Iowa City, IA
Nancy Swisher has lived a full life. She raised a family. She was a world traveler who taught English in Spain, Poland, Italy, Chile, and Bolivia. She’s still an avid follower of politics, and she’s a great cook.
But in 2011, she hadn’t been feeling well for some time.
Nancy had been pale and short of breath, with difficulty sleeping. She’d also had frequent fainting spells and bouts of nausea. Plus, she had little energy and was napping more and more each day.
For the first time in her life, Nancy began to lose interest in the things she’d enjoyed, like cooking or driving herself to her summer place in northern Minnesota. She even started declining lunch invitations.
“I would be afraid I’d have one of those fainting spells and embarrass everybody and fall in a heap,” she says. “And that’s not good.”
It didn’t occur to Nancy that she might have a heart problem. She simply figured she was finally “getting older” at age 90.
While visiting family in Minnesota, Nancy—pale, anemic, and short of breath—was taken to the emergency room. She was diagnosed with aortic stenosis, a narrowing of her heart’s aortic valve that can lead to heart failure or cardiac arrest.
The cardiologist told Nancy she had 18 months to live. She was put on oxygen and began having regular blood transfusions. For a while, she was being hospitalized about once a month. She just didn’t feel well and often had to sit up to breathe comfortably.
It was a distressing time for Nancy and her family. In fact, she seriously began thinking about pallbearers for her funeral.
Once Nancy was back home in Iowa City, she went to see Richard Dobyns, MD, in the Geriatric Medicine Clinic in the University of Iowa Department of Family Medicine. Dobyns referred Nancy to Phillip Horwitz, MD, an interventional cardiologist with UI Heart and Vascular Center, who told Nancy about a new minimally invasive heart valve procedure that had recently received Food and Drug Administration approval in November 2011.
The procedure, known as transcatheter aortic valve replacement (TAVR), is for patients who are not good candidates for traditional open-heart surgery and would have been considered untreatable in the past. TAVR uses an artificial valve that is compressed onto a balloon, inserted into an artery in the patient’s thigh and delivered to the valve site. Once in place, the valve is expanded with the balloon, making it immediately functional.
Horwitz explained the procedure and the risks involved, but it didn’t take long for Nancy to make up her mind.
“I was thinking that if I was just going to be sitting doing nothing, I’d rather shuffle off,” she says. “I would prefer to have the surgery and take the chance.”
Nancy was one of the first patients to have the TAVR procedure at Iowa, and the outcome was excellent. It showed in the “great big smile” on Nancy’s face soon after the procedure, according to her daughter, Sarah.
Since then, Nancy’s life is back in full swing. She’s been to the Mississippi coast with her family, and she’s made several trips to her place in Minnesota. She’s thrilled to be back in her regular routine. Best of all, since the TAVR procedure, Nancy hasn’t been hospitalized or needed oxygen.
Her advice to other women is simple: Know the symptoms of heart disease, and seek medical attention if and when necessary. She also encourages older women with heart disease to ask their doctors about newer cardiac procedures like TAVR.
“There must be lots of people like me who need that type of surgery,” Nancy says. “It’s sad to think there may be daughters out there who are losing their moms when they don’t have to.”
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