Robert Gamble is on his third heart.
His first — the one he was born with — lasted 38 years before the heart attack.
He got a replacement in 1991, heart No. 133, as in the 133rd heart transplant in Tampa General Hospital's history.
The second transplant came in 2004, heart No. 625.
"I wear them out," Gamble jokes, while making his rounds at TGH, where he visits new transplant patients a couple of times a month.
The 59-year-old runs a monthly support group, the National Organization for Transplant Enlightenment. A few members have had multiple transplants like him.
Though still not the norm, second transplants are becoming more common as patients live longer and sometimes get heart disease again, said Angie Korsun, TGH's transplant administrator. "We have about a 3 percent re-transplant rate," she said.
For the patients there, Gamble offers advice, and hope.
"I know how important it was to talk to someone like me and find out there's life after transplant."
• • •
"They told you about going out in the sun?" Gamble says to Steve Riambau. "You have to get greased up like a pig."
Riambau, 53, of Naples, had gotten a new heart 10 days earlier, after waiting more than a month for a donor, and medications that keep transplant patients alive also make them susceptible to sunburns.
Gamble remembers TGH's heart recipients like jersey numbers. Heart No. 2 belongs to Lakeland resident Frank Spurlin. Today, 24 years later, he is the hospital's longest living transplant recipient.
"We all look up to him," said Gamble.
The other numbers he carries are the ages of the men who died and left him their hearts. The first was 47, the second 20. That's all he knows of them.
High cholesterol and heart disease ran in Gamble's family; an older brother died at 34 of a heart attack.
Gamble was 38 and living in Michigan when he had his first attack. Almost a year later, he had another, followed by a triple bypass surgery.
In 1989, doctors told him to pack his bags and "move somewhere warm to be comfortable," he said. He needed a transplant, but he was so far down on Michigan's waiting list that doctors said he would die before one came through. He might as well enjoy what time he had left.
"Where do you want to move?" Gamble and his wife, Dorothy, asked their three boys. Upper Michigan, where they had vacationed before? Florida?
"I took a quarter and flipped it," Gamble said. "It bounced onto the floor landing on heads —Florida."
Gamble didn't know it at the time, but the waiting list here was much shorter than in Michigan. He was on Tampa General's list four months before he got a new heart.
The procedure was experimental back then. Just a few years earlier, in 1985, Tampa General doctors performed Florida's first successful heart transplant on Tom Thrasher, who would live 10 years and start the support group Gamble now leads.
• • •
After a transplant, the body operates on a delicate balance of medications to keep it from rejecting the foreign organ. Survivors live in controlled rejection, requiring immunosuppressant drugs, which narrow arteries. This is what caused Gamble's first transplant to eventually give out.
The transplant had cost $130,000, which his insurance covered. Afterward, his former boss told him he could come back to work — but not with health insurance. The cost of his care would put the small conveyor manufacturer out of business, he was told.
Gamble couldn't afford to go without insurance. He had worked in construction previously, but doctors told him that was no longer an option. No dirty or stressful jobs. He ended up on disability and going back to school. He got an associate's degree in business management from Pasco-Hernando Community College in 1995.
With his degree, he threw his efforts into championing causes for the disabled. He volunteered with various groups and LifeLink of Florida.
Medicare and a TGH program for patients who need financial help covered the $250,000 for his second. His drugs cost about $1,700 a month, he said.
Through the support group at TGH, Gamble helps raise money for survivors' medications. Recently, the group paid for a week at a motel for the family of an 18-year-old heart transplant patient. They've paid for wheelchairs, gas cards and an electric bill.
His doctors told him the volunteer work he does is more important than any job. "You can be proud of that scar," Gamble told Riambau at Tampa General.
• • •
Gamble focuses on enjoying family and life from his home in New Port Richey. He rides his motorcycle most every day.
Still, death feels like a close companion, constantly lingering in the back of Dorothy Gamble's mind.
"Is today going to be the day?" she wonders.
She makes sure her husband takes his medications and notices when he seems off.
Gamble doesn't foresee getting a third transplant.
After his first, doctors told Gamble he'd probably live five years. He got 14.
They told him 10 years for his second.
He's hoping to get 15.
Elisabeth Parker can be reached at firstname.lastname@example.org or (813) 226-3431.