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Pacemaker puts spring
back in a patient’s step

Oct. 7 was really a red-letter and unforgettable day for me. I thought I was going to die on the operating table during an ICD operation at The Queen's Medical Center.

Actually, I am exaggerating. The implantation of an implantable cardiac defibrillator, a sophisticated heart pacemaker, is a simple surgery with the mortality risk of less than 1 percent.

My apprehension disappeared as soon as I reported to the Cardiac Ambulatory Comprehensive Care Unit, where two registered nurses from my hometown of Wahiawa greeted me in the pre-op room. One was Marie Baysa, the other was Joyce Hong. They are both personable and outstanding nurses.

My worries were also lessened when my daughter, Linda Yoneshige, and her son, Kyle, came alongside my bed and gave a short prayer for me. I'm not a very religious person, my church being the Kalakaua Golf Course clubhouse on Sundays. The prayers really helped.

The implantation of the ICD was first suggested by my family physician, Jason Florimonte of The Wahiawa Medical Arts Clinic, and Atsushi Terakubo of Cardiology Associates after I went to the emergency room at The Wahiawa General Hospital for congestive heart failure on Aug. 23.

My ejection fraction of my recent echocardiogram showed it at less than 15 percent. The ejection fraction is the percent of blood pumped out of a ventricle of your heart with each beat. The normal range is between 50 to 70 percent.

I had been experiencing palpitations and shortness of breath while watching the University of Hawaii football games. I also experienced a constant swelling in my legs. These symptoms, together with the congestive heart failure, made me a possible candidate for a pacemaker.

Luckily, I was referred to Edward N. Shen, a cardiologist and electrophysiologist in the Queen's Physicians Office Building No. 1. Shen, who performed the ICD surgery, is a five-time recipient of the Honolulu Magazine's annual "Top 10 Doctors in Hawaii" award.

The 2 1/2-hour surgery went well, and my overnight stay at Queen's was made comfortable and enjoyable at their new Cardiac Comprehensive Care Center under the professional care of registered nurses Edwina Gosnell, Amanda Curtis and Juanita Ward.

One of my daughters jokingly said to me recently that I am truly the million-dollar man. She was referring to all the money spent on fixing my body -- the ICD implantation, the quadruple heart bypass operation in 1984, hernia operations in 1988 and 1998, stent and angioplasty operation in 1997 and the cataract operation on both eyes in 1996. I'm still in the organ donor program. Certainly, there must be at least one good part left in this body.

The ICD will protect me somewhat from a heart attack for the rest of my life. The defibrillator will kick in whenever my heartbeat falls below 40 and rises above 180. The batteries in the ICD will have to be replaced every five to eight years.

I was able to resume my exercise (walking, line-dancing, taichi, hula) a week after the surgery. I'm not supposed to raise my left arm or do weight lifting, calisthenics or golf for eight weeks after the surgery.

The September issue of the Harvard Men's Health Watch magazine published an article about sudden cardiac death which stated, "Researchers are scrambling to develop new medications, but they have already created a device that can prevent sudden death in patients at risk for ventricular fibrillation. It's the implantable cardiac defibrillator (ICD), and it's already helped tens of thousands of people, including the vice president."

The ICD was first introduced about 11 years ago and approved by the federal Food and Drug Administration only about 2 1/2 years ago.

I'm grateful to receive the ICD, which will definitely improve the quality of my life. However, I don't want to live too long because I want my wife to enjoy the life of a widow. Many of the widows I know look so happy.

All my doctors have reminded me to cut down on the use of salt. Sometimes it's hard because I have two great cooks at home. My wife cooks the oriental dishes and daughter, Sherry Ryan, who lives with us with her husband, Paul, cooks the fancy cosmopolitan gourmet dishes.

Upon leaving Shen's office on Oct. 15, I told my wife, "Amy, wait! I forgot to ask Dr. Shen an important question. Doc, now that I have the ICD, how soon can I take Viagra?" Amy looked at me disgustedly and said, "Forget it!"

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