Tuesday, August 16, 2022

Recovery





A year and a half ago, it was my daughter's fourth birthday party, a Zoom with just our family at home, though I had made a ton of appetizers and cake pops and a cake. I was sad that she was having a COVID party, but it was during the early peak of the Delta wave, and we were doing our best to have Kona's (just nuclear family) dragon-themed party with flare. I was of course super busy all day and had made all the dragon eggs and dragon cake pops with Kona's help. We were blowing out candles when my husband, Curtis pointed out to me that my parents weren't on the Zoom. I was just thinking that they had forgotten. He said that I should call, so I called my mom on video chat, thinking my parents could say happy birthday to Kona.

My mom answered, wearing a mask and short of breath. It looked like she was in the hospital. I said aloud, "Mom, do you have COVID?" Half-joking with her. She answered, "No, Megan. Your dad..." She paused. I went to the other room, obviously upset. Curtis saw my face and knew. He decided it was movie time for the kids and didn't miss a beat; they thought, "What a great party." My mom told me she had done CPR at home and gave a rundown, step by step of what had happened and what was going on. She hung up to get more updates. I cried in the corner, then got up and went to hug the kids and sat stunned, not watching whatever movie they were watching, just staring straight ahead, holding onto them. It was Curtis who had the insight to tell me that I was vaccinated and I should get on a plane. It was true. Our family had still been living in its little bubble, isolated except for me being a frontline worker wearing full PPE (finally) at work. (Finally we had enough stores due to a cleaning process of used N95s...Yes, it was still that point in this traumatic chaos.) I was a month out from my first Pfizer, lucky enough as a frontliner to be offered the vaccine first, but also vaccinated to ensure that I could continue to work during a pandemic.

Being the ER doctor that I was, I booked a flight, threw some black flats and a black dress into my backpack for what I assumed would be a funeral, grabbed my Envo (a reusable N95-comparable mask I bought for work), and prepared to get on a plane for the first time in over a year. I was sure there was no way he would survive, knowing cardiac arrest at home has a 10% or less survival rate. It was late January in Georgia, and I forgot that it got cold there. I hadn't even brought a long-sleeve shirt, much less a jacket. I was dazed and also terrified to give my mom or my family COVID by flying on a plane with a bunch of people who were (sorry) stupid enough to be flying on airplanes with COVID numbers so high and at a point where we still didn't have a lot of treatments or many people vaccinated. We hadn't seen my parents in well over a year, not wanting to risk flying and bringing them something. What if the last time I saw my dad was the last time I saw my dad...

My mom somehow had used her RN and NP powers to get into the cardiac ICU with my dad at a time when no visitors were allowed in the hospital due to high COVID numbers across the country. She was sitting by his side while he was being cooled with multiple drips going and a balloon pump. It was a medical miracle and emergency medicine and intensive care in practice. It was medically amazing and beautiful and why we do what we do, for the save. But it was my dad. He was pale and swollen and intubated and having these shivering movements that didn't stop with more sedation. I worried about his brain and how he could recover and if he could wake up. But he was alive.

His nurse for the night was 36 weeks pregnant but wore her N95 and maneuvered sideways around the bed and adjusted his drips and gave meds as scheduled and checked on us. She was wonderful. We waited for the doctor. My mom had probably told the story over and over to everyone that night, just like she continued to do for weeks afterwards, processing the most important code of her life, the code that was actually on her husband. I am so thankful she was there that day and heard him fall down. She said to me so many times when we spent time in the ICU or at home, waiting for the evolution of his prognosis: "I really think I started compressions within the first minute." Amazing. So thankful for her and her unique and unrelenting thirst for medical knowledge because she had kept reading after retirement and knew about hands-only CPR. She started compressions and never gave breaths, confirmed with the 9-1-1 operator that she had put on speaker. She was already doing compressions when they answered her call. God, my mother is amazing. True grit, that woman.

My dad still has no memory of the time he was in the hospital. He remembers the days before when my parents were camping and hiking and biking 15 miles a day and doing all the other long cardiovascular exercises with which they fill their travels and retired lives. Probably some things it's really best we don't remember, and that's why our brains have a way of protecting ourselves and helping us forget. One day he was hiking up a mountain, and the next day he fell on the laundry room floor carrying in groceries. My mom and an incredible EMS team resuscitated him and gave all the right meds, and they had ROSC (Return of Spontaneous Circulation) by the time they arrived in the ER. My parents live out in the country, but a few years ago they were lucky enough to get a fire station 3.2 miles from them, and that fire station just happens to have a supervisor who does all the ACLS (Advanced Cardiac Life Support) training for the state of Georgia. And that supervisor was with the team that day who answered the call. I think back to my own EMS rotation. The way the firefighters tell stories: "One day, I got a call..."

My dad doesn't remember waking in the CVICU and not understanding why he was in the hospital. "I'm fine. I just don't know why I'm here." He didn't believe us when we told him what happened. In the cath lab, prior to getting his balloon pump, his ejection fraction (EF), the amount of blood his heart could pump out to his body had been 15 percent. Fifteen percent. Normal is something like 50 to 75. He had a confident and exceptional cardiothoracic surgeon who found a way to bypass 4 coronaries (blood vessels that supply blood to the heart), and my dad's amazing cardiovascular training had given him enough collaterals to survive the arrest and the surgery. Who knows how long he had had an EF of 15. But the man didn't believe he needed the bypass because he had ICU deliria. I worried he had had a stroke, but it turns out, when you die and come back to life and get cooled for a long time and then rewarmed, your brain really doesn't let you remember all that. And thank goodness. It was enough that the rest of us do.

Brasstown Bald, Georgia

But here we are, one and a half years later, with amazing labs, a man that would never take medicine before but now has a pillbox, and a complete turn-around on nutrition. My mom is being his life-saving angel yet again by constantly making healthy recipes and altering everything. (Stay tuned for her heart healthy cookbook whenever she has the time to write it.) My dad is hiking mountains again, biking, and fishing with his grandkids. It really is a miracle that we are so happy we can be a part of with him. Our family seems to have a lot of journeys lately, but the recovery is definitely where it's at. We work and live for that recovery, and really there's no looking back.

Gone Fishin'