west virginia success stories

WV Local Success Stories
Quality improvement endeavors can often feel overwhelming, but chances are, you can learn from the experiences that another physician, hospital or nursing home has had in a similar situation. Coupled with support from Quality Insights Quality Innovation Network, learning what has worked for others — and what didn't — is a valuable strategic planning component. 

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Brush with Death Leads to Family Vaccination Pact

1/29/2019
When Diane Martin’s son-in-law came down with flu-like symptoms this past March, no one in the family could have ever imagined the twists and turns his illness would take. Dalton, whose nickname is Doc, spent a week on the couch trying to recover. When his symptoms only worsened, he agreed to visit a walk-in clinic for treatment.
 
At the clinic, Doc tested positive for the flu as well as pneumonia. The medical team started him on an antibiotic and sent him home. Three days later, Diane got a call from Doc. “He said it felt like he was breathing through a straw.” She advised him to go back to the doctor to request a chest X-ray and a different antibiotic.

Concerned that he couldn’t get to the doctor by himself, Diane left work and drove to the home he shares with Diane’s daughter. “When I got there,” she explains, “he was so sick that he was too weak to walk to the car. He was struggling to breathe.” Thinking fast, Diane helped Doc into an office chair on wheels and rolled him to the car.

As an otherwise healthy 27-year-old, Doc had never been so sick. Diane decided to take him to an urgent care center that was at a local hospital. Clinicians there discovered that Doc’s pulse oximeter reading was 60 percent. Since a normal reading would range from 95-100 percent, staff thought the machine was not working correctly. Though they gathered additional oximeters, the highest reading they were able to take on Doc was a 70.

At that point, the urgent care center staff advised Diane to take Doc to the emergency room. Once there, he was admitted to the intensive care unit (ICU) and put on a bilevel positive airway pressure (BiPAP) to force his airway open.

On his second day in the ICU, the medical team discovered that Doc’s pneumonia had turned into acute respiratory distress syndrome (ARDS). The next day, the medical team put Doc on a ventilator. Calling the family in, his doctor said, “It’s in God’s hands now. We’ve done all we can do.”

By the fourth day, the ventilator had not improved Doc’s condition. Diane explains, “We thought he’d get on the ventilator and come off and be fine. But things kept going from bad to worse.”

When Doc started going into organ failure, his kidneys shutting down, the doctor recommended that he be transferred to another hospital with specialized equipment. 

Although the transfer was dangerous, it was the family’s only hope. At the new hospital, Doc was put on extracorporeal membrane oxygenation (ECMO) to improve the level of oxygen in his bloodstream as well as continuous dialysis to aid his failing kidneys. Once again, Diane’s family was told that the medical team did not know if Doc would survive.

“They said that if he makes it, he would be on ECMO for thirty to forty days and when he gets out of the hospital, he’d need a few weeks of rehabilitation,” Diane says. “They told us that he would have a long, long recovery period.”

Thankfully, Doc’s health finally took a turn for the better. He spent twelve days on ECMO and was able to come off of it earlier than the doctor expected. He spent a total of three-and-a-half weeks in the hospital, three of those in the ICU and on a ventilator.

Once Doc’s health reached a turning point, he recovered quickly. “He didn’t have to go to rehab after all,” Diane says. “But he was on dialysis for a total of six weeks, so that continued after he was back home.” Overall, it took time for him to get his energy and strength back but not as long as initially expected.

While Doc has fully recovered now, this ordeal hit the family very hard. “We spent a lot of time at the hospital but there were certain hours we couldn’t get in the ICU because it was closed,” says Diane. “One of those times, we were all sitting around my dining room table, discussing the events of the day and the seriousness of the situation and we vowed to each other that we would always get the flu shot every year. We all agreed that we didn’t want to sit at the bedside of another one of our family members like this.”

In the past, Diane had been ambivalent about getting the flu shot. “I got it if it was convenient,” she explains. “But there were years I didn’t get it.”

As for Doc, Diane says, “He’s doing great now. He’s had his flu vaccine.” When he caught a cold a few weeks ago, he had a very positive outlook. “He knew it was just a cold and he wasn’t worried at all.”

According to Diane, the experience was devastating but also expensive. The dialysis and hospital costs amounted to $700,000. After some negotiations, the family was able to get the bill reduced and Doc’s insurance covered most of the charges.

Diane hopes that Doc’s experience encourages others to protect themselves by getting vaccinated. The Centers for Disease Control and Prevention (CDC) recommends that everyone six months of age and older get a flu shot every year. Some older adults are at a higher risk for illness. If you have asthma, trouble breathing (COPD), heart disease or diabetes, you are at a higher risk. Vaccination is even more important in that case.