Congenital defect means open-heart for Petoskey teen
Beth Anne Piehl - Petoskey News-Review
Jean Forton can’t figure out what all the fuss is about. She’s fine, really; she feels good, is looking forward to running again in the spring on the Petoskey High School track team. Life is moving ahead, so why is there a newspaper reporter in her living room?
At just 16, her mom Michelle reiterates, Jean has an amazing story to tell. Not many teens experience open-heart surgery, or are fortunate enough to have skilled surgeons for the job in their own small hometown. And some teens don’t survive heart conditions that go undetected until it’s too late. But Jean — Jeannie to her mother, father, Larry, and nine siblings — was among the fortunate, for whom all the pieces came together: Unexpected diagnosis thanks to a cautious school trainer; top cardiac and vascular surgeons anywhere in the world in Petoskey; loving and supportive family and friends; and maybe some guardian angels on the side, according to her mom.
“She is such a special girl to so many people,” said her older sister, Lynne, 21, home for the holidays in late December at the family’s Crooked Lake home.
Jean is the middle child, literally the fifth of the brood that ranges in age from 23-5. She’s the one who never complains, with a delicate nature and easy smile who loves to run.
Back in the fall of 2008, cross-country was starting up for the school year and during two warm-up runs, Jean, a junior, felt a searing pain in her chest that radiated under her ribs. After the second episode, she went to the school trainer who advised her to see a doctor before running again.
After an examination that involved some jumping jacks and running in place, things seemed normal, but the healthy-looking Jean was referred to a cardiologist to make sure her heart was functioning properly.
Dr. Andrew Teklinski, with Cardiology Consultants in Petoskey, ordered an echocardiogram and stress test for Jean. “I thought he’d say it was an irritated rib,” said Jean. Added Michelle, “This was such a surprise for us.”
The only option: Open-heart surgery
What Teklinski found from the tests was a shock to the Fortons. They had known that Jean was often out of breath from climbing the stairs, and sometimes took three-to-five hour naps, which seemed a bit long for such a healthy teenager. She had fainted once after a track meet, but then again, the kids run themselves so hard, Michelle thought then.
But the diagnosis put the pieces together: Jean’s heart was malformed, resulting in severe leakage of blood from the aorta back into the left ventricle. Doctors call it a bicuspid aortic valve, aortic insufficiency and dilation of the ascending aorta. The condition can be fatal, particularly when the body experiences another stressful episode such as childbirth in Jean’s future. It can cause heart damage from the stress on the muscle and other complications. Surgery is the only option.
The Fortons consulted with Dr. Brad Vazales, a cardiac and thoracic surgeon with Great Lakes Cardiothoracic and Vascular Surgery in Petoskey. Vazales would perform Jean’s surgery using what is known as the “Ross Procedure;” the family learned it is a type of specialized aortic valve surgery where Jean’s diseased aortic valve is replaced with her own pulmonary valve. The pulmonary valve is then replaced with cryopreserved pulmonary valve from a donor/cadaver.
In children and young adults, this procedure offers several advantages over traditional aortic valve replacement with manufactured prostheses, according to information from the University of Michigan.
Although cardiac surgeons in this country began using the procedure in the 1980s, the U of M data reports, it is still performed only at a select group of hospitals and centers, including in Petoskey by Vazales, whom the Fortons hold in admiration along with Vazales', physician’s assistant Jim Gracy and all of the hospital staff whose lives entwined theirs.
“We had no option. For whatever reason, she was born with this and our only option was open heart, one of the most risky surgeries, in my mind, for life or death. With Dr. Vazales, we had the best,” said Michelle. “… I think God put these doctors into our lives. Had we gone anywhere else, I don’t believe my daughter would have received the same intensity of care.”
Slated for surgery
In late October, Jean began harvesting her own blood in preparation for the surgery, and the date was set for Nov. 20. Jean said she wasn’t nervous until the night before, but she knew her situation was positive; there is just a 1-2 percent chance of something going wrong, and her odds were greatly improved because of her youth, physical health and strength.
Several of her siblings who live out of the area drove north through the night to be there with Jean, and all 12 family members held tight during the 6-hour surgery. The ICU waiting room was packed with family and friends once surgery began at 7:15 a.m.
“Every hour they’d come out and give us an update,” Michelle said.
During the procedure, Jean’s chest wall had to be cut and spread open to reveal her heart, and she was connected to a heart-bypass machine that kept her organs functioning while Vazales and medical staff replaced her faulty valves.
Understandably, Jean doesn’t recall much of the time immediately following the surgery, and she was hospitalized for six days.
Her family said her positive outlook was inspiring. “Even on her bad days, the nurse would ask, ‘How do you feel?’ and she said, (in a feather-soft voice), ‘I hurt a little bit. It’s, um, a 7,’” sister Lynne said. “She just never complained.”
On the run
Today, Jean bears a 7-inch vertical scar down her chest and some smaller scar holes at the top of her abdomen, from wires that were connected to her heart as a temporary pacemaker to make sure it pumped correctly after the surgery. Those had to be removed by literally pulling them out through the skin, leaving the scars alongside those left by the drainage tubes.
After the diagnosis of the heart condition, Jean missed a considerable amount of school because of fatigue and preparation for the open heart surgery. PHS accounting teacher Jane Babcock has ensured she has kept up on her school work with tutoring and delivering school work. At press time, Jean was looking forward to heading back to class in early January. She has no restrictions on activities and anticipates becoming a member of the track team in the spring.
“I’m a little bit nervous,” Jean said. “I want to see how I’ll do, if I’m good. I’ve been running with a heart problem and I want to see how I can do, now that I’m fixed.”
If the significance of the overall experience is lost on Jean’s youthfulness, it’s not on her parents. “The surgery is a permanent deal. The surgery is a lifelong repair,” said her dad, Larry. “Her heart has been manipulated, tugged, cut and stitched. Sitting in the ICU, watching her heart beat steadily — we understand a lot, but not everything — and that she could recover so well from something so traumatic is remarkable.”