Overcome all odds against chronic total occlusion
David Schneider was told he was out of treatment options.
Luckily, these heart specialists said otherwise and performed advanced, minimally invasive surgery that put David’s life back on track.
A year after the operation, Schneider is a different man.
The chef and cooking instructor has completely changed his diet, eliminating salt, fats, dairy and red meat in what he calls a self-regulated, 80% vegetarian diet.
David Schneider had a decade-long career as director of the Macomb Culinary Institute at Macomb Community College and later as an advisor on two other culinary programs.
He’s the first to admit his diet as a chef wasn’t exactly heart-healthy – high in butter, red meat and rich foods on trips he took with his students across Europe. Schneider’s family history was not good either.
His mother, father, and uncles on both sides of the family all suffered heart attacks, and his father lived to be 65.
Facing odds, Schneider, who turns 70 this fall, retired from the culinary institute nine years ago and began long, daily hikes with his wife, Katherine, in the parks and woods near their Boyne City home north Michigan.
One day in April 2022, fate struck.
Schneider collected wood for the fireplace and as he threw the bundles into his car, he felt pain in his back that got worse with each toss.
When he thought he’d pulled a muscle — “I didn’t know what it felt like to have a heart attack,” he recalled — Schneider got in the car to run errands with his wife.
When they were done, he suggested going to the park where he would try to get rid of it.
But they hadn’t gone more than half a block when he lost all energy and felt weak enough to fall.
He knew he was in trouble.
Cardiologists at a local hospital diagnosed a heart attack, and a cardiac catheterization revealed several blockages, which they tried unsuccessfully to open with stents.
When told there was no other option, Schneider received medical therapy and was scheduled to return in a month to see another cardiologist.
He felt lonely, had nowhere to go and had little trust in the doctors, he recalls.
Fortunately, a close friend had just read an article about Daniel Menees, MD, director of the Chronic Total Occlusion Program at the University of Michigan Health’s Frankel Cardiovascular Center.
She suggested getting a second opinion. The Schneiders soon found themselves on a 250-mile drive to Ann Arbor.
“As soon as I walked in the door of this hospital, I felt at home and cared for. dr Menees is amazing and he has the best bedside manner I’ve ever seen in a doctor,” said Schneider.
“He spoke to me a lot about my options and that really boosts your confidence.”
Menees and his team partner, Brett Wanamaker, MD, reviewed the local hospital’s imaging studies and began formulating their plan.
Imaging showed an artery at the back of the heart that was severely diseased but not completely blocked.
However, Schneider had a complete occlusion of the left anterior descending artery, the largest of the three main coronary arteries that supply blood to the front of the heart.
Advancing patient care
In the past, treatment options for patients with chronic total occlusion were largely limited to medication or coronary artery bypass grafting (CABG), open-heart surgery in which an artery is removed from another part of the body and used to create a coronary artery bypass graft. Transplant uses new pathway for blood flow.
Today, Menees and his specially trained partner, Wanamaker, offer patients an advanced, minimally invasive option with percutaneous coronary intervention, which Schneider ultimately helped.
“The narrative of opening chronic total closures has changed,” Menees said.
“Patients are often told that this does not need to be done, that the body creates natural bypasses and that medication is all that is needed.
But patients like David, whose symptoms are severely limited despite taking these drugs, have other options worth exploring.”
In Schneider’s case, while they discussed open-heart surgery as an option, they ultimately agreed to first try placing stents in two separate procedures.
First, they placed two stents to open the artery at the back of the heart. A month later, Menees and Wanamaker managed to open the chronic total occlusion LAD at the front of the heart and place three more stents to keep this critical artery open.
An experienced surgical team is on standby if for any reason they need to change course and perform the bypass surgery, Menees reassured his patient.
“We had very nice results. He felt better straight away,” Menees said.
“He got his life back and can do the things he wants to do again. The procedure can be technically challenging, but seeing a patient like David who has been told he has no other options is truly the most gratifying. It really was a great success story.”
A year later enjoying life to the fullest
A year after the operation, Schneider is a different man.
The chef and cooking instructor has completely changed his diet, eliminating salt, fats, dairy and red meat in what he calls a self-regulated, 80% vegetarian diet.
He lost 25 pounds by hiking two to five miles a day with Katherine and her corgi, and has returned to his normal activities: traveling, restoring a 1965 Ford pickup, and spending time with family.
“I used to live to eat, and now I eat to live,” Schneider said.
“My wife keeps me focused on healthy meals. Now she mainly cooks and we eat a lot of vegetarian food.”
He will continue to visit Menees twice a year for follow-up visits, which he says he looks forward to.
“DR. Menees said I’m good to go, everything is fine. I’m not saying I have a new life, I’m just looking forward to a great life. I don’t feel fixed. I just feel new.”
Written by Staci L Vernick.
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