Joseph Szweda

I am 28 years old, and at age 4, I was diagnosed with a nasty primus ASD, which was repaired along with a partial AV canal, and repaired a leaky mitral valve. They said at the time there was a possibility that I may need to have something done with that valve several years down the road. I was 25, just moved to Orlando, and I caught a staph strain of endocarditis. I am not sure how much of my valve got eaten away.

My cardiologist kept deferring treatment, so I went to Deborah Heart and Lung Center in NJ. I was diagnosed with congestive heart failure, and came dangerously close to requiring a transplant as a result of my leaky mitral valve that was due to a missing leaflet (congential). I have a #27 Carbomedics valve, and I am just a little over 2 months post-op, and I have not felt this good in about 10 years or so. Before I went to surgery, I started off with 10mg of Enalapril, and within a few months I was at 20mg. When I went to 20mg, I was a candidate for surgery as my heart was expanding, but my physician would not refer me because my insurance would not cover it (pre-existing condition).

I got worse within a year and a half, and I was feeling some fluttering in my chest. I had partial blackouts, near fainting spells, chronic fatigue. They screwed up on the echo and told me I was stable, and the last echo they said my heart had shrunk. I was having shortness of breath while doing little or next to nothing (class III/IV symptoms). When I noticed these new symptoms and after a few days they would not go away, I spoke to him, and then he asked if it was in my head.

This was in July of 2002, and at that point I decided to get a second opinion. I had my first open heart at DeBorah Heart and Lung Center in Browns Mills, NJ. I did not know they had 3 cardiologists affiliated with them. So after pulling teeth to get my records from my old cardiologist, I went and got a second opinion through DeBorah. By that time my cardiologist had cut my medication back, but that just led to palpitations. Because I could not get a hold of my cardiologist in time, I decided to go back to 20mg of Enalapril so I could function. Before I was done talking to Dr. Palanniyandi (affiliated with DeBorah), he asked me if I wanted to go, and stated he had no quams at all making that recomendation.

I made it to DeBorah on the 4th of November, 2002. I had a cardiologist who did not miss a trick and within minutes I was getting answers I did not get for years. One of the first things she noticed was I was retaining fluids as my ankles were way swollen. The other doctor did not check for that. She looked at my records and before she tested me, she came back with a resident and 2 PA's. She told them what she suspected was there were actually missing leaflets; I was born without them and they just never grew. She was drawing the thing out before she did any tests, and said that is most likely the problem, consistent with a very nasty primus ASD.

I went to get an echocardiogram, and it was the most thorough echo I had ever gotten in my life. Most places have a technician do that; DeBorah does not work that way. I had another pediatric cardiologist do the echo, then my attending (Dr. Caldaron) walked in. The physician doing the echo (Dr. Bali) noticed several things that nobody could tell.

She said she could see the ASD I had repaired, and that the previous surgeon repaired it by the arrangement of chordae in the left ventricle. She also noted that she could see the partial AV canal I had done. By chance, me and the doctor could see that fluttering feeling. It happened and we got it on tape. We could see the heart beat with the mitral valve completely shut. She said right then and there, when you see something like that, its a red flag that something needs to be done. There was also a missing leaflet just as Dr. Caldaron had predicted, and she told me of the scar tissue and the calcification that had been there for years. My old cardiologist saw none of that.

My attending was quite concerned and gave me a 99% chance of having a replacement, and was so scared at the size of my heart. If I had waited much longer at all, I would have been facing a transplant. They wasted no time at all in getting everything they needed to replace that valve. I assure you that you will not find a more thorough facility, and the expertise they provided was nothing short of forensic.

I was lucky enough to get their top ranked surgeon Dr. McGrath; who has 9000 some heart surgeries to his credit. He was ranked the top cardiac surgeon in the state of New Jersey and considered one of the best in the country. I got delayed a few times the morning I was to go in simply because instead of having someone make the inital decision and do part of the work and someone else close, he decided he wanted to make sure he could do all that himself, and was quite adimant about that.

I was told after the surgery via family and the surgical team that they noticed something they did not expect. My heart actually started to shrink a little. They were very encouraged by that, and I saw the x-rays to confirm that. I would say I had about a centimeter of shrinkage within a day or so post op. I was in shock to see that huge white melon inside of my chest. That gave me yet another clue as to how bad off I was.

After I left NJ, I went to recover in NC with my parents, and I saw an old pediatric cardiologist I knew of in Charlotte, NC at The Sanger Clinic. The echo was nothing like the one pre-op. From what I could tell on my chest x-ray, 10 days after I left the hospital my heart shrunk in half. I was not expecting that dramatic of a difference for 6-12 months as I was advised of that by DeBorah by Drs. McGrath and Caldaron.

I don't have class III/IV symptoms anymore, and my heart has shrunk dramatically without ACE inhibitors as a result. I went off ACE inhibitors withing a month post op. The only thing I am taking now is 7.5mg of cumadin. My prognosis is excellent, and I have been told that within a few months I will have more energy than I will know what to do with. I can't tell you how strange it is to feel "normal". My ankles are not swollen anymore, my stomach is not so bloated, and 3 flights of stairs is not quite the issue that one was before. I have more energy, light years less fatigue, and each day gets a little better. Before I could only do 2 minutes on an exercise bike a few years back. Now I can do 20 with no problems.

I was scared as hell before I went in, but the surgery was like nothing to me. The recovery is a little long, but within 2 months, its amazing how much better you will feel. I started to notice on day 2 when I walked the entire ward of the hospital and I was not short of breath. If you need to go through something like what I have, I would say don't be scared but that is unrealistic. Look at it as a new lease on life. As long as you have a good cardiologist and a good surgeon, you should be fine.

I will say this; the procedure is very radical. It is major. However, when you have it done, you would be surprised how much better you will feel and being able to do things you could not do before. Just take your Cumadin, get your INR checked, and listen to your cardiologist and you should be OK. I have heard people within the medical field that are not in cardiology say you don't get much better if any than DeBorah is. They are a non-profit organization, and they saved my life not once, but twice. If you don't like what your cardiologist is telling you, ask Deborah Heart and Lung Center how to get a second opinion. They don't cherry pick their patients like some clinics do. If you need to have something done, they will take care of you, and you will never see a bill from them.

If you need the job done right, and you absolutely can't afford to take any chances, talk to DeBorah Heart and Lung. Trust me when I say it is well worth the trip to NJ. Chances are that by the time your local hospital has something new and innovative, DeBorah has been doing it for years. I thank God every night for the expertise of the staff their, and for them to open their hearts enough to open mine and save my life.

Thank You,.

Joseph I. Szweda, A+ Certified Technician

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407-963-1455