By Wally Kennedy, Joplin Globe, January 5, 2007

FAIRLAND, Okla. - John Brock''s heart failed while looking into the mouth of an open grave.

It happened on a cold day in 1993 when he was using his backhoe to open a plot for a local funeral home. He was 53.

Today, Brock is using new therapy for heart-failure patients that is letting him spend time with his family on his farm east of Fairland. He''s giving hope to heart patients who, like himself, will never be a candidate for a heart transplant.

After exhausting virtually every other remedy, Brock''s physicians at Barnes-Jewish Hospital in St. Louis, Mo., told him a left ventricle assist device, an LVAD, was his last chance.

An LVAD is an implanted mechanical device that pumps oxygenated blood to the rest of the body. It takes over the left ventricle''s vital job while the heart remains in place.

LVADs, which are operated by a battery pack the patient carries with them, were first used to keep patients alive until they could receive a transplant. But, the Food and Drug Administration approved LVADs as end-stage or "destination'''' therapy for heart-failure patients who were ineligible for a transplant.

An LVAD patient, like Brock, can leave the hospital and return to more normal lives.

A search for alternatives

Brock and his wife, Darlene, take care of the horses and their pooch, a German shepherd. Their daughter, Angie White, lives in a log house nearby that Brock built.

Brock, now 67, likes to work on things, especially wood, in his shop with his grandson. The shop is a detached building that sits on a hillside near his home. He''s figured out how to get back and forth from his home to the shop.

Pointing to the red Honda all-terrain vehicle in his back yard, he said, "That''s my wheelchair."

The path from 1993 to 2007 has not been an easy one for Brock. His family says he is an example of a miracle.

Said Darlene Brock: "You don''t know how many prayers were going up from every church in town and elsewhere. He made a lot of friends working with the backhoe business over the years. I do believe that was the polishing touch on that.

"He would not be here today. That''s what makes things work and happen."

When his heart failed, Brock was transported to St. John''s Regional Medical Center in Joplin, Mo., where angioplasty opened blocked vessels. But his heart was damaged. It would get progressively weaker.

An irregular heartbeat developed. In 2002, he was scheduled for an implantable cardioverter defibrillator. Before the surgery he was team roping and fell off his horse.

"I forgot to tighten the saddle," he said. "The next day I was operated on for the defibrillator. I was pretty sore."

When a heartbeat becomes irregular, the defibrillator shocks the heart back into a normal rhythm.

"It felt like I had grabbed hold of an electric wire,'''' he said. The defibrillator helped Brock stay active. He continued to bale hay and work for the local water district.

A second defibrillator was planted, but his heart continued to decline. He was evaluated for a heart transplant. It was determined that his body harbored antibodies that would make it almost impossible to get a matching heart in time.

The Brocks looked for alternatives, including a promising new clinical trial in which myoblast skeletal cells are injected into damaged areas of the heart to generate healthy new heart cells. Brock''s defibrillator made him ineligible for the study.

In November of 2004, the Brocks traveled to Barnes-Jewish Hospital to meet with Dr. Nader Moazami, surgical director of the heart transplant and LVAD program. Before they went to St. Louis, Darlene Brock took some photos of her husband in their home at the farm. He was pale, frail and near death.

"He looked awful. We didn''t think he would make it," she said.

Her daughter, Angie, said, "When he got there, they said he had maybe another week."

Said Moazami: "Mr. Brock was very sick when he got here. An LVAD was the only chance for him."

A will to live

After the LVAD was implanted, Brock immediately began to recover his color and his strength. He soon did not look anything like the man in the photos.

He was able to leave the hospital by Christmas and by the spring of 2005, he was working on the farm and doing woodwork daily. He even did some work with the local water district.

Brock''s first LVAD was designed to last two years. It made a ticking noise that you could hear quite distinctly and it had a filter that needed to be changed regularly.

"It was loud," said his daughter, Angie. "You could hear him in another room."

In June 2006, he returned to Barnes-Jewish to have first LVAD replaced with a newer version of the device. He was one of only a dozen or so people to have the new model implanted in Missouri last year, according to Kathryn Holleman, spokeswoman for Barnes-Jewish.

"It''s a much better pump," said Brock. "You don''t hear the pumping. There is no filter to change. This one is designed to last seven years instead of two years."

The Brocks travel to St. Louis every two months to have everything checked out at Barnes-Jewish, and they have access to round-the-clock assistance if they need it.

"There are people on call on a 24-hour basis. We know them by name and they are always there when we call," said Darlene Brock.

The fact that Brock outlived his first heart pump is no surprise to his family.

"It looks like he may be kicking up dust for a while longer," said Darlene Brock.

Angie Brock, his daughter, said, "Dad has an incredible will to live. We kid him a lot. We tell him he''s like the Energizer bunny, and keeps on going, and going... "

How does an LVAD work?

The left ventricle is the large, muscular chamber of the heart that pumps blood out to the body. A left ventricular assist device (LVAD) is a battery-operated, mechanical pump-type device that''s surgically implanted. It helps maintain the pumping ability of a heart that can''t effectively work on its own.

The devices are becoming very common and are now available in most heart transplant centers.

Part of the device is implanted in your heart and abdomen, and part remains outside your body. You carry the external part of the device on a belt around your waist or on a shoulder strap. Most LVADs have an electric pump, an electronic controller, an energy supply (usually batteries weighing about 8 pounds) and two tubes.