Rev. Cassie Tritthart of Miami is one of only four people in the world to undergo a still experimental surgical treatment for a heart condition.
MIAMI – It could be said that every human being has two hearts. One of the body and one of the soul.
For Miami native Rev. Cassie Tritthart the medical trials of her physical heart have served to strengthen and deepen her spiritual one.
As a healthy and active sports athlete, Tritthart suddenly began to experience some of the frightening symptoms of a rare syndrome known as POTS (Postural orthostatic tachycardia syndrome) in high school.
"When I was a sophomore, I was an athlete, and I started having problems usually in the morning with passing out," said Tritthart.
According to the U.S. Department of Health and Human Services, POTS is a form of Dysautonomia and is characterized by too little blood returning to the heart when moving from lying down to a sitting or standing position.
Currently, the cause of POTS is unknown, and there is no cure.
A search for answers
It was a long road to a proper diagnosis for Tritthart and often a scary one. With POTS, a person's heart rate often jumps 30 beats per minute (bpm) or more upon sitting or standing up. Common symptoms include racing pulse, lightheadedness, and fainting. All symptoms Tritthart contended with for years.
"It happened for about seven years before I got a diagnosis and it was Mayo Clinic that finally gave me one of Dysautonomia called POTS," said Tritthart.
By the time she was diagnosed a host of related issues had already been wreaking havoc on her body.
"At that point, I had to have my gallbladder removed because it had enlarged and quit working. It also caused my appendix to go bad," said Tritthart. "It caused endometriosis and problems with that system, and then it got to the point where I had inappropriate sinus tachycardia."
Tritthart said doctors explained the diagnosis of inappropriate sinus tachycardia by likening it to someone fully pressing down on a car accelerator, but when lifting their foot instead of decelerating, the ramped up speed was maintained.
What that meant for her was even lying still she averaged a resting heart rate of 120 to 130 bpm. According to the Mayo Clinic, a normal resting heart rate for adults ranges from 60 to 100 bpm, with a lower resting heart rate implying more efficient heart function.
Tritthart said while still seeking a diagnosis she was told by cardiologists in Joplin that her accelerated resting heart rate was a bit high, but not something that should cause too much discomfort or alarm.
"But it did. It felt awful," said Tritthart.
She was prescribed beta blockers and calcium channel blockers, which she was soon taking at their max doses without any changes to her resting heart rate as other symptoms worsened.
"If I got up moving around I couldn't catch my breath and sweat would be pouring off of me," said Tritthart.
Being so physically limited, Tritthart said she had to extend her reliance on her mother, Winnie Sue, who cared for her daily needs.
Together they continued their quest for answers ending up at the Mayo Clinic where Tritthart was given her POTS diagnosis and then on to the University of Kansas Hospital in Kansas City.
Through the KU Hospital Trithartt underwent two cardiac ablation surgeries. Cardiac ablation is a procedure to scar or destroy tissue in the heart that allows incorrect electrical signals to cause an abnormal heart rhythm.
Unfortunately, the surgeries were not effective, and doctors at KU wanted to refer Tritthart back to Mayo, but the clinic rejected the recommendation.
According to Tritthart, Mayo's stance was that any continuing symptoms were simply a result of the Dysautonomia, while the KU Hospital diagnosed the issue as her having developed an inappropriate sinus tachycardia along with the POTS.
A nurse at the KU Hospital suggested Tritthart seek care at the Johns Hopkins Hospital in Baltimore, Maryland. She explained a direct referral would not be needed and that KU could arrange to have Tritthart's records sent ahead of a scheduled appointment.
The road to hope
Tritthart and her mother took the advice of the KU nurse and arranged a visit to Johns Hopkins. That decision would prove to be a life changing one.
On May 22 Tritthart and her mother met with electrophysiologist Dr. Hugh Calkins. He explained that he could go ahead with performing another cardiac ablation, but thought Tritthart might be an excellent candidate for an experimental path of treatment by his colleague, Dr. Harikrishna Tandri.
Tandri, a fellow electrophysiologist, was working on a surgical approach to the treatment of inappropriate sinus tachycardia with cardiothoracic surgeon Dr. Kaushik Mandal.
Tritthart met with Tandri within a few days, and after reviewing her case, he informed her that she appeared to be a perfect candidate. But, there was more. At the time, the surgical procedure he was suggesting had only been performed three times.
Tandri explained that two of the three operations had been a success in relieving the inappropriate sinus tachycardia in two patients, but the third had no effect on the patient's condition.
Tritthart was also advised that the procedure is a highly invasive one, requiring incisions along the ribs on both sides and long incisions under both arms.
The surgery involves permanently severing nerves in two that are responsible for controlling how the heart beats. It had originally been developed to treat the symptoms of men suffering from excessive sweating in the upper part of the body, which is signaled by the same nerves.
Thankfully, testing had been developed since the first surgeries that would allow the doctors to best determine if the surgery would likely be a success for Tritthart in treating her inappropriate sinus tachycardia.
"They said there was a way they had now to test if the surgery should work or not, before the permanent more invasive procedure," Tritthart recalled. "It was an electrophysiology test, and they had a pulmonologist insert something through my throat to put a temporary nerve blocker in place."
The test results were very promising, with the temporary nerve block resulting in Tritthart's resting heart rate dropping into the 80s while it lasted.
Tritthart underwent surgery, still considered experimental in correcting inappropriate sinus tachycardia, on May 30, and like two of the three patients that had proceeded her, the procedure was a success.
Body and spirit revived
Since the surgery, Tritthart says her resting heart rate now averages in the 80s for bpm. A significant improvement over the racing numbers that kept her body stressed and exhausted. Also well within the medically accepted levels for an average adult.
Tritthart says life has been much better, taking note of what many tend to take for granted.
"It has been a long recovery," said Tritthart. "Just being able even to bake something or cook something to eat has been wonderful because once I couldn't even stand long enough to do that."
Her recovery is continuing, and she will always have to contend with the fallout of Dysautonomia that invaded her life, but every day she continues to regain strength in body and spirit.
Her focus is on a life built around soulful celebrations and transitions. While a passion that was always present, it wasn't able to be fully nurtured as she sought answers and relief from the conditions that attacked her body.
In caring for her body she and her mother stay on top of monitoring her vitals and have together embarked on slowly reintroducing exercise into their routines.
In caring for herself spiritually, she says she remains trusting in her faith, which is a bedrock for her, and she credits her trust in God for her ability to persevere.
"I truly think that going to Baltimore was all part of God's plan, to have this procedure because Mayo Clinic almost never turns people down," said Tritthart. "Before I even went to KU, I had an episode where my heart rate was in the 150s, and I could not get it to break.
"Mom took me to the ER (Emergency Room), and the doctor who saw me had problems with Atrial Fibrillation and had an ablation at KU, and he recommended the doctor up there."
Tritthart said if not for that visit that she would not have known to seek help at KU or have had her first two procedures. She said everything leading to her surgery at Johns Hopkins just fell into place.
Today Tritthart is an ordained minister, public speaker, columnist and religious services provider in Miami and the surrounding areas.
She is also the owner and operator of Tritthart Special Event Services.
Her life is one led by faith at the helm as each heartbeat affirms for her that there are no small moments.
Tritthart can be reached for inquiries or services at 918-919-1500, www.Facebook.com/tritthartses, or www.tritthartspecialeventservices.com.
Dorothy Ballard is the managing news editor of the Miami News-Record. Contact her at email@example.com and follow her on Twitter @dm_ballard.