{"id":29355,"date":"2020-02-26T08:22:31","date_gmt":"2020-02-26T15:22:31","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=29355"},"modified":"2024-07-17T10:08:53","modified_gmt":"2024-07-17T16:08:53","slug":"heart-disease-patient-engages-medical-team-to-extend-life-many-years","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/heart-disease-patient-engages-medical-team-to-extend-life-many-years\/","title":{"rendered":"‘They said I\u2019d be dead by Christmas’: Heart disease patient actively engages with medical team to extend life"},"content":{"rendered":"
<\/div>

Growing up, he worked the family dairy with his seven siblings and later became a professional bull and bronc rider. Jack Silva was tough as nails.<\/p>\n

At 72, the cowboy shares a different message: \u201cTough will get you dead.\u201d<\/p>\n

\"Jack
Heart disease patient Jack Silva said that one reason he’s survived heart disease for 11 years is because he has a “good woman” that takes care of him \u2014 that woman being Tina. Photo courtesy of Jack Silva.<\/figcaption><\/figure>\n

Silva stands tall in his turquoise, button-down shirt, black leather waistcoat and veteran-pinned felt cowboy hat. Beneath his rugged appearance, though, is a heart that\u2019s been failing for almost 11 years.<\/p>\n

Silva says he shouldn\u2019t have hesitated to see a doctor and he should have listened more closely to his body.<\/p>\n

\u201cI figured, I\u2019m tough. I can handle it,\u201d he said.<\/p>\n

Identifying heart disease early<\/strong><\/h3>\n

Silva\u2019s family has a history of heart disease. In fact, he is the first Silva man to live past the age of 70. His grandfather, father, one brother, and two sisters have all experienced heart issues.<\/p>\n

Silva has heart failure, a condition in which the heart doesn\u2019t work efficiently. It\u2019s usually results from a heart being weakened or stiffened by a heart attack or other factors that damage the muscle\u2019s tissue, including high blood pressure or cholesterol, diabetes or obesity.<\/p>\n

\u201cAnd if it is truly dead tissue, it doesn\u2019t work again, and we can\u2019t get it back, at least with the current modalities,\u201d said Dr. Lance Richards<\/a>, a cardiologist with UCHealth Heart and Vascular Center \u2013 Medical Center of the Rockies<\/a>. \u201cHeart failure naturally progresses as the heart gets more tired and declines.\u201d<\/p>\n

\"Jack
Jack Silva has been a heart disease patient for the past 11 years. He’s a cowboy at heart but learned the hard way that “tough will get you dead.” Photo courtesy of Tina Silva.<\/figcaption><\/figure>\n

Heart disease is the leading cause of death for both men and women as well as people of most racial and ethnic groups in the United States, according to the Centers for Disease Control and Prevention<\/a>.<\/p>\n

UCHealth Heart Failure Clinics throughout Colorado\u2019s Front Range use a multidisciplinary team of cardiac-specialized nurses and doctors to provide individualized care to address specific heart failure concerns of each patient.<\/p>\n

\u201cThere are all sorts of different types of heart failure \u2014 it\u2019s very heterogeneous,\u201d Richards said. \u201cIt\u2019s complicated, and usually these patients have multiple issues that are contributing to their condition.\u201d<\/p>\n

The signs and symptoms of heart failure<\/strong><\/h3>\n

It was about 11 years ago that Silva first suspected something was wrong. He and his wife, Tina, were living on their 15-acre property in Virginia.<\/p>\n

\u201cI was eating Rolaids \u2014 a lot,\u201d he recalled.<\/p>\n

Then one day he woke feeling particularly unwell, but he decided to head out to work nonetheless.<\/p>\n

He was just going to \u201ctough it out.\u201d<\/p>\n

But when he wasn\u2019t able to put on his pants \u2014 the sheer effort left him breathless and in pain \u2014 he decided he\u2019d put Tina at ease and head to the hospital instead.<\/p>\n

\u201cI have a really good woman \u2014 she takes care of me,\u201d Silva said.<\/p>\n

Doctors first thought he had GERD, or gastroesophageal reflux disease, and were going to send him home when Tina insisted she wasn\u2019t about to take her husband home to die. She pushed for more tests.<\/p>\n

Those tests revealed that Silva had experienced multiple small heart attacks.<\/p>\n

\"Jack,
Jack and Tina Silva like to play patriotic music while participating in local floats. Their first float entry was in Greeley during the 4th of July parade about eight years ago. Photo courtesy of Jack Silva.<\/figcaption><\/figure>\n

