In 1997, Ronald Westgate was an active 59-year-old living with his wife Mary in Pleasanton, California. "My father's side had a history of heart failure. My father and grandfather both died of heart attacks in their fifties," explains Ron. "I kept in shape because of that, a lot of exercise, biking, hiking, you name it." In the years to come, genetics would prove a stronger force for Ron and his two brothers, Jim and Chuck, also of Northern California. By 2006, all three brothers would undergo heart transplants at Stanford Hospital & Clinics.
Familial cardiomyopathy, a form of inherited heart disease, often leads to heart failure. Heart failure affects nearly 5 million U.S. adults, with an estimated 400,000 to 700,000 new cases each year. In the case of cardiomyopathy, the heart muscle loses the ability to pump blood effectively. Cardiomyopathy is progressive and sometimes worsens fairly quickly. While there are a number of medications that can slow cardiomyopathy's progression, some patients require a new heart to survive.
Journey to a new heart
In 1998, nearly one year after Ron noticed he couldn't exercise as much as he used to, his heart had begun to fail. The year was spent in and out of John Muir Clinic in Walnut Creek. As Ron's condition deteriorated, Michael Fowler, MD, cardiologist at Stanford Hospital & Clinics, took over his care. His treatment included having a defibrillator implanted in his chest to reduce the risk of sudden death.
"My heart had become so weak, it was in real danger of stopping," says Ron. "The defibrillator would fire—there would be these storms of it going off." With the defibrillator doing all it could to keep Ron alive, it became clear that he would require a new heart. After spending days at John Muir Clinic, the Stanford Hospital LifeFlight helicopter was dispatched by Dr. Fowler to bring Ron to the hospital, where he would wait for a heart transplant.
"Ron was the worst," says Chuck Westgate, one of Ron's younger brothers. "He was on a left ventricular assist device for a while, just a survival situation." The Westgate brothers rallied around Ron, and were there when he finally received his heart.
One recovers, another heart fails
Jim watched his brother recover from his transplant with an additional level of trepidation. "My heart failure started in about 1998. I had a minor heart attack. That was an alert for us," Jim explains. "I went through the typical process—getting a pacemaker and defibrillator after Ron had his transplant. That told us that we were getting pretty close."
Jim began seeing Dr. Fowler as well, who put him on the transplant list in early 2000, hoping to prevent the rapid decline Ron endured before his transplant. But Jim's case would have an additional complication. On his 37th wedding anniversary, while Jim was undergoing testing for a new heart, doctors found a mass on his kidney.
"That was really our lowest moment," admits Jim. "More than two years earlier, I had had melanoma. They thought the mass on the kidney was a malignant tumor; they had to go in and take it off."
Jim received prayers from across the Christian ministries he'd been involved with for more than a decade. One week later, those prayers were answered—Jim's kidney was spared and the mass on the organ turned out to be benign. He would be able to go forward with the transplant. On August 4, 2000, Jim left Stanford Hospital & Clinics with a new heart. He credits his successful outcome with the teamwork the Hospital staff displayed while he was there. "I never felt like there was just one person making decisions for me," says Jim. "Seeing how much was done by the team was the most comforting thing for both Nancy and me."
A family at risk
Chuck Westgate was there for his older brother Ron's transplant, and again for his twin brother Jim's. As Ron and Jim got back on their feet, Chuck knew he needed to keep a close watch over his own heart health. Three years passed without incident, and it seemed like Chuck might avoid the troubles his brothers endured.
"I saw Ron go through it and then Jim went next; I thought I would go through the same thing, says Chuck. "The help for me was that I'd seen what they went through—it prepared me."
In 2003, Chuck was in Poland on a mission trip with his church. Like his brothers, Chuck has a very strong spiritual side; he has been a pastor for 37 years. During the second week of the trip, Chuck experienced heart failure. He was treated in Poland, and had a defibrillator implanted when he got back to the states. Two years later, Dr. Fowler added Chuck's name to the transplant list.
"Mentally, I was ready to accept a heart. I knew that, yes, I would," Chuck says. He knows what a difficult decision it is to accept a transplant. Many recipients deal with guilt after a transplant. Stanford Hospital& Clinics provides support groups for transplant patients where they can discuss their feelings. Additionally, a team of social workers meets with patients and their families, facilitating the difficult emotional process each side experiences.
Chuck, just over a year out from his transplant, is still benefiting from the follow-up care he receives from the Hospital. "I have a terrific follow-up nurse. She answers questions and chews me out when she needs to," admits Chuck. "You need that at times; you need a kick in the pants. All of us have a great appreciation for her and everyone at Stanford Hospital & Clinics; we give them an A+, that's for sure."