A NEW LEASE ON LIFE
I performed the first insertion of a MicroTrach in July 1980 at Deaconess Hospital. The patient was a sixty-year-old man whom we’ll call “Don.” Don, who bought and sold engineering equipment, was stricken with emphysema and a chest injury. He had been confined to his home for seven years as he took oxygen through a nasal cannula.
Within a few minutes of inserting the MicroTrach into Don’s trachea and starting the flow of oxygen to the device, he jumped up into a sitting position.
“What happened?” I remember him shouting. “I haven’t breathed like this in years!”
Don had newfound energy after having been fitted with the MicroTrach. Four months after he received it, he required no further hospitalization for two years. When he did return to the hospital, it was for a condition unrelated to the MicroTrach device. Within a few months, Don was driving his car across the county for his job, and he continued to lead an active life until his death from pulmonary insufficiency five years after having received the MicroTrach.4
Other patients who received the MicroTrach also felt immeasurably better immediately after having it inserted. One of the most interesting cases was that of Thomas Stuber. I fitted Mr. Stuber with a MicroTrach in 1989. Mr. Stuber was so debilitated by a condition that prevented oxygen from moving to his bloodstream from his lungs that he had to be transported to Deaconess Hospital in Cincinnati by ambulance. He could not walk, and even sitting in a car for a short while was exhausting for him. Mr. Stuber’s need for oxygen was so great that he breathed through a facemask that could deliver oxygen in large quantities.
Receiving the Heimlich MicroTrach changed Mr. Stuber’s life. Within days, he was walking the halls of the hospital. After treatment, he not only walked out of the hospital, he also rode the several hundred miles home sitting in a car. Six months later, he was able to go to school and was much more physically active. His life only improved from there. Ten years after having received the MicroTrach, Mr. Stuber appeared in a cable television program called The Real Me, which chronicled my life. During the taping of the show, the audience watched a video about Mr. Stuber, who appeared to be in his midthirties at the time of filming. I was deeply moved watching him easily walk around, wearing his small shoulder bag containing an oxygen tank, chatting with friends, and putting on the golf course. During his interview, Mr. Stuber wore a pullover shirt that hid where the MicroTrach exited his trachea.5
“There is no question in my mind that, had the MicroTrach not come along when it did for me, I would not have been able to do things and probably most likely would have died,” Mr. Stuber said in the video. Then he thanked me for inventing the MicroTrach. He said, “There has been no other thing that has helped me more in my ability to be active and to lead a much more normal life than I would have had otherwise.”6
Many other patients who have received the MicroTrach have enjoyed similar experiences of rejuvenation. Before having it inserted, they were weak and fatigued, and their physical activities and social lives were extremely limited. Afterward, they had much more energy and lived normal lives.
“I call it the Heimlich Miracle,” Nancy Horton said to a reporter in 1982 after she received the MicroTrach.7 Ms. Horton, an advertising executive from Fairfield, Connecticut, who was stricken with emphysema was greatly debilitated by her disease and the cumbersome breathing equipment she had been using. But all that changed after receiving the MicroTrach.
“It’s given me a whole new life,” Ms. Horton told the media. “I’m now working at full capacity. I can do everything I did ten years ago and couldn’t do one year ago.”8
Another MicroTrach success story was reported in March 1990, when the Shreveport Times of Louisiana reported on an unusual wedding day.9 Twenty-five-year-old John Stoddard had been sick with cystic fibrosis his whole life and could not leave the hospital. After I oversaw a physician insert a MicroTrach into Mr. Stoddard’s trachea, Mr. Stoddard not only checked out of the hospital, he married his fiancée, Susan Gibbs. At the ceremony, an oxygen machine with a tube leading to his throat was hidden under his tuxedo.
“I thought I wasn’t going to make it, but I made it all right,” Stoddard told the newspaper. “A contagious smile was a fixture on his face,” reported the Shreveport Times.10
Yet another patient who benefited from my invention was sixty-two-year-old Charles Robinson of Naples, Florida. Mr. Robinson was confined to a wheelchair and was suffering from a heart and lung condition that caused his health to swiftly deteriorate. As he relied on an oxygen tank with all the necessary tubes for his breathing, he felt his strength slowly draining away.
“I could never seem to get a deep breath,” Robinson said in a media interview. “I was breathing shallowly as a matter of habit.”11
But after receiving the MicroTrach, Robinson said he felt the improvement in his strength almost immediately. “I suddenly became aware I could take a really deep breath, like I had not taken in eleven years,” he said.12
HIDDEN FROM VIEW AND CHEAPER
In addition to the ease with which they can breathe, patients who have received the MicroTrach have appreciated the fact that they get more breathing time with a portable tank, allowing them to be more mobile. Also, they can easily conceal the device with a turtleneck or a buttoned shirt. I once lectured on the MicroTrach at Yale University Medical Center, where I demonstrated the device for the media. Afterward, I said, “One person sitting here is taking oxygen through a MicroTrach right now.” The reporters looked around the room, unable to detect who it was. Then, a patient from New Haven identified herself. She had been breathing normally with her small oxygen tank hidden in her purse.
