A Miracle Laid At Our Feet
By Barry Ginter, Nevada Appeal
It was just another busy night for Chris C.. After work at the Tahoe Daily Tribune in South Lake Tahoe she’d driven down Highway 50 into Carson City to a hair appointment, then back to Douglas County and her home off Stephanie Way. Now, at about 6:30 p.m., she was finally home with her husband Bob, and daughters Sabrina and Samantha. The girls were sick, so her next chore was to take care of their colt, Billy Jack, while Bob made dinner. The night was windy. There was a mist in the air as she pulled on a heavy coat and gloves, picked up the flashlight and hurried out the back door to the small hay barn behind the corral gate, 50 yards from the deck. She’d been busy for several minutes brushing and feeding the colt when a wave of dizziness hit. She staggered to a hay bale and sat down to rest, to clear her head.
There was nothing in her past to suggest what was happening inside her. She was 45, athletic, in perfect health. Whatever it was would surely pass. But it became clear within minutes this was not going away … it was getting worse. She wanted to lay down in the hay and close her eyes. There would be many decisions that would combine to save her life that night, and the first of them happened at that moment. She decided she had to get back to the house. She struggled to stand, but now her feet and legs were numb. She forced herself to take each mechanical step toward the corral gate. At the gate, halfway to the house, her strength gave out. She fell to her knees in the dirt and cried out her husband’s name. But her words were lost in the wind. She began to crawl toward the lights of the house, stopping over and over to catch her breath.
Bob had looked out the window several minutes earlier, a glance to see how Chris was coming on the chores. The flashlight beam moving in the darkness had reassured him, and he turned back to fixing dinner. He knew she might be out there another 15 minutes or more working with the horse. Then, as he glanced up, he saw her, struggling to crawl up the steps of the deck. He ran to the sliding door and out to her side. Within a minute, he called 911, then returned his attention to his wife, still on the carpet. Her voice was pained. There was something wrong in her abdomen, she said, struggling to breathe, then closing her eyes.
It was just a few minutes later when volunteers from East Fork Fire and Paramedic District pulled into the gravel driveway, and in a few more the ambulance arrived. Driver Chad Sheldrew and paramedic Jonathan Plumer rushed inside. They could see instantly their patient was clammy and her skin was pallid. Chris was conscious now, and they asked questions, trying to narrow their focus. Was she pregnant? … no. Was there pain in her chest? … no. Any previous medical problems? … no. Any medications? … no. Nothing hinted at the catastrophic damage around her heart.
Plumer suspected internal bleeding in her abdomen, but all they knew for sure as they wheeled her out to the ambulance was that her vital signs were critical, her blood pressure too low to register. As they slammed the ambulance door, Bob and the two girls, still in their pajamas, piled into his pickup to follow. Less than 45 minutes later, the ambulance came to a stop outside the emergency room doors. Dr. Brett Eisenmesser was the emergency room doctor, and he knew before she arrived it was going to be a difficult case. Plumer had radioed in her blood pressure, pulse and breathing, and all were at critical levels. She was barely alive. Worse, there was no clear diagnosis. It could be a pulmonary embolism, a blood clot in a lung. It could be an ectopic pregnancy, where a fertilized egg implants outside the uterus, then bursts the fallopian tubes as it grows. The pains and the loss of blood pressure could also indicate the aorta had ruptured in her abdomen, Eisenmesser thought. He knew there was no time to be wrong. He decided to do a CAT scan. Within 10 minutes of her arrival, emergency room staff were wheeling her into the radiology department and, in a few more minutes, Eisenmesser was looking at the scan. He had his answer, and it was bad.
The chances she would live much longer were slim. Few patients with aortic dissections survive, even if doctors take all the proper steps and take them quickly. A dissection occurs when the blood pressure causes a tear through a layer of the aorta and forces the layers apart. The damage swells the aorta — in Chris’ case to the size of a baseball — and a rupture can lead to a quick death. If she were going to live, Chris would need surgery, and soon. As nurses rushed Chris back to the ER, Eisenmesser was on the phone with Dr. Todd Chapman, chief of cardiac surgery at Carson Tahoe Regional Medical Center.
Doctor Chapman was at his Washoe Valley home when the call came, and he was on his way immediately. It was a five-minute drive to the hospital. He called his surgical assistant of 17 years, Julie Hansen. They’d been through this drill many times before, and the other members of the team were en route in minutes. Chapman was among the first to arrive, and he knew instantly the gravity of the situation. He had no reservations about his abilities or those of his team. But sometimes none of that matters, the damage is too great to be repaired. He’d seen patients with the same condition die. After looking at Chris, he went upstairs and stuck his head into the operating room. “She’s really bad,” he said to nurse Ruth DuValle. “We’ve got to move.” Then he turned to get himself ready. DuValle decided to call in extra help and dialed nurse Laurie Van Epps. When the second-floor elevator opened, carrying Chris from the ER Bob kissed his wife. “I’ll see you in a little while,” he said. Then, to the staff, as he watched the operating room doors open, he said, “Take care of her.”
