Why I Specialize in Adult Congenital Heart Disease

Julie Kovach, MDBy Julie Kovach, MD

“I’m a cardiologist who takes care of adults who were born with heart defects.”

This is what I tell anyone (patients, other physicians, friends or family members) who asks me “what kind of cardiology” I practice. My answer is almost always met with a quizzical look and a polite, “What?”

Everyone knows cardiologists who care for adults who have had heart attacks, or have high blood pressure, heart failure or heart rhythm problems (arrhythmias). These are common heart problems people face as they age.

But adults with congenital (present at birth) heart defects? What does that mean? How many of these patients could there possibly be out there? Don’t these folks just keep seeing the same cardiologist that they saw as a child?

So I tell them about Carrie*. When I first met Carrie, her husband brought her into my office in a wheelchair. A diminutive, 42-year-old woman dressed in a stylish suit, with tubing in her nose attached to an oxygen tank on her wheelchair, she smiled shyly and told me her story. Her husband stood behind her with tears in his eyes as she talked.

Carrie’s parents were told she had a heart murmur when she was nearly two years old and couldn’t keep up with the other kids while playing.

Fatigue, shortness of breath

As a young adult, Carrie remembers her mother telling her that doctors had suggested Carrie have heart surgery. Her parents were reluctant, however, because every child they’d heard of who had heart surgery died. Keep in mind, this was 40 years ago, a time when open heart surgery was a new specialty in its infancy.

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Well, Past 100

Norman Prestine and Penfield Faber, MDNorman Prestine was 88 years old when he was diagnosed with two cancerous masses in his chest in 2001. He came to Rush to undergo surgery to remove them, and he’s come back each of the 13 years since then.

During his recent annual follow-up visit, the hale 101-year-old said hello to his surgeon, Penfield Faber, MD, a relative youth at 84. “It’s always a pleasure to see somebody you’ve operated on for cancer who’s alive and doing well,” says Faber, an emeritus professor of thoracic surgery.

Prestine’s longevity is all the more remarkable for his ability to undergo major surgery in his late 80s, which Faber also performed after first carefully assessing his condition. “He was physiologically much younger than his stated age,” the doctor says. “He was working out. He had all the physical parameters of a younger man. It was apparent that from the shape he was in that would withstand the procedure.”

Prestine attributes his longevity to the basics — eating right and exercising. He walks half an hour on a stair climber in the morning and another 30 minutes on a treadmill in the evening, and eats “everything within reason.”

He was accompanied on his visit to Rush by his wife, Nancy, 86. The couple, who have known each other since the 1960s, married in 1993 after each of their first spouses of more than 40 years passed away. The Prestines live in their own home on Chicago’s northwest side and keep busy with seniors club activities.

Faber performed surgery for more than 50 years before he set aside his scalpel in 2006, retiring from clinical care altogether the next year. But he still continues to teach surgery residents.

Holiday Greetings From Rush

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Last February, the son of a patient stamped out this message of hope and life in the snow atop our parking garage. What started as a special note to one mom became an image that touched all of us at Rush — our patients, employees, students — and then millions of people around the world.

As 2014 comes to a close, take a moment to think about what has inspired you this year. Wishing you joyful holidays and a peaceful New Year.

Bringing Christmas Cheer to the Children’s Ward, 1940

Christmas1940

By Nathalie Wheaton

Season’s greetings from the Rush Archives!

This image from the December 1940 issue of St. Luke’s News shows the hospital’s children’s ward on Christmas morning. Each young patient received a gift hand-chosen by members of the Women’s Auxiliary of the Medical Board of St. Luke’s Hospital. This charitable organization was comprised of the wives of the medical staff. The accompanying article describes the development of the group in 1933 and its various service projects.

This newsletter of St. Luke’s Hospital, one of Rush University Medical Center’s predecessors, was published from 1940 until 1956, when St. Luke’s merged with Presbyterian Hospital. Other holiday-themed topics in this issue include Christmas shopping at the patient’s bedside and the bustling hospital kitchen.

