Discussion: George Minarik

Long time Bay Area orienteer George Minarik suffered a serious heart attack yesterday and is being treated at a hospital in Richmond CA. I gather George's condition is quite serious. This was quite a surprise for an otherwise healthy fellow, who competed on the green course at the recent SML championships near Boston.

The family has set up a site for friends and family to register, receive information when it becomes available and post well wishes. To enroll in the site, go to https://www.lotsahelpinghands.com/c/650191/

George's wife Leslie and daughter Sarah, and his very good friends Dennis Wildfogel and Louise Madrid have been at his side, and what I know about this I know from Dennis. George has been an M-60 competitor of mine (and every age group along the way) for 25 years, and one of the nicest guys in the sport (and our sport is well supplied with nice guys).

George was having some breathing difficulties setting controls for the Henry Coe rogaine. He had thought it was exercise-Induced brochoconstriction. He missed Sprint the Golden Gate because of that.

Best wishes to George, Sarah, and Leslie. Given his lifelong athletic history, I'm sure he'll make it.

Thank you Charlie for sharing the news. I'm wish all the best to George and his family!

+1 to him being a very nice guy who has done so much for orienteering over the years. The first A-meet I ever flew to was in Big Basin in California. George was organizing the meet. Sarah and I had concocted a plan that I would fly out for the meet... and my parents actually sent me! I stayed with their family the whole weekend, and remember being so impressed by the huge California redwood trees.

Yes--hang in there George and family.

Here is an update posted by Sarah, George's daughter. Seems like some encouraging news.

Good morning all.

George is showing us what a strong man he is! I want to thank you all for rallying and showing us your love and support. The doctors say this will be a marathon, lucky for us, my Dad is an expert at those.

I will be using this site to add frequent updates and requests. I am happy to say that we have been overwhelmed by your support, and these mass communications will make it easy to communicate to you all. We are currently limiting visitation, until he is in a more stable state, but will be requesting folks to sit with him in the days and weeks to come. We may also need help with simple tasks, like food and errands and we will be able to mange this all from the site.

I will start with a little background for those of you who have not heard.

On Monday night, he woke up with severe chest pain and was brought to Doctors Medical Center where he was diagnosed with Coronary Heart Disease and myocardial infarction of the left aorta. In other words, a very serious and life-threatening heart attack. The doctors and nurses very quickly inserted a stint and removed the blockage. There was damage to the heart and in order to let his heart rest and recover they inserted a balloon pump into the left aorta. This combined with blood pressure medication to keep his heart rate up kept him stable through the night.

This morning the doctors removed the pump and he has reacted well. His heart is beating on it's own. There has been damage to the muscle, but this is very good news. The lack of oxygen is having some side effects on his kidneys, so they continue to keep him on the ventilator. He is still in very critical condition, but we are very hopeful.

He is reacting with open eyes to my mom and I and has been getting a bit feisty during his moments of lucidity - he is ready to get better quick.

I will continue to send updates. Keep thinking positive and sending your love.

With gratitude,

Sarah

Thank you Sarah, and Charlie, and I'd like to add to the pile of support.
Best wishes to all.

Likewise. Wishes for a full recovery!

A very nice guy, indeed.

Thoughts and prayers for George, his family, and friends.

Our thoughts and prayers are with George and family.

Best wishes to George and family.

Thanks for the update, I was a bit nervous to open the thread. But George is a strong man and will win the battle. Best wishes and hope for full recovery so we can see him out in the woods again.

Our thoughts are with you, thank you for keeping us updated.

Best wishes to George and Family. Sorry I missed you during the set-up for Henry Coe and at Golden Gate Sprints. My thoughts and prayers are with you.

Get well soon George.

Here is another post from Sarah, as of the end of the day yesterday.

As the day comes to an end, we are counting our blessings and are grateful for another day with my dad.

We are ending the day in good spirits, yet all in the face of the unknown. My dad is an excellent navigator, but we are not out of the woods yet.

George is still heavily sedated and the doctors have opted to keep him sedated and on the ventilator, which will allow him time to rest and for his heart to gain strength. This also means that there has not been much forward progress today. Slow, steady and cautiously we proceed.

Although we look forward to progression, the calm afternoon has brightened my mom's spirits and she has even cracked a smile a few times. We are in good hands. Doctors Medical Center is known to have one of the best cardiac labs in the area and we have been impressed with the level of care that he is receiving. Claudia, my mom's sister from San Diego has been with us since yesterday and is staying through the night. Tommy, my dad's youngest brother from Baltimore arrived this evening and is sitting with my dad at the hospital.

Tomorrow is a day for gratitude and I can say that my mom and I have so much to be grateful for. We are surrounded and supported by an amazing community of friends and family and this has helped us to stay calm and hopeful giving us the strength to pass this energy on to my dad.

