N.C. heart surgeon saves life of Honduran woman

Published 12:00 am Wednesday, July 15, 2009

WILMINGTON, N.C. (AP) ó The 24-year-old woman’s heart was about to burst.

Worse, nobody in her country could help her because of lack of money, equipment and trained doctors who specialize in heart complications like the one of Aracely Ortega Alfaro.

A grapefruit-sized swelling, or aneurysm, was ballooning in the Honduran woman’s ascending aorta that carries blood from the heart to the head and body. Aneurysms that size are rarely seen in this country, and much less in young patients. Doctors in the United States typically see aneurysms about half that size ó in elderly adults. Ortega Alfaro began experiencing problems late last year when she started having trouble breathing. Ortega Alfaro also noticed that her heart beat quicker and worked harder than she had ever experienced in her life. In general, her energy would run out even when she wasn’t exerting herself.

“I couldn’t hang out with my friends,” said Ortega Alfaro, a single mother who lived and worked in San Pedro Sula, the country’s second-largest city in northwestern Honduras. “I would get too tired.”

The Star-News of Wilmington reported that after she doubled over in pain in December, doctors took X-rays of her heart. Her boss, a doctor, gave her news that she had never imagined: You have an aneurysm measuring nearly 9 centimeters and you need surgery as soon as possible. What he didn’t tell her was that without surgery, she had few months to live.

Ortega Alfaro, who worked as a live-in caretaker in the doctor’s house, didn’t have money for surgery and even less to travel to another country where doctors could do the operation.

Her bosses weren’t going to sit back and let her die.

With the help of the non-profit Ruth Paz Foundation, Dr. Howard Marks at Coastal Thoracic Surgical Associates, donations from people in her country and help from people in Wilmington, Ortega Alfaro flew to Wilmington on Mother’s Day, May 10.

On May 13, Marks, Dr. Ivan David and their staff performed the operation at New Hanover Regional Medical Center. Ortega Alfaro’s aorta was stretched to the max, so doctors replaced it with a tube made of Dacron, a synthetic fiber, and reattached arteries to the tube that now serves as her ascending aorta. They also inserted a new, mechanical valve in her heart because the aneurysm had damaged her heart valve.

The ascending aorta, the body’s largest blood vessel, stems from the top of the heart, curving into a U.

Ortega Alfaro is one of a growing number of foreigners treated at New Hanover Regional Medical Center. Since 2004, 181 foreigners from at least 42 counties have been treated, according to hospital figures. Since then, the number of people has remained steady at under 40 per year except for when it peaked at 40 in 2006. Last year, 36 foreigners were treated at the hospital. So far, Ortega Alfaro appears to be the only Honduran to receive care at New Hanover, according to the hospital.

“It feels beautiful,” she said. “Since I came here, the doctors and nurses have treated me so well. I will never forget it.” Ortega Alfaro is thankful because she’s been given a new chance at life ó one she doesn’t plan to waste.

When Ortega Alfaro was 3 years old, her father died of heart problems. She doesn’t know exactly what killed him. When she was 21, her brother died on his 22nd birthday ó also of heart problems.

At the end of last year, Ortega Alfaro couldn’t bike or play soccer because she would run out of breath. During the Christmas break, it became harder to keep up with her friends.

“I couldn’t lead a normal life,” she said, adding she felt like her heart was beating out of her chest. “I felt like my breathing was very hard. I felt like I had a bomb inside me. … I didn’t feel normal.”

After Christmas, intense stomach pain crippled her. She could barely move, so she ate to see if that would help. Instead, she started vomiting. Family members tried to heal her by massaging her stomach and performing a healing ritual. It didn’t work.

Finally in January, her bosses, Dr. Carlos Funez and his wife, Claudia Benitez, took her to a doctor. She had lost a lot of weight. Doctors performed exam after exam until an X-ray revealed the source of her problems. Ortega Alfaro will never forget when Funez told her the news. He sat down in the lobby of a clinic with a worried look on his face.

“He kept looking at me with a face that said I was dying,” she said. “He said I needed surgery, (that) they don’t do this surgery in this country, and it’s very expensive.”