Nathalie Wheaton is archivist with the Rush Archives. To learn more about the Rush Archives and the history of Rush, please visit the Rush Archives web page. Did you know some of the Rush Archives’ commonly requested books and historic documents are online? To view our current collection of digitized publications, visit our Internet Archive page.

What’s With the Mustache?

movember-rush

From left: Ivan Salvador, Thomas Amaya, Carlos Olvera, Ricardo Kirgan, Cesar Mendoza and Terence Maynard. Photo by Lauren Anderson.

By Carlos Olvera

It’s a question I get asked a lot these days.

Everyone agrees that the mustache is not the best look for me, but not everyone knows the reason behind it. Every November, also known as Movember, men and women join together to raise awareness and funds for men’s health. The Movember Foundation aims to increase early cancer detection, diagnosis and ultimately reduce the number of preventable deaths.

So what triggered my decision to participate in this campaign?  Over 15 years ago, my dad was diagnosed with stage IV colorectal, prostate and bladder cancer. He never went for his routine colonoscopy. For years he experienced rectal bleeding but didn’t think much of it. He thought it was just hemorrhoids and he never mentioned the symptoms to his primary care physician.

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Veterans: The Road Home Program is There for You

veterans-day-flagsBy Will Beiersdorf

As we celebrate Veterans Day this year, the Road Home Program would like to deliver an expanded message to our veterans and their families. Along with the traditional message of thanking veterans for their service and sacrifice to our country, we’d like to add that the Road Home Program is there for you (the veteran) and your family.

We have seen firsthand over the last seven months since our opening, the important role Road Home is playing in the veteran community. It’s not just in the services we deliver around counseling and care for PTSD, TBI, military sexual trauma or other challenges, but in the fact that we are there for the veterans and their families.

There to listen, there to assist, there to direct and advocate for each of the veterans and their families members that come to Road Home. It is truly an honor to serve and support our veterans, and we ask our peers and friends in the Rush community to pass along the message about Road Home Program to others in your local communities.

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‘My Motivation, My Strength and My Courage’

Young patient inspires med student, marathon runner

marc-dadiosBy Marc Dadios

Many people ask marathon runners the question “Why would you put your body through 26.2 miles of hell?” The very thought of a marathon can make even the most avid distance runner question their ability to complete a marathon. Most marathon runners tend to have a very strong reason to commit to the training and dedication required to cross the finish line. My motivation for running the 2014 Chicago Marathon was to fulfill a promise I made to a brave teenage boy who lost his battle against Duchenne muscular dystrophy during my third year inpatient pediatrics rotation.

Duchenne muscular dystrophy (DMD) is an X-linked genetic disease meaning that it primarily affects young boys. A good analogy for how this disease works is to think of a bridge that is built with inherently weak, easily breakable supports. The more that the bridge is used, the more that the supports break, and the weaker that bridge gets until it eventually collapses. DMD is a disease of the muscles where the proteins necessary to provide tensile support for their function as they expand and contract during movement are inherently weak or absent. When a child with DMD uses his or her muscles to move around or even breathe, they tear and eventually become unusable. The average life expectancy for someone with active DMD is 17 years because of heart and lung problems associated with prolonged use.

Unable to walk

For the sake of patient privacy and HIPAA, I will refer to my patient, good friend and inspiration as “Jay.” I first met Jay at the beginning of my inpatient pediatric rotation at Rush University Medical Center. Before meeting Jay I had only heard about DMD from my studies during my first and second year of medical school. Jay was only 15 years old but he had an extensive medication list that would make even the most seasoned health care practitioner cringe as well as a medical chart that could have been mistaken for a lengthy Harry Potter book. Although I was initially overwhelmed by the complexity of his case, as I got to know him better, I became much more passionate about learning as much as I could about DMD.

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