told him he had been in atrial fibrillation, which was a new problem.” In addition to the irregular heartbeat, it appeared they found a blood clot in his heart, so he was immediately put on blood thinners for a month. In June, doctors at Danbury Hospital defibrillated him, shocking his heart back into a normal rhythm, and he was sent home. After taking a nap later that afternoon, he woke up struggling to breathe. “The procedure was successful, it stopped the atrial fibrillation, but it put him into active heart failure,” Ms Krauss said. Mr Krauss was admitted into the hospital that Thursday night and was diuresed of all the fluid in his lungs. The following Saturday, a mere two days later, he was released, being told he was most likely experiencing sleep apnea and that there was nothing more that could be done. All the while, Ms Krauss felt something was not right. She had been in constant communication with their trusted cardiologist Dr Jorde, who was now working at Montefiore in the Bronx, N.Y. She let him know what was happening, and Dr Jorde was adamant he wanted to see him right away.
After being diagnosed with congestive heart failure more than a decade ago, Newtown resident Dan Krauss received a left ventricular assist device, known as an LVAD, prior to getting a heart transplant. Pictured is Mr Krauss with the LVAD battery packs and computer over his clothes. —photo courtesy Dan Krauss take his mind off it all. Shocking The Heart “I was relatively healthy until the win-
ter of 2016, around January,” Mr Krauss said. He noticed he was becoming more tired than usual and would have to take naps
LVAD Mr Krauss was admitted into Montefiore that Monday where a bed was waiting for him in the intensive care unit. By the next day, they performed a right-heart catheterization, to measure the pressures of the heart. It was determined Mr Krauss would need a left ventricular assist device, known as an LVAD. He remained in the hospital for a week before his open-heart surgery on August 2, where they cracked open his chest and implanted the LVAD. When he awoke from the five-hour surgery, he found he was in the intensive care on a ventilator. “I was in the hospital for a total of 29 days,” Mr Krauss said. “Recovery was slow… and I was in some pain.” While he recuperated at Montefiore, Ms Krauss was by his bedside every day, working only when she could find a moment.
“I really didn’t sleep very much,” Ms Krauss said, adding that she was grateful her mother stayed with them to help take care of their young daughter. The particular LVAD that Mr Krauss received was called a Heartmate 3. At the time of the surgery it was considered a trial model (that became officially approved in August 2017). The device pumps blood in a continuous stream throughout the body and causes patients to not have a pulse or normal blood pressure while on it. The Heartmate 3 not only had a pump attached to his heart, but also a tube that exited his lower abdomen and attached to a portable computer. From there two lines attached to batteries that rested on his sides. It was crucial the tube always be in a sterile environment, so Ms Krauss was in charge of learning from the nurses how to change the dressing over it. Once her husband was discharged from the hospital, she would change the dressing three times a week. The couple was also trained on what to do with the batteries and controller in case there was ever an emergency. “Any time I went out of the house I had to carry a backpack that had spare [batteries]. If it were to malfunction you’d need to change it,” Mr Krauss said. “My big thing was that I was always concerned I was going to snag it in the car door.” For eight months, Mr Krauss had to live with the restrictive device and even though he was upset at first with it, he knew it was keeping him alive until he could receive his much-needed heart transplant. A New Heart It was on April 7 this year that Ms Krauss received the long-awaited call they had been hoping for: there was confirmed match for a heart. The couple dropped off their daughter at a sleep over and drove to Montefiore that night to have Mr Krauss ready for the 15½-hour transplant surgery the next morning. Unfortunately, Mr Krauss said, “Surgery did not go well.” The transplanted heart that was put in his body did not start, due to a very rare complication called primary graft failure. Mr Krauss was hooked up to a type of life support machine called an extracorpo( continued on page C - 2 )
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