The start of heart disease<\/strong><\/h3>\n

In September 2008, doctors placed five stents in Silva\u2019s coronary arteries, after which he started his first cardiac rehabilitation program.<\/p>\n

To help rebuild the strength of the heart muscle and improve cardiovascular health, patients are referred to cardiac rehab after a significant heart event. The program is supervised by a medical team that provides personalized instructions on exercise, lifestyle changes and diet to help the patient recover.<\/p>\n

At that point, Silva weighed 315 pounds \u2014 100 pounds more than he does today.<\/p>\n

\"Old
Jack Silva always wanted to be a country singer. He taught himself to play the guitar and the base. Photo courtesy of Tina Silva.<\/figcaption><\/figure>\n

\u201cI told the lady at rehab I\u2019d do whatever it takes,\u201d Silva said. \u201cI\u2019d eat cardboard if I had to \u2014 but she told me I didn\u2019t need to do that.\u201d<\/p>\n

Over the next year, Silva reduced his weight to a more manageable level, but despite his motivation to improve his health, his heart continued to worsen.<\/p>\n

Dealing with a failing heart<\/strong><\/h3>\n

In March 2009, Virginia doctors put a battery-powered device called an implantable cardioverter defibrillator (ICD) under the skin on Silva\u2019s chest to keep track of his heart rate. Thin wires connected the device to his heart so that if an abnormal heart rhythm was detected, the device would send an electric shock to restore it to a normal beat.<\/p>\n

His doctors told him his heart probably wouldn\u2019t make it more than five years.<\/p>\n

Silva returned to rehab, but his heart was just too weak. \u201cI couldn\u2019t do it,\u201d he said.<\/p>\n

The following week, Silva was back in the hospital for more procedures and while on the table, he said, he had what he believes was an \u201cout-of-body experience.\u201d<\/p>\n

\u201cSomeone told me that I could choose to stay or go, but they said staying would be a lot harder,\u201d Silva recalled of that experience. \u201cAs you can see, I decided to stay.\u201d<\/p>\n

And in April 2009, Silva underwent a quadruple bypass.<\/p>\n

\u201cThey told me I\u2019d probably be dead by Christmas,\u201d he said.<\/p>\n

\"Jack
Jack Silva has been entering his float into area parades for the past eight years. It’s his way to make people happy and continue to work outside. Photo courtesy of Tina Silva.<\/figcaption><\/figure>\n

Heading to Colorado as a new heart disease patient<\/strong><\/h3>\n

Stubbornness runs in the Silva family. When Silva told his siblings of his shortened life span, none of them would dignify the prognosis with an end-of-life visit to Virginia. So, Silva decided he\u2019d return to his home state to spend his dying days around his three brothers and one sister, who still lived in Colorado.<\/p>\n

\u201cWe put a camper shell on the back of our truck,\u201d Silva explained. \u201cThe hell with them \u2014 those doctors who said I couldn\u2019t come out here (to Colorado). They said I\u2019d never make it, and if I did, I wouldn\u2019t find a doctor who\u2019d be willing to care for me.<\/p>\n

\u201cSometimes we\u2019d only travel an hour before I\u2019d have to get in the back to rest, but I was going to come say goodbye to my family.\u201d<\/p>\n

After selling their Virginia home and making the trek to Colorado, Silva and Tina moved in with Silva\u2019s brother in LaSalle, Colorado.<\/p>\n

\"Old
Growing up, Jack Silva worked the family dairy with his seven siblings and learned hard work at a very young age. Photo courtesy of Jack Silva.<\/figcaption><\/figure>\n

Finding a cardiologist in Colorado<\/strong><\/h3>\n

Another Colorado relative helping Silva was the first to come across the UCHealth Heart and Vascular Center – Medical Center of the Rockies. She passed the information on to Silva, who, after a bit of research, called the office.<\/p>\n

He explained his situation and how doctors out East had told him no one would take his case.<\/p>\n

\u201cI told them to give me the best you got \u2014 and they did,\u201d Silva said.<\/p>\n

Silva first met UCHealth cardiologist Dr. Thomas Downes in 2010.<\/p>\n

As a member of the UCHealth team, Downes was able to access the resources within his own group to connect Silva with clinical cardiac electrophysiologist Dr. Russell Heath<\/a>.<\/p>\n