Ortega Alfaro wanted to go back to her home town of Yoro to be with her 5-year-old son, Fabricio Cabrera Ortega, who lived with family while she worked as a caretaker. She was ready to give up because she thought there was nothing more to do. Since she couldn’t work and take care of the doctor’s children, she didn’t want to bother her bosses. She also broke up with a boyfriend, telling him the only thing she could offer him was death.

“I didn’t know what to do because I thought I was going to die,” she said. “I was sad and I started crying. I thought about my son. Who was going to take care of him with no mother and practically no father?”

Her bosses didn’t want her to stop fighting for her life so they contacted the Ruth Paz Foundation, a nonprofit that provides medical care to poor Honduran children and their families. In this case, the organization decided to help Ortega Alfaro because she had a young son who would lose a mother if she didn’t have the operation.

But she would become frustrated. How was she going to get the money for a flight to the United States? Who would do the operation? How would she pay for it?

She left it in God’s hands.

Ortega Alfaro’s visit would not have been possible without a sponsor. Enter Lucy Vasquez, executive director of Amigos Internacional, a local nonprofit organization that helps Hispanics and other immigrants. The organization also hosts the yearly Festival Latino. Vasquez found out about Ortega Alfaro’s case through an e-mail from Nicholas Faherty, the operations director of Centro Latino, a program of Amigos Internacional. The organization had been contacted by a Honduran woman familiar with Ortega Alfaro’s case.

When no one responded to calls for help sent out to many in the Hispanic community, Vasquez opened her Bible and found the answer she had been searching for. “I didn’t have time,” said Vasquez, mother to a 5-year-old girl.

Vasquez sponsored Ortega Alfaro for most of May and all of June so she could travel to the United States for the surgery. Another Honduran woman, Ligia Martinez de Jackson, just met Ortega Alfaro about six months ago. She traveled with her and stayed with her in the hospital during her recovery, giving her water, comforting her and translating because Ortega Alfaro doesn’t speak English.

“I felt like she was my daughter because I was responsible for her,” she said.

Besides Vasquez, too many people to name helped Ortega Alfaro by giving her rides, providing shelter and offering their friendship.

For the doctor who performed the operation, it wasn’t a difficult decision to make when the Ruth Paz Foundation contacted him. “She was a bit of a time bomb,” Marks said. He spoke to Jack Barto, the hospital’s president and CEO, and told him that Ortega Alfaro would die without surgery. “He didn’t hesitate,” Marks said. The hospital donated space for the surgery and the surgeons donated their time for the procedure and related costs that ran into the tens of thousands of dollars, Marks said.

Ortega Alfaro lay in a hospital bed, unable to talk or hold down food. Once she got better, Vasquez took her to the beach, downtown and shopping. Meanwhile, Ortega Alfaro maintained a strict diet: she was prohibited from eating greens, salt, fat and sugar. She had to practice walking in spurts.

The only visible sign of the procedure is a scar that runs most of the length of her chest bone showing above the top of her black bathing suit top one June evening. She tossed up small pieces of white bread, feeding squawking seagulls at Caswell Beach. Ortega Alfaro couldn’t yet swim because of her surgery, so she stayed on the beach watching children splash and giggle in the calm surf.

But she was not completely cured.

“After the surgery, I had a stomach ache,” she said. “The pain wouldn’t go away.” She became nauseous. Doctors ran more tests and found she had gall bladder disease.

Ortega Alfaro needed another operation.

After Dr. David Miles removed her gall bladder, Ortega Alfaro was ready to return home. She will need blood thinning medication for the rest of her life. The medicine will prevent her new mechanical heart valve from causing blood clots. On July 1, the day before returning home, Vasquez took Ortega Alfaro to Walmart to buy enough medicine to last nearly a year.

Even though she must take medicine for the rest of her life, she doesn’t complain. She is thinking about studying to become a nurse. More importantly, she wants to make good on a promise she made to God before the surgery. Ortega Alfaro’s son is entering kindergarten this year.

“I’m going to bring him to live with me, to take care of my son and be where he is,” she said, adding that she asked God to let her live for her son.

With a healed heart, Ortega Alfaro promised she would never again leave her son without a mother.

“God gave me this opportunity for a reason,” she said.