Six Months On (Episode 4) — The Monster Under the Bed

According to the American Thoracic Society pneumonia is described as an infection of the lungs in which the lungs fill with fluid making it difficult to breath. About 3 million cases of pneumonia were reported in the U.S. in 2015 and around 65 thousand of those resulted in death. Most pneumonia patients recover without hospitalization but the mortality rate for pneumonia patients has not changed much since antibiotics became widespread over 50 years ago. Pneumonia is caused by bacteria, a virus or fungi. To oversimplify things, it can be serious — even fatal — but most of the time it is treated and gone in a few days.

So how did I go from a little wheezing and a mild fever to (not to be overly dramatic about it) a deathbed? Especially in such a short period of time. As it turns out there was another monster hiding under the bed that gets far less attention than its friend with the silent “p” — Acute Respiratory Distress Syndrome (ARDS). ARDS is an infection of the lungs in which fluid builds up in the tiny, elastic air sacs in you lungs. It is often caused by injury to the lungs and typically occurs in patients who are already critically ill. It is described by more than a few sources as “often fatal.” Those who do survive often have severe problems for the rest of their lives due to the damage it does to the lungs. Treatments typically center around trying to keep enough oxygen in the blood and preventing damage that ARDS can cause, meaning time is the only real cure for the disease itself. In other words, shit was getting real and it was about to get realer.

When they intubated me it took longer than it should which meant I was going longer without oxygen than I should. Brain damage from going too long without oxygen was a real concern. (I know. I know, How could anyone tell? Yeah, I get it.)

After telling Susan that they did not expect me to make it through the night, they came back to her with a possibility of another treatment that might help the situation. The procedure was called ECMO (Extracorporeal Membrane Oxygenation). Essentially an ECMO unit is machine that resides outside of the body — extracorporeal — and acts as both a heart and lung by pulling blood from the body, putting oxygen into the blood and pumping it back into the body. The only problem was they were not able to do that procedure at Baptist. There are 2 places within driving distance that do it: a hospital in Memphis or UAMS. UAMS was the obvious choice as: a) it was in town, b) Susan worked there and c) going to Memphis would have likely included an obligatory trip to IKEA because how often do we get over to Memphis?

So the decision was made that I would be moved to UAMS that night to begin ECMO treatments. Moving patients is something that happens all the time and going from North Little Rock across the river to mid-town Little Rock would be a relatively simple matter. Susan and the girls went on ahead to be there when I arrived. My parents stayed behind to make sure that I got out okay. (I think you know where this is going.)

Problem # 1: The patient is on a ventilator and not able to breathe on his own so a life support capable transport vehicle was needed. I’m guessing they are not as numberous as standard transports are.

Problem # 2: The patient is a big guy so a bigger gurney was needed.

Problem # 3: Getting this large patient onto a bigger gurney while keeping his ventilaor hooked up and then getting that bigger gurney and the ventilator into the transport vehicle.

That took a while.

So imagine that you have just been told that your spouse/loved one is not expected to make it through the night. You gather your family to get them there. No, don’t stop to try to deal with all of that now because there is a decision to be made. As it turns out there is procedure that could possibly help but it requires your spouse/loved one to another hospital but the process of moving them is dangerous in and of itself. Nope, Don’t stop to process things yet. You’ve got to gather his/her stuff and get yourself and your children over to the other hospital to get things ready for his/her arrival there. Then when you get there you are waiting and waiting and waiting way longer than you should have to for their arrival. What the hell is taking so long? If you can imagine going through all of this then I’m guessing you are in rare company. When I learned the details of these events I was in awe of how this fiery redhead and her daughters handled it.

Turns out, these gals were just getting warmed up.

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