While Downes managed Silva\u2019s medications, Heath put in Silva\u2019s new defibrillator. He also treated Silva\u2019s ventricular tachycardia \u2014 a very fast heartbeat in the heart\u2019s lower chambers \u2014 with ablation, a procedure in which the area of the heart causing the arrhythmia is cauterized.<\/p>\n

A trust in the team approach<\/strong><\/h3>\n

For the next several years, Silva\u2019s heart failure was well-managed. And during that time, Downes transitioned out of medical practice to become UCHealth\u2019s Chief Medical Officer for Poudre Valley Hospital<\/a> and Medical Center of the Rockies<\/a>, so he needed to transfer Silva\u2019s care to a new cardiologist.<\/p>\n

\u201cI told (Dr. Downes), \u2018No (nonsense). Give me the best guy for my condition,\u2019\u201d Silva said.<\/p>\n

It was 2014, and Richards was creating the heart failure clinic in northern Colorado. Downes assured Silva that Richards was an excellent doctor for the job, but Silva wanted to be certain.<\/p>\n

\u201cMy first visit with Jack, he interviewed me for the first 30 minutes,\u201d Richards said. \u201cHe wanted to know what kind of doctor I was; how we\u2019d work together. He knew he needed someone he could trust and work alongside.<\/p>\n

\u201cI actually had to have a second visit to be able to ask my questions,\u201d Richards continued. \u201cThat\u2019s atypical, so I knew right away that Jack was going to be compliant and a good team member in his health care.\u201d<\/p>\n

\"Jack
About eight years ago, Jack and Tina Silva began entering into parades as a fun way to enjoy their local communities and stay busy. Photo courtesy of Tina Silva.<\/figcaption><\/figure>\n

Being involved as a heart disease patient<\/strong><\/h3>\n

Every visit with Richards, Silva would arrive with a binder of personal information, a log of daily blood pressure, heart rate and weight readings, as well as notes on his exercise, diet and sodium intake.<\/p>\n

\n

Symptoms of heart failure that should be tracked<\/strong><\/h3>\n

Shortness of breath<\/strong>.<\/p>\n

Changes in heart rate<\/strong>.<\/p>\n

Weight.<\/strong> Weight gain of more than 2-3 pounds in a 24-hour period or more than 5 pounds in a week can be one of the first signs of worsening heart failure.<\/p>\n

Swelling<\/strong>. Patients can experience fluid buildup (or an increase in swelling), often in the ankles, lower legs and feet.<\/p>\n

Confusion or impaired thinking<\/strong>. Too much sodium or too little oxygen in the blood can results in changes in mental state. This could include memory loss, or worsening symptoms of depression or sadness. Welcome the feedback of others, as they may be the first to notice these mood changes. <\/div>\n

\u201cJack follows and trends these things to extreme accuracy, so he is the first to know if his weight trends up, or what happens when he skips an exercise,\u2019\u2019 Richards said. \u201cHe can tell, and he contacts us to either help him make adjustments, or he gets right back on that horse.<\/p>\n

\u201cFor someone with his chronic heart condition, that can be very difficult to do. But one of the things that\u2019s let him live so well for so long is that active participation in his health.\u201d<\/p>\n

People with heart disease need to track these details because their condition can worsen by small degrees over time, often going dangerously unnoticed, according to the American Heart Association<\/a>.<\/p>\n

Noticing the symptoms of heart diesease in time<\/strong><\/h3>\n

After years of successfully managing his heart failure, Silva began to experience worsening symptoms in the summer of 2019.<\/p>\n

\u201cWeight gain, shortness of breath, less energy \u2014 these are all classic symptoms of heart failure,\u201d Richards said. \u201cSo we did a work-up of Jack and found that his heart was very weak, but it had also gotten enlarged.\u201d<\/p>\n

Jack had two leaky heart valves and had developed slowed electrical conduction through his heart. It is the solving of such complications on which the multidisciplinary cardiac team thrives.<\/p>\n

\u201cRichards got a hold of everyone and put a team together,\u201d Silva recalled. \u201cThat\u2019s what I like, to be part of a team.\u201d<\/p>\n

\"old
Jack Silva grew up on a dairy farm in eastern Colorado and use to ride horse with his sister. He later became a bronc and bull rider in Wyoming. Photo courtesy of Jack Silva.<\/figcaption><\/figure>\n

Richards collaborated with interventional cardiologists and the valve and electrophysiology clinics to figure out the next steps. An angiogram showed that Silva\u2019s arteries were clear, so there was no need for more stents or surgery. But they also found his valve was too leaky to fix, so one alternative was to implant a special type of pacemaker.<\/p>\n

