What a save!

A small miracle happened recently.  Actually this one wasn’t really that small – it was ‘huge’ considering the stakes.

 

A middle-aged man, who considered himself otherwise healthy had developed some chest pain after hiking.  He didn’t do anything about it for a whole day such as calling his doctor, which turned out to be a big mistake.  When he finally went to the hospital, the doctors ran a few tests and found out he was having a massive heart attack.  As fate would have it, he survived just long enough for the doctors to start treatment.  If he had waited only a few hours longer, he would have died.

 

The doctors had to perform an emergency surgery to bypass the areas of the heart where no blood was flowing.  He struggled after the surgery, requiring a special machine called an intra-aortic balloon pump to help his circulation.  This type of intensive treatment is very concerning as a lot could go wrong.

 

I got called in on the case because the patient developed pneumonia while on the breathing machine after his cardiac bypass operation.  I’m an infectious diseases doctor, and I knew we had to start some broad spectrum antibiotics, but he was critically ill and I didn’t think he was going to make it.  He had multiple organ failure because of his weakened condition – his heart wasn’t able to pump enough blood for quite some time.  The cardiac surgery and the intra-aortic pump helped, but his kidneys had shut down, his liver was damaged from shock, and he remained dependant on machines to keep him alive…  after all, he remained in extremely critical condition.

Adding insult to injury, a few days later he developed a fungal infection of the blood.  I just thought to myself, ‘oh no, this is it’ – there just seemed no way he could survive.

 

The medical and surgical teams didn’t give up though – they continued to do all they could.  We started the patient on an antifungal medicine called caspofungin.  I like using that medicine because it has virtually no sideeffects and it is easy to manage even when the patient is very sick.  Within several days of this treatment, he actually improved.  Doctors call this ‘turning the corner’, which means he pulled out of the nose-dive he was in.

 

The cardiothoracic surgeons removed the pump and some of the other tubes and lines.  We were all amazed that he kept getting better.  After about two weeks, it was possible to have a conversation with the patient.  It didn’t seem he was really aware of just how sick he was – I didn’t want to tell him I thought he was going to die.  I was happy to be ‘proved’ wrong.  So many times doctors do everything they can and the patient doesn’t make it.  This small miracle made me happy – ‘what a save’!
RW