A diligent nurse was the first person to help save Geoff Speirs life.
"That nurse in Lindsay (Ont.), she knew what she was doing," says the 31-year-old, reflecting back to 2008 when, he says, doctors at a hospital in his hometown told him they couldn't do anything for him.
It was the day after his wedding and Geoff was battling pneumonia and intense fatigue. The worrisome symptoms landed him in a hospital west of Peterborough with a suddenly-enlarged heart.
Healthy and active, nothing pointed to potential heart trouble. A tall, strapping, figure, Geoff played rugby throughout high school and at the national level, eventually suiting up for a few games with the Canadian Under-21 Team.
"That nurse" – Geoff doesn't recall her name – arranged to have him transported to Toronto and the Peter Munk Cardiac Centre (PMCC). There, he would spend two full months – leaving with a newly-implanted defibrillator and a fresh lease on life.
With his new defibrillator working well, Geoff moved to Alberta later in 2008 where he worked as a heavy equipment mechanic. He became a father in 2010, when his daughter, Sawyer, was born.
Things went well for Geoff for five years, until a stroke in 2013 brought him back east. The culprit? A failing heart valve.
Eventually doctors in Lindsay sent him back to the PMCC, where Geoff says he was told: "I was not going to make it with the heart I had. My heart was so big and enlarged, it just wasn't functioning properly."
There was simply no other choice. Doctors at the PMCC put him on the heart transplant list.
While he waited for a donor heart, Geoff retreated to Lindsay, about 130 kilometres northeast of Toronto, where he took up work on a farm.
As had been his pattern, and is the case for many cardiovascular patients, it happened again. Seemingly out of nowhere one day in 2015.
"Just all of a sudden, I started not feeling well," Geoff recalls. "It began with the flu and I had pain in my lower back, I didn't realize it then but the back pain was the result of my kidneys shutting down. I was throwing up constantly and then one day my stool was black."
The clock started ticking.
Geoff was given sedatives, put into an emergency helicopter and flown to the PMCC.
"They told me I had roughly 24 hours to live," he says.
The date was March 1, 2015. Little more than two weeks later, on March 17, the then-29-year-old was implanted with a mechanical cardiac assist device — a left ventricular assist device, or LVAD, at the PMCC.
"I never thought I would need it," he says.
The technological marvel uses a battery-operated mechanism, worn outside the body and is connected through a small incision inside the body, assuming the blood-pumping action of the heart.
"The LVAD took some getting used to," he says. "But I could do my regular stuff."
One year and one day after his LVAD surgery, Geoff and his fiancé, Dawne Rossen, welcomed a son, Lincoln, who was born on his father's birthday, March 18.
It also marked only the second time in the PMCC's history that an LVAD patient had become a parent.
With his LVAD and new baby, Geoff and his family continued to live in Lindsay, making regular visits to the PMCC to verify his LVAD and ensure he and his medications were okay. All the while, he waited for a new, donor heart.
Eight months later, on a November morning in 2016, the phone rang.
"I was looking after my son Lincoln and I got the call," Geoff recalls. "They had a potential donor."
But he was worried that a bout of bronchitis at the time would put the brakes on heart transplant surgery. The heart failure team at the PMCC confirmed the surgery would take place at 8 am on Nov. 15, 2016.
"Yes, I was nervous. Dr. [Phyllis] Billia came in to my room that morning," Geoff recalls. "She said, 'it's a real good heart and it's a young heart. You'll be fine.' And that put me at ease."
Dr. Robert Cusimano, cardiac surgeon, PMCC, implanted the new donor heart as planned.
But, things did not go well, following the surgery. As Geoff puts it, "the heart wasn't happy when they first put it in me. But I was doing ok."
In reality, Geoff was bleeding heavily. He was put on a bypass machine twice, and it was a touch-and-go scenario for several hours post-surgery in the second-floor cardiovascular intensive care unit (CVICU).
Dr. Billia, cardiologist and Medical Director of the Mechanical Circulatory Support Program at the PMCC remembers it vividly.
"I was there the night of his transplant and he was terrified that he wouldn't make it," says Dr. Billia.
"His fiancé was by his side, holding their newborn and I am sure that all Geoff could think about was if he would see them again. That was a very tough night for me as a physician, to see the look on his face as he watched his family."
Just over two weeks following his heart transplant, Geoff lost his uncle, who at age 60 was awaiting a donor heart of his own. A stroke claimed his uncle's life.
That death also signalled the start of another chapter in Geoff's story and in his relationship with the PMCC.
Unravelling the family ties
Prior to his death, Geoff's uncle was tested by doctors at the PMCC. They confirmed that he carried the same gene that also led to his heart condition – diagnosed as gene positive familial dilated cardiomyopathy.
The revelation prompted tests at SickKids for Geoff's children. Echocardiography tests, blood work and ultrasounds confirmed that both his six-year-old daughter and infant son also carried the same gene. As a result, both children will be monitored via yearly tests at SickKids.
Geoff's brother and sister are slated to get tested next.
From the time he received his LVAD implant up until his heart transplant, Geoff was followed by Dr. Danna Spears, cardiac electrophysiologist, PMCC, who is also Clinical Director of the Inherited Arrhythmia Program.
Dr. Spears and her team have created a database of patients with a genetic predisposition to heart conditions – to better understand their origin, among other factors.
A quiet, thoughtful man, Geoff relays all the facts of his winding journey and brushes with death – rather matter-of-factly.
When it comes to his family and the donor he will never fully know, the emotion is apparent.
"I think about the donor family more than anything," Geoff says. "It's a selfless act.
"I would like to talk to them and say thanks. I think about that all the time. I'm in the process of putting together a letter to them," says Geoff, who was an organ donor even before needing a donor heart himself.
Adds Dr. Billia: "Geoff is a man who didn't let his illness define him.
"Even after he got his LVAD, he went back to work to provide for his family. I have been privileged to be involved in his care. And it is clear to me that the focus in his life is his family.
"He wants to be there for all of them. He wants to see his kids grow up."
Ask Geoff to summarize his journey and he says, "I know I'm exceptionally lucky."
And on the care he has received at the PMCC, where he first arrived nine years ago?
"I wouldn't change a thing. That hospital is by far the best."
Just like "that nurse" in Lindsay, the PMCC's multi-disciplinary medical teams are also responsible for saving Geoff's life, several times.
Geoff Speirs' Medical Journey
2008 – First referred to the Peter Munk Cardiac Centre
2008 – Defibrillator implant at the PMCC
2013 – Suffered a stroke in Alberta
2014 – Put on heart transplant list
2015 – Implanted with a left ventricular assist device (LVAD) at the PMCC
2016 – Becomes only 2nd PMCC patient to become a parent while on a mechanical cardiac-assist device
2016 – Underwent heart transplant at Toronto General Hospital