When DuValle got her first look at their patient, she understood the urgency. It occurred to her that Chris looked as bad as any patient she’d seen in her 28 years as a nurse. There was no color. She was moaning and unresponsive. They knew that even if they made every move perfectly, there might not be enough strength left in her body. They began, in perfect calm. Clockwork … they had done this so many times before there was little need to even talk as they went about the tasks before them.
First, before they could open her chest, they used a heart/lung bypass machine to take the place of her heart and restore circulation to her body. It allows them to shut down a patient’s heart as they repair the damage. Chapman made the incision into the chest and saw the damage. A surprise, and not a good one. He could see it was an aneurysm that had ruptured. When that happens, death usually comes quickly.
But Chris was lucky.
The rupture happened in a place where the blood did not flow out freely into the body cavity. Instead, it bled into the leathery sack that surrounds the heart, called the pericardium. When that sack had filled with blood, the pressure inside the pericardium and in the aorta equalized and the blood no longer flowed out freely. It had slowed her heart. Chapman also saw an opportunity. The aorta above the rupture was undamaged, and he knew he would be able to sew in a Dacron tube to repair the aorta. They worked quickly, in surgical terms. Two hours into the operation, a nurse came out to talk with them. As she approached, Bob looked in her face for any sign of bad news. Things were going OK, but there was a long way to go. Chris was still alive and that was all Bob wanted to hear.
Nearly six hours after the operation began, Chapman and Hansen approached them in the waiting room. They watched him, trying to read his face. It seemed to carry no hint of tragedy. In fact, everything had gone nearly perfectly, but it was still too early to say Chris was going to be OK. Her color had returned quickly after the operation, but this was not over. Chapman knew there were the “unexpected assassins waiting around the corner” that could still take her life. It was also possible she had brain damage. The next two hours would be critical. He remained serious talking with the family, telling them her odds had risen to 75 percent now. But compared to what they had been through, the news was unmistakably positive.
“Thank God she’s OK,” Sabrina thought through her tears. “She’s going to be OK.”
Dr. Chapman rode the elevator down and walked into the ER. He didn't have to be as reserved now as he talked happily with the nurses who were the first to care for Chris when she arrived. They were elated at the news. “You have to go see her,” Chapman told them. “She looks great.” Once he was sure his patient was stable, Chapman drove home. Then he fixed his usual double espresso, took off his cowboy boots and went to bed.
Chris recovered quickly with no permanent damage. On Thursday, she awoke to the words of a nurse: “Hi Chris, do you know what happened to you?” Later in the day, she took a slow walk down the hospital hallway. In the days after the surgery, she was visited by many of the staff members who cared for her in those initial hours. They told her they were amazed at her strength, and she and Bob told them how grateful they were.
On Friday morning, when the nurse pulled the curtains open to reveal the rising sun, Chris began to cry. She suddenly understood how close she had been to death.
She was discharged from Carson Tahoe Regional Medical Center on Saturday. Family members say things won’t ever be like they were. For one thing, they don’t like to let Chris out of their sight for long. They don’t want to risk losing her. Bob kept his composure throughout the ordeal, but he knew there would be a time to deal with the emotions he had been suppressing. It happened a few days after Chris returned home. He went outside and sat on the steps alone in the dark and thought about all the changes and tests the family had been through … his tour of duty in Iraq, a move from Kansas to Nevada, and now this.
“I had been in crisis-management mode since I looked out the back window and saw Chris crawling across the backyard, so every emotion I had pushed down was coming up. I was angry, happy, frustrated and scared all at the same time. I remember laughing as I thought, ‘Now I know what a teenage girl feels like.’
“Chris came out right on cue. She sat down next to me and suddenly everything was all right. My wife was still with us, smiling and healthy, and that made all that other stuff seem so small.
“I knew, just like we had always done, we could deal with whatever came our way.”
Carson Tahoe Regional Healthcare’s cardiac program began open heart surgery in February 2006, and to date, there have been over 700 life-saving open-heart surgeries. Had Chris Campos needed to travel outside of Carson, she likely wouldn’t be alive today. Luckily, Carson Tahoe Regional Healthcare was there for Chris with the latest technology and services…just as they are for the entire region.