Noah's new heart: two years and counting
Date: March 1, 2012
Before his heart transplant in September 2009, Noah Thyberg hoped he would be able to play football again. Now, he’s not just playing football, but lacrosse, too—and even better—“for multiple teams,” says his pediatric cardiologist, Janet Scheel. A busy eighth-grader, “Noah continues to do great,” she says.
That doesn’t mean life is back to normal for Noah and his family: There are still pills to take, morning and night; there’s still the worry of rejection or infection; there are frequent biopsies. The medical issues will always be there.
But all in all, the “new normal” is pretty good. As his family and doctors hoped it would be, Noah’s heart transplant has been a great beginning, of many things. The transplant itself, performed as a treatment for cardiomyopathy by pediatric cardiac surgeon Luca Vricella, went well. The biggest concern afterward was that Noah’s body might try to reject his new heart; after one scare early on—his first biopsy showed signs of rejection, but Scheel prescribed high-dose corticosteroids, which remedied the problem—his recovery was fairly uneventful. He returned to school two months later.
There are other risks, such as the development of coronary artery disease, to watch for vigilantly. “You obviously worry about the child’s coronary arteries,” says Scheel, “but if we’re lucky, he’ll get 20 to 25 years out of this heart.” Thanks to comprehensive patient education from Scheel, Noah and his family know well how to spot the signs of infection and rejection, and live every day knowing other serious complications—pulmonary issues, hypertension and metabolic abnormalities—could come along. “There is also the psychological impact of receiving the heart of a child who has died,” notes Scheel; thus, counseling is an important part of the transplant experience, in addition to all the blood work, biopsies, X-rays, echocardiograms and medication.
Scheel does much of Noah’s specialized follow-up care at one of several Hopkins pediatric cardiology clinics throughout Maryland. “It’s best for heart transplant patients to stay in one system,” she says. Almost all of the pre- and postoperative clinic visits can be handled at suburban outposts like Scheel’s. A sonographer from Hopkins conducts portable echocardiograms, an on-site lab expedites the blood tests, and a nurse helps patients and families with home-management strategies. It’s more convenient and less time-consuming for Noah’s family, and that gives Noah more time to enjoy being a 13-year-old.
“Our goal has always been to get Noah to where he was before the onset of disease,” Scheel says, “so he can do all the things he used to do.”