Malaysian girl Tee Hui Yi can take heart from Mr Loa Nguang Peng’s experience.

She was recently in the news as she was pictured walking around Kuala Lumpur with a trolley bag. Inside it is a 9kg portable battery that powers her mechanical heart.

Last September, the 13-year-old became only the second person in Malaysia to be fitted with a mechanical heart. She was diagnosed with heart failure at the age of two.

Like her, Mr Loa had to strap on a belt with two 3kg battery packs when he was implanted with a similar device more than five years ago.

The 46-year-old bachelor is one of only a handful of people in Singapore to have been implanted with a mechanical heart, since it became available here in 2001.

The National Heart Centre (NHC) is the main centre here for implanting devices.

They are used on patients who suffer from heart failure, a condition where the heart cannot pump enough blood to the other organs.

“The mechanical heart takes over this function. It has an inlet and an outlet, and essentially pumps blood that comes out of the heart’s left ventricle to the heart’s aorta, which then sends the blood to the rest of the body.

The pump’s cables stick out of the body, so that it can be connected to the battery – which is strapped around the body and worn underneath the clothes – or a power source.

Mr Loa had his pump installed in October 2001, after a series of admissions to the hospital for heart failure.

His ordeal started five years before that. In 1996, after a sudden and severe bout of vomiting and stomach pain, he was hospitalised and test results showed that it was a result of heart failure.

There are many causes for heart failure, ranging from blockage in the artery to high blood pressure and heart defects. In Mr Loa’s case, it was suspected to have been caused by a viral infection.

All these lead to insufficient blood and oxygen flow to the heart and cause damage to the heart muscle.

As such, the remaining healthy heart tissue has to work harder to pump blood to the rest of the body. It’s a long-term condition that tends to gradually worsen, as the weakening heart keeps fighting an uphill battle.

With the heart pumping overtime, this usually results in fatigue, drowsiness and shortness of breath.

And because the heart pumps blood to all parts of the body, its failure may lead to other parts of the body losing their function as well.

Mr Loa was treated successfully with medication on that first visit in 1996. The drugs helped his heart pump more efficiently and also opened up the blood vessels for easier flow.

But in 2000, his condition returned and he admitted to hospital again after suffering increasing shortness of breath.

Over the next year, he went from someone who “almost never had to see a doctor my whole life” to someone who had a revolving-door relationship with the hospital. He was going in and out of hospital so many times that he lost count.

By then, his heart was beating at only about 10 per cent of its capacity and his liver function started deteriorating. His kidneys weren’t working well either, causing him to have problems urinating and his feet to swell.

During this time, even the simple act of sleeping was beyond him. Three hours of snoozing would be considered good because he usually felt so breathless that he couldn’t fall asleep.

He would also feel very warm every night, because his body wasn’t dissipating heat well.

“Every night I would be on my bed and stare out of the window. I would think, if I can see the sun when I wake up, that will be my bonus tomorrow. I called it my one-day bonus,” he says.

It was when his condition worsened rapidly in mid-2001 that his doctors decided to implant the mechanical heart.

Usually, doctors treat patients suffering from heart failure, with medication first, followed by surgery to correct the cause, says Dr Lim Chong Hee, the director of the heart and lung transplant programme at NHC.

The mechanical heart or a heart transplant is only for patients who don’t respond to those initial measures and will die if no other steps are taken,” he notes.

The mechanical heart serves as a stop-gap measure, to buy the patients more time while they wait for a heart transplant, or to take the load off the heart to allow it to recover.

Installing a mechanical heart also comes with its own problems, such as blood clots or infection. In fact, after he had the HeartMate device implanted, Mr Loa still had to stay in hospital for about a year because his skin where the cables jutted out was constantly infected.

The worry for doctors was that this infection might spread to other parts of the body and lead to further complications.

But fortunately for him, his heart slowly but steadily regained its strength and pumping ability, and the doctors gradually weaned him off the device by running down the pump’s power.

Eventually, almost a year after he was implanted with the device, an operation was done to remove it. His heart has been beating well on its own for more than four years now.

After spending half a year in recuperation, Mr Loa went back to work, first doing part-time electrical appliance repair for a friend. Six months ago, he found a full-time job as a driver at a nursing home.

“Don’t want to do anything hectic now,” he says with a chuckle, referring to the more physical job he used to have as a cargo hand.

He lost that job in 2000 because of his illness. The treatments cost him more than $20,000 even after subsidies, depleting his Medisave and personal savings.

When things got tough, his younger siblings – he’s the oldest of five – chipped in to tide him over.

He lives with his retiree father and housewife mother. But while they bemoan the tough hand that life has dealt him, the man himself takes a very optimistic view.

Recalling the many months spent in Ward 56 of the Singapore General Hospital after he was implanted with the mechanical heart, he surmised that there was “no point hanging your head down all day”.

“I was told the patient next to me that there were only two possibilities either I was walking out, or I was going to be carried out in a bag,” he says matter-of-factly.

“So there’s no need to think so much, just try to take things easy and stay optimistic.”

He even spent time chatting with nurses in the dead of the night when he couldn’t sleep, listening to some of their personal problems.

As for Tee Hui Yi’s plight, he has this piece of advice: “Whenever you feel down, think of the love and support of your family and friends. A new year brings new hope, so be strong, be brave and be happy.”


Source: Sunday Times © Singapore Press Holdings Limited. Permission required for reproduction.