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‘Our first moment of joy’

By Sue Thoms/Spectrum Health Beat • Feb 11, 2019 at 4:00 PM

GRAND RAPIDS — Sid Sybenga’s survival story starts with an angel — his 11-year-old granddaughter, who dashed for help when he suffered a cardiac arrest.

Dozens more became involved, including the man who performed CPR and the medical team that kept Sybenga alive.

And then there was groundbreaking technology — the valves placed in his lung, which gave him the edge he needed in his life-or-death struggle.

In the end, old-fashioned love and innovative medicine collaborated to deliver the miracle he needed to live another day.

Sybenga, a Christian Reformed Church minister, never thought he’d be a candidate for heart disease. The 69-year-old has run 20 marathons. He exercises regularly. Eats a healthy diet.

He and his wife, Adriana, were born in the Netherlands and grew up in Sarnia, Ontario, Canada. They lived in West Michigan a few years while he went to Calvin College’s seminary and then spent the next 20 years working in California.

They moved back to Grand Rapids a few years ago to be closer to family. Retired, Sybenga worked as an interim pastor. Although he quit competing in marathons, he continued to run regularly.

On Father’s Day 2018, Sybenga celebrated with his adult children and their families. He doesn’t remember it, but his kids tell him he played basketball and did cannonballs in the pool.

His granddaughter, Anna Sybenga, a sixth-grader at Central Woodlands School in Forest Hills, spent the night with her grandparents. The next day, she walked with her Opa to Calvin College’s track.

“He was running four 100-meter sprints and I was running a mile,” Anna said.

As they walked home through the college campus, Sybenga stopped talking mid-sentence and collapsed on the grass.

“I just thought he fell,” Anna said. “I checked on him and he was unconscious.”

There was no one in sight. She ran back to the tennis courts, the last place she saw people, and yelled for help.

By the time she got back to her Opa, his face had turned blue and his nose was bleeding from the fall. But the campus security guard already knelt beside him, performing chest compressions. Anna saw him use the defibrillator to shock his heart.

“I was scared,” she said. “I didn’t really know what was happening.”

Struggle for survival

Sybenga made it to Spectrum Health Butterworth Hospital, but his survival would be far from certain.

Adriana struggled to come to terms with the rapid change in her husband of 47 years.

“I saw him leave the house with our granddaughter and they were both fine,” she said. “Hours later, somebody was telling me he was going to die.”

Word spread through their family, friends and their extended church family. The prayers and well wishes came pouring in.

Sybenga spent the next week fighting for his life, aided by the cardiac specialists and nurses of Spectrum Health Meijer Heart Center. Complicating his recovery were lung punctures caused by the CPR chest compressions that saved his life.

A ventilator delivered the oxygen he needed, but it caused other complications, said Dr. Gustavo Cumbo-Nacheli, an interventional pulmonologist.

Air went into his lungs, exited through the holes and pooled in the space around the lungs, called the pleura. The pressure in the pleura could cause the lung to collapse inward. Doctors inserted a chest tube to relieve the pressure.

“At this point, he was between a rock and a hard place,” Cumbo said. “He was actively dying from having a cardiac arrest and he had holes in his lungs. And he was connected to a machine keeping him alive that was also making the holes worse.”

In his fragile condition, Sybenga wouldn’t be a candidate for surgery to remove the affected area of the lung.

Lung valves

Cumbo employed an innovative medical device to help him. A week after Sybenga’s cardiac arrest, he implanted endobronchial valves, which block airflow to a damaged area of the lung and allow time to heal.

First, Cumbo had to determine the location of the holes in Sybenga’s lungs. Working through a bronchoscope — a tube inserted through the mouth into the airway — he placed a balloon in different sections of the lung and inflated it.

“There is a significant amount of detective work as we try to isolate the area of the diseased lung,” the doctor said. “It takes a lot of patience, tinkering, dexterity and understanding of the physiology of the body.”

In Sybenga’s left lung, the doctor found holes in four areas that could be blocked by the placement of three valves.

Working through the bronchoscope, he placed a valve in the middle part of the lung and two in the upper part. The umbrella-shaped, one-way valves prevented airflow to the diseased part of the lung while allowing trapped air and fluid to escape.

“We were able to divert the air to other areas of the lung and let this area heal,” Cumbo said.

The holes in the lung closed within a few days. Doctors removed the chest tube. Sybenga could soon be weaned from the ventilator, an important milestone in his recovery.

“The longer you are on a ventilator the more likely you are to develop further complications, such as collapsed lungs, deconditioning and infections,” Cumbo said.

The use of endobronchial valves is an exciting development in pulmonology, Cumbo said.

In June 2018, the U.S. Food and Drug Administration approved the Zephyr endobronchial valve to treat patients with severe emphysema. The treatment can deliver a big quality-of-life boost to emphysema patients, who also suffer from damage in the upper areas of their lungs, Cumbo said.

“We need to give these guys back the hope, the joy of life,” the doctor said. “They will be able to not be a hostage of their condition and get them back in command.”

‘I just felt a healing’

Sybenga’s recovery continued through summer and into fall. He spent four weeks at Meijer Heart Center recovering from the cardiac arrest, followed by two weeks at the Inpatient Rehabilitation Center at Spectrum Health Blodgett Hospital.

On July 31, his 69th birthday, he went home. Eight weeks, later he returned to the Meijer Heart Center for triple bypass surgery.

The valves did not remain in Sybenga’s lungs. Three months after they were implanted, Cumbo removed the valves in an outpatient procedure.

“Those areas of the lung are not permanently shut down,” the doctor said.

Sybenga had returned to a full and active life by mid-November, spending time with family and traveling to Canada to visit relatives.

As they talked about the recovery, Sybenga and his wife marveled at the number of people who made it possible. This included the man who performed CPR, his cardiologist, Dr. H. Paul Singh; Cumbo; and the other providers involved in his care.

“They are amazing,” Sybenga said. “And the compassion of the nurses — they are amazing, too.”

Adriana cites her husband’s fitness level before the cardiac arrest as a factor in helping him regain strength after surgery. They both believe the power of prayer and the love of his family sustained Sybenga throughout the ordeal.

“When I woke up, the whole room would be full of grandkids and family,” Sybenga said. “The love would just soak into my being and I just felt a healing.”

And it all started with Anna, the granddaughter who had the presence of mind to get help in a hurry.

“She’s my hero,” Sybenga said, giving Anna a hug.

“We were glad she was there,” Adriana said, “though we are sad she had to see it.”

Although Sybenga does not remember the day Cumbo implanted the endobronchial valves, Adriana looks back at the treatment as a major turning point.

“That was our first moment of joy,” she said. “That was the first moment of, ‘He just might make it.’”

For Cumbo, Sybenga’s progress is immensely gratifying.

A surgeon saved his life, years ago. As a 9-year-old boy in Rosario, Argentina, he suffered a serious injury in a bike accident and lay in critical condition in the hospital.

“If it wasn’t for that surgeon who was thinking outside the box, I never would have made it,” Cumbo said. “That is why I force myself to say every day, ‘What else is out there? What else can we do to save somebody’s life?’ It’s a way to honor the people who saved my life.”

For Anna, watching her grandfather’s victory over cardiac arrest has been equally inspiring. It has her rethinking her career goals.

“I wanted to be a neurosurgeon before,” she said. “But, after this, I want to be a cardiothoracic surgeon.”

This article first appeared on spectrumhealthbeat.org.

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