‘This unit is a blessing’: Patients undergo stent procedures at HMC

  • HOLLYN JOHNSON/Tribune-Herald Sisters Agnes Nathaniel, left, and Gwen Fernandez, right, sit with their parents, Herbert Troche Jr. and Gladys Maiers, and Dr. Carl Juneau, an interventional cardiologist at Hilo Medical Center. Juneau recently treated both Troche and Maiers.

It was an emotional reunion of sorts last week at Hilo Medical Center.

Crowded in a small exam room in the hospital’s Cardiology Clinic were Gladys Maiers, of Kurtistown, her ex-husband Herbert Troche Jr., of Ainaloa, their daughters Agnes Nathaniel and Gwen Fernandez, Maiers’ twin sister Lorraine Reddick, younger sister Madeline Silva and brother-in-law Paul Silva.


The family was joined by hospital staff, including Dr. Carl Juneau, HMC’s new interventional cardiologist who recently treated both Maiers and Troche.

Troche and Maiers were among the first patients who underwent stent placements at HMC, an interventional procedure that has only been performed at the hospital in the recent months.

For that, the family is grateful.

In February, Nathaniel, who is a caretaker for her father, said that Troche, 84, was tired and having chest pains. She brought him to see Juneau, who worked to see if Troche had a blockage.

“So they told me by 1:30 he would be done and I could pick him up and I could take him home,” she said. “I called and he said that my dad had three blockages and he put three stents in his heart and he had to stay over night.”

The procedure has only been performed on non-emergent patients at HMC since January, starting shortly after Juneau’s arrival. Troche was just the second person to undergo the stent procedure here.

If they had been unable to do the procedure in Hilo, Troche probably would have been sent elsewhere to for an angioplasty or surgery, Juneau said.

While Troche’s procedure was non-emergent, that wasn’t the case for Maiers.

Earlier this month, Nathaniel received a call from her younger sister who said their mother was taken to the hospital with chest pains.

Juneau said it was determined that Maiers’ heart needed revascularization, or bypass surgery.

Such surgery, though, would have to be done at another facility.

But high blood pressure caused Maiers to have a stroke — which meant surgery was no longer an option, the doctor explained.

Transferring Maiers the next morning was not possible because she became unstable, he said.

Juneau ended up placing two stents.

Maiers, who is still recovering, teared up as she addressed Juneau on Friday.

“I gotta say, I want to say, all my doctors, all my nurses, everybody being there for me, I want to thank all of you. You are the best …”

HMC just began performing such emergency interventions on March 1.

Prior to Juneau’s arrival, doctors at HMC could administer clot-busting medications and perform diagnostic catheterizations to determine if a patient needed to be transported off-island for further care.

But with his arrival, the hospital can now perform interventional catheterizations to stop a heart attack in progress and insert stents to maintain blood flow.

Being able to be treated close to home is “awesome,” Maiers said.

“When she was supposed to be (transported), the only thing that came out of her mouth was ‘I don’t want to go,’” Nathaniel said.

When a family member is treated off-island, it can be cost prohibitive for families to be present.

“A lot of families have family members that have to go to Oahu because the care is not here. And they’re alone because the family members cannot fly to support (them),” Nathaniel said. “So this being here, this is very, very, very good.”

The program, though, is still being developed.

“We’re in the early stages of developing a 365-day, 24-7 interventional cardiology program,” hospital CEO Dan Brinkman said. “We’re in the early stages and in the early stages offering services on a limited basis.”

HMC is limiting the service at the start “because we have to grow it,” he said.

Two more interventional cardiologists — Dr. Jamison Wyatt and Dr. James Smith — will join the HMC staff this summer and the hospital is gradually adding to the team that supports its cardiologists.

“The first main reason this is crucial is that it will save lives — period,” Brinkman said. “… This is something we know if we do, there will be 10-15 lives a year that won’t die because we did this. (It is) one of those really feel-good things because you know you’re going to get a concrete result.”

HMC sees about 60 of “these big heart attacks” each year, he said.

The program also provides general cardiology services in addition to interventional cardiology, “then you’re able to start treating and potentially preventing cardiac disease or complications of cardiac disease,” said Brinkman.

Juneau said he has performed 13 stent procedures in Hilo so far.

“Initially we were not supposed to start until this summer, but then we just got ahead of schedule,” he said.

Hilo Medical received $1.5 million from the state legislature during its 2018 session to help bring the interventional cardiac catheterization program online, and is seeking additional funding for the program in the upcoming biennium budget.

Legislation introduced in both the state House and Senate seeking funding to support the establishment of HMC’s cardiac catheterization lab have passed through their original chambers.

Senate Bill 911, which has crossed over to the House for consideration, and was referred to the House’s Health and Finance committees. The measure was approved by the Health committee on Tuesday. House Bill 527 crossed over to the Senate and passed first reading on March 7. The measure has been referred to the Senate’s Commerce, Consumer Protection and Health, and Ways and Means committees, but as of Tuesday no hearing have been scheduled on the legislation.


“We need to fund this unit,” Nathaniel said. “They need to. This unit is a blessing. … If it wasn’t for this whole team, this whole unit, I wouldn’t have my mom.”

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

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