(Editor's note: Erik Gelhar's illness and hope for a new heart has been chronicled in The Bellingham Herald since September 2009, when he was living in Bellingham.)
EVERETT - Erik Gelhar pulled up his T-shirt to show the pink, vertical scar on his chest. Beneath beat the heart from a donor.
"It was Oct. 27. It was my new birthday," the 29-year-old Gelhar said of his heart transplant at the University of Washington Medical Center in Seattle.
During the difficult 13-hour surgery that day, the Bellingham High School graduate suffered a stroke caused by a large clot in his brain stem. He couldn't move, breathe on his own, speak or see.
His family didn't know the extent of the damage to his brain. They didn't know if he would ever recover.
Yet, here he is this Monday, March 31, walking with the help of a cane into Providence Regional Medical Center in Everett for occupational, physical and speech therapy sessions to correct the damage caused by the stroke.
His new heart is fine, Gelhar said. Now living in Everett, he said his goal is to get back to normal.
"Only time will tell if Erik will make a full recovery, but if anyone has a shot at it, it's Erik," said his wife Jenn Johansen Gelhar, 28. "Erik is a fighter and has a stronger will to live than anyone I know."
His fight started when Gelhar was 23 years old.
He started to feel "funny" in July 2007. He couldn't sleep, he felt anxious, and his chest felt tight.
That August he was diagnosed with idiopathic dilated cardiomyopathy, which essentially means he has heart failure and doctors don't know why.
Formerly healthy, Gelhar's condition deteriorated within months, and he had to give up the high-paying merchant mariner job that he loved.
In January 2010, he flew to Dusseldorf, Germany, to begin stem-cell therapy, using his own cells, in the hope of stabilizing his weakening heart and delaying a heart transplant.
A heart transplant has risks and, even if all went well, he could need another heart in as soon as 10 years.
The stem-cell therapy didn't make his heart better.
So in December 2010, doctors implanted a battery-operated mechanical pump, called a left ventricular assist device, to help his failing heart do its work.
Then he waited for a heart transplant.
During the wait, two of his friends on LVADs - as the mechanical pumps are called - developed clots and died.
Gelhar also developed a blood clot, in the inflow tube of the pump. He was given a drug called tissue plasminogen activator (tPA), which has been likened to Drano, to dissolve the clot.
It rarely worked, he said. It did for him. "I really dodged the bullet there."
He had stomach problems and headaches. He didn't have much energy. "I felt crummy," he said.
When the call came the afternoon of Oct. 26, 2013, telling Gelhar that a donor heart had been found for him, "I thought they were kidding."
He had pushed the idea of a heart transplant to the back of his mind. He had learned the first year or so of his illness to "not really set your hopes high."
Jenn said she was in "complete disbelief."
"It was a call we had been waiting for almost three years," she said. "After waiting that long, you start to believe it will never happen.
"I cried tears of joy for about two minutes and then went numb, into survival mode. I had to prepare myself for what was next. A very risky surgery. The chance I would never see my husband again."
THE ROAD BACK
Gelhar bled heavily during the surgery. Infusions were needed to replace his blood five times over.
Before she left the hospital the night of Oct. 27, Jenn briefly saw her husband.
He was sedated and on a ventilator. There were tubes and lines everywhere. He was swollen and looked like he had been through hell, she said.
"It brings tears to my eyes to think about what my husband has had to endure, not once but twice - first the LVAD and then the transplant."
Doctors found the large clot - made up of connective and fatty tissue - in his brain stem two days later. The surgery to remove it was supposed to take one hour; it lasted three.
"Erik has been recovering every day since then. He has gone from not being able to move, speak, breathe or see, to walking with a walker, carrying on conversations, reading books and breathing without oxygen," Jenn, a cardiac nurse working at The Everett Clinic, said in mid-March.
"He spent almost three months in the hospital in an intense rehabilitation program fighting for every inch of what he has regained."
That fight continued March 31 at Providence Regional Medical Center as Brian Nitta, an occupational therapist, guided Gelhar through a series of exercises meant to improve his upper-body strength and endurance, eye-hand-foot coordination, fine-motor coordination, and his ability to scan with his eyes and to multitask.
In one exercise, Gelhar had to guide a metal ball into different holes in a labyrinth designed for rehabilitation. He grasped two handles on either side of the table to move it left and right and pushed down on a lever with his two feet to move the maze inside the table up and down.
"As you're doing it, I want the motions to be nice and smooth," Nitta said.
In another exercise, Gelhar had to grab three small nails with his right hand and then put them into a number of small holes. Then he repeated the exercise with his left hand.
"Take your time," Nitta said. "Try to get all three in at the same time."
After the session, Gelhar worked with physical therapist Nancy Kelley on balance and coordination in his lower body.
Touching his waist and shoulders to help guide him, Kelley had him walk. Then walk while holding a cup of water to help him focus.
She had him do lunges until his knees touched a cushion on the floor.
Gelhar's mom watched as her son went through his rehabilitation.
"I'm sure it's a miracle recovery," said Susan Gelhar, a Bellingham resident. "We always knew he was a strong person."
Erik Gelhar is intent and positive during the sessions. Later, he said he just tried to make the best of things.
"I've always been an optimist," he said. "I can't tell if I'm really lucky or unlucky."
He and Jenn said they're grateful for his continued recovery and "forever grateful to his donor."
(All they know about the heart donor is that the person was 6 feet 9 inches tall.)
"I'm very grateful for all the support," Gelhar said of what's been offered to him over the years by friends, family and strangers. "I feel like I'm right at home wherever I am."
Jenn added: "My husband is truly the most amazing person I will ever know. He has not been mad or felt sorry for himself, not even for a second. He has only felt lucky and grateful for receiving the gift of life."
The Gelhars said they're no longer waiting for that call. Their lives are no longer on hold. Gelhar plans to go back to school for a degree in city planning.
They have big plans for travel and for children. Jenn is pregnant, with their first child due mid-November.
"I'm very happy," Gelhar said, adding that the baby's birth gives him a goal.
"It makes me want to get better faster," he said. "By then, I expect to make a full recovery."
VIDEO OF ERIK'S REHAB
Go to bellinghamherald.com/multimedia to see a video of former Bellingham resident Erik Gelhar as he talks about his heart transplant, stroke and rehabilitation.
An account has been set up to help former Bellingham resident Erik Gelhar with his medical bills.
Donations may be made to The Erik Gelhar Donation Fund, account no. 283726, at Whatcom Educational Credit Union branches. Or send them to the credit union at P.O. Box 9750, Bellingham, WA 98227.
Reach KIE RELYEA at firstname.lastname@example.org or call 715-2234.