Garrett Finkbeiner, 22, was at the point of planning his own funeral and preparing to give away his belongings during the early months of the COVID-19 pandemic.
It wasn’t the coronavirus that directly threatened his life — rather, it was severe heart failure likely brought on by another viral infection — but the quickly-spreading coronavirus did create obstacles in route to securing a life-saving organ transplant.
“I couldn’t imagine it being any worse; it was very chaotic for a while,” Finkbeiner said. “It made just about all aspects — personally, emotionally, medically — very challenging. And nobody had gone through something like that, so it was a lot of learning as you go.”
It’s been 13 months since the Marquette native received his life-saving heart transplant. He’s had to re-learn how to walk and eat, and ease back into everyday activities.
“Looking back, it’ll honestly be a defining moment in my life,” he said. “I’m very proud of where I am now compared to where I was. Looking back, it’s remarkable.”
Through it all, he’s come away with a new outlook on life. Things he tells himself: Don’t get caught up in the material things. Smile and make others smile more. Judge others less, and take life less seriously.
“To go to where I was and come back to real life, it’s almost comical,” he said. “Whenever my time comes, it’s not something I’ll be frightened about … We all have the same fate so enjoy life while you can.”
Diagnosing the problem
Finkbeiner had an active upbringing with no notable health scares and no family history of cardiac issues. He played baseball, basketball and football through high school, before adding a couple seasons at the junior college level.
As a junior, he enrolled at Central Michigan University and regularly played intramural sports without complications, until late fall 2019 when he began suffering from abdominal symptoms including nausea, upset stomach and trouble keeping food down.
“I thought it was stomach ulcers,” he said.
By the spring, he saw a gastrointestinal specialist in Big Rapids who found nothing wrong with his stomach, but noticed his resting heart rate was up to 130. Further testing found a dangerously enlarged heart and a blood clot in his heart, leading to a diagnosis of cardiomyopathy.
Finkbeiner’s hospital admittance was March 12, the day before the World Health Organization labeled coronavirus a global pandemic.
“He really didn’t want to stay in the hospital a minute longer than he needed to because he was by himself and we weren’t really sure, at that point, how safe it was to keep people in the hospital,” said Dr. David Fermin, an advanced heart failure cardiologist at Spectrum Health. “That affected our decision to send him home.”
Finkbeiner returned to his Mount Pleasant apartment with medications aimed at improved his condition, but by April he had declined further and returned to the hospital.
“It was pretty quickly apparent he was in end-stage heart failure and that it wasn’t going to get better,” Dr. Fermin said. “It was a quick progression from the time he was diagnosed to the time he needed life-support for his heart.”
In a matter of months, he underwent multiple surgeries to increase blood flow and support his failing heart. He spent time in and out of medically induced comas, during which he was placed on the transplant list and given the highest status, reserved for medically urgent patients.
“I was up to maybe five or six days between comas,” he said. “I was awake and alive and all that but I have zero recollection and only faint memories from what I’ve been told from my family.”
Finkbeiner’s life changed June 7, 2020, when he received his new heart.
Transplanting during the pandemic
The early days of the pandemic provided real challenges for the transplant community, altering how hospitals procured donor organs and adding new levels of risk assessment in evaluating which organs could safely be transplanted.
“It was huge concern, not just for us but around the country with transplant programs,” Fermin said. “We didn’t know what we didn’t know (in the early days). We didn’t even have testing at first, so considering flying somewhere and getting a donated organ and not being able to test it for COVID and then giving it to one of our patients who is going to be on heavy immune-suppressing medications, was not something we were comfortable with at first.”
Living donors were brought to a “near halt” around the country, while transplants from deceased donors were limited to only the most dire cases. As time went on, hospitals grew more comfortable scheduling transplants for the most seriously ill patients.
Despite the obstacles, the medical community bounced back in the late spring and through the rest of the year to finish only slightly behind previous year totals for combined living and deceased donations. The U.S. conducted 39,034 transplants in 2020, the second-highest annual total behind only 2019 when there were 39,719.
In Michigan, there were transplants involving 160 living donors, which is about 25% fewer than a typical year but followed national trends for 2020. Dr. Christopher Sonnenday, director of Michigan Medicine’s transplant center in Ann Arbor, said that is to be expected during times of economic uncertainty.
“Anytime there’s an economic downturn, there’s also a decrease in living donations,” he said. “But it’s hard to know how much of the downturn related to fear associated with COVID and how much with the craziness of the last year and all the pressures many individuals have felt.”
By the time Finkbeiner’s new heart became available, Fermin said his team was comfortable with the policies put in place to limit risk.
Road to recovery
Especially for young and previously active patients like Finkbeiner, Dr. Fermin said he tries to emphasis that the point of getting a heart transplant is to get back to as much of a normal life as possible.
There are of course some restrictions and recommendations to consider following a transplant, like avoiding foods and places with higher risk of containing harmful bacteria. Organ recipients will continue to be immuno-compromised moving forward and will require medications for the rest of their lifetime.
But the goal is to return to a semi-normal life, and Finkbeiner is well on his way. After leaving the hospital, he was largely quarantined at his apartment until getting vaccinated this spring. Getting the shot has allowed him to feel more comfortable going out into the world “without fear” of a life-threatening coronavirus infection.
He has gotten back to working out and shooting hoops at CMU’s student activity center where he works. It’ll take some time before he tries lifting heavier weights or gets back to more physical sports, but he’s proud of the progress he’s made to date.
For Dr. Fermin, his patient’s journey has been made possible by the resiliency he showed throughout the last year.
“He was really a fighter through all of it,” Fermin said. “It was pretty remarkable to watch, he went from someone who was almost in disbelief that his heart was this bad to basically having to fight for his life every hour, every day, sometimes for many weeks, to get a transplant and then to walk out of the hospital. He’s a pretty unique character.”
Finkbeiner’s case is a rare one, but he’s not the first young patient Fermin has seen need a transplant. The cardiologist noted that symptoms like fatigue, chest pain and shortness of breath can be explained by a lot more common things than a serious heart condition, but said it’s important to talk to your doctor if such symptoms persist.
“Most of the time, it’s not going to be a severe heart problem, but we don’t want to miss it if it is,” he said.
The average life expectancy after a heart transplant is in the 10-to-15 year range, but Finkbeiner’s age could allow him to go longer with his new heart. Still, it’s likely he’ll need another transplant in the future.
In the meantime, he’ll require regular medical follow-up appointments and to remain on anti-rejection and other medications for the rest of his life. While his future comes with questions, Finkbeiner has learned to make the most out of every day.
“Looking back, it’s hard to comprehend the enormity of the whole situation,” he said. “The best way I’ve come to terms with it is realizing we all have that expiration date in our lives. Nobody knows when it’ll be.
“For me, I try to look at is as an advantage — I have an idea when mine might be and I can live my life accordingly.”
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