A: As you are well aware, there is an extreme shortage of organs, including hearts, suitable for transplantation. In 1982, the United Network for Organ Sharing (UNOS) was formed to provide equitable distribution of transplant organs. Located in Richmond, Virginia, UNOS is a nonprofit organization that administers the Organ Procurement and Transplantation Network (OPTN) to facilitate organ matching and placement according to equitable policies based on objective medical criteria such as blood and tissue type, medical urgency of the patient, time spent on the waiting list, distance between the donor and recipient, and so on. There are about 2,500 heart transplants yearly in the U.S., with many thousands more on the waiting list. The waiting time varies from several days to several months or longer.

Give the Gift of Life The Saturday Evening Post

For the nearly 50,000 Americans seeking relief each 
year for debilitating bone-on-bone ankle pain and disability, there’s good news. Recent advances in arguably the 
most intriguing area of orthopedic surgery—total ankle replacement—are making strides in restoring mobility and quality of life to patients.

Today, four total ankle replacements are used in the U.S.: the Agility, the Inbone, the Salto Talaris Anatomic Ankle, and the Scandinavian Total Ankle Replacement (STAR).

“The technology is light years ahead of where it was a decade ago,” says Dr. Robert Anderson, an orthopedic surgeon in Charlotte, North Carolina, who performed more than 40 Inbone procedures in the past two years and is part of a design team working on a second-generation device.

Hi-tech artificial ankles provide a new alternative to surgery, which permanently fuses worn-out joints. That procedure reduces ankle pain but often limits mobility, causes a limp, and can lead to arthritis in nearby foot joints. An estimated 25,000 Americans underwent ankle fusions in 2009; others considered even more drastic measures.

Reasons for needing an ankle replacement include wear-and-tear over time, accidents, sports injuries, and bone diseases that lead to severe and life-limiting arthritis.

Four years ago, Jeanne St. John’s ankle problems led her to the brink of a difficult decision.

“I was born with deformed ankles and, eventually, was 
so immobilized by arthritis that I considered a double amputation,” recalls St. John, who lives in Oregon. “Then a friend heard about the Inbone. It’s been life-changing for me.”

As with hip and knee replacements, the history of total ankles dates back to the 1970s. Healthy ankles can withstand 1.5 times one’s body weight while walking, but early devices didn’t hold up. Then, Dr. Mark Reiley—who performed St. John’s surgeries in the San Francisco Bay Area—devised a new way to replace the complex joint.

“Dr. Reiley took the proven technology of knee replacements and basically flipped it upside down to be used in the ankle,” Dr. Anderson describes. “The device, now called the Inbone, has very good mechanical advantages and can be used for primary replacements, as well as revisions of failed or previously placed devices. We believe it will be successful 
for a long time.”

Orthopedic surgeons select the specific ankle replacements depending on patient age, anatomy, bone quality, and goals. Long-term success rates on Inbone are not yet available; European data show that 85 percent of modified Salto and STAR devices are functioning well after 10 years.

But Jeanne St. John, now age 67, prefers to focus on how far her new ankles take her.

“I think in terms of steps rather than years,” she says. “I save my steps for selected activities and for travel. Some of my friends are slowing down, but I have this ‘reverse aging’ thing going on, and I’m so thankful.”

Good News for Bad Ankles The Saturday Evening Post

A: Bypass vessels, particularly when veins are used in contrast to arteries, can clog or narrow (note President Bill Clinton’s recent incident), but it usually occurs years after the surgery. Damage to the bypass vessel during surgery sometimes triggers early scarring. In any event, an obstructed bypass vessel can often be propped open with a heart stent, a wire mesh tunnel that is inserted with a catheter, as Clinton had done.

Heart Scars The Saturday Evening Post

He knew that, at his age, his career was in the ‘now or never’ stage, and it seemed this season was the one that would make it ‘now.’ Through May, Cerv was leading the American League in home runs and RBIs while batting .344 with the Kansas City Athletics’ (now in Oakland).

Then, fate struck.

