Preventable, early deaths have happened too many times in Louis Ashley’s family.
“I’ve lost three of my four brothers,” said Ashley, a 51-year-old fluids engineer with a Texas oil company. “One drank himself to death, another died by suicide and one died in a car wreck. I suppose I’m the one who can change his lifestyle before it’s too late.”
Though he and his love Juliet live in Louisiana, Ashley has worked in Texas for 15 years on a 14 days on, 14 days off schedule. He designs the hydraulics and fluid systems that the company uses to pull oil out of the ground.
Juliet is a nurse who specializes in cardiovascular medicine and was the first to notice dangerous warning signs in Ashley’s health.
“Sometimes I am on my feet for 18 hours,” explained Ashley, “so when I get home and see some swelling, I usually elevate my feet, take a break and don’t think much about it.”
Compounding Ashley’s health issues were his weight (260 pounds on a 6’ 4” frame), smoking and poor diet.
“Especially when I was working in Texas, I ate whatever I felt like eating,” he recalled. “I know I could have lost 20 to 30 pounds if I tried, but I didn’t consider myself obese. Still, I ate a lot of salty and fried foods, especially when eating at restaurants. A healthy diet wasn't on my priority list.”
Out of the blue
Then in November of 2022, Ashley mentioned to Juliet that he was often short of breath and his feet were swollen. She immediately suspected that he had congestive heart disease.
“I never thought there was a history of heart disease in my family, though my dad did have bypass surgery when he was 72 years old.” Despite the news, Ashley was slow to take action and did not see a doctor before heading back to work in Texas.
But when he woke up with severe shortness of breath and not feeling well, Ashley asked his friend to take him to the Emergency Department at UT Health Tyler. He was put under the care of Dr. Preetham Muskula, an interventional cardiologist with UT Health East Texas Heart and Vascular Institute.
“I learned later that I had so much fluid around the heart muscle that it was difficult to pump blood to my body,” said Ashley. “They said that I was close to dying, as my EF was only 5%.”
EF stands for ejection fraction, which is the amount of blood that the heart pumps (ejects) out to the rest of the body. A percentage of 45 or less can be evidence of disease of the heart muscle cardiomyopathy).
Dr. Muskula quickly used a catheter to install a device into the left ventricle of Ashley’s heart. This miniature pump helped Ashley’s heart push more oxygen-rich blood throughout the body.
The device, however, is best used for short-term support of the heart, so once he was stable, Ashley was airlifted to receive further care at another facility in Dallas.
Transferred to Dallas
In Dallas, Ashley was put into a medically-induced coma on a ventilator to help him breathe easier while his heart was resting and healing.
After 14 days, patients must be taken off a ventilator to breathe on their own. As the staff started to move around his bed to remove the equipment, Ashley lay unconscious but said later that he still aware of many things.
“I could hear voices in the room and felt a sense of activity around my bed. I don’t remember any of them being enthusiastic about my chances to survive when they turned the ventilator off and removed the tube. The room became silent except for one voice, Juliet’s, so close to my right ear that I could sense her breath and smell her scent.”
"Louis baby, can you hear me? You have to breathe baby, take a deep breath,” she said. “Good, you’re doing great. I'm right here, take another breath love... wonderful, you’re doing so good."
With those first breaths, Ashley started breathing on his own and slowly regained consciousness.
Once home, Ashley told Juliet how much her support and words of encouragement helped him.
“I told her what happened, what I heard and what it meant to me. That’s when she gave me the look she gives me when she disagrees with me or tells me I’m mistaken. She said, ‘But Louis, I was 400 miles away when the staff took the ventilator out of you.’”
Now it has been scientifically proven that patients in a coma do retain their ability to hear sounds around them. As Ashley was starting to come out of his medically induced coma, perhaps a combination of sounds, medications and a dream-like state made him “hear” Juliet’s voice. Regardless of the explanation, her encouraging words motivated him to wake up and start breathing on his own.
Back to Tyler
Ashley returned to UT Health Tyler to complete his recovery and begin rehabilitation under the care of Dr. Muscula. “He got me on a diet and on an exercise program,” said Ashley. “I lost 30 pounds from being in the hospital and have gained a few back, so I now weigh 240. I am also increasing my activities and trying to quit smoking.”
While in his hospital room, there was one moment with Dr. Muskula that made a profound impact on Ashley.
“One day Dr. Muscula came into my room, introduced himself and sat in a chair,” he recalled.
“I’d like to have a conversation with you,” he said.
“Sure, doc. What would you like to talk about?”
“It doesn’t matter, Louis” he replied. “The day you arrived at the ED, we saw three men that day with the same condition – cardiogenic shock. Two of them did not survive, so you’re the only one who will be walking out of here. That’s why I want to get to know you.”
“I am a faith-filled guy,” Ashley said. “I believe in the Creator. I also know that my heart was not working well enough to sustain my life. Perhaps the Creator put me into Dr. Muskula’s capable hands that day because it just wasn’t my time.”
Looking ahead
As Ashely regains his strength and completes the rehabilitation program, he is looking forward to going back to work.
“I love my job and I’m looking forward to returning to work, I just need to make sure I’m physically able to do so,” he said. “I made great strides in the five to six weeks after getting out of the hospital, but my progress has leveled off lately. Hopefully, I can continue to improve and return to work.”
As for his diet, Ashley has become more aware of what he eats every day.
“I'm very careful what I eat because when I eat too much salt, I can actually feel the water retention. I will swell up the next day and it will take me two more days to get that out of my system. I have also found that there are a lot of good healthy foods that taste good and make you feel good. It’s only now that I learned that,” he added. He also plans to severely limit his smoking and eventually quit.
Ashley credits Dr. Muskula and staff for returning him to his current level of health.
“Dr. Muskula, his staff and the entire clinic treated me exceptionally. They went out of their way to look out for my well-being. If it weren’t for his actions, I wouldn't be alive. I owe my life to him.”
He also realizes that he has a rare second chance to live the life he truly wants.
“I'm aware that I am around the same age as my brothers when they passed, but it’s not something I really think about,” Ashley said. “After the recent events, when I was afforded the opportunity to come face to face with my own mortality, it brought to the forefront the fragile and short experience of what we call life. Those events have become a strong motivator to reevaluate myself and take inventory of my priorities.
“To me, and perhaps to others, this is the moment when you realize that you have more things that you'd like to do in this world than you will have time to do them, so choose carefully.”
For more information about cardiac care services, ask your doctor about a referral or visit UTHealthEastTexas.com/heart.