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Soccer Player With Transplanted Heart Upsets Thinking About Rehabilitation

November 23, 1990| From the American Health and Psychology Today Service-Washington Post Writers Group

This was one scouting report the general manager had to check out himself. He walked up to Simon Keith, who was about to become his team's top draft pick of the Major Indoor Soccer League (MISL), and asked for clarification.

"I understand you've got some sort of heart problem, some sort of valve job or something," said the GM. Keith knew it was time to give yet another skeptic an education. He pointed to his chest, looked the GM square in the eyes and left no doubt about his medical status.

"One went out, one came in," said Keith. "Oh," said the GM.

"People don't actually come right out and say, 'Wow! You've had a heart transplant!"' muses Keith, who got his new heart in 1986. "It's disappointing that the public doesn't really know what transplantation is all about."

Since 1986, more than 6,000 people worldwide have received heart transplants. The majority have resumed a normal lifestyle, but in Keith's case, what's normal for him would seem miraculous to anyone else. The 25-year-old native of Lewes, England, plays for the Cleveland Crunch and is the first athlete to play a professional sport with a new heart.

Of course, Keith is not an ordinary heart-transplant patient. In superb condition before he underwent surgery, he was physiologically worlds apart from the typical transplant candidate. For those patients, just getting back to work and cutting the grass would be considered a fine recovery from transplant surgery. Still, the fact that Keith is playing at all is forcing physicians, trainers and exercise physiologists to re-evaluate the presumed limits of recovery for transplant patients.

Although heart transplants have been performed for two decades, in the early '80s doctors were still more worried about whether their patients would survive than whether they would thrive. With the introduction of the anti-rejection drug cyclosporine in 1983, survival rates began to soar. Now 80% of heart transplant recipients live at least one year, and the five-year survival rate is between 74% and 82%.

Still, the mind set until Simon Keith came along was that exercise for heart-transplant patients should be kept to a moderate level. Keith has shattered that notion.

Keith first noticed that he was sick while attending the University of Victoria in British Columbia. "I noticed that my hands and feet would go white with cold. And my stomach was real sick," he recalls. "I was still playing, but it took me longer to recover from a game or workout and I didn't have the energy I had before."

His deterioration was gradual but ultimately terrifying. "After my sophomore season I had to take myself out of school. Eventually, it came down to, 'Basically, you need a transplant.' " In perhaps the most bizarre twist to this story, his new heart came from a 17-year-old soccer player who died of an aneurysm while playing in a game.

Keith's recovery was astonishing. During the first few days, while still in intensive care at Papworth Hospital outside of London, he sat in a chair and pedaled a small machine that offered no resistance. He soon encountered plenty of resistance--not from the machines, but the people who ran them.

It took a week of angry confrontations before his nurses and doctors let Keith proceed at more of an athlete's pace. Two weeks after his transplant, he was jogging a few miles a day on a treadmill, in addition to working out twice a day on the exercise bike for 15 minutes at a time.

Less than three weeks after the transplant, Keith was discharged and immediately took up a home program that included a few miles of running each morning. and regular walks into town--town being Cambridge, England, an hour and a half away. After his breastbone healed some three months after surgery, he began weight training and within another three months he regained the muscle tone he had lost due to inactivity.

With his return to the soccer field, Keith has forced the medical community to re-evaluate its thinking about rehabilitation therapy for transplant patients. "Keith has set the tone," says Ohio University professor of exercise physiology Tom Murray. "We can now start to work our patients harder than we have in the past."

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