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New Start at Life Following Double Transplant

Crystal Safford struggled with progressive heart disease, then heart failure and found out she needed a new heart and a new kidney.

Crystal Safford made her way to the therapy gym at Magee Rehabilitation with the assistance of a rollator walker and physical therapist, Sarah McMahon, PT, DPT, by her side.

“I feel really good today,” Safford shares. The 58-year-old Philadelphia woman had come a long way over the last several months. Her emotional well-being, physical health and faith had been tested beyond measure.  Safford’s trademark smile was beaming even brighter than usual though, because she was finally well enough to go home.

Caught by Surprise

Progressive heart disease would occasionally land Safford in the hospital and each time she recovered and moved on with her life. On April 27, 2021 her body had enough. Without warning, Safford collapsed at home and suffered three episodes of ventricular tachycardia. Also known as v-tach, the dangerous heart arrhythmia occurs when the lower chamber beats too fast. It almost took her life that day.

During a visit with her cardiologist nine months earlier, he told her it was possible she may eventually need a heart transplant. As she laid in her hospital bed recovering, doctors informed Safford that she was in heart failure. She couldn’t go home until she got a new heart and a new kidney. The process is very tough on the kidneys. Hers had not been functioning well for a long time and wouldn’t support her through the heart transplant.

“Although I had been hospitalized a few times, the reality of needing a double transplant really caught me by surprise,” Safford says.

Crystal in an occupational therapy session with a therapist

Waiting and Praying

Safford was referred to the Jefferson Transplant Institute for care. Finding a donor match would be an additional feat. Tests showed high levels of antibodies in her blood. Although it’s a natural occurrence, it can limit a patient’s ability to match with donors.

“It’s common for women who have had children, and people who have mechanical devices implanted in their bodies, or have received blood transfusions,” explains heart transplant coordinator Olivia Leonard Millan. “In Safford’s case, her body would reject an organ from someone she did not match perfectly. That would be fatal.”

Safford’s health information was added to a database in which several criteria determine priority.  Her care team worked to keep her health stabilized and from there it was simply a matter of waiting.

“She was tough going through it,” says heart transplant coordinator Drew Thabault. “Patients ask us all the time, ‘How long do I have to wait?’ Unfortunately, someone has to pass away for all this to happen. We just don’t know.”

Days turned into weeks and weeks turned into months as they waited for notification of a match.

I have a 30-year-old daughter and a 26-year-old son. I haven’t seen any weddings. I don’t have grandbabies I’m not ready to go. So I told myself to trust God that I am going to get what I need. – Crystal Safford

For most of the day Safford was bound to her bed with balloon pumps in her legs, which helped to pump blood throughout her body so her heart didn’t have to work as hard.

“It’s a hurry up and wait situation,” Thabault explains. “There were two false matches. On paper they looked like they could be matches, but once doctors took a closer look at blood samples, they realized they wouldn’t work.”

“We have a heart for you.”

Safford tried to keep a smile on her face, but the situation was taking a toll on her mentally.

“I was debilitated. I couldn’t stand on my own. That’s so difficult to process when you’re used to getting up and doing things on your own,” Safford shares. “I had a normal life. I drove, I shopped. Then suddenly I was stuck in bed in the hospital. You have a lot of time to think.”

Safford had been waiting in a hospital bed for 69 days when she got the news she had been praying for. She was about to take a bite of the food her daughter brought for lunch when a nurse ran through the doorway and said, “We have a heart for you!”

“I was floored and grateful to God,” says Safford. “I got both the heart and the kidney from the same donor.”

“It was really emotional,” Millan recalls. “She called her family and put them on speakerphone and everyone was cheering.”

From that point, all of the attention was focused on preparing her for surgery. Safford underwent numerous tests to ensure she could handle the operation. As the organs were transported to Jefferson, surgery got underway so the heart could immediately be placed into Safford’s chest upon arrival.

“A heart should not be outside the body for more than four hours for the best chance of a successful transplant,” Thabault explains.

The surgery was a success, but her journey is far from over. The high antibody levels in her blood means there is a higher-than-normal chance her body could reject the new heart and kidney.  Safford’s health was fragile and will remain so for a very long time. She will be monitored and cared for by the Jefferson Transplant Institute for the rest of her life.

Crystal recovering and learning how to walk up stairs again

“I hadn’t stood up in months.”

When Safford’s health stabilized following the transplant surgery, she transferred to Magee for the next stage in her healing journey.

“Crystal didn’t have the energy to perform even the most basic tasks,” explains Natalie Collins, MS, OTR/L, Magee occupational therapist. “She couldn’t even sit up on her own.”

Her body was very weak from heart disease, major surgery and being bedridden for more than two months. She required a lot of medication and monitoring for her body to have the best chance at accepting the donor organs.  Safford’s Magee care team developed an individualized rehabilitation plan to help her get back to living her best life.

“I hadn’t stood up for months and my legs were like cooked spaghetti,” Safford says jokingly. “I wondered how I was going to manage three hours of therapy a day.”

And she did it–always with a smile and sense of humor. During daily occupational therapy sessions, Collins helped Safford get strong enough so she could do things such as getting in and out of bed unassisted, brushing her teeth and showering and dressing herself. Over time, with Collins’s support, Safford was able to do laundry and even cook in the kitchen. Meanwhile, she worked with her two physical therapists, Sarah Mc Mahon, PT, DPT, and Caitlin Corbin, PT, DPT, NCS, to build her overall strength and mobility. Their sessions focused on the mechanics of sitting to standing, walking and going up and down stairs.  Safford also enjoyed recreational, art and dance/movement therapies, part of Magee’s holistic approach to rehabilitation.

“It’s a humbling experience when you have to depend on others to take care of you in that state,” Safford shares. “I knew this was part of the process to becoming healthy and independent.”

Positivity and Progress

The last few days of physical and occupational therapy were aimed at measuring Safford’s progress. She was tasked with several simple movements, such as balance and walking exercises that she had performed at the very beginning of her stay. The evidence of her recovery was in the numbers. Crystal completed each exercise much faster and with more repetitions and strength.

“Crystal had a positive attitude since day one,” says Sarah McMahon, Magee physical therapist. “Even if she was having a tough physical therapy session, she always looked for a silver lining.”

Six months after she was rushed to the hospital for a heart attack, Safford headed home with a new heart, new kidney and a new thirst for life.  She couldn’t wait to enjoy the comforts of her own home and spend quality time with her mother, and adult son and daughter, whose weekly visits helped keep her spirits high once again. Although faith always played an important role in her life, this experience reminded her to live each day with gratitude.

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