On June 18, 2002, Michael Kornstein came home from work and went to bed to rest. Although he had been going about his daily routine, he had not been feeling well for the past couple of months. He felt lethargic, his feet were swollen, and he was being treated for anemia. But things were about to get much worse.
When his wife came home she went to her husband and tried to wake him. "I couldn't get him up, and his left arm just flopped," said Cookie Kornstein. That's when she called 911. When the paramedics came, Kornstein tried to get up but he just stumbled. He was then rushed to the University of Maryland Medical Center.
As it turned out, Kornstein had just suffered a stroke, which affected his entire left side including his hands, arms, legs and mouth. "My left arm and leg, I couldn't feel them," he recalled.
Subsequent tests conducted by Medical Center staff determined that Kornstein
had endocarditis, an
infection of the heart valve. This infection is actually what caused his stroke.
"There was a bacteria that attached to my heart valve," said Kornstein.
"So what really caused the stroke was the bacteria that broke off and went
into my bloodstream and then into the left side of my brain."
"He had a really serious problem; it was scary. He had endocarditis, which is fairly rare," said James Gammie, M.D., a cardiac surgeon at the University of Maryland Medical Center and an associate professor of surgery at the University of Maryland School of Medicine.
The endocarditis worsened a condition Kornstein already had, called mitral valve prolapse. Mitral valve prolapse is a disorder in which the heart's mitral valve billows out and does not close properly. Kornstein had already had this condition for a few years, and was being treated with medications.
But once Kornstein contracted the endocarditis, it started to damage his mitral valve. "The fact that he had a second embolic event, and that his valve was more leaky meant that an operation would be necessary," said Dr. Gammie.
After a series of tests were run for several days, Dr. Gammie told Kornstein that they had to operate on him to replace or repair his infected mitral valve.
"Michael's mitral valve was extremely leaky; without an operation, he would have developed heart failure. Also, operating made it much more likely that he would completely eradicate the infection," Dr. Gammie explained.
Dr. Gammie informed Kornstein that he had two types of valve replacements to choose from in case surgeons couldn't repair the valve -- a tissue valve, or a metal valve. Tissue valves last about 10 years, but there is a possibility of needing a replacement. The metal valve lasts a lifetime, but requires that a patient take blood thinners for life. Kornstein decided on the lifetime valve.
Kornstein said although the situation was frightening, Dr. Gammie put him totally at ease. "He left me with the confidence that he would do what was needed to be done and I would be fine," he recalled. "He was the most impressive doctor; his presence left me relaxed."
Despite his concerns, Kornstein was determined to move ahead. "My wife was more nervous; I was much more confident. I knew my objective -- I would do whatever had to be done to get better," he said.
Good News After Surgery
Kornstein went in for surgery on a Thursday. "Dr. Gammie's entire team couldn't have been better," noted Kornstein. "They were very professional. When I came out of the surgery, Dr. Gammie was so excited because he was able to repair my existing valve and did not have to replace it."
"We were able to repair his valve because the infection was localized to several small areas on the valve leaflet; we cut these out and patched the holes with some pericardium (the sac that lines the heart)," explained Dr. Gammie.
So instead of being on blood thinners for life, Kornstein would only be on them for a few months.
Recovery and Rehabilitation
The day after his surgery, the nurses were already helping Kornstein out of bed and getting him to sit up. After the surgery, Kornstein reassured Dr. Gammie that he would be fine. "I basically said to him: "I'm going to get better because I'm not going to let you down. Before he left I showed him that I was able to lift my left hand," said Kornstein.
Doctors were so pleased with Kornstein's progress that he was sent to Kernan Hospital for rehabilitation therapy five days after his heart surgery. He remained there for three weeks and was then released.
"They were amazed at the progress I had made in the therapy, and I gained the ability to walk," Kornstein said.
Said Kornstein's wife, Cookie: "He's really doing very well. He came from not being able to walk at all, [and having his] speech affected to being able to walk and talk. He still does not have full use of his hand. His general mobility is fine. He's driving now."
She said throughout the whole ordeal, her husband's determination never wavered. "He's got such a good attitude, very stubborn. His stubbornness has paid off," Cookie said. "He's never complained, since day one."
Now that Kornstein is back home, he is receiving outpatient cardiovascular rehabilitation therapy, and occupational therapy to improve the mobility of his left arm and hand.
He is driving again, and he went back to work after Thanksgiving at the store he and his wife own, "I Love Theater." The store, located in Ellicott City Md., features entertainment-related merchandise such as hats, T-shirts, mugs, and key chains.
A month after his surgery, Kornstein went to Dr. Gammie for a checkup. "He was really happy with my progress," Kornstein said. "I told him once I was back to normal I wanted to come back to the hospital to do volunteer work. I wanted to be able to give back in some way."
Kornstein also showed his gratitude to Dr. Gammie in another way.
"From the time I went home until the time I had my four-week checkup I had a company make up a plaque for Dr. Gammie and his team. We spilled our guts on the plaque thanking them," said Kornstein. "I couldn't think of a better way to thank them, and it was something I had to do."
By Michelle Weinstein Murray