Facing the Future with Courage After Heart and Bariatric Surgery

At an early age, Antwine S. knew he was born to sing. When at the age of 28 he was diagnosed with congestive heart failure (CHF), he was determined that would not stand in his way of pursuing his dream.

"For most of my life, singing have just been a part of who I am," says Antwine, 33, who is a member of several local choirs and who has done professional background singing. "I will not let my health problems stop me from achieving the things I want to achieve."

But, as most people with CHF learn, the condition is progressive. As fluids build up around the heart, the heart's ventricles aren't able to pump blood efficiently to the body's organs and tissues. In Antwine's case, his left ventricle wasn't able to contract normally - a condition he later learned is genetic.

“My older brother has CHF, and so do some aunts and cousins,” he explains.

Antwine's weight was compounding the problem. At one time, he was over 500 pounds. "My doctors counseled me about bariatric surgery, an opportunity to correct my weight and get me on the path to being healthy enough for an LVAD implant," he says.

A left ventricular assist device, or LVAD, is a mechanical pump that is implanted inside a person's chest. It helps a weak heart circulate blood to the rest of the body.

Deciding bariatric surgery was the right course of treatment, Antwine scheduled the procedure. But while waiting for the surgery, he began noticing some serious health changes: He was getting tired more easily and was short of breath even doing simple things. "My heart wasn't pumping blood properly. I was going to the hospital more and more frequently," he explains.

During one of those hospital stays in late December 2018, his defibrillator went off. A few weeks later, while still in the hospital, the defibrillator went off five times in a row. "My heart was giving up, and at that point I was a week away from bariatric surgery. My doctors - Dr. Ramsey Dallal for bariatrics and Dr. Alexandra Tuluca for heart - decided to pivot. We did the LVAD implant instead," he says.

"The LVAD is literally a motor that runs my heart," Antwine says. "I have a wire coming out of my belly that is connected to a heart controller and two large lithium ion batteries. I carry these around with me in a backpack. I cannot be without electrical power, ever."

Antwine spent a week in the hospital after his LVAD surgery and then two weeks in rehab, where he learned to walk and manage his LVAD. "Einstein did an excellent job of helping me figure out how to handle all this," says Antwine.

About 10 months after getting his LVAD implant, Antwine was well enough to have bariatric surgery. "I wanted to continue with the plan and have the bariatric surgery so I could lower my weight and take pressure off my heart," he says.

Bariatric surgery was also important for his next step toward wellness: a heart transplant.

"The LVAD gives my heart a break, but I will probably need a full heart transplant. I can't be accepted into the transplant program until my weight is down - you can't have the surgery if your BMI is over 35," he says.

Eight months after his bariatric surgery, Antwine is making excellent progress. "I've lost about 200 pounds and my BMI is down to 50," he says. "Plus, I am off some medications and I no longer have diabetes."

Reflecting about his experiences with two major surgeries, as well as a corrective procedure between the two, which dealt with an infection, Antwine credits the people at Einstein with helping him regain his health and face the future with courage.

"The doctors, the nurses and everyone I met during my stay - well, to me they are family now," he says. "As a man of faith, I was particularly impressed by those who took time to pray with me and comfort me, including Tim Robbins, coordinator of the Einstein VAD program, and Rabbi Leah Wald," he says.

Antwine knows he has a long journey ahead. But he is willing to take that journey one day at a time with a thankful heart. "I have been able to sing again. There was a time I couldn't even do that. This entire process has taught me to value every moment and appreciate all the people and experiences that life brings."