/ by UK HealthCare
When it came time to replace it with a transplanted one, there was only one place he would trust for the surgery: UK
Congestive heart disease had plagued Reuben Ligon for almost 40 years. It limited his ability to work as a diesel mechanic – a job he loves – and to enjoy time with his family, which includes two sons, a daughter and, now, six grandsons.
It finally threatened his life.
Doctors and nurses at the UK Gill Heart & Vascular Institute and later at the UK Transplant Center had taken care of Ligon, 59, and his failing heart for years, carefully managing the progressive disease and the symptoms it caused. Reuben and his wife Janet drove two hours, each way, from their home in Warsaw, Ky., to Lexington and then back on more occasions than they can count.
In 2011, Ligon had surgery in which doctors implanted a left ventricular assist device, or LVAD, a mechanical pump for people with weakened hearts. His LVAD coordinator, Amanda Hart, became like family to Ligon and Janet.
“She called him ’Ruby,’ and there’s nobody that can call him ’Ruby,’” said Janet. But Hart had helped Ligon through many medical challenges, Janet said, so if she wanted to call him Ruby, that was fine with him.
Ultimately, there was no option for Ligon but a heart transplant. His weakened heart was wearing out. He was put on the transplant list at UK.
Then came a small catch. His insurance company told Ligon it would cover the out-of-pocket expenses for the surgery only if he went to a certain hospital in Ohio.
Ligon did not want to go there. He stood firm. If his life was on the line, there was only one place he would trust – and that was UK HealthCare. Doctors and nurses there had taken excellent care of him for years, and there was no place else he would feel comfortable, he said.
“I wasn’t about to go to Cleveland,” said Ligon. And it was not that he had concerns about that hospital. He just did not want to leave UK and the great care that he – and the entire family – had received there.
“I got great care, always. I couldn’t ask for any better doctors and nurses,” said Ligon.
He also did not want to think of his wife “up there all by herself,” he said. And, Ligon wanted the TLC (tender loving care) for Janet and the couple’s three grown children that they had received at UK as well.
“They absolutely offer the best care so far as the patient but also for the family,” said Janet Ligon, remembering the support, kindness and information she received at UK many times over the years.
So, Ligon and his wife talked to his cardiologist, Navin Rajagopalan, MD, director of the UK Advanced Heart Failure Clinic. Ligon wanted desperately to stay at UK. The people, the trust, the care – he was scared to think of leaving that. Rajagopalan could not have been more comforting, the couple said.
“He said, ‘We’ve been through a lot together, and we want to keep you here,’” Ligon remembered the cardiologist telling him.
Rajagopalan then discussed options with medical and financial colleagues at UK HealthCare.
“Dr. Raj came back to us and told us he wanted us to stay,” said Ligon, choking up at the memory. “They made it work.”
The call that changes everything
When Janet Ligon received the call Aug. 24, 2015, that a heart had become available for her husband, “I could have just sat on the floor,” she said in describing her surprise – and relief.
Transplant coordinator Donna Dennis explained that she would have to talk to Reuben to proceed. Janet knew it would be hard to reach Reuben that day. He was out with her father looking at diesel motors, and cellphone service was spotty. She anxiously waited and kept calling her husband.
By the time Ligon heard the news and returned the call to Donna Dennis, it was midday, Janet recalled. He accepted the surgery and the couple dashed to their car to begin the two-hour journey to Lexington they had made so many times. Only this time, the stakes were higher. This was a transplant – Alexis Shafii, MD, the surgeon who would perform the transplant, would be cutting into Ligon’s chest, taking out his failing heart and replacing it with a healthy one.
Hours later, Reuben's failing heart Is exchanged for a healthy one
Surgery was scheduled for 4:30 p.m. – only about four hours had passed since Reuben said, “Yes.”
“As soon as we got there, there’s a roomful of people,” Janet recalled. “And then at 4:30, they were wheeling him down the hallway into surgery.”
Ligon got “a little emotional” before surgery, his wife learned from Amanda Hart. Because he was already in the operating room, she could not be there to comfort him. But Hart was, so she held his hand.
Hart said she felt emotional, too. She had met Ligon when she first started her position “and I could tell right then how dedicated a person he was.”
“He’s very driven and motivated but at the same time, very humble. He would do anything for anybody. When he was rolling down the hall, he said, ‘Now if there’s anyone who needs this more than I do, let him have it instead,’” Hart recalled.
