A doctor you trust, whom you know and who knows you, is one you stick with. And J. Rob Walker, a 90-year-old native Texan who is a veteran of both the second World War and Texas' oil and gas industry, has had the same doctor for a quarter century.
Walker met Houston Methodist DeBakey Heart & Vascular Center cardiologist Mohammad Attar, M.D., an expert in cardiovascular disease, in 1987, after his doctor, Antonio Gotto, M.D., brought in Attar to consult on Walker's case.
It turned out to be a murmur — an extra or unusual sound heard during the heartbeat, usually caused by extra turbulence in blood flow through the heart.
Murmurs can be caused by a wide variety of things, and can be serious or harmless. Attar determined Walker's murmur did not require dramatic intervention, but the two maintained a close relationship so Attar could keep an eye on Walker's health.
Walker continued to work and live without heart trouble until 2000, when Attar identified an abnormality in Walker's aortic valve function, and also diagnosed — separately — coronary artery disease.
"I had a bypass for that," Walker said. "And Dr. Attar and I decided it made sense to hold off doing anything with the valve. I knew about the problems with a weak valve, but mine wasn't bothering me too much at that point."
Near the start of 2012, that changed.
"I suddenly found myself a little short of breath," Walker said. "I didn't like feeling that way."
Walker has always been physically active. After leaving the U.S. Marine Corps in 1945, he went to work for National Supply Company, a major producer of oil field drilling equipment.
"I had a lot of jobs with them," Walker recalls of his time with National Supply. "And that helped me stay pretty active. I was district manager, then an area manager... Eventually they moved me to Houston in 1965."
Walker moved up through the ranks. After running oil field supply stores, he was promoted to two vice presidencies, and then to President of Armco National Supply and Vice President, Armco, Inc., positions he held until retirement.
Walker said that even after he stopped doing some of the harder work, he was good about taking walks at a local mall and getting to the gym at least three times a week.
"I've always been up and about," Walker said. "So when I started feeling tired and not able to do things for very long, I got concerned. I'd never experienced anything like that."
Walker consulted Attar, who told him that the aortic valve had become further weakened, and dangerous — because it was no longer regulating blood flow properly. Attar brought in interventional cardiologist Neal Kleiman, M.D., and cardiovascular surgeon Basel Ramlawi, M.D., who specializes in heart valve repair and replacement.
Because Walker is older, and because he'd had a bypass operation, the doctors deemed open surgery would be too risky. With few other solutions to recommend, Attar , Kleiman and Ramlawi suggested Walker might learn about a semi-synthetic valve Houston Methodist DeBakey Heart & Vascular Center's Valve Clinic had recently acquired — the Sapien, made by Edwards Lifesciences LLC.
The Sapien is put in place via a procedure called trans-catheter aortic valve replacement, or TAVR. Instead of relying on open heart surgery, doctors move the valve through a small incision near the femoral artery, up through the aorta, to the problem valve. Once in place, the valve is expanded and begins working immediately. Very few hospitals and clinics have access to the valve, primarily because Edwards has been selective about the hospitals it allows to purchase the devices.
First, though, the Houston Methodist doctors needed to make sure Walker would be a good candidate for the device and would withstand the procedure of putting it in place.
"Houston Methodist is exceptional," Walker said. "The last couple weeks before I got the valve, I was getting three to six tests a day. The tests weren't bad and they didn't take long. But I was impressed that at no time did I have to wait more than 5 to 10 minutes to see someone to get these done. It just seems like they're always on schedule. I can't do anything but say kind words about my experience during that time."
Walker received his valve on Feb. 16, 2012. The day before the procedure, he said things had gotten so bad, "there were very few things I could do without getting short of breath."
Walker was discharged from the hospital five days later, and said every day since, he has felt improvement.
"The first thing I noticed when I got home was that I didn't have the same shortness of breath anymore," Walker said. "This may be a small thing, but I also noticed my ankles didn't swell up like they used to, which made it hard getting my boots on and off, and I also had more energy."
Walker was advised to stay active following the procedure — but to ease slowly into more rigorous physical activity.
Read more patient stories:
- Jesse Aldrich
- Susan Dickson
- Felicia Galloway
- Henry Ham
- Brian Hodder
- Rose Joubert
- Kurt Salziger
- Gilbert Swagger
- J. Rob Walker
- Ronny Yon
For more information about the Houston Methodist DeBakey Heart & Vascular Center, please call 713-DEBAKEY (332-2539) or complete our online contact us form.