Change of Heart

If you think your life is doomed after undergoing coronary artery bypass surgery, you seriously need a change of heart

Open-heart bypass surgery. Those four words conjure up images of knife-wielding doctors making a rib-splitting slice down the middle of the chest.

Most assume anyone who has undergone such an invasive procedure experiences a diminished quality of life and is living on borrowed time before another heart episode causes a patient to clutch his chest and fall to his death.

However, those who have experienced bypass surgery know otherwise. Just ask De Burkholder, a 72-year-old Eustis resident whose arteries were so clogged his cardiac surgeon put in six bypasses. That surgery in 1999 left him with both a change of heart and attitude. “I was only 55 years old when I had the surgery and felt I was too young to die. Although I tried to live a healthy lifestyle before my surgery, I knew I needed to take my health to an even higher level.”

Burkholder has spent the past 16 years doing that with steadfast determination. Today, he spins, shuffles, and sidesteps as a ballroom dancer, spends several days each week tending to his beautifully landscaped yard, and frequents the Golden Triangle YMCA to engage in strength and aerobic training.

In addition, he is vegetarian most of the time, allowing himself a limited amount of meat on special occasions. “Other than heavy lifting, I can participate in most physical activities,” he says. “My level of physical fitness is much better than other people I know who are my age.”

Through bypass surgery, surgeons split the breastbone down the middle and separate the rib cage to access the heart. Veins are taken from an arm or leg and used to “divert the flow of blood around a section of a blocked or partially blocked artery in your heart,” according to the Mayo Clinic.

This enables patients to breathe better, work harder, and feel healthier. Instead of becoming cardiac cripples, bypass patients find themselves doing anything they want—running, bicycling, and working full-time. Doctors support this increase in activity.

“Patients who have just undergone bypass surgery should begin exercising by doing little things, such as walking for five minutes and then resting,” says Dr. Mark Rothschild, a cardiologist with Heart of The Villages. “They should attempt to walk every day and gradually build up their endurance. Doing so is good for the patients and their heart.”

That mindset is a stark contrast to 50 years ago when patients were encouraged to slow down, lead sedentary lifestyles, and consider leaving work. However, studies indicated these patients suffered poor outcomes. Moreover, leaving a career they were passionate about created more stress than resuming their job. “There used to be a time when doctors wanted bypass patients to remain in bed for two months,” Dr. Rothschild says. “Nowadays, we mobilize them as soon as possible and have them enter a cardiac rehab program, where they undergo supervised exercises.”

Of course, bypass surgery does not ensure patients will enjoy a life free of heart disease, nor does it prevent future heart attacks. In fact, the 20-year survival rate after bypass surgery is only 40 percent, according to a clinical study published in the European Heart Journal. “Once you have coronary artery disease, you will have it for the rest of your life,” Dr. Rothschild says. “Bypass surgery doesn’t change that; it merely treats symptoms.” That’s why patients such as Burkholder alter their lifestyles considerably to end unhealthy habits and risk factors that re-clog the arteries.

Bypass surgery:

The Road to Recovery Burkholder has been an avid exercise enthusiast for most of his adult life. Ironically, he was participating in a step aerobics class in 1999 when he first experienced extreme shortness of breath. “It felt like I had a chest cold,” says Burkholder, who resided in Michigan at the time and worked as a purchasing manager for Ford Motor Company. Several days later, he struggled to breathe again. An abnormal EKG prompted his cardiologist to perform a heart catheterization that revealed grim news. Of his three main coronary arteries, one was 100 percent blocked, while the other two had 75 percent blockage.

The result was shocking to Burkholder. He lived a healthy lifestyle, was not overweight, and only smoked for a brief time. However, his father suffered two heart attacks before undergoing bypass surgery in 1980. “It appears my heart disease was genetically inherited. I was living on the edge of disaster. After the catheterization, they never let me leave the hospital. Before the surgery, doctors barely let me get out of bed unless I needed to use the bathroom. They did not want me doing anything. That’s how bad of shape I was in.” Following his surgery, Burkholder began taking steps to resume a normal life. But they were unquestionably the most difficult steps he has ever taken—literally. “Because of the surgery I had no strength at first,” he explains. “I remember trying to walk outside on a fall day and I could only go one-tenth of a mile. My wife went to get the neighbor so he could help me make it back to my home.”