In those tense moments, minutes turning to hours during surgery, information is vital for family and other loved ones. UK nurses provided updates just as often as Janet needed it.
“They would come in (to the waiting room) all the time. They’d update us. ‘We’ve got the old heart out now.’ ‘We’re implanting the new heart.’ There was always someone coming out with an update,” Janet said.
And Hart was there for her, too.
“She was hugging me, telling me he was going to be OK,” Janet said. And, he was. Ligon made it through the surgery in excellent shape.
Hart said she felt honored to be there to support the Ligons. All members of the transplant team have a sense of dedication to their patients that makes her proud to be part of the team.
“I feel like it comes naturally with our program,” Hart said. “Our patients are our family. The empathy is real. It’s genuine. What you get at UK is sincere.”
Hart and other members of the team strive to meet the needs of each individual patient and also each patient’s family. That’s particularly important with transplant patients, she believes.
“It’s such an amazing experience to be in a room with a patient when they are about to undergo a life-changing surgery. There can be a lot of anxiety,” Hart said. She makes sure to evaluate the needs of the patient and to respond accordingly.
Just as she held Ligon’s hand pre-surgery, she will sometimes talk quietly and reassuringly with other patients.
“I like to tell them that ‘We’re going to take great care of you and I’ll see you when you wake up,” she said. Sometimes, a patient will feel sad and needs to grieve. Hart aims to respect the emotional needs of the patient as she meets their medical needs. “My motto is, ‘I will treat every patient like I’d want my family to be treated,’” she said.
It’s a pervasive attitude, the Ligons believe.
After Reuben’s surgery, the nurses were so attentive once he was settled in his room that the Ligons said they will never forget the surprising touches and kindnesses they showered on them. As they look back, there were so many attentive nurses and aides they could not even begin to count them.
“Even the people who clean the rooms all have a special way about them,” said Janet. “You get the sense that they really care.”
At one point a few days after surgery, Ligon was craving a biscuit and gravy. One of the nurses heard him talking about one, and voila, the next day, she appeared with a biscuit and gravy.
Dr. Rajagopalan, as the medical director for heart transplantation, was in their eyes the maestro coordinating all details throughout. He calmed the Ligons when they were anxious or scared, and he took time to answer every question they had.
“He’s this really big, tall guy. He has a big, strong voice. But he talks to you person-to-person and makes sure you understand things,” said Janet.
"We remember our work is not in vain"
Rajagopalan credits the entire transplant team, from dietitian to social workers, to nurses and surgeons, as being very committed to the program.
“We’ve all seen people who have been saved from dying,” he said, “and we remember that. We remember our work is not in vain.”
The team stresses communication, said Rajagopalan, among its own members and with patients. At the Tuesday morning staff meeting of doctors, nurses, dietitian and the various therapists who will help to restore a patient to good health post-transplant, “everyone has a voice,” said Rajagopalan. “We want everyone to know that their input matters,” he said.
They also want the patient to know that his or her concerns matter.
“We explain, we answer questions, we take our time,” Rajagopalan said. If patients and their families have questions after-hours, they are encouraged to contact their doctors.
Ligon was close to being ready for discharge in early September 2015, and was hoping he could be home in time to spend Labor Day with his grandchildren.
Discharge after surgery always takes time, but particularly so after a heart transplant. Patients often are discharged but then stay nearby so they can be close to the hospital for follow-up care after surgery.
Janet said that Rajagopalan told the couple, “‘I’ll make it happen, even if I have to pay for your motel room,’” meaning that he would make sure Ligon would be out of the hospital that Sunday, even if it was too late in the day for the couple to travel.
“He emailed us throughout the day, saying everything’s great, we’re going to get you out,” said Janet. And he did. The Ligons spent the holiday with their children and grandchildren.
Life with a new heart
In June, the Ligons went to Myrtle Beach for a vacation with the grandchildren – the family’s first in a decade or more.
“We still look at each other and say, ‘Did you think this day would ever come?’” said Reuben.
The donor and the donor’s family will always be in their hearts and minds.
“He worries about the donor’s family,” Janet said. “Someone lost their child. I tell him ‘God has a plan,’ and he wants to make sure he lives up to that plan. I don’t know if those parents will ever understand the gift they gave. But we do.”
Reuben Ligon promises that he, like his UK team of doctors and nurses, will make sure that the gift of life he received will not be in vain.
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