Keep the love flowing and raise a glass to my pops as you give thanks around the table tomorrow.

With love and hope,

Sarah

Sarah here. Thank you all for your loving thoughts and support. Keep it coming! More updates later today.

Compared to my first thoughts on seeing a thread named for George existed, the actual contents thereof are a relief. Hang in there, George.

More news from Sarah.

Hello all,

George is settling in well after his transfer to the ICU at Kaiser San Francisco.

He is stable, yet still critical. Not much change to report. He is still heavily sedated, on the ventilator and many drips to keep him stable. The doctors re-inserted the heart pump to assist him during the transfer and there were no complications.

We will speak with the new cardiac doctors in the morning and will have more to report then.

Big thanks to Dennis and Louise who brought us a full thanksgiving spread today. Tommy shared stories of George and we gave thanks for having such an amazing man in our lives.

We are encouraged by your messages and well wishes. Keep em coming. I read them to my Mom and they bring smiles to her face.

More tomorrow.

Sarah

Another post from Sarah, sounding pretty favorable, but a long way to go"

Like the mascot of my father's alma matter, the mighty terrapin, my dad is making slow and steady moves toward the finish.

Today we were greeted with positive news from the nurses and cardiologist. George is still in critical condition, yet the numbers (of which there are many) are all slowly improving.

We understand that they will pull the heart balloon soon. This is another sign that the numbers are better. (Maybe this is due to the fact that the Ravens won last night. ) So we will wait for the next few hours to see how he reacts. If all goes well he will have crossed a big hurdle.

We are doing well at the hospital and are taking care of each other. We feel the love from all of you and enjoy reading all of the messages and well wishes.

More updates tonight once the pump has been removed.

Sarah

And another update.

Good evening all,

We are ending the day with some more positive news. The pump was removed without complications. His blood pressure holds steady and they are letting him rest tonight before assessing the next move. We feel confident in his care. Although things are moving slowly, this is due to the diligence and caution of the doctors and nurses.

Tomorrow they will begin to assess the timeline for taking out the ventilator. They say that his lungs look good and don't anticipate any complications in removing it.

The staff continue to express positive news as well as to caution us to his still critical condition. Keep him in your thoughts and well -wishes. So far, so good.

More news in the morning.

Sarah

A question to Evan or anyone else qualified out there given Evan's latest post detailing the medical circumstances (synopsis: full occlusion of left main coronary artery, most cases quickly fatal, this one not fatal because of collateral artery development, the latter most certainly because of exercise). Would a standard exercise echo stress test (in which they take ultrasound images before and after an escalating treadmill load) have shown the occlusion before the event? The main reason I am asking is because Stanislav Rachitskiy had near 100% coronary artery blockage (sorry don't recall which artery) which was not evident on an echo stress, only on catheter angiography, and the likely reason it was not evident on the echo was because of the collateral arteries.

Wikipedia says

"Most artery flow disrupting events occur at locations with less than 50% lumen narrowing (~20% stenosis is average). [...] Cardiac stress testing, traditionally the most commonly performed non-invasive testing method for blood flow limitations, in general, detects only lumen narrowing of ~75% or greater [...]"

Vlad - not really a qualified comment, but when I had my blockage (95% blockage of the Left Anterior Descending - April 2000), it was only nuclear stress test that suggested the blockage which was then confirmed with a catheter angiogram. Regular stress testing & EKG's did not show any cardiac anomalies and my cardiologist said it was likely because of the collateral arteries that had developed.

My questions come from the understand-and-prevent angle. We were very fortunate George's event didn't occur at Henry Coe with no cell phone coverage amd without anybody within easy distance. We also most certainly should require that rogaine course setters and checkpoint pickers only go out in teams of 2 (perhaps unless they are under 40). Most of them did go out in teams at Henry Coe, or were under 40. George was one of about three exceptions.

Back to Clint—why did your doctor keep escalating the matter, suggesting a nuclear stress test? In Stanislav's case, his symptoms were unmistakeable.

We also most certainly should require that rogaine course setters and checkpoint pickers only go out in teams of 2 (perhaps unless they are under 40).

You're kidding, right?

I am so totally not kidding. I'm not going to have a problem at my event that is preventable/remediable. Most of the course setters and checkpoint pickers at this year's Coe voluntarily opted to go out in teams because they understood the challenges and the remoteness of the venue. We are also very firm in not allowing solos on the 8 hour course, and never on the 24 hour course. We lost some sales, but no sale is worth it.

P.S. I believe all trail runs in our area have an AED at the finish. We gave serious consideration to procuring one for Coe, but in the end decided against it, since the time to get somene with a shockable problem to the finish (or, more likely, the device to the problem) would unlikely be such that a benefit could be derived from the use of the device.