The surgery also took an emotional toll. “I went from working full-time and exercising several times a week to barely moving. It’s hard mentally when you go from one extreme to another like that. I wondered whether I’d get back to the level I was at.” Through it all, though, Burkholder was determined to have a successful recovery. At his first follow-up appointment after surgery, his cardiologist issued a stern challenge. “He told me that I should be walking a mile within one month. I ultimately met that goal. If it was nice outside, I’d go for a walk, and if the weather was nasty, I would walk on a treadmill in my basement. Meeting that goal was a big triumph, and that really encouraged me to continue pushing myself physically.” Making dietary changes was another crucial component of his lifestyle change. After reading “Reversing Heart Disease,” a book written by Dean Ornish, he eliminated hydrogenated oil from his diet. Hydrogenated oil is a trans-fat that “increases your risk of developing heart disease and stroke,” according to the American Heart Association. “Hydrogenated oil is used in baked goods because it extends the shelf life, but at the same time it shortens your life,” he says.

Did you know?
About 80 percent of patients who underwent open-heart surgery were angina free five years after surgery, according to the National Institutes of Health. Angina is chest pain related to the heart.

Burkholder also began monitoring his saturated fat intake and transitioning to a mostly vegetarian diet. “The amount of time I spent at grocery stores doubled because I had to carefully read food labels. I didn’t mind, though, because I wasn’t going to go through that again. I decided that my physical well-being is more important than a steak.” After moving to Eustis in 2003, he became a member of the Golden Triangle YMCA and eventually served as a group fitness instructor. For five days a week, he taught classes such as kickboxing, group cycling, deep-water aerobics, and strength training.

Although he recently retired after nine years, he continues exercising there several times a week. For Burkholder, ballroom dancing is another heart-healthy activity that keeps him on his toes. He and Salemae, his dance partner and wife, take private lessons in Mount Dora. On Saturdays, the couple attends dance night at Hawthorne, a retirement community in Leesburg, where they elegantly and gracefully perform the cha cha, fox trot, swing, tango, and waltz. Studies indicate ballroom dancing improves heart and blood vessel function of patients with heart disease. “Not only does dancing help me keep physically fit but it also helps me keep my mind active because you have to learn all the steps,” he says. “I feel fortunate that I can participate in all these physical activities.” Now, he’s encouraging other bypass patients to do the same.

Burkholder is a member of Mended Hearts, a national support group offering hope to heart disease patients and their caregivers. During his chapter’s monthly meetings at Florida Hospital Waterman, Burkholder shares his triumphs and struggles with others battling heart disease and inspires them to live full, healthy lives post-surgery. “Cardiac patients can relate most to others who suffered from heart-related issues,” he said. “When they see how well I’m doing 16 years after my surgery, it provides them with hope and motivates them to live a healthier lifestyle.”

Adopting and maintaining a healthy lifestyle following open-heart surgery gives patients like Burkholder a new lease on life. “I constantly see people who are having a heart attack or on the verge of having a heart attack and near death,” said Dr. Duane Cook, a cardiovascular surgeon with Leesburg-Ocala Heart Institute. “I perform surgery on them, and two months later they come back and tell me they feel 10 years younger. They find life is worth living again.”

Surviving bypass surgery

Dr. Mark Rothschild, a cardiologist with Heart of The Villages, shares some tips to help open-heart surgery patients make a full recovery and live healthy lifestyles.

1) Join a cardiac rehab program, which helps patients increase cardiovascular fitness and the heart’s functional capacity.

2) Strongly consider the Mediterranean diet, which consists of eating plant-based foods such as fruits and vegetables and whole grains.

3) Use olive oil or canola oil instead of margarine or butter.

4) When it comes to exercising, walk for a minimum of 30 minutes per day and gradually increase your time and distance. Listen to your body and don’t overdo it.

5) If osteoporosis makes walking difficult, consider swimming or water aerobics.

STORY: JAMES COMBS PHOTOS: FRED LOPEZ