A Walking Wonder

At 73 years old, Jim Mosetter has an attitude—and a heart—that won't quit. With ten stents in his arteries, he's still going strong. Jim's story starts the same as many others: He had pain and ignored it. For three months, he experienced mild pain in his chest that he didn't pay attention to until it became so great he found himself in the hospital.

Jim and his wife Isabel were attending an event at Fort Mifflin in Philadelphia when Jim started to feel unwell. He went to rest in the car and all of his friends kept checking on him. Later on, when he still wasn't feeling well, his wife called the ambulance. At the hospital, the doctors confirmed that he had indeed suffered a mild heart attack and performed open heart surgery on him.

That was nearly eight years ago. After almost 50 years of marriage, Isabel was relieved that he was OK for the time being. Jim and Isabel had met when they were in college and, in Jim's words, he "didn't marry her soon enough." In the early years they lived on Chinese food, and Jim "wined and dined" her on cinnamon rolls and coffee. They had one child together, a son, and now have a 22-year-old granddaughter, Stephanie.

While Jim and Isabel still share Chinese food on occasion, their bigger mutual passion is participating in Revolutionary war re-enactments and providing living history about the war. They dress up as real people from that time period and answer questions about the war.

"It was our son who sparked our interest over 38 years ago. We took him to Independence Hall for a presentation with Red Skeleton and he was fascinated with the soldiers," said Jim. "After the presentation, we went to talk with them and they invited us to Fort Mifflin. I've been hooked ever since and Isabel followed soon after."

While it is Jim's passion to continue to provide living history about the war to anyone who asks, the "war" with his arteries continued after his open heart surgery.

Within eight months of that surgery, Jim's pain started again, and once more he found himself back in the hospital. The doctors performed surgery to place three stents in his heart arteries to address the blockages he had. Around this same time, he began to experience claudication, or pain in his legs when walking.

It was in November of 2001 that Jim first met Dr. Emile Mohler, a vascular medicine specialist at the University of Pennsylvania, who confirmed a suspected diagnosis of peripheral arterial disease (PAD). PAD occurs when the arteries that supply blood to the legs become blocked. It was not a real surprise to Dr. Mohler, since having blocked arteries in one part of the body is a risk factor for having blocked arteries in other parts of the body. It is common for blocked arteries in the heart to be associated with blocked arteries in the brain and legs.

"Jim came to see me for claudication and risk-factor modification (management of blood pressure and cholesterol)," said Dr. Mohler. "I invited Mr. Mosetter to participate in a gene-therapy study that we were offering at the university."

The study Jim participated in was the "Regional Angiogenesis with Vascular Endothelial Growth Factor (VEGF) for PAD" study. The study, which had over 100 participants, sought new ways to improve the growth of new blood vessels as a way of bringing more blood to the legs in patients with PAD.

Unfortunately, the study proved inconclusive and did not benefit Jim or the other participants, "I had so much pain in my legs that I could barely walk," said Jim, "but I was happy to volunteer to see if the treatment might help others."

Dr. Mohler continued to prescribe a regimen of exercise and some medications to help manage Jim's blood pressure and cholesterol, and his symptoms improved somewhat. Jim now has a regimen of over ten medications, including anti-platelet medications. He was stable for about two years when his chest pain started again. According to Dr. Mohler, Jim was not considered a candidate for angioplasty of the legs.

Jim had another episode right before his and Isabel's 50th wedding anniversary, which they celebrated by taking a trip to Hawaii. While they were in the air on the way home from a "wonderful time," Jim began to experience chest pains once again.

"We were 30,000 feet in the air and I didn't want to worry Isabel," he said. "We had had such a wonderful time that I just kept popping my nitro (nitroglycerin tablets) and praying everything would be alright."

The next day Jim again found himself in the doctor's office. He was catheterized and had five more stents placed in his arteries. At about this same time, the doctors ran additional tests and discovered that Jim's blood sugar was high and diagnosed him with diabetes.

Through medication they were able to control his blood sugar, but he then started to experience a sensation of pins and needles in his feet. Without a formal diagnosis, this pain could be characterized as peripheral neuropathy, a common effect of diabetes (see article on page 3 for more information about neuropathy) that affects the feet.

Jim comes from a "strong Irish family" that does have a history of heart disease and diabetes. He also smoked a pipe for many years, but stopped after he had his heart attack. He has five doctors that he still sees, including Dr. Mohler.

"Jim is a real gentleman, a gentleman with a limp," said Dr. Mohler. "While he is currently stable, we need more research to find new ways to open up and grow new blood vessels for him and others with a similar condition."

Jim worked as a paint salesman for over 40 years and has now retired, but he strives to have fun and enjoy himself every chance he gets. While he continues to have leg pain and now has trouble with his knees, he takes medication to manage his blood pressure, cholesterol, and blood sugar, takes daily walks, and he stays as active as he can. He quit smoking after his first heart attack. These are all important risk factors which people need to be aware of when managing heart disease and PAD. He and Isabel continue to travel around to various states on the East Coast to provide history and participate in war re-enactments.

"I am married to a wonderful woman and now I have a beautiful granddaughter," says Jim. "The key to life is to make the best of what you got and just have fun. The doctors say that 'I'm a walking wonder and it's a wonder I'm still walking'. Maybe so, but I'm still here and going strong!"