While a heart that heals itself sounds like a superhero power, forever limited to comic book pages and wild imaginings, it is, in fact, a reality here and now. With the rise of Regenerative Medicine, new opportunities gleam for those who suffer from severe ailments of the heart.
Doc Allan’s Dilemma
One individual whose life was changed by this revolutionary field of medicine is Dr. Allan Evangelista, Chief Health Program Officer of the Department of Health’s (DOH) Bureau of International Health Relations. While still a young intern, just at the beginning of a promising medical career, Doc Allan, as he is fondly called, was diagnosed with a serious heart condition.
“I began experiencing shortness of breath,” he recalled. “Soon, I was panting at the slightest effort.”
Doc Allan grew concerned. While he suffered from high blood pressure, he was on the proper medication, and had felt healthy and fit. He did recall suffering from flu-like symptoms a few weeks before he observed his breathing difficulties.
“His 2-D echocardiogram revealed a heart with markedly depressed pumping ability,” says Dr. Eugene F. Ramos, TMC’s Medical Director and Doc Allan’s cardiologist. “However, a coronary angiogram showed normal coronaries with no blockages.”
Dr. Ramos thus diagnosed his condition as Idiopathic Dilated Cardiomyopathy, a weakening of the heart muscle likely due to a past viral infection.
“My heart muscles had started to lose their ability to recoil or contract effectively,” Doc Allan recalls, “And therefore, my heart no longer functioned normally.”
“The ejection fraction measures the amount of blood pumped out of the heart with each beat,” explains Dr. Ramos. “While a normal heart has an ejection fraction of at least 55%, Allan’s was only 23%.”
“I was a virtual ticking time bomb and, short of a heart transplant, I knew of no cure for my disease,” Doc Allan adds.
In spite of aggressive medical therapy, his condition continued to worsen over time. He would vomit blood, tire easily, and could sleep only in a sitting position. Ironically, it was while in Bohol, participating in Doctors to the Barrios, an outreach program for health professionals, that he came closest to death. One day on assignment, Doc Allan just collapsed.
It was Dr. Alfredo R.A. Bengzon, the President and CEO of TMC, who convinced Doc Allan to consider Regenerative Medicine as a treatment option. Dr. Bengzon was then Dean of the Ateneo Graduate School of Business, where Doc Allan was working for his Master’s Degree under the Leaders for Health Program. In August 2007, Doc Allan enrolled in the TMC Regenerative Medicine Program.
The Facts behind Regenerative Medicine
Regenerative Medicine is an innovative program that involves the engineering of living cells, tissues and organs to further the quality of life. Proponents of the treatment say it can be used to prevent disease and maintain wellness, as well as restore organ function lost or impaired due to disease, injury, or aging.
It involves procedures that allow the patient to, quite literally, heal himself.
The key lies in stem cells or “master cells,” which have the ability to grow into any one of the body’s 200 cell types, or be sensitized to attack diseased cells, including malignant tumors. They can replicate themselves many times over and, theoretically, do so without limit, so long as the person is alive.
“We’re working with the patient’s own living cells,” Dr. Samuel Bernal, Consultant-Advisor of TMC’s Regenerative Medicine Program, points out proudly. “That’s what makes it different from other treatments using conventional—often toxic—drugs and devices.”
The unique properties of stem cells have spurred worldwide interest in their application in the treatment for many other diseases—cancer, kidney failure, Parkinson’s and Alzheimer’s, spinal cord injuries, strokes, burns, diabetes, osteoarthritis, and rheumatoid arthritis. With stem cell treatments, healthy unspecific or undifferentiated cells are extracted from the patient and, under complex laboratory conditions, induced to transform into cells with highly specialized functions. These are then reintroduced into the body as organ repair agents. In Doc Allan’s case, they were transformed into heart-repairing cells.
The benefits, however, don’t end with the treatments.
“The purpose of Regenerative Medicine is not only to help patients who are already ill, but also to prevent the onslaught of disease,” Dr. Bernal added. Thus, wellness and even aesthetic applications for Regenerative Medicine are also available.
While research into this pioneering medical field forges on, Dr. Bernal stresses that the patient’s well-being is still the doctor’s foremost concern. “This is not an academic exercise. This is about making patients’ lives better.”
Indeed, with the ever-growing range of therapies today, a constant dialogue between patient and doctor allows each to consider the unique circumstances of the case, and agree on healthcare options most appropriate for these circumstances. With Regenerative Medicine, the approach is even more personalized as it responds to the patient’s unique qualities at the most basic level – the level of his cells.
Doc Allan as he is today is living proof of Regenerative Medicine’s promise.
“A few weeks after his first infusion,” says Dr. Ramos. “His ejection fraction rose from 21% to 40%. He has had 3 infusions so far; and at present, his ejection fraction has stabilized at 38%. “
He is now gainfully employed at the DOH, and was even promoted recently. He plays badminton occasionally, and no longer experiences shortness of breath or any limitation in activity. Doc Allan has never felt better, and now looks forward to a long and fulfilling career as a public health doctor in the service of those with the greatest need.
Today, the 36-year-old physician makes the most of his new lease on life by working to save the lives of others. Apart from his heart, his drive to help and heal has also undergone regeneration. His personal journey speaks eloquently about the new hope that Regenerative Medicine presents.
Dr. Allan Evangelista is fellowship-trained in reconstructive surgery of the foot, ankle, and leg. He is dedicated to providing comprehensive evaluation, exceptional care, and various surgical and nonsurgical treatment options to all patients. He is accepting new patients for: Adult and pediatric foot and ankle deformities, revisional and salvage surgery, Charcot foot reconstruction, trauma (all fractures, tendon ruptures, sprains), arthritis, tendonitis, gout, sports or industrial injuries, emergency or urgent care, paralysis or muscle weakness, joint replacement, spastic neuromuscular diseases (cerebral palsy), gait abnormalities (toe walking), joint cartilage transplantation, and general podiatry (neuromas, ingrown toenails, warts).
Dr. Evangelista received his degree in Doctor of Podiatric Medicine from Temple University and completed his fellowship in complex reconstructive surgery and traumatology of the foot, ankle, and leg at Sarasota Orthopedic Associates in Sarasota, FL.