Let's see how you feel about this two years from now. And should it apply to mapping in general?

I feel that I am responsible for my event participants' and staff wellbeing to the extent that is reasonably achievable. No, it should not apply to mapping because mapping is not part of an insured event. Checkpoint placement and pickup are.

Please also note that my stance applies to rogaines set in large, remote, rugged areas without cellphone coverage, not to relatively more vanilla orienteering events. There shouldn't be a difference for competitors vs. course setters/pickers; if you don't want your competitors to be there by themselves, the same should apply to course setters, and the reverse is true, too—no reason for special precautions for event staff if they aren't in place for the participants.

Please also note that my stance applies to rogaines set in remote, rugged areas without cellphone coverage

So, back to my concern (which I obviously should have made more clear), why would you let relatively unexperienced people (i.e under 40), go out by themselves? Shouldn't they be required to have someone over 40 with them for safety reasons? :-)

The age-40 limit comes from the likelihood of a cardiac event. There's a trough in such events between ages of 35 and 40, and they start to go up after about that age. Youngerfolk are more likely to have undiagnosed morphological issues, and almost of these should be either diagnosed or played out by about age 35. I assume (or know with certainty) that my under-40 staff don't have these morphological issues, since these, unlike plaque and occlusions, are diagnosed with remarkable accuracy on ECG and ultrasound.

It's true that there are other dangers out there so perhaps we shouldn't limit the pairs rule to those over 40. After cardiac events (or perhaps before), femoral artery puncture is perhaps the largest risk to rogainers/orienteers, and then perhaps wild animal encounters? and neither of these two would be limited to the elders.

Vlad - my only symptoms were a burning sensation in my throat when doing high intensity intervals, which went away upon slowing down. The first cardiologist my primary sent me to wanted to admit me for an 'exploratory' angiogram after a normal stress test, but that doctors manner didn't inspire confidence in me, so I asked my primary to arrange a second opinion, who in turn ran more thorough testing before calling for the angioplasty.

And for the record, I was in my 30's when I had my episode, with no standard risk factors for heart disease. If we choose to participate in ultra type events, we need to assume a certain level of personal responsibility and acknowledge the fact that unforeseen situations can & do occur - we can't depend upon organizers to protect us from all possible outcomes. If course setters would feel more comfortable in teams, by all means accommodate them, but don't make it mandatory...

With regard to Vlad's question. I am not a cardiologist, so do not know the fine details. However, the teaching point in George's case was that he had symptoms, namely chest pain with exertion, which he had not had before. Although the symptoms are classic for coronary artery disease in retrspect, there was a red herring in that George said the symptoms started after being diagnosed with sleep apnea and started using a CPAP machine. Also George absolutely did not fit the risk profile of a person who should get coronary artery disease. He did not smoke, he was not overweight, he ate a good diet, he exercised, and his parents are still alive. Physicians rely a lot on risk stratification, but in George's case, it probably delayed his diagnosis. As with any statistic, there are outliers. He had a resting EKG which was normal, but had not yet had a stress test. If he had had it, I think it probably would have been abnormal, but I can't say that with certainty. A nuclear imaging cardiac test may have been necessary as in Clint's case. If either of those had been abnormal, he probably would have been scheduled for a coronary angiogram. I think if you can run the Bay Area hills without any symptoms, that is a good stress test in itself. However, George had chest pain and needed further workup which had been scheduled but unfortunately not soon enough. His case has certainly made me rethink that no one is immune to cardiac disease, no matter how good a life style one has.

we can't depend upon organizers to protect us from all possible outcomes

Indeed, but the organizers can and should take normal and expected precautions. If an AED is standard at most public places and at marathons, it should perhaps be expected at a trail run or an orienteering event that attracts participants above a certain number. If the participants are expected to go out in teams, course setters who are in similar circumstances should go out in teams, too.

Back to George -
- let's hope the news continues to be positive. We all want to see George's smiling face again soon. Best wishes to Sarah and Leslie.

Yup, one of the things I look forward to each year at the QOC events is knowing that George will show up in the results at some point, or maybe two, if the timing is right. And, if the timing is really good, I will actually run into George at the event as well.

Here is today's update from Sarah:

"Today was a good day", said the cardiologist, Dr. Ku. Now those are words that we are happy to end the day with!

Details: The fever has made no signs of returning, thus any possible infections seem be getting taken care of by the wide-spectrum antibiotics. We are still waiting for bacteria cultures, which is actually a good thing. Major infections tend to rear their nasty heads very quickly once cultured, so the fact that we have not gotten anything affirmative, means that the infection is not of huge concern at this time.

