Man with Congestive Heart Failure Seeks Adult Stem Cell Treatment

By Susan Jenks, Florida Today, August 21, 2006

Powerless to catch his breath, Shelton initially became aware of the fact that his heart was straining while square-dancing one evening.

"He started getting worse and worse," Shelton said, and he was finally diagnosed with congestive heart failure at Cape Canaveral Hospital in Cocoa Beach.

"I overheard one of my doctors talking to another doctor who said I was on a slippery slope," and that is when the 74-year-old Merrit Island resident realized the critical nature of his heart condition. Congestive heart failure afflicts about 5 million other Americans.

His relatives felt a hospice was the best choice, a non-curative care center for those individuals whose life expectancy is not anticipated to surpass six months.

While under hospice care, Strickland read about how doctors use adult stem cells taken from the patients own blood, and through an experimental procedure treat and strengthen an individuals deteriorating heart.

Referring to the $34,500 price tag he said, "it is expensive." The price includes treatment and accommodations for 14 days in Bangkok and is not covered by insurance. “But my kids told me: 'Go for it.'”

He did; and in late April, accompanied by his wife, Carolyn, he left the country for the adult stem cell operation.

This is a final option that less than a projected 200 patients worldwide have searched out. This adult stem cell procedure involves injecting millions of these early-developmental cells directly into his heart. It has the potential to construct new blood vessels and heart muscle by contributing to new blood vessel development and helping to generate new tissue in the heart.

The clinic states that, "overall, our success rate is 70 to 80 percent, as measured by how the patients themselves feel" after treatment. "At least half feel markedly better; another 25 percent feel somewhat better or no worse; and 25 percent have little benefit."

Securing a second opinion from a heart doctor in Brevard County and talking with six other heart patients in the United States who had undergone the same procedure helped him make up his mind. The doctor told him, "If it was worth anything, we would be doing it here," Shelton recalled.

But he was undeterred, and with fluid backing up and accumulating in his lungs and other tissues of the body, Shelton had nothing to lose.

After a sequence of tests to check kidney function and his heart status, blood was drawn from his arm and the stem cell expansion process began. (An average of 20,000 stem cells are extracted during the process and then expanded up to 20 million) A week later the cells were injected directly into his heart.

"They cut a 1.5-inch incision between the ribs, and collapsed my lung, separating it from the heart," he said. "Then they injected the stem cells into 30 different locations -- into the heart muscle, the veins and the arteries."

After a four day hospital stay following the surgery, Strickland was discharged to his hotel where he relaxed for the next few weeks.

Through surgical operation the cells are directly implanted into heart muscle or akin to an angioplasty, the reinfusion is directed through a catheter.

"Generally, those with severe coronary artery blockage get stem cells through a catheter," doctors said, "while those in heart failure, like Mr. Strickland, get a direct injection into the heart."

Now, approximately three months following his operation, his heart is pumping far more efficiently than it did -- a doubling in his ejection fraction from less than 10 percent to between 20 percent and 25 percent -- he already has been hospitalized once since his return, because of fluid accumulation around his heart again.

When asked about his progress so far he stated that, "I can change the oil in my car and put up storm shutters, but that's about it."

But he has been told it will be "a while" -- at least a year -- before the stem cells begin to fix his heart tissue, he said. And he is no longer in hospice care or on daily oxygen.

Now he follows the advice of his heart doctor in Cocoa Beach and sends back his test results to his doctors overseas every three months.

"He said: 'Just stay active and do what you feel you can do,'" Shelton said. "There is no other option."