'Unique and remarkable': Heart of WWII veteran, 101, inspires others in cardiac rehab
By TREVA LIND | The Spokesman-Review | Published: March 11, 2021
SPOKANE, Wash. (Tribune News Service) — Getting a heart valve replacement as a centenarian is unusual in itself, but Donald Hitzel stood out before and after his August cardiac procedure.
The World War II veteran, who turned 101 on Feb. 20, drew the admiration of other participants in ongoing cardiac rehab classes at St. Luke's Rehabilitation Institute. Since October, Hitzel inspired others for how he steadily walked for 30 minutes on a treadmill during weekly sessions.
Even before his procedure, Hitzel often used his treadmill at home and remained active, living independently in his north Spokane home. It was only about six months before the valve replacement when he started having shortness of breath. His otherwise solid health made him a good candidate for a transcatheter aortic valve replacement, or TAVR, requiring only small incisions to work in a catheter.
"There's no pain; I spent one night in the hospital and then went home, and the next day I was home and walking on the treadmill," Hitzel said. "My son was there, and he couldn't believe it, so he took pictures of me. I think I only went 15 minutes that day."
In working with St. Luke's staff, Hitzel said he felt quick improvement in his endurance and breathing. That energetic recovery hasn't escaped the notice of his cardiologist, Dr. Muaz Abudiab with Providence Spokane Heart Institute.
"It's worth saying about Don as an individual that he's certainly unique in a lot of ways," said Abudiab, noting Hitzel's military service and career as a credit union leader.
"About six months before he had the procedure, he was independent driving, enjoying life and exercising on the treadmill at that time just to keep fit because even though he was 100 years old, he was doing exceptionally well for his age and had really taken very good care of himself."
But Hitzel had developed a narrowing of the aortic heart valve, and as recently as about a decade ago, a repair for his condition would require open heart surgery, Abudiab said. Then TAVR emerged as a minimally invasive option. In this procedure, doctors insert a catheter typically via the artery of a leg and guide it to the heart. A replacement valve is inserted through the catheter.
"Using a catheter, they deliver the valve prosthesis and then actually balloon it up and have it replace the narrow valve," Abudiab said. "We have an excellent TAVR team here that does a large volume of those procedures. If you go back about a decade, TAVR wouldn't be an option."
As people are living longer and remaining healthy, these procedures are expected to be more common among older patients reaching into their 90s or 100, Abudiab said. Considerations include life expectancy of a year or more and how it would improve a patient's life.
"It may seem unusual to be doing these kinds of procedures on older patients, but we don't like to think of age as a contraindication by itself," he said. "So in spite of Don's age, he's doing very well, and therefore it made sense to offer him a therapy that would likely improve and return his life quality to the level it had been just months prior.
"I think that played a large role in why he did so well. A lot of the patients who undergo this TAVR procedure can go home the next day, but I would say that's less common in somebody of Don's age, so he's certainly unique and remarkable from that standpoint."
Hitzel first came to Spokane in 1939. During the war, he was stationed from 1944-45 in the South Pacific with the U.S. Army Air Corps air transport command. The landing strip was in Nadi, Fiji. "It's all big condos now," he said.
"We serviced all aircraft that went to the front. They had to stop there overnight. We serviced aircraft and took care of the crews. They left the next morning, then more would come that night. It was around the clock."
He returned to live and work in Spokane. "I was the first manager of Spokane Federal Credit Union," he said. "I started there in 1962."
Hitzel was at SFCU for about 14 years, then worked at a Wenatchee credit union for 20 years. In past hobbies, he learned to fly an airplane and restored cars. Retirement brought him back to Spokane. His wife died five years ago.
At St. Luke's, Rawnie Oehler worked with Hitzel as a registered dietitian nutritionist and clinical exercise physiologist. Hitzel's first day was Oct. 13, she said, and he quickly took to his exercise regime.
In classes, people spend about 30 minutes doing cardiovascular exercise that's monitored along with vital signs. About 15 minutes in classes often covers educational topics such as blood pressure, nutrition and emotional health. There's stretching and some strength training.
Each patient is evaluated for an exercise plan starting with a six-minute walk in the hallway, she said. There are regular reviews and goal-setting.
"Don is one of our very few patients who spends the entire 30 minutes on the treadmill," Oehler said. "Usually, we'll have them kind of switch between different modes, but he does really well on the treadmill and enjoys it. That alone has really inspired people. They'll go up to him and say, 'Did you just do 30 minutes there?' and he'll say, 'Yep, no problem.' "
Recently, more people became aware of his age because of a small class celebration for his 101st birthday.
"A lot of people didn't realize that he was 101, and that alone was inspiring," Oehler said. To Hitzel, she added, "You weren't in class that day, Don, but we had cardiac rehab week the week before, and on the last day, we asked everyone what motivates them. We had someone say you motivate them to be healthier."
Others noted his perseverance and mental sharpness.
His classes at St. Luke's are scheduled to end this month, after a total of 36 sessions, so Hitzel said he'll start up walking again on his treadmill at home.
Oehler said she hasn't worked with a centenarian before, with the closest age being about 92. "It's pretty rare, and Don's become quite the little celebrity around here."
It's become a standard of care to refer recovering cardiac patients into the St. Luke's program, Abudiab said. Data indicates improved exercise capacity and survival rates.
While Hitzel has amazed his caregivers, and remains among a few centenarians seen in the practice, more are sure to follow, Abudiab said. "We're recognizing these are the types of patients we'll be seeing more of and that we'll be seeing more stories like this in the near future."