Figure 15.3. Easily hidden: When patients wear clothing around the neck and store the oxygen tank in a shoulder bag, no one is aware he or she is taking oxygen with the Heimlich MicroTrach. (Photograph courtesy of Robert Horton.)
Dozens more patients benefited from the MicroTrach thanks to a study that was conducted by the University of Pennsylvania, both Beckley College and Beckley Hospital in Beckley, West Virginia, and the Massachusetts Department of Public Health in Boston involving forty-three individuals who were severely ill with COPD. Most were disabled miners who had black lung disease, emphysema, or both. Once a month, I came to Beckley, where I performed several MicroTrach insertions. The study followed the subjects from July 1981 through October 1982, after which time the device showed “significant improvement . . . for experimental patients and declines for the control group [who had not received the MicroTrach].” That is, patients who had received the MicroTrach experienced greater independence of daily activities, such as bathing, putting on socks and shoes, and rising from a chair. They showed improved ability to carry on normal activities without assistance, such as stair climbing, walking from house to car, eating at the dinner table, and completing meals without stopping due to shortness of breath. All the control-group patients, however, showed declines in those same activities. The study also showed that medical costs were reduced, as subjects who received the MicroTrach spent fewer days in the hospital than those in the control group.13
Interestingly, when the study concluded, I inserted a MicroTrach into the trachea of a man from Beckley who was a board member of the Benedum Foundation, which had funded the MicroTrach study. The man, who was in the advanced stages of lung disease, was so impressed with the results of the study that he wanted to receive a MicroTrach, too.
In 1982, I spoke at the annual meeting of the American Broncho-Esophagological Association meeting in Palm Beach, Florida, where I reported on fourteen patients who had been fitted with a MicroTrach. The group was comprised of male and female patients who were aged forty to seventy-seven years. Before receiving the device, all had been housebound and required wheelchairs to move around. After following the patients for two months to two years, I reported that thirteen of the patients were ambulatory and returned to many of their normal activities. What’s more, patients’ needs for oxygen were reduced
by nearly 60 percent while maintaining normal arterial oxygen levels.
As was found in the Beckley study, medical costs were also reduced. Before receiving the MicroTrach, one patient’s oxygen needs cost an average of over $400 per month; after receiving the MicroTrach, her average costs were only $145 per month. Furthermore, the patient previously had been hospitalized for nineteen weeks at a cost of $33,000 during the year before receiving the MicroTrach; during the first eighteen months after receiving the MicroTrach, she required no hospitalization for her pulmonary condition.14
My address to the association was reported in a July 9 article of the Journal of the American Medical Association. The journal commented that the MicroTrach “promises to free many patients with [COPD] from their reliance on cumbersome tanks, nasal cannula, and face masks.”15
In the late 1980s, I conducted a more extensive study in which I inserted MicroTrachs in more than two hundred patients at Deaconess Hospital in Cincinnati and followed their progress over a six-year period. The study, which was written up in the medical journal Chest, showed the following benefits achieved by patients who received the MicroTrach compared to those who had been taking oxygen by way of nasal cannulas:
no major complications or deaths
virtually no oxygen waste
patient compliance was superior due to no nasal irritation and improved appearance
patients increased activity and resumed normal sleep habits
returned sense of taste and smell and improved appetite
required approximately half as much oxygen
avoided accretion of large mucus balls
decreased hospitalization and lung infections
instillation of saline-solution cleaning method brought on coughing, which expels mucus16
Compared to conventional oxygen delivery systems, the MicroTrach—which costs $50–$150—requires less oxygen at less cost. And patients can rely on it for continuous, twenty-four-hour oxygen delivery because it has been found to remain in place at night.
THE NEED FOR PATIENT ACCESS
So, you may be asking, if this idea is so sound, why aren’t people all over the world using it? Unfortunately, as most medical inventors know, coming up with an idea is only half of what it takes to get a product to market. Allowing patients to benefit from the MicroTrach means finding a company that will manufacture it. Over the years, a handful of companies have expressed interest and even begun manufacturing it, but ultimately they felt the selling price was too low for them to make a profit, so those companies gave up on the idea.
I’m pleased to say that, today, one manufacturer has expressed a strong interest in producing the MicroTrach and is looking at the cost to get it to market, so I have not given up hope that this device will finally be made available to the millions of patients who need it. In fact, I believe that the MicroTrach will become the technology of choice for most patients requiring oxygen. I know this because I have received letters from patients (and their loved ones) who have lived with lung disease and have been fitted with MicroTrach.
Martha Simmons of Aurora, Colorado, is one such correspondent. In 1981, I inserted a MicroTrach in her mother, who suffered from emphysema. Ms. Simmons wrote in a letter dated September 2, 2008, that her mother was a proud woman who often stayed at home because she did not want to endure the glances of others when she went out in public wearing her nasal oxygen apparatus. After the MicroTrach was in place, however, Ms. Simmons wrote that she was “somehow set free from her terminal medical condition.” Ms. Simmons said her mother’s stamina improved, and the opportunity to hide her medical condition from others did wonders for her self-esteem.