A cardiac resynchronization therapy (CRT) pacemaker is used for patients whose left and right heart chambers do not beat in unison, according to AHA<\/a>. Heath again performed Silva\u2019s implantation.<\/p>\n

Richards advised Silva to visit with his partners in Aurora, specifically Dr. Amrut Ambardekar<\/a>, an advanced heart failure and transplant cardiologist with UCHealth Heart Failure Clinic \u2013 Anschutz Medical Campus<\/a>.<\/p>\n

\u201cThere have been a number of different treatment options and advances in medications over the years,\u201d Ambardekar said. \u201cWe looked at the MitraClip<\/a> (mitral valve therapy) and LVAD, as well as the CardioMEMS<\/a>, a pressure monitoring system currently in a clinical trial stage at all three of UCHealth\u2019s sites (northern Colorado, metro Denver and southern Colorado).\u201d<\/p>\n

One of the more advanced therapies for Silva could be an LVAD<\/a>, or left ventricular assist device. It is a surgically implanted device that takes over for the main pumping chamber (left ventricle) of the heart.<\/p>\n

Silva decided not to go this direction with his care.<\/p>\n

\u201cLVAD is for the sickest of heart failure patients who can\u2019t undergo heart transplants,\u201d Richards explained. \u201cJack decided that living with a heart pump and going through major surgery was just not what he wanted his quality of life to be<\/a>, which is very reasonable.\u201d<\/p>\n

\"Jack
Jack Silva had to give a few “cowboy” hobbies up when he became a heart disease patient. But he still enjoys driving his tractor in local parades. Photo courtesy of Tina Silva.<\/figcaption><\/figure>\n

Finding the right heart failure treatment for you<\/strong><\/h3>\n

Silva continues to beat the odds, a credit to his heart team \u2014 both inside and outside the hospital \u2014 his attitude, his involvement in his own care, and his support group.<\/p>\n

\u201cOne of the unique things about Jack \u00a0(is that) statistically, his chance to ever making it five years was 50 percent, and making it 10 years with that degree of heart function is 25 percent, if not less,\u2019 Richards said. \u201cHe\u2019s definitely beating the odds.<\/p>\n

\u201cOne reason he\u2019s beaten the odds is who he is and what he\u2019s done to take care of his body despite the situation he\u2019s found himself in. He really cares for his health and advocates for his health. He knows what is going on with his body and pays attention.\u201d<\/p>\n

It\u2019s a lesson that Silva said he had to learn the hard way and why he tells people today that \u201ctough will get you dead.\u201d<\/p>\n

\u201cWhen I was in trouble, I didn\u2019t go to the doctor right away, and it damaged my heart,\u201d he said.<\/p>\n

But since then, he\u2019s led by example and followed every instruction from his doctors and his cardiac rehab team, who have stressed the importance of support and joy in your life.<\/p>\n

\u201cWe can focus on the clinical and medical side of it, but if the patient doesn\u2019t have that outside social support system to help him with daily life, giving him meaning to life, we often see our medical treatments fail. The patient doesn\u2019t thrive like they would. That\u2019s really half the pie,\u201d Richards said.<\/p>\n

For Jack, that half of the pie includes his wife, Tina, his family and his community.<\/p>\n

\u201cHeart failure is a very serious condition that has a high degree of mortality in it,\u201d Richards said. \u201cSimilar to cancer, people are scared when they are diagnosed. But it doesn\u2019t have to mean the end is near soon. We have a lot of new and old heart therapies that are allowing our patients to live longer, happier and healthier.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Growing up, he worked the family dairy with his seven siblings and later became a professional bull and bronc rider. Jack Silva was tough as nails. At 72, the cowboy shares a different message: \u201cTough will get you dead.\u201d Silva stands tall in his turquoise, button-down shirt, black leather waistcoat and veteran-pinned felt cowboy hat. […]<\/p>\n","protected":false},"author":2164,"featured_media":29360,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[335,2923,167,495,3512,811,1013,3300,3511,174,9167],"class_list":["post-29355","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-anschutz-medical-campus","tag-blood-pressure","tag-clinical-trials","tag-electrophysiology","tag-heart-and-vascular-care-cardiovascular","tag-heart-disease","tag-heart-failure","tag-heart-surgery-treatments","tag-heart-transplants","tag-medical-center-of-the-rockies","tag-specialized-services"],"acf":[],"yoast_head":"\nHeart disease patient engages medical team to extend life many years - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Heart disease is serious but not the end. 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