They also continue to monitor his lungs - specifically for fluid and breathing capacity. They are continuing to remove fluid from the lungs and have been able to decrease his supported oxygen through the ventilator from 100% down to 50%! This is great news and means that he is moving closer to having the the ventilator removed.

As for the stroke, the neurologist spoke with my mom today and said that the stroke was quite small and that he is optimistic about improvement.

Kidneys continue to gain strength and are functioning well.

And, my Dad's strong and courageous heart is doing quite well considering the circumstances.

All in all today was calm and steady. We prepare for this new week with renewed hope and surrounded by all your love and support!

Sarah

These encouraging messages are great to hear. Thanks for sending them, Sarah, and for posting them, Charlie! Best wishes to George! The whole US orienteering community is rooting for him.

Best wishes George and thank you for all the posts Sarah, Charlie, etc. Get well soon!

Best wishes to George and speedy recovery! Best wishes to Sarah and Leslie too. Your courage and support help George all the time.

Another update from Sarah:

As my dear cousin Nicole wrote yesterday, "Uncle George, if love alone could heal you you would be back to your old self already!"

Can I get an amen?! Now that is the truth.


My greatest moment of the day was when my mom called to tell me that my dad had started to move his right arm - this is the arm that they thought had lost movement during the stroke. Right there on the street I started jumping up and down with a big smile on my face - I hadn't smiled like that in a while. Suffice to say, this is an indication that the stoke was minor and that he is recovering. Although of course, a full assessment can't happen until he is off of the sedation.

Bill, George's brother arrived today and will be staying with us for the next week - I imagine this will perk my dad up a bit.

Notes from the nurse: Another stable day, with numbers improving slightly or holding steady. Cultures taken Saturday showed positive for pneumonia, which is common for patients on a breathing tube for extended periods of time. George has been on antibiotics for 4 days now and they now have it under control.

I may sound like a broken record, but THANK YOU for all of the support - there is more and more everyday!

In good spirits,

Sarah

Tonight's update from Sarah: I will keep this brief tonight as I am practically falling asleep as I write this. All is stable and pretty much the same. George's heart is showing small signs of gaining strength. The fluid in his lungs continues to decrease as well. He was a bit more lucid this evening - seems to recognize me. The nurses say he was following commands earlier in the day. All good signs. He looked very peaceful when we left.

Good night to all,

Sarah

Leslie & Sarah,

We just became aware of George's difficullties and are pulling hard for his recovery.

Rick Worner
Linda Kohn

Another update from Sarah:

The first of the month is proving to inspire some firsts in my fathers recovery. Here is a morning update from Bill, George's brother:

"George is having a good morning! Slow and steady is the situation, however his response to verbal commands are immediate and much stronger. He is comfortable even with lesser meds. He indicated that the leg constrictors were bothering him and the nurse took them off. George started wiggling his toes, stretching his legs and brought his knees up high in an exercise move. WONDERFUL!"

And again: An update from my wonderful Uncle Bill who spent that day with my dad and gave my mom and I an opportunity to rest and wrap-up loose ends:

"Today I found myself grabbing cards to fill out for the “Nurse of the Month Award” at Kaiser Hospital. My only problem was which nurse to enter, because, across the board, the care is phenomenal.

The significant development today started with some jerky movement of George’s legs. Try binding the legs of any champion orienteerer and you will quickly see that, “That ain’t gonna work for long”!
Our attentive nurse Lisa asked George “Do you want me to take these leggings off”? To my surprise and glee, George nodded. So off came the restrictive bindings and I asked George if he could wiggle his toes. Those ten little piggies sensed their new found freedom and wriggled happily away. This was followed by some amazing stretches that had me thinking George was planning to run a quick 5K before lunch. The hi ghlight of the day was when he brought his knees up high to his chest, something that after 10 ten days of constriction seemed to be the greatest stretch a body could have. If he could have given a satisfied grunt with all of the tubes in his mouth he would surely have. If you have ever seen George dance, then you know that these movements were not pretty, but today the judges gave him a perfect 10.

This morning’s events gave us a break from the hard reality that liquid is still in his lungs and his heart is damaged. At what levels will not be known until tubes can be removed and George can show and tell us how good or bad it is. We just don’t know when…

As for me, I choose to believe that things will turn out as good as the fine food I am enjoying when coming back from the hospital. You NorCal folks can sure cook! Thanks. Your words and actions mean a lot."

Lot's of love and wishes for a smooth recovery to George, Leslie, Sarah, and family!

My thoughts are a lot with George and his recovery, but also Leslie and Sarah, and I keep checking at least twice a day what the news are. Charlie, thanks to you too, for "lending" your AP log!

Also checking every day. Best wishes to George and family for a speedy recovery.

George update from Sarah:

Well folks, my dad has had enough of all of the turtle references. No more of this 'slow and steady' progress - my dad is ready to get out of the woods and to do it at a winners pace. This all to say that we have been blown away by his progress over the past two days.

Yesterday they began to lower the sedation and for the first time they were able to do it without him grimacing in pain. He reacted to this change so well that they we able to completely stop one of the sedation medications today. Although he still has the ventilator in and is on many medications for pain, blood pressure and fluid reduction, he has become quite lively. He is able to communicate with us using a communication board that has a printed keyboard and has even been able to write a bit. He is so eager to communicate, yet he is being incredibly patient with himself as it is taking some time for his motor skills to become more fine tuned.

Despite the effort it takes him to 'type' out e ach word on the board, he has managed to use it to joke with us! His saving grace has been the ice chips that they allow him to have and he asks for them regularly. Less than an hour ago, he pointed to the communication board and I brought it to him. He held it in one hand while he typed slowly. First attempt was 'stoocook'. His second attempt had us laughing out loud - 'stock option ice' !!! Ha ha ha. I can't express in words how absolutely wonderful it is to see his fun-loving spirit shining through all of the tubes and meds. Our champion has caught his second wind.

Here is what seems like the best news so far for our friend George:

Drumroll please............. Ladies and gentlmen they have removed the ventilator! (The crowd roars) Whoohoooo!

They removed the ventilator at around 10:30 this morning, so we have spent our Sunday chatting, joking and watching football. Lucky for George the Ravens were playing and they won!

The doctors were able to stop all sedation and pain killers and he is resting quite comfortably without them. He is not yet ready to eat solid food, but that day is just around the corner. He also began some physical therapy today which included sitting up and and some enthusiastic leg exercises. The therapist gave him some socks to prepare him for walking which he has coined as his, "new orienteering shoes".

He has begun to read your messages and well wishes and he is delighted by the amount of love he has received. The reality of his situation is beginning to sink in and the overwhelming support will continue to guide him on the road ahead.

I asked him if he wanted to share anything with his community of supporters and he said, "Tell them - I love them all."

Yep, that's my dad - a courageous fighter with a gigantic heart, that is gaining strength every day.

Awesome!

Way to go, George! We're all pulling for you.

These are very good news!!!!

Yay!

Things are looking up. Here is a report from Dennis from yesterday:

George passed his "swallow test" this morning, and early this afternoon they brought him a meal: turkey, carrots (both pureed, of course), and corn chowder. George ate enthusiastically (though lightly), and really liked the corn chowder, though his favorite was the thickened milk that he had afterwards. Eating tuckered him out a bit, so he rested. But we did have a chance to chat some about a number of things - important and not - and it was just terrific to see that the real George is back! ESPN is on constantly in his room, and George was definitely up on all the bowl pairings and NFL results!

Good to hear! Keep up the pace, George!

Here is another update from Sarah. Things are looking up, but there is a long way to go. We are with you, George!

Our miracle man has proved himself to be too healthy for the ICU! He was transferred to another level last night and is resting comfortably with a great view of San Francisco from his window. He has begun physical therapy that will overtime help him gain the strength to start walking. He is no longer attached to any IV's and the nurse found him standing by the window admiring the view, utilizing his new found freedom from cords and tubes.

As he is now out of critical care, I want to share with our community our outlook for the future based upon the events and the many opinions of the doctors and nurses. As much as we continue to stay positive, and I believe this has had a significant impact on my dad's recovery process, it is also very important to be realistic. Dr. Arnold, the first cardiologist we worked with at Doctors Medical Center in San Pablo made it very clear to us that most people do not survive this type of heart attack, and this has been confirmed by man y others along the way. My dad's fitness is what ultimately kept him alive and that level of training, stamina and determination will prove to be imperative to his recovery, which will be gradual. We do expect my dad to surpass all expectations - with that said his heart has been damaged and the doctors would be happy to see him able to take short walks in the future - and it is possible that this is as good as it will get. It is important that we encourage him on his recovery, yet we do not want to set expectations so high that he feels that he cannot meet them. So once again we are back to slow and steady.

My dad is aware of the challenges he faces and he has met this reality with patience, positivity and compassion for himself. He is VERY determined to make the best of everyday and continues to express his gratitude for all of the amazing staff that have been at his side and for all of you who have been so supportive in taking care of me and my mom.

I exp ect to slow down on the updates, a few a week with just the highlights :)

Sending all of you our love,

George, Leslie and Sarah

George is home! The latest from Sarah:

After 20 days in the hospital my dad is finally HOME!!! I have few words to express how happy we are. I have been singing this song all day, and now maybe you will too - http://youtu.be/4306i99LMXo. I have also added a wonderful picture from today that you can see on the site. LOVE to you all!

Here is a recent letter from my Uncle Bill:

These have been the toughest of days. George fighting for his life and the rest of us hanging on and doing what we can.

George has done his part by surprising doctors, amazing nurses, exceeding our hopes and fulfilling our prayers. As for the rest of us, the generous meals, kind messages and loving thoughts and prayers have been an encouragement beyond words.
Leslie and Sarah went from shock to dealing with the realities of not knowing the results of disheartening events and being at the epicenter of this earthquake. My ten days with them have been a blessing and I am stronger for seeing not only their love f or my brother, but for their resolve and determination. They are astounding people.

George will be coming home soon and he will not be the same. None of us will. He understands his challenge and has already laid a plan in his mind that everything moving forward for him will be hard earned, but they will move forward. He will need our help and support, but be prepared to see George maybe at his finest. He may not be what he was, but inside he is so much more than the champion we knew.

I am back in Maryland and treasure the 10 days that I spent in California. His old pals, Dennis, Ramsay and their wives made such an impression as they shrunk, as only good friends can, the past 40 years. The great meals after an exhausting day at the hospital was more than appreciated and soon George will be able to taste that wonderful homemade Nor Cal cuisine so many of you have been cooking up (Thanks Louise for organizing).

Already George is beginning to see that in s pite of it all, life can be great. During these dark days, Sarah was to interview for a fulltime position at Fair-trade. The timing frankly was horrible and interviewing was not at the top of her list. In a incredible display of courage, Sarah took a cue from her Dad, sucked it up, nailed the interview and got the job. I love these Minarik and I know you do too.
Thanks.

I haven't posted any news from George for a while, but I have a message here from Leslie. George continues to have a long road ahead of him, but a lovely family and lots of friends pulling for him:

George has been in the ICU at the Oakland Kaiser for 9 days. The did get 2 liters of fluid out of his right lung, but have not been able to find a combination of medicines that allow his heart to function well enough to provide sufficient oxygen or kidney function. So the will transferring him to the Santa Clara Kaiser's Heart Failure Unit Monday morning to do a few more tests and evaluations. They will also be discussing what devices might work to help his heart function. We won't know how long he will be there until they see him. He wants you to know that he is in good spirits and appreciates so much all of your support and well wishes, as do Sarah and I. Take good care of yourselves. Love, Leslie

George just received the news yesterday that he has been accepted to the wait list for a heart transplant at Stanford. He has been in and out of the hospital ever since his major heart attack in November, rarely being out for more than a week. He has been in chronic heart failure since his heart attack, since just too much of the heart muscle was damaged for the heart to be an effective pump. Normally the left ventricle expels about 50% of the blood it contains with each contraction, the so called ejection fraction. George's is about 20%, and as a result blood backs up in his lungs and he gets very short of breath. The doctors have been trying to find the right combination of drugs for him to stay out of heart failure, but have been unable to do so. His last combination kept him out of heart failure, but it also lowered his blood pressure so much that the kidneys were not getting perfused enough and he was developing renal failure, plus he had no energy and was constantly fatigued. He now has a portable pump that injects a drug called dobutamine into his blood stream. Dobutamine increases the contractility of the heart muscle, but must be given intravenously. It also increases the chance of a cardiac arrhythmia, and is usually only given in an ICU with constant cardiac monitoring. They have placed a defibrillator in him, so if he does get an arrthymia, hopefully it will automatically shock the heart back into normal rhythm. Obviously, this is not an optimal solution. Since he is in generally good health otherwise, with no chronic diseases such as diabetes, emphysema, liver or kidney disease, he is considered a good candidate for a heart transplant. He does not know how long he will have to wait, but they told him, it probably won't be over 6 months. Of course, this was not an easy decision, since it will mean major surgery plus all of the potential complications of being immunocompromised because of the anti-rejection drugs he will have to take. But it does offer him the possibility of a more normal life. George has been remarkably upbeat during this whole episode, and always has his usual broad smile when you see him. He is with Kaiser, and has nothing but praise for the doctors and nurses he has had. He has been going to Kaiser in Santa Clara, about an hour and a half from his home, since that is Kaiser's heart failure/heart transplant center, and says that is a marvelous facility.

Thanks Evan. Lots of interesting information. Your post prompted me to do a bit more research on heart transplants. All and all, it seems like a much more routine operation these days. Hopefully George will maintain his sunny attitude through the whole procedure.

It is interesting that
- there are only 3000 people in the US on the waiting list, of whom 2000 should get new hearts this year
- a donor heart cannot be without blood circulation for more than 4 hours. So recipients have to remain constantly available and ready
- there's now a 75% survival rate after 5 years
- those of us over 65, forget about filling in the donor forms...they don't want our hearts anymore.

they don't want our hearts anymore

But maybe other parts are still okay? Failing all else, donating one's body to a medical school for new doctors to learn on is always helpful, and according to friends of mine in the profession, likely more useful in the big picture than organ donation.

I haven't posted anything about George in a while. He has had a very difficult recovery period from his heart attack in November, and he has been on the waiting list for a transplant. It appears the day may have come, and Sarah (his daughter) has sent the following update:

Hello all,

Earlier today I was riding my bike through Oakland and thinking to myself that this was definitely the best day of 2012 yet, the sun was bright and warm, my poppies were blooming and despite all of the ups and downs of the past several months, my family was doing great - I was soon to find out that this was to be truer than I thought. At 2pm today I received a call from my mom that Stanford had called and they had a donor that they thought was a good match. By 3:30 we were at Stanford and preparing my dad for the excitement ahead. My dad will soon have a strong, healthy new heart!!! He is beaming with excitement as he looks to his new beginning. My oh my, we have such a strong and positive man on our hands!

Currently they are evaluating the new heart with many tests and preparing my dad with many examinations and tests as well. While they believe the heart to be a good match they will be making the definitive decision once all tests have be en done but want to have my dad ready to go once the okay is given.

Here are the details about the surgery: They plan to take my Dad into the OR at 11pm tonight and begin surgery at Midnight. The surgery will take approximately 6 hours so he should be out around 6am. It will then take him about 2 hours to come out of sedation at which point they expect to take out the breathing tubes. Once they have taken the breathing tubes out they hope to have him up and walking around shortly thereafter to assist with circulation and prevent blood clots.

He will be in the ICU at Stanford Medical Center for 24-48 hours and then transferred to general care for about a week. Once he is released from Stanford he will be staying at a hotel in Cambell, very close to Kaiser Santa Clara, for 30 days so that he is close by if any complications are to arise. He will have a handful of friends and family acting as full-time caretakers during this time. Over the next week will be sending o ut requests for people to relieve the care-takers during the day by taking George to appointments, grocery shopping or just for company. We will put the request out through our on-line calendar.

His recovery could come with many negative side effects, but George is looking fantastic and is the strongest he has been since November, so he is in the best shape possible for this procedure.

His doctor, Dr. Oyer (http://stanfordhospital.org/profiles/Philip_Oyer), has performed more heart transplants than any other doctor in the US and has great credentials. The managing nurse explained to us that the team of surgeon’s is VERY meticulous and if they have any reason to doubt the match of the new heart with my dad before surgery they will cancel the procedure until they find a match that they feel is the best one possible.

Once I hear the final word I will post an update.

So prepare your good thoughts, your prayers and whatever method you prefer for bringing about the best possible outcome. Tonight’s gunna be a long one and we are ready!

With love, hope and anticipation,

Sarah

Sarah sent an update a couple hours ago saying George is still in the OR. Should be out any time now.

Here is another update from Sarah:

We made it through the night folks!

We just spoke to the lead surgeon and the procedure took place without any complications. We will be able to see him in less than an hour and he should be awake this afternoon with the breathing tubes taken out this evening.

In some ways this was the easy part - routine and controlled. The greatest challenge for George will come in the recovery. There are inherent risks involved including uncomfortable potential side effect such as tremors or seizures as well the possibility of rejection of the new heart. Despite the challenges ahead we know he has some of the BEST care possible and now we must just be patient, get rest and take care of each other.

Thank you all for your love and thoughts throughout the night. Please envision his body accepting this new, younger heart over the next few days - these will be critical.

We have absolutely gorgeous weather here at Stanford today - so grateful for sunshine, life, modern medicine and good people.

I will continue to update with progress.

With a big grin,
Sarah

George- we are thinking of you and wishing you a speedy recovery! Hang in there! Get better soon!
- Dasha and Clem

Latest update from Sarah:

This morning they took my dad off of sedation and removed the breathing tube. He is now awake and talking albeit with difficulty. He recognizes my mom and I yet is not quite aware of what has happened to him. He does seem a bit confused but this is common after being sedated.

Later today he will work with a speech pathologist and have a swallow test to see if he can eat on his own or if he will need a breathing tube. We are letting him rest in the meantime so that he is nice and rested for the test.

He has a pump in his heart that is lessening the load so that his energy can be put towards recovery. His surgeon will look at him later today to determine when the pump can come out.

He has a 1:1 nurse with him 24/7 and during the next few days the doctors will be allowing him to rest while monitoring for any side-effects.

We will continue to update you all periodically.

Thanks for the abundance of love-filled messages and well-wishes. They keep us going strong!

Sarah

George seems to be doing well with his new heart. Here is the latest update from Sarah:

Yes - My dad began marching forth with a strong, healthy, younger and larger heart on March 4th, 2012. What a lovely coincidence - I can heartly beleive it ;) (a little heart transplant humor)

He is progressing quite nicely and his confusion has subsided. Yesterday he was a bit delusional and confused and would not believe that he actually had a transplant. Today he is much more lucid, talking more coherently and remembering to say please and thank you before and after his constant demand for ice chips :) They expect to take the heart-pump out on Friday, which has been helping his heart to pump so that the energy can be spent on healing. His progress seems to be right on track with no further complications. We expect him to be in the ICU at least through the weekend and possibly released from the hospital at the end of next week. Once he is released from the hospital he will be staying at a hotel for 30 days that is within a mile of Kaiser Santa Clara so that he ha s ease of access for regular appointments and if any emergency is to occur. During this time we will be requesting assistance with grocery shopping, rides to appointments and relieving the care provider for an hour or two. We will post that request to the calendar once the release date is definitive (which is often only hours prior).

I am saving all of your heart-felt messages and will share them with him when he is ready.

Happy Wednesday!
Sarah

Whilst I do not know George I wish him all the best. One of my Aunties had an early heart transplant and went on quite well for a number of years.

I was interested to see where the US placed in organ donor rankings.What about Canada? Surprisingly we here in Australia rank poorly. Not sure why since it couldn't be a relgion thing as we are for the most part secular and if pushed, most would suggest sport was their religion. It can't be due to ignorance either because we have the option to nominate on our drivers licence. I'm not sure why we do so badly. Perhaps I should ask my non-donor registered fellow coutrymen.

It seems such a waste not to nominate as a donor when good people like George can have such a great opportunity to regain health due to such a wonderfull gift and such skilled surgeons.

Another update from Sarah. Good news!

George had the heart pump removed yesterday and was able to sit upright today and begin physical therapy. As you would expect, he is quite happy to be moving around and is wearing a huge grin on his face.

Oh happy day!

Surprisingly we here in Australia rank poorly. It can't be due to ignorance either because we have the option to nominate on our drivers licence.

Crikey, tick a box? On a form? That sounds like a lot of work. She'll be right mate, I'll do it next year.

So good to hear that things are going well!

Things are looking up! Latest info from Sarah. Go George!

My dad has bid farewell to the ICU. We are all hoping that he won't be visiting again for a VERY long time. He has been moved to a transitional unit and it looks like he will be out of the hospital by the end of the weekend. His ICU nurse today said that he was the best heart transplant patient he had seen yet! He does not cease to amaze.

Thank you to all who have signed-up to help us over the next month! This would be SOOOO much harder without you and it puts my dad's mind at ease to know that my mom and I are well supported. We still have many dates available so feel free to sign-up on the calendar if you feel compelled.

Spending time with my dad these days it quite nice. He is making faces at me as I write this. He definitely has retained his sense of humor through all the pain. He even made a surprising discovery this morning when a nurse offered him a morning paper - his eye sight has improved dramatically. He mentioned it to the doctor and the doctor said he was signing himself up - Ha!

I hope this reaches each one of you well!

G'night,
Sarah

Nice to hear! Thanks!

Here is an update from Dennis. Long way to go, but things are looking up for George:

George is starting to look too good to be in a hospital. The plan is for him to be discharged tomorrow. If all goes as planned, he would then start his 30-day stay at the Larkspur Landing Hotel in Campbell.

George is in great spirits and looking forward to getting outside, even if only for a little bit. We got a look at the mask he'll be wearing, and all I can say is, if you're afraid of insects, you might want to stay away :-) Seriously, it's a long road ahead, but George is ready for the next step.


Stay tuned. We'll try to let everyone know as soon as he is released from the hospital.

At last, a communication from George himself! Things seem to be going really well.

Hello to all my dear friends and family.

It is now a month after my heart transplant and I am progressing well. The two major complications that can complicate a heart transplant are rejection and infection. My weekly biopsies do not find evidence of either of these. I am having some of the predicted side effects from the surgery and medications, but these are manageable. I should be another week or so here at the hotel in Campbell and then on my way home. My new heart is healthy and strong and my doctors are saying that I could be back running sometime in the future.

I have been overwhelmed by your support. Even though I have not responded to most of the messages, each e-mail, phone call, web posting and visit has been a boost for me through the past five months. I will never forget what you all have done for me and Leslie. I am an incredibly lucky guy.

Hope to see everyone soon,

All my love,

George

Just wanted to add to Charlie's post a thank you to the orienteering community. I have known for 30 years that Orienteers were a special slice of humanity. But I could not have imagined, the support and compassion that has come my way from all of you. In particular, the members of BAOC who have given us assistance and/or visited most every day in the past months. Leslie and I will be forever grateful.

See you all soon in the woods.

George