28-year-old Mansfield woman needs heart transplant
Emily Mills
MANSFIELD — Sarah Adkins doesn't have a pulse.
She has a mechanical hum, powered by a device in her heart that keeps it pumping.
If the pump stopped working, Adkins' heart would stop, too.
The pump is working as a temporary fix, but she needs a heart transplant as a permanent solution.
"I have a life to live," she said. "This is just, I guess, part of my journey."
All her life, Adkins, 28, has been healthy and active, cheering and playing volleyball at Mansfield Senior High School nearly a decade ago.
Neither she nor anyone in her family has had any previous heart issues.
But she started feeling poorly in September, developing a constant cough and heart palpitations.
Her primary care doctor thought it could be a cold, allergies or anxiety and prescribed her medicine.
But Adkins kept feeling worse, with symptoms included vomiting, fevers, weight gain, swelling and profuse sweating. She felt like she couldn't breathe and like she would pass out.
After several trips to the hospital, an echocardiogram at a later cardiology appointment showed Adkins was in advanced heart failure, with her heart functioning at only 10 percent.
Adkins' care was transferred to OhioHealth Riverside Methodist Hospital's Congestive Heart Failure Clinic in Columbus, where her cardiologists are Dr. Lee Jordan and Dr. Anupam Basuray.
Basuray, an advanced heart failure and transport cardiologist, could tell Adkins was sick just by looking at her.
"Her heart was really, really weak," he said.
Basuray said initially, Adkins' team tried to manage her symptoms with medication.
But with more tests, the team learned Adkins likely needed a heart transplant, and she'd need an LVAD in the interim.
Learning about the LVAD
It was in Columbus that Adkins learned about the LVAD, or left ventricular assist device, a mechanical pump that helps blood flow in people with weak hearts.
Basuray said it essentially acts as a sump pump, helping blood flow out of the heart to the rest of the body.
He said one end of the pump connects into the left ventricle, a main pumping chamber of the heart.
The other end of the pump connects into the aorta, the main blood vessel that takes blood away from the heart.
"While your heart is contracting and working, the sump pump is basically sucking blood out of that ventricle and into that aorta and helping circulation," he said.
In the U.S., there are more than 22,000 patients with an LVAD, Basuray said.
LVADs generally increase survival of heart failure patients from six months to an average of three to four years, he said.
Adkins and her family had never heard of the device before, save for on an episode of "Grey's Anatomy."
Her doctors wanted to implant the pump as soon as possible while Adkins' other organs were still operating normally.
"I was unsure about it, and the doctors... said if you don't get it, you're not gonna be here much longer," she said.
While checking her heart function before the surgery, her doctors found it had decreased to 9 percent.
"I was dying," Adkins said.
She underwent the roughly four-hour LVAD surgery in mid-January, staying in the hospital for about a month after.
The LVAD implanted in Adkins' heart connects through a white tube coming out of her abdomen to a controller that she constantly carries in a black cross-body bag.
The battery-powered, portable controller allows her to check her levels to make sure everything's normal. The batteries last 10 to 12 hours, and if they run out, her heart stops.
"I no longer have a pulse. I have a hum," she said. "If you had a stethoscope to listen to my heart, you wouldn't hear a heartbeat. It's a constant hum because it's the pump."
Adkins expected to feel great immediately after the surgery, but she said recovery was long and slow.
"In the beginning, it was rough. I was just like, 'Why me?'" she said. "But now, I thank God for this. It's a life-saving device."
She said more than six months post-surgery, she feels great and is back to doing the things she loves, such as caring for her and fiance Eric Vrabel's four children, shooting guns, camping and "adventuring."
"They gave me this to live, not to sit at home. The LVAD's for me to live my life, not to sit and watch it fly by," she said. "It's a part of me, and I'm thankful for it."
Adkins and Vrabel met and dated in high school but went their separate ways. They got back together about four years ago.
Vrabel ha been by her side constantly during the last several months, missing work to sit at the hospital with her and changing her dressings.
Her faith, parents, "cousin-best friend," Heather Debo, and kids help her, too: Zoey, 5; Zane, 4; Kimber, 2; and soon-to-be-stepson, Brently, 3.
"It does a mama and papa's heart amazingly good to see their child who was at the brink of death, to see her get her life back," said her mother, Loretta Adkins.
But still, one of Adkins' biggest fears is getting in a car accident. She says paramedics wouldon't know not to move her bag or give her chest compressions.
Adkins' parents, Bernie and Loretta Adkins, spoke with area fire departments to teach them about the LVAD, who knew little about it.
"We felt helpless as parents," Lorettta Adkins said. "We would give her our heart."
Steps to transplant
The next step for Adkins will be a heart transplant.
"You run on batteries (with the LVAD)," Basuray said. "You have to have a power cord coming out of you, so there are certain things mentally and physically that are challenging when you compare it to a transplant."
Her doctors at Riverside contacted doctors with The Ohio State University's Wexner Medical Center. She met with OSU doctors in early July to start discussing the heart transplant process.
"The LVAD was a bridge to transplant for me," she said.
Survival outlooks for transplant patients average 10 to 12 years, although Basuray said younger patients can live much longer.
"Statistically, you (are) likely to live longer with a heart transplant," he said.
Adkins said she thinks she has a good chance at finding a heart, as she's young and relatively healthy.
"It has to be a heart that's perfect," said Adkins, who estimated it'll likely be six months to a year before a heart is available.
One of the toughest things for Adkins to accept is she doesn't know why her heart is so weak. She's never used drugs. Doctors found no infections or clogged arteries.
The only diagnosis she's received is nonischemic cardiomyopathy, a type of heart disease.
"I feel like I would have had a little bit more of a closure type of thing if I could've known, well, this is why," she said. "But not knowing, it scares me."
She's currently seeing a genetic specialist to try to figure out why her heart is so weak.
Basuray said the team is leaning toward the cause of her disease being familial.
Adkins said she wishes someone else didn't have to die for her to live, but she knows there's no other option.
"That breaks my heart, and it makes me feel selfish almost for praying for a heart," she said.
There are a little more than 3,000 heart transplants done on patients with advanced heart failure each year, Basuray said.
"There's probably 10 times that in terms of patients that might need one," he said. "There's not enough hearts for everyone."
Adkins and her family stressed the importance of becoming organ donors.
"Unless it hits home... people don't really think about it too much, 'cause I mean I was guilty of it," she said. "Now I'm like... can't take it to heaven with me, so I might as well let somebody down here live for it, with it."
ejmills@mansfieldnewsjournal.com
Twitter: @EmilyMills818