It began in January 2020 when David, then 70, was diagnosed with inoperable chronic total occlusion (CTO), complete blockages of his coronary arteries. He, a retired law enforcement officer and traffic-school teacher, and his wife Linda, a registered nurse with adult and neonatal intensive care experience, lived in El Centro where they ran a hospice that she had founded 25 years prior.
“We had an opportunity to buy a house in Palm Desert which enabled us to be near David’s cardiologist at Eisenhower and our twin sons,” Linda relates, noting that they have a third son who lives in Washington. The couple moved in July 2020. Over the next year, David’s health continued to decline.
“If we didn’t get a miracle, he wouldn’t make it,” Linda says. “Then, last summer, our cardiologist told us that, thanks to new technology, Eisenhower’s cardiothoracic surgery team believed they could perform surgery that would restore some quality of life. It would be risky, but David’s condition was terminal otherwise, so we made arrangements for him to have surgery in mid-August of 2021,” she adds.
It was not to be smooth sailing leading up to his surgery, however.
In June, Linda’s younger sister died suddenly, and Linda flew alone to Texas to bury her. The day after Linda returned home, David reported he’d been having blood in his urine. Tests revealed he had bladder cancer and he underwent surgery to remove a 1 cm tumor. Then, about a week after David was discharged, he started experiencing severe chest pain and was readmitted to Eisenhower.
“He was having a heart attack,” relates Eisenhower Board Certified Cardiothoracic Surgeon Daniel Logsdon, MD, who was called in to consult. “He needed bypass surgery sooner rather than later.” A cancellation enabled him to get David on the surgery schedule for Monday, August 9, when Dr. Logsdon and Eisenhower Board Certified Cardiothoracic Surgeon Joseph Wilson, MD, would perform a triple coronary artery bypass and place a stent.
As Linda watched David being wheeled to surgery that morning, the traumatic events of the past few weeks suddenly hit her.
“I went into a can’t-breathe, can’t-talk, can’t-do-anything scenario,” she says, initially thinking she was having a panic attack. “I thought if I could just get to my son who was waiting downstairs in the car, I could talk to him and I’d be okay.” She managed to get from the fourth floor of the hospital to the edge of parking lot and called her son. “By then my chest hurt so much I thought I was having a heart attack. So, while my husband was undergoing open-heart surgery at Eisenhower, my son was taking me to the emergency room with chest pain.”
It turns out, Linda was experiencing takotsubo or stress cardiomyopathy, also referred to as broken heart syndrome. It’s a temporary heart condition often triggered by stressful situations and extreme emotions, causing sudden chest pain that makes people think they’re having a heart attack.
Once the emergency department team ran tests that ruled out a heart attack, they gave Linda medications to help calm her and relieve the pain, and discharged her to home around 5 p.m.
In the meantime, David made it through surgery “wonderfully,” she says. “He was discharged four days later, transferred to Vibra Rehabilitation Hospital for 12 days, and then he came home. Our son from Washington, Dr. Heath Marrs, arrived to care for his father for the next two weeks.”
But the story doesn’t end there.
“I had to be taken to the hospital via ambulance three times after I came home due to low blood pressure or low blood sugar,” David says. “They’d keep me for a few days, stabilize me and adjust my medications, then send me home.”
On the night of this third admission, the Marrs’ son Neal offered to stay with his mother. His presence probably saved her life.
“I went to bed feeling totally normal, then woke up around 1:30 in the morning paralyzed from my waist down,” Linda recalls. “I could move my arms and I knew where I was, but I couldn’t speak, and I had intense pain in my chest and abdomen.
“I managed to turn around in bed, fall to the floor and drag myself on my elbows to the guest room where my son was,” she continues. “I hit the door with my elbow and when Neal opened it, I looked up and mouthed ‘9-1-1.’
“The paramedics were here in no time,” Linda says, noting that the EKG they performed right away showed no sign of a heart attack. “When they brought me in the ER, one of the residents who’d seen me the day of my takotsubo episode was there and yelled for an echocardiogram to check for an aneurysm.”
The resident’s instincts were spot on. Linda had what’s called a type A aortic dissection, a life-threatening condition in which a tear occurs in the inner layer of the ascending aorta, the curved part of the body’s main artery that extends upward from the heart. Blood rushes through the tear, causing the inner and middle layers of the aorta to dissect (split). An aneurysm had weakened her aorta, causing the dissection.
“If not treated within hours, 90 percent of people with aortic dissections will die since the patient loses blood flow to the brain and the rest of the body,” Dr. Logsdon says.
Dr. Wilson was on call when Linda was brought into the emergency department. He, in turn, texted Dr. Logsdon, since the surgeons work in the operating room as a team. It was about 5:30 a.m. and Dr. Logsdon was just getting ready to work out at the gym.
“I recognized the name since we’d just operated on her husband a month prior,” he says.
The surgery to repair the dissection was successful and Linda regained movement in her legs. Within hours, however, she lost all leg movement again, necessitating placement of a lumbar drain in her spine. The drain collected cerebrospinal fluid to reduce pressure in the spinal cord or brain since too much pressure can slow blood flow to the area, leading to pain, weakness and even paralysis. She regained leg movement, only to lose — and regain it — one more time before stabilizing.
While recovering from surgery, Linda also exhibited symptoms of Raynaud’s disease. Her toes and fingertips swelled and changed color, requiring administration of high-dose steroids. She experienced kidney failure, which has since reversed. And she required antibiotics for an infection in her aorta which doctors believe she’d had for several months prior to her dissection.
After a nearly three-week hospital stay, including eight days in the ICU, Linda was transferred to Vibra Rehabilitation Hospital, before returning home to her husband.
“Our son J.Todd stayed with us throughout this time,” added Linda . “Our sons are wonderful caregivers.”
When we spoke in late December, David was wrapping up a 12-week cardiac rehabilitation program at Eisenhower that he calls “the best therapy I’ve ever received. I’m improving weekly.”
Linda is still undergoing outpatient physical and occupational therapy and works with a trainer at her club.
“A lot of people didn’t think I was going to live, let alone walk again,” she says, noting that she still has residual numbness in her legs. “But today I walked into a store to get thank you cards for the doctors who cared for me, and I promised them that I’d walk into their offices before the end of the year.”
“We both have a ways to go, but with Eisenhower’s help, the future looks bright for both of us,” David adds. “We’ve been blessed.”
To find an Eisenhower physician, call the Physician Referral line at 760-568-1234.
The complexity of the Marrs’ cases — and their good outcomes — is a testament to the sophisticated cardiac surgery resources available at Eisenhower Health.
“Our heart surgery program has evolved significantly in recent years, keeping pace with technology advances and state-of-the-art techniques and putting us on a par with major university programs across the country,” says Eisenhower Board Certified Cardiothoracic Surgeon Joseph Wilson, MD, who has led the program for more than two decades. “We’re equipped to perform all aspects of adult cardiac surgery, emergency or elective, particularly mitral valve repair, aortic valve replacement and aneurysm repair.
“We recently recruited Daniel Logsdon, MD, from USC who’s brought extensive experience in aortic aneurysm surgery, and we’ve hired two new physician assistants and a nurse practitioner to work with the program,” he continues. “It all adds up to enhanced quality and access to an even higher level of cardiac care at our institution.”