“I can honestly report that thanks to you and your transtracheal oxygen procedure, my mother experienced an additional five wonderful years of life with her family and friends,” wrote her daughter. “Each of the Simmons family members is most grateful to you, Dr. Heimlich, for giving us five more years with our beloved mother. What a gift, the gift of life!”
Figure 15.4. Keeping it simple: The Heimlich MicroTrach and the Heimlich Chest Drain Valve are two devices that have improved and saved the lives of many and will continue to do so. (Photograph from Jan K. Herman, Navy Medicine.)
If I have a gift, it’s an ability to see shortcomings in medical treatments—some that have been used for decades—and improve on them.
Throughout my career, I have been recognized with numerous awards for medical innovation. Such awards include the 1981 Distinguished Service Award, presented by the American Society of Abdominal Surgeons; the 1984 Albert Lasker Award; and the 1985 American Academy of Achievement Award. I was the guest of honor at the 1992 National Awards Dinner of the Maimonides Research Institute. In 1993, I gave the 1993 Chevalier Jackson Lecture for the American Broncho-Esophagological Association. I was inducted into the Engineering and Science Hall of Fame in 1984 and into the Safety and Health Hall of Fame International in 1993.
My devotion to saving lives has never ceased. From 1963 to 1968, I was president of Cancer Care, a national nonprofit organization headquartered in New York City that is part of the National Cancer Foundation. While I headed the organization, we worked with congressional lawmakers toward the passage of a bill that was signed into law by President Lyndon B. Johnson on October 6, 1965. The law established centers for research and treatment of heart disease, cancer, stroke, and other diseases. It was an unforgettable honor to have President Johnson personally hand me a pen that he had used it to sign the measure into law—a law that helped many patients with serious diseases find treatment at specialized facilities.
Christian theologian and author Norman Vincent Peale once declared that I had “saved the lives of more human beings than any other person living today.”1
Figure 16.1. A presidential gift: On October 6, 1965, President Lyndon B. Johnson gave me the pen he used to sign into law a bill I had helped bring about, a law that would establish treatment centers for patients with serious diseases, such as cancer and stroke.
Some of my ideas have been adopted the world over, while some have not been fully put to the test. And I’ll be the first to admit that a number are controversial and, in some ways, unorthodox.
Sometimes, though, my ideas consist of studying methods that are already known and applying them in new ways. Just as I used the oral antibiotic sulfadiazine to topically treat eye infections during World War II, I have taken other good ideas and put them to use in ways that others haven’t tried, whether those ideas were invented by me or other researchers. Either way, this kind of “recycled medicine” can be just as effective at saving lives as coming up with a whole new approach. Some examples include using the Heimlich Maneuver to help victims of drowning and those suffering from asthma, teaching stroke victims and other patient how to swallow again, and treating HIV and AIDS with malariotherapy.
USING THE HEIMLICH MANEUVER FOR DROWNING
When I first came up with the Heimlich Maneuver, I hadn’t considered that it could be used to save drowning victims. The first time I took notice of this possibility was when I read a story in the Chicago Daily News that appeared on August 24, 1974, two months after the maneuver was introduced.2
Dr. Victor Esch, the chief surgeon for the Washington, DC, fire department and an advisor on water safety for the American Red Cross, was vacationing on Delaware Bay when a lifeguard brought an unconscious drowning victim onshore. Dr. Esch applied the maneuver on the seemingly lifeless man. “I used the Heimlich technique that I had read about in the paper,” Dr. Esch told the Daily News. “The water gushed out of his mouth and he began breathing. He had to be treated for pneumonia, which proved he had water in the lungs.” The man was treated in the hospital for two days and later released.3
The number of people who drown in the United States each year is alarming: Nearly 3,800 drowning deaths occurred in 2010, the latest year in which statistics are available.4 In 2009, drowning was the leading cause of accidental death in children from ages one to four years.
5 More than half of all drowning victims in the United States require hospitalization or need to be transferred to some other facility for care. Drowning victims can suffer brain damage that may result in long-term disability, including memory problems, learning disabilities, and permanent loss of basic functioning.6
To treat a drowning victim, the American Red Cross and the American Heart Association recommend calling emergency services and performing cardio-pulmonary resuscitation (CPR).7 CPR is a method that uses a combination of breathing into the mouth and chest compressions to try to restore circulation and breathing to a person who is not breathing or has no pulse. Unfortunately, CPR, when used in drowning cases, has had only moderate success.8
I agree with Dr. Esch that the Heimlich Maneuver could be useful in saving drowning victims. To understand why, it’s first important to take a look at what happens when someone drowns. After a victim is no longer able to hold his or her breath, he or she is likely to aspirate and swallow water. For a short time, a conscious or unconscious person will experience laryngospasm, a constriction of the larynx that prevents water from entering the lungs. However, following this stage, laryngospasm relaxes, at which time water can enter the lungs.9
At least two studies show that the lungs of drowning victims take in water. In 1986, a study published in the Journal of the American Medical Association concluded that victims experience a “flooding of the lungs.”10 Another study, conducted in 1993 and published in the New England Journal of Medicine showed that approximately 90 percent of drowning victims “aspirate fluid.”11
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