Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life (Excerpt #58)

SANDYPicture (2)
Photo by Mariano Peralta – July 2010

Author’s note: The following passage is from Chapter 7, “Sticking with God,” of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life.  This is the 58th excerpt in the blog series.

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The numbers and the answers from the medical team weren’t promising. The most pressing issue was the cause of the lung failure. X-rays showed that my lungs were saturated with fluid. Reviewing the images on the X-ray screen was like looking at a blizzard from the safety of a window.

Only a trained eye could see through the heavy white haze and recognize any resemblance of normal lungs. Fever was constantly present surpassing 100 degrees several times per day indicating the possibility of infection. Despite these tell-tale symptoms, every culture sent to the lab returned negative for infection, pneumonia, or bronchitis.

Nevertheless, my oxygen saturation level fluctuated from 70% to 90%, numbers that were dangerously low especially as I was breathing with the help of the ventilator and oscillator.

While doctors were eliminating causes for the respiratory problems through tests, Sandra became more frustrated and confused. Marianne’s theory that ARDS could be the reason for my lung failure was echoed by one of the ICU nurses who cared for me. The nurse told Sandra that she had treated several ARDS patients before and my oxygen saturation levels and X-rays pointed to the respiratory syndrome as the culprit.

Every time Sandra addressed the issue with doctors, they were reluctant to confirm the diagnosis until all other more common causes were eliminated. Sandra and others were beginning to believe that ARDS could be the problem. The waiting room internet researchers agreed, but continued to be puzzled that I hadn’t experienced any of the conditions that led to the onset of the rare and deadly syndrome.

My medical record sheds some light on what doctors were thinking. Doctor comments about ARDS first show up on the record shortly after the 4th of July weekend. Using words like “possible” and “feasible,” they developed a course of action that addressed the syndrome. As there is no cure for ARDS or medication that directly addresses the symptoms, doctors took aggressive steps to enhance the probability of survival.

The ventilator, oscillator, induced coma, paralytic medicine, and steroid treatments combined to give me the best chance to overcome what looked like a hopeless situation. What still created the atmosphere of bewilderment was what caused me to be in this state. There was no infection, no blunt trauma, no pneumonia, or any other event that shouted out “ARDS!”

One entry into my medical record on July 1st indicates that doctors were concerned about the continued use of amiodarone, the medication I was prescribed to keep my heart stable and prevent another episode of cardiac arrest. The entry read:

“recommend stopping amiodarone, as you already have, after getting more details around the circumstances for starting it and weighing risks/benefits of using it.”

Several hours later, the same doctor wrote the following directive:

“Discussed circumstances for amiodarone therapy which was related to arrest during acute event. Would therefore stop amiodarone.”

For almost two decades, the drug has been used to stabilize the heart rate during cardiac arrest episodes. The American Heart Association (AHA) determined that amiodarone improved the survival of cardiac arrest patients and recommended its use in the 2000 AHA Advanced Cardiac Life Support Guidelines.

Since then, the drug has been a staple in hospital rooms where a life-threatening cardiac event unfolds. Ten years later, the 2010 AHA Guidelines for Cardiopulmonary Interventions declared that the first-line remedy to basic life support for cardiac arrest patients is amiodarone.

The drug has many potential side effects due to its toxicity. However, amiodarone use has rarely been associated with the development of ARDS. Some studies have shown that no more than 5% of patients who take the life-saving medicine develop lung poisoning.

The studies further found that a rapid progression to ARDS in cardiac patients could be related to the dysfunction of the left ventricle in the heart, the precise location where my heart was damaged. However, the main theory in recent studies is that that there could be a connection between amiodarone and a high concentration of oxygen delivered to the lungs during a lengthy time on a ventilator and an intubation pipe.

When doctors expressed concern about amiodarone in my medical record n July 1st, I had been intubated and on mechanical ventilation for a prolonged period of 13 days. Since researchers are still in the hypothesis stage, the diagnosis of ARDS, especially related to amiodarone, is challenging and routinely overlooked.

The damage to my lower right heart muscle allowed nothing more than a weak stream of oxygenated blood to reach my worsening lungs. On July 1st, it had been three days since the doctors aggressively addressed the situation that was causing my lungs to fail. While ARDS wasn’t the official diagnosis, it was clear to everyone – doctors, nurses, Sandra, the waiting room information gatherers, Marianne – that I was part of that 1 to 5% with full-blown acute respiratory distress syndrome.

The best-case scenario was that I had a 70% chance of survival with some organ and brain damage due to oxygen loss. Worse-case, I would succumb to this rare syndrome like the 30% who don’t live through it.

Despite all of the data that was conspiring against me, Sandra’s entries into her journal were upbeat. On July 5th she wrote, “Today is a new day and I thank God for one more day with you.” She had endured a long weekend when each hour brought a new concern, another setback, and renewed hope when the last crisis was resolved.

It was a holiday weekend when lots of visitors came to support her and the girls in the waiting room. The few who were allowed to see me tried to give Sandra hope even though their faces expressed hopelessness. Sitting alone looking at my lifeless body and hearing the numbing sounds of the life support machines doing their work, her faith gave her more hope than ever.

That weekend, Mariano snapped a photo of Sandra one morning after breakfast. She sat pensively contemplating an uncertain future. Her eyes reveal enduring faith, steely determination, eternal hope, and unconditional love. Reminiscing about the photo a few years later, Mariano wrote,

“Without her knowing it she reignited something inside of me at that time …and that was to NEVER QUIT! No matter how gloom the situation to never stop believing and to never step down from the fight, to have Faith! She provided an example to me that I could never have learned from reading a million books or going to hundreds of seminars. I felt that for the first time in my life I was looking straight in the eye of Unshakable True Love At Its Finest!”

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Next Wednesday: My heart starts racing and doctors work to stabilize the situation while Sandra, once again, turns to her faith.

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