By Maureen Gilmer, IU Health senior journalist, firstname.lastname@example.org
Zane Hendrickson remembers seeing colors just before he collapsed on the pool deck during an early morning swim practice.
The 15-year-old sophomore at Boonville High School near Evansville, Indiana, doesn’t remember much else about that day or the week that followed, but his mom still can’t shake the realization that she almost lost her son.
Christa Hendrickson adopted Zane as a baby from Kazakhstan. For most of the past 15 years, it’s been the two of them.
He is her only child. Her world.
That world was nearly shattered Jan. 7 when she got a text from her son’s swim coach that Zane, a champion swimmer, was complaining that his stomach, shoulder and back hurt after swimming laps. Muscle cramps caused by dehydration seemed a logical cause, but then Zane began shaking.
That’s when Hendrickson, who was home sick herself, asked a friend to take Zane to the hospital.
“By the time he got to the ER, I don’t think anybody thought he was that bad,” she said. “He said the abdominal pain was getting better, but then he said he couldn’t breathe. He had a seizure and threw up and went into cardiac arrest.”
And that marked the beginning of a chain of events involving a network of medical professionals from three hospitals, including Riley Hospital for Children at IU Health and IU Health Methodist Hospital, who refused to give up on a young teen who seemed healthy one minute but lay close to death within the next hour.
HIS HEART STOPPED
Hendrickson was with her son in the emergency department of Deaconess Hospital in Evansville when he coded the first time. When his heart stopped, hers nearly did too.
She will never forget the image of so many hands working feverishly to bring her boy back. Zane would suffer cardiac arrest at least eight more times, requiring more and more lifesaving support over the next several hours.
How could this be happening to her healthy teenage son? He was fine that morning when he left for swim practice. A swimmer since the age of 8, he loved the water and he loved competing. It didn’t make sense, and her brain had trouble accepting it.
It wasn’t until the hospital chaplain came in to speak with her that the fog lifted long enough for her to comprehend that her son was not expected to survive.
“This is a fatal event,” she recalls one of the emergency physicians telling her.
And yet, no one would give up on him, she said.
“You could see the intensity in the room.”
Behind the scenes things were happening too. A physician from Deaconess reached out to Riley for a consult. Dr. Riad Lutfi was on service that day in intensive care at Riley and discussed the feasibility of transporting Zane up to Indianapolis, but the teen was too unstable for the trip at that point.
And there was another problem. Zane needed to be on ECMO (extracorporeal membrane oxygenation), which provides prolonged cardiac and pulmonary support to patients whose heart and lungs are unable to do their job. A surgeon in Evansville could get the process started, but the hospital wasn’t equipped to handle the extensive care that Zane would require.
Riley has an outstanding ECMO team but no way to transport a patient while on ECMO. That’s where Methodist comes into the picture. The adult hospital has an equally outstanding ECMO department and frequently handles adult ECMO transports, but it had never transported a pediatric patient on ECMO.
“BRING YOUR ‘A’ GAME”
Phone calls were made, texts were sent over the next few hours as Dr. Mrunal Patel and Dr. Kashif Saleem at Methodist discussed with the Riley and Methodist teams the viability of transporting a pediatric patient via IU Health LifeLine ambulance, not to Methodist, but to Riley.
Lucky for Zane, “the stars aligned in terms of people being willing to give their time to do it and do it quickly,” said Tracie Layne, manager of clinical operations for the adult ECMO program at Methodist. “I’m just so grateful that we were able to do what was best for the patient.”
Layne didn’t have staff to spare at Methodist to make the trip, so she called in two of her best ECMO clinicians – James Peoples and Lindsay Maurer – from home to ask if they were willing to staff an overnight ECMO transport from Evansville back to Indianapolis. Like everyone else in this story, they said yes.
“James and I went, and we were privileged to be able to do that,” Maurer said.
Still, it was outside her comfort zone.
“I don’t work with kids very much, they tug on my heart,” she said. “But this is what I’m needed for. If I can help in any way … I’m going to do that. When you hear there’s a 15-year-old, it’s a unique situation, and we need your experience, we can’t say no.”
Riley ECMO manager Gail Hocutt stood ready to help in any way she could, even offering to send Riley technicians to Methodist to support that team. In the end that wasn’t required, but it represents the collaborative nature between the two IU Health hospitals.
“Without their team being willing to do this, we would not have been able to get our patient here,” Hocutt said of Methodist’s action. “We were fortunate that an adult CV surgeon (in Evansville) was willing to put cannula in this patient and put him on support, not knowing how we would get him here. Tracie and her team stepped up to make that happen, and we are grateful.”
