Lucky stars
Missouri Heart and Stroke Stars, Bob Heiberger and Alice Cunningham
Today a staggering 36.9 percent of Americans have some form of heart disease. Stroke is the third-highest leading cause of death in the United States and claims more than 140,000 lives per year. The chance of actually surviving a brain aneurysm, heart attack or stroke is significantly low. That’s why Bob Heiberger and Alice Cunningham are both lucky to be here, and that’s why both are being honored as Heart and Stroke Stars at this year’s Dr. Hugh E. Stephenson, M.D., Heart and Stroke Ball, held in Columbia at the Reynolds Alumni Center on Jan. 28. University Hospital doctors nominated Heiberger after he survived a brain aneurysm last year, and Cunningham was nominated by Boone Hospital after her speedy recovery following a four-vessel heart bypass. Here they share their incredible stories and sage advice for overcoming life’s sudden obstacles.
Not So Silly Questions
Every hour on the hour, one of Bob Heiberger’s doctors came to his bedside.
“I’m going to ask you a few silly questions,” he or she would say. “Do you know what your name is? Do you know where you are? Do you know why you’re here?”
Heiberger didn’t know any of those things in the beginning. He couldn’t imagine what he’d done to end up in this square, clean room with the fancy machines. He was pretty foggy on personal details, too. He had no idea that he’d suffered a brain aneurysm, and it certainly hadn’t occurred to him that he was lucky to be alive.
Aug. 30, 2010, was a typical day until he was getting ready for bed with his wife, Victoria, when he was struck with severe head pains. Then he passed out.
Victoria couldn’t wake him; she couldn’t even tell if he was breathing. Immediately she called 911. While she was speaking to the dispatcher, Heiberger woke up. He seemed coherent enough when the first responder showed up to their home in Brumley, Mo., but he was surprised to find it was their mailman, Mark Whittle, who moonlights as Brumley’s assistant fire chief. He chatted with Mark until the ambulance arrived. The crew didn’t know what to do with him; his vital signs were fine. They asked Victoria what she wanted to do.
“Take him,” she said. “He passed out cold, and I couldn’t revive him. That’s not normal.”
She followed the ambulance to Lake Regional Hospital in Osage Beach, Mo., where Heiberger was given a CAT scan that revealed bleeding on his brain. His condition was declining, and doctors recommended airlifting him to University Hospital in Columbia. He remembers the whir of the helicopter blades above his head but had no idea where he was going. Fortunately, he was being delivered into very capable hands at University Hospital’s Trauma Center, which is the only American College of Surgeons-verified level I trauma center in mid-Missouri. The neurosurgery team quickly determined that the bleeding was caused by a brain aneurysm. “What I learned is that an aneurysm is sort of like a balloon on the side of your artery, and as blood goes through the artery, it weakens the balloon until it finally breaks,” Heiberger says.
At 7 a.m., neurologist Dr. Ashish Nanda rushed him into surgery, but he had no intention of cutting open Heiberger’s brain. The aneurysm was in a region that would have been risky to operate on, but its hook-shaped opening made it possible to use a procedure called coiling. Through an incision in the groin, Dr. Nanda wound a tiny metallic wire through Heiberger’s artery all the way up into the aneurysm in his brain and filled it with tiny coils like a ball of yarn until blood could no longer rush into the affected area. In the next few days, there was another procedure and another surgery to relieve pressure and swelling from fluid buildup in the brain, but Heiberger pulled through.
“If someone has a bleed in the brain from aneurysm rupture, prognosis is not that good,” Dr. Nanda says. “One-third of patients continue to live life the way they are now, one-third of patients will die and one-third will live with lots of deficits and neurological problems. He was in that lucky one-third.”
During his 11-day stay in the neurological/medical intensive care unit, the entire staff went out of their way to make both Heiberger and Victoria feel more at home. “I believe that gets you through so much of the difficult things,” Victoria says. “To be surrounded by people who care if you have a warm blanket, who care if you’ve eaten, who care about you also.”
One nurse, Mallory Trosper, saw that Victoria was exhausted and struggling to keep a brave face in front of her husband, so she made her go home and promised to take her place watching over Heiberger. Mallory also brought Heiberger his favorite banana hot-fudge sundae on her day off when he was discharged from the ICU into a regular hospital room. When he went home on Sept. 13, they sent him a detailed thank-you card with notes from everyone who’d known him as a patient. He asked his neurosurgeons what he should do next, and they told him: “Just go back to living your life. It’s fixed.”
With no medications or physical therapy required, Heiberger only needed two weeks of time to heal. He started working half days on Oct. 4 at his job as director of maintenance for the School of the Osage and eased himself back into full-time hours. He still enjoys his active lifestyle and coming home to do work in the yard until it starts getting dark, but everything feels a little different now.
“Take every day at its fullest because you just never know,” he says. “When something like this happens, you’re fine, and then two seconds later you’re on the floor. It just shows just how fragile life is.”
Bouncing Back
Alice Cunningham loves the slots. The shiny, colorful machines themselves, the crowd clamoring for the big payday and the thrill of “maybe” hanging in the air bring her back every day with a smile on her face. A slot attendant at the Isle of Capri in Boonville since it opened 10 years ago, Cunningham, 65, has never been much of a gambler, but she does know a thing or two about chance.
Cunningham is living with coronary heart disease, a condition in which plaque builds up inside the coronary arteries, limits blood flow to the heart and poses a risk of life-threatening blood clots. She was diagnosed when she had a heart attack coming home from work in 2004. At Columbia’s Boone Hospital, cardiologist Dr. Sanjeev Ravipudi inserted several stents to open up the blocked arteries.
“She was asked to think about modifying her lifestyle and addressing her cardiac risk factors,” Dr. Ravipudi says. “This included diet, exercise, managing her high blood pressure, cholesterol and diabetes.”
Even secondhand smoke from the casino could’ve played a role in her disease, but Cunningham enjoyed her job and needed the money, so she returned full time.
She also returned to work quickly in 2007 after her second mild heart attack, which was caused by a blood clot the doctors removed.
Cunningham also suffers from peripheral arterial disease, in which plaque builds up in the arteries that carry blood to the head, organs and limbs, which puts her at risk for stroke. In early 2011, she had surgery to remove the buildup that was causing her arteries to narrow as a preventive measure, but the effort backfired. Shortly after the surgery, she was struck with a transient ischemic attack, or “mini-stroke,” which lasted only a few minutes.
Yet her greatest scare came last Oct. 14, when she collapsed suddenly in her bedroom. Her husband and son called an ambulance because she wouldn’t wake and couldn’t breathe for herself. The EMTs put in a breathing tube when they arrived before whisking her away to Boone Hospital, where she was admitted for respiratory failure. “Presumably, what happened to cause her to collapse was one of the arteries clotted off and caused a rhythm problem in her heart,” says Dr. Eric Thompson, her heart surgeon at Boone. “It didn’t happen long enough for her to die; without a doubt she was critically ill.”
After three days on a ventilator, Cunningham was gradually waking up when she heard Dr. Ravipudi telling her husband, Leslie, that he had found three new blockages in her major arteries and she would need a four-vessel bypass. “Oh, my God,” she thought. “What if I don’t make it?”
Cunningham spent the next excruciating week and a half recovering and waiting for certain medications to leave her system before she could have the bypass. On the table at her home in Bunceton, Mo., she set out her insurance papers along with everything else of importance for Leslie, just in case.
Cunningham’s bypass, performed by Dr. Thompson on Oct. 25, went wonderfully. “She’s really got a positive attitude, and she’s one of those people who was gung-ho about returning to work ASAP,” Dr. Thompson says. “And when people are motivated, they just do so much better after surgery.”
Cunningham found Boone’s entire staff to be very helpful and encouraging. “Everybody bragged on how well I was doing so quickly, even the gentleman who comes in to tell you about therapy,” she says. “He took me on my first walk the second day, and he couldn’t believe how bouncy I was.”
Four days later, she came home and recovered for three weeks before going back to work full time, resilient as ever. Cunningham’s heart attacks didn’t damage her heart too severely, and she’s allowed to resume her normal activity without limitations or special instructions. She sees her cardiologist regularly, monitors her diabetes closely and takes good care of herself because she knows how blessed she is to be alive.
“Half of all people who suffer a heart attack die before they can get to a hospital for medical attention,” Dr. Ravipudi says. “Patients with heart disease, diabetes and peripheral arterial disease are at six to seven times greater risk for developing recurrent problems with their heart and vascular disease and have a much higher mortality rate. She is lucky to still be with us.”
Cunningham never dwells on her heart problems, nor does she coddle herself. Her only complaint about her bypass is that it sullied her perfect attendance record at work. Everything else is back to normal, exactly how she likes it. But she still feels “changed” by the experience.
“Faith and family are what get you through,” she says. “I thank God every day I live. I have more respect for people and try to get along rather than argue and fight. Life is short; you better enjoy it.”
