"An Extra Happy Camper:" An Extraordinary Journey with AFiB

At the spry age of 95, Bob Burke is ready to go to the moon. If, that is, EvergreenHealth cardiologist Dr. Jason Talavera, FACC, moves his practice there.

A father of four, Bob's 28-year Navy career flying the P-2 Neptune moved him all over the country before he retired in 1981 with 9,700 hours of flight time. He and Betty, his wife of 68 years, eventually settled in an Oak Harbor assisted living facility before she passed away in 2022.

A Change of Pace

One morning in 2021, Bob woke with weakness and low blood pressure, so his daughter Maureen, a social worker, drove him to the hospital in Anacortes.

Doctors performed an electrocardiogram (EKG), a non-invasive test that uses small sticky patches called electrodes to measure the electrical impulses of the heart.

The EKG showed that Bob's heart rhythm was in atrial fibrillation, or AFib, which is the most common type of irregular heartbeat and also known as an arrhythmia. AFib occurs when your heart's upper atria squeeze faster than they should due to irregular electrical signals and puts their rhythm out of sync with the lower ventricles. Your heart rate increases, which causes your heart walls to quiver, or fibrillate.

AFib can cause fatigue, blood clots and weakness in the heart, shortness of breath, light-headedness, stroke or, in some cases, no symptoms at all. It can be treated with medications, procedures and healthy lifestyle changes.

Bob's condition was stable, so the emergency room (ER) doctor in Anacortes sent him home with a referral to see a cardiologist. But on the drive back to Oak Harbor, his granddaughter, an ER nurse at another hospital, called and said, "Turn around and get to the hospital in Bellingham. I've already called up there and they're going to give you a pacemaker on Monday."

A pacemaker is an implanted device that uses electrical pulses to help the heart pump regularly. Even with a pacemaker, the heart's upper chambers, or atria, can still go into AFib, so doctors still prescribe blood thinners or other medications to prevent stroke and control the heart rate and rhythm.

"I'm an Extra Happy Camper"

Four months later, Bob's heart rejected the pacemaker. This time, his daughter Maureen knew exactly the cardiologist she wanted managing her father's care: Dr. Jason Talavera, who practiced at the Everett hospital where she worked at the time. She knew from experience that his care was comprehensive, empathetic and patient-centered, so even though the trip from Oak Harbor to Everett takes over an hour, it was well worth it for the quality care her dad would receive.

It was a great fit right away. "From day one, I just hit it off with him," Bob said. "He's really personable, he's professional, he speaks simple English that a layperson can understand. Every time I see him, which isn't that often anymore, he gives me a hug, and I give him one back."
Dr. Talavera ordered Bob a new pacemaker and dialed in his medications. "The battery's good for 7 years," Bob said, "so I'm an extra happy camper."

Bob wasn't the only one camping happily. "It has been a privilege to partner with Bob on his cardiovascular health journey," Dr. Talavera said. "He is truly a gem—embodying the qualities we all aspire to: kindness, resilience and a joyful heart. Over the years, Bob has faced a number of clinical challenges, but through collaboration and commitment, we developed a plan that has served him remarkably well."

To Kirkland, and Beyond!

A few years later, Maureen and Bob learned that Dr. Talavera was moving his practice to EvergreenHealth in Kirkland.

On whether to follow Dr. Talavera to Kirkland or find a new cardiologist, Bob's answer was simple: "I wasn't gonna go get another doctor," he said. "I've got the best; I'm happy." So they transferred care to EvergreenHealth, and Bob and Maureen have been making the two-to-three-hour-long trip from Oak Harbor to Kirkland ever since. "Because it's worth it," Bob added.

"After working in a hospital all those years, you know amazing care when you see it," Maureen said. "I don't worry about his heart. If something happens, I know I can call the office, and I know I'll get an answer in half an hour. He has a button he can push if he feels his heart flutter, and we can call them to see if he's fine or we need to do anything. They're always looking out for him."

Bob is similarly content. "Dr. Talavera's been fantastic," he said. "Every diagnosis, prognosis and medication adjustment has been nothing but perfect. He's dialed in the right combo where the AFib comes and goes but it's less than two percent, which is nothing. He says I'm good to go to 100 and I said to him, ‘If I'm gonna go to 100, I've got to have you around.'"

"I already followed him from Everett to Kirkland, so if he moves to the moon, I'll be on the next shuttle," Bob said with a chuckle.
And who knows? With well-controlled AFib and 9,700 hours of flight time, he might even fly it himself.