Gill Affiliate Network (and 116-Pound Dog) Save Myrl Sizemore's Life
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LEXINGTON, Ky. (July 14, 2015) – His big brown eyes stare up at the camera dolefully, as if to say, "I couldn't help myself, can you forgive me?"
Apparently, this isn't the first time Sarge has had to beg for Myrl Sizemore's forgiveness. The 116-pound lab has a reputation around Manchester, Kentucky, for his antics.
"For starters, he happily accepts – and then rips apart – all packages delivered to our home," Myrl said with a laugh. Then he ticks off some of Sarge's other more dubious accomplishments:
1. Eating the driver's seat in Myrl's ATV
2. Chewing the wires on the underside of Myrl's camper
3. Ripping the running boards off of Myrl's SUV
4. Eating the Sizemore's patio umbrella
However, according to Myrl's wife Leslie, Sarge has now shown his true worth. That's because Sarge helped save Myrl's life.
Myrl hadn't been feeling well for weeks. The 50-year-old had no reason to believe he was desperately ill; his BMI was 25, his cholesterol numbers were excellent and he didn't smoke. He had been diagnosed with Type 2 diabetes two years ago, but it was well under control. Myrl thought he had a bronchitis he just couldn't shake.
One evening in late January as he returned from work, Myrl collapsed in his front yard. Inside the house, his family had no idea Myrl was in serious trouble.
But Sarge was out. He licked Myrl's face and shoved his nose under Myrl's shoulders to wake him, then supported Myrl as he crawled back into the house.
At first, Myrl refused to go to the hospital. By the next morning, however, Leslie said he "looked gray" and insisted he see the doctor. An abnormal EKG in the offices of Dr. Neeraj Mahboob and Karen Cheek earned him a trip to the Emergency Department at Manchester Memorial Hospital (MMH).
The Gill Heart Institute at the University of Kentucky had just recently formalized a partnership called the Gill Affiliate Network to provide MMH staff with supplemental expertise for their sickest patients. Chief of Staff Dr. Jeffrey Newswanger at the MMH Emergency Room knew Myrl needed that expertise: Myrl was having a massive heart attack.
Myrl was transferred to ARH Hazard, where Dr. Rao Podapati determined Myrl's ejection fraction (EF), a measure of the heart's ability to pump blood, was just 7 percent. A normal EF is 55-60 percent.
"Dr. Podapati was baffled that Myrl could even walk and talk," Leslie said. Then he gave them "horrific" news: Myrl likely needed a heart transplant. An ambulance would take Myrl to Lexington for further evaluation.
When Gill cardiovascular surgeon Dr. Ted Wright met Myrl in Lexington, he had a hunch: there had been discussion among the Gill faculty about a relatively new concept called "hibernating viable myocardium," and one of Wright's colleagues, Dr. Vince Sorrell, had a particular interest in this condition.
Sorrell uses the metaphor of a hibernating bear to illustrate.
"If you come across a hibernating bear, you might think it's actually dead because its temperature is low, its heartbeat is down and its respirations are slow, but as we know that bear will be wide awake come springtime," he said. "In some cases, our heart muscle is so sick that it actually hibernates to conserve itself. An ECHO test will look like the heart muscle is dead and a nuclear scan will usually look the same. But a contrast-enhanced cardiac MRI can tell us whether heart muscle is hibernating (alive) or dead (scarred). If it's hibernating, restoring blood flow to the heart with bypass surgery is usually sufficient treatment and obviously preferable to a heart transplant."
"That MRI changed our lives," Leslie said. Instead of a heart transplant, Gill Surgical Director Dr. Michael Sekela gave Myrl a triple bypass.
"He just flew through the surgery," Sekela said. Myrl's ejection fraction has improved to 45 percent – a statistic Sorrell pronounces "phenomenal."
It has long been an institutional philosophy at UK to partner with other health care institutions so that patients could stay as close to home as possible for their treatment, bringing only the very sickest patients to Lexington. There is perhaps no better example of the effectiveness of this team approach than the journey Myrl Sizemore took. At each level of care, the best expertise pointed Myrl in the right direction: from Mahboob to Newswanger to Podapati to Wright to Sorrell to Sekela.
Leslie is convinced that having the Gill Network in place made a huge difference in Myrl's outcome.
"I serve on the board of Manchester Memorial Hospital, and I'm very proud of their work," she said. "I'm grateful they had the foresight to partner with Gill, and now I know first-hand the benefit the network provides for our citizens."
"We were able to use high-tech to justify a less dangerous, more 'low-tech' treatment for Myrl's condition," Wright said. "In doing so, we avoided a lifetime of costly and high-risk care for Myrl."
Last May, Myrl walked his daughter Maggie down the aisle.
"Sarge was not invited for obvious reasons," Leslie said. "But he will be a trusted and beloved member of our family forever, and will always share a special bond with Myrl."
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