By Kathryn Carse Staten Island Advance
“What if?” generally is not recommended as a question to dwell on after you’ve been through a traumatic experience. Whether the outcome is good or bad, looking back at the possibility of one thing or another having happened or not can be immobilizing.
Unless you’re Kevin Rogers and you know just how much impact those two little words can have.
Last summer, Rogers came within hours of dying from severe pneumonia and respiratory failure. He survived through the treatment from a machine with a cute, almost cuddly name — ECMO. But it almost didn’t happen.
Still recovering from the ordeal, Rogers says he would be happy never to tell his story again. But the question of “what if” looms large, as in, “What if someone else whose life could be saved isn’t because a hospital is unaware of the technology that made it possible for his own lungs to heal?”
Evelyn Rogers helps fill in many of the details of her son’s treatment because he was sedated through the most dramatic events unfolding around him. She left her Travis-based catering business, A Taste of Honey, in the hands of her staff, while she helped him fight for his life.
It began last May when Rogers, a healthy 25-year-old West Brighton resident, developed severe back pain. Lifting heavy equipment as part of his work with Rucci Oil Company, West Brighton, seemed like a logical cause. But the persistent pain led to the diagnosis of pneumonia; when a high fever developed, Rogers was hospitalized at Richmond University Medical Center on the Friday of Memorial Day weekend.
By Tuesday, he was in the intensive care unit with acute respiratory distress syndrome (ARDS), wherein the air sacs in the lungs fill with fluid and unable to provide oxygen to the blood. Kidney failure followed.
Mrs. Rogers spent a frantic week contacting family and friends all over the country in the medical field.
“The RUMC doctors were open-minded. They didn’t let egos get in the way in the search for a solution,” Mrs. Rogers said. “They said they would