On May 17, Cerv was rounding the bases trying to score against the Detroit Tigers. As he rounded third, he knew the throw was going to beat him to home plate. There are only a few things a baseball player can do in that situation. One is try to slide below or jump over the tag by the catcher. Unfortunately, at 6 feet and 220 pounds, agility was not Cerv’s forte. This left him one option—lower his shoulder and run head-on into the catcher to jar the ball loose.

Base runners make this decision to this day. It is a scary situation: the catcher is standing still, concentrating on trying to catch a ball often thrown from all the way across the field, while an opposing player is running at him full speed, with every intention of knocking the ball — and the daylight — out of him. (This is why the catcher is typically the stoutest and strongest player on the team.)

In Cerv’s case, it did not work out. Not only was he tagged out, but the collision left him with a broken jaw.

Bob Cerv (right) fractured his jaw in this home plate collision with Detriot Tigers catcher Wilson.

Doctors said he would be out for six weeks, but Cerv was having none of it. He was back three days later. After six weeks playing with his jaw wired shut, Cerv was still batting .310 and leading the American League in home runs and RBIs.

The Saturday Evening Post covered this story in 1958, and we recently caught up with Cerv, for a follow up interview.

Not surprisingly, he is still going strong. “I may be 85, but I still have a pretty strong brain,” Cerv says.

He recalls that season like yesterday, especially eating with his jaw wired shut: “That was my best season. I hit 38 home runs, finished third in hitting; RBIs and runs, and beat out Ted Williams to start in the All-Star Game. I remember when I first had to eat after I broke my jaw. We got a ½ pound of steak, green beans, and potatoes, threw it all in a blender, and I had dinner through a straw.”

Although he was with the Kansas City A’s in ’58, he spent the beginning and end of his career with the Yankees, playing with all-time greats like Mickey Mantle, Joe DiMaggio, and Yogi Berra, to name a few. He still stays in touch with the ones that are still around. “I just saw Yogi recently,” says Cerv. “Our birthdays are only a week apart. I was born on May 5, and he was born May 12.”

Cerv was Roger Maris’ roommate when he hit home run number 61. Cerv and Maris often roomed together, because the Yankees’ manager didn’t understand Maris’ personality and wanted Cerv, the seasoned veteran, to help him figure it out. “Roger asked me ‘Why are you my roommate now?’ when I first roomed with him,” recalls Cerv. “I told him, ‘To tell the truth, the skipper wants to know what makes you tick.’ We were best buds after that.”

Free at last: Cerv could open his mouth, but sore jaws forced him to forgo the sirloin steak he craved.

Cerv also recalls playing with another Yankee legend, Billy Martin. “He was a ballplayer. A little hotheaded, though. He didn’t take any crap.” Many New York fans know this is true. Although Martin played with the Yankees on several World Series teams, he is best remembered as the fiery manager who got in umpires’ faces, got angry with veteran players (especially Reggie Jackson), and won games.

Although his playing days are long over, Cerv still reminisces about his time in the big leagues and compares his experience to players today. “When I signed, it was for $5,000.” Obviously, a little less than what players are making now. “Pitching was the name of the game back then. There were only eight teams in the National League and eight in the American, so teams stockpiled the very best pitchers,” he said. “That was also before they lowered the pitching mound. If you got a hittable pitch across the middle and fouled it off, you screwed up.”

After baseball, Cerv became a family man. He has 10 children, all of whom went through college, 32 grandkids and 10 great-grandchildren (with one on the way). He currently resides in a quiet condo in Nebraska.

Read Bob Cerv’s original 1958 article, “I Played Without Eating” [PDF].

A True Tough Guy The Saturday Evening Post

Changes in mentation (mental activity) can occur in a minority of patients after coronary artery bypass surgery. The reason(s) for this are not entirely clear but may relate to use of the heart-lung machine to which your blood circulation was connected as a “substitute heart” when your own heart was stopped to make repairs. In some patients it is thought that very tiny clots form in the tubes of this machine and travel to the brain, affecting its function. A second possibility for your hallucinations is a side effect from medications. You don’t mention taking any drugs, but sometimes narcotics like Percocet or other medications can be responsible. Whatever the cause, if these hallucinations continue, you should definitely tell your doctor about them so you can be evaluated. They are not fun to have.

Hallucinations and Heart Surgery The Saturday Evening Post