Layne knew it was asking a lot of two clinicians who typically treat adult patients to assume care for a child who was so desperately ill, but she also knew they were his best shot at survival.
“When you’re talking about kiddos, that’s not something we’re used to,” Layne said. “There were layers to the challenge of this from an emotional standpoint. You just hold your breath and hope that everything goes the way it’s supposed to. And you bring your ‘A’ game.”
When Maurer and Peoples, both respiratory therapists by background, arrived in Evansville later that night along with the LifeLine crew, they found a very sick boy with an exhausted team of nurses and physicians working mightily to keep him alive.
It would be a few more hours before they were able to leave, but they got him to Riley safely, arriving shortly after 7 a.m. the next day.
“You see all of these Riley team members standing there waiting on us with gowns on, gloves on, ready to go,” Maurer said. “That team was phenomenal. He had somebody looking out for him that day. He was very sick, but we managed to figure it out and get him to a higher level of care.”
FEELING OF PRIDE
Dr. Patel, a pulmonologist at Methodist, said the willingness of so many people to set aside their initial reservations to help this teenager shows a deep commitment to patient care and teamwork.
“From the story I heard from the intensivist at Riley, this was someone who was young and we thought we could help if we could just get him (to Riley) safely. I talked with our surgeon that night (Dr. Saleem), and he agreed that it was a good idea and potentially lifesaving for him,” Dr. Patel said.
“I was really glad when I heard that we were able to get him here safely and we actually, really and truly made a difference,” he added. “Kudos to the IU Health team. We’ve been stretched with COVID, and for people to come in on their time off, it shows we really care about our patients.”
Layne saw what Dr. Patel saw, the same as Dr. Lutfi and the Riley team saw: Everyone working hard to figure out how to make this transport work.
“It makes you so proud,” Layne said. “We talk about our values; we talk about our IU Health promise. We needed to make this right for this patient. We were able to still do what we’re good at but make sure we got him to the right place to be managed in the right way because that was best for him. It was nice to be able to coordinate that and do it so quickly.”
Dr. Lutfi said this is a perfect example of IU Health stepping up to a challenge.
“I never had a single person who said you can’t do this.”
ZANE IS BACK
Because of that, Zane is recovering today in the rehab unit at Riley after suffering a stroke and undergoing open-heart surgery by Dr. Mark Turrentine to repair a defect that had gone undiagnosed his whole life. It was cardiologist Dr. Tim Cordes who suspected an underlying heart problem and ordered the heart catheterization that found the defect.
There were many dark days early on in the teen’s treatment when physicians worried that he might not wake up or he might have suffered significant brain damage due to the multiple cardiac arrests. But Zane is still Zane, his mom says. His sense of humor with a side of sarcasm is intact.
He suffered loss of function on his left side, but has regained much of it and continues to work out in therapy several times a day. His appetite is recovering, though he prefers pulled pork and Mexican food to hospital meals, Hendrickson said.
Hearing how well Zane is doing two months after that emergency transport filled ECMO clinician Maurer with elation.
“That just made my day!”
ROOMMATES AT RILEY
Hendrickson has a hotel room in town but prefers to sleep on a cot in her son’s room.
“I can’t really sleep, but when I leave, I kind of panic and find I can’t sleep at the hotel.”
It will get better, she tells herself. It already has.
She has flashbacks to the codes, the CPR, the somber warnings from that first day.
“Initially, I was just in shock, trying to make sense of it, but you have to keep going. You do what you do as a mom – whatever has to be done.”
She remembers whispering to her son even when he couldn’t hear her.
“I told him to prove them wrong when they said he wasn’t going to make it. He’s a swimmer, and many times I sat in the stands and tried to talk him through a meet. So I tried to talk him through this, telling him to be strong and keep fighting.”
His spirits are surprisingly good, she said, helped no doubt by a recent parking garage visit from friends who gathered on a blustery day to talk to Zane by phone while he could see them from a window on the third-floor cardiac step-down unit.
His goal is to regain full function so he can get his driver’s license this summer, she said. Meanwhile, he jokes about his condition, saying “How many 15-year-olds do you know who’ve had a heart attack and a stroke?”
Hendrickson said it’s hard as a mom to put your trust in others to care for your child. But the Riley team has made it easy.
“He made some special friends in these units; it’s just been amazing,” she said, commending the nurses, physicians, therapists, child life specialists and chaplains. “And Dr. Turrentine – you’re not going to find a better surgeon.”
Despite the heart attacks, the stroke, the setbacks and the rough road to rehab, she is rejoicing.
“I still have my boy, and if anything can come from this to help other children, that would be wonderful.”
Photos submitted and by Mike Dickbernd, IU Health visual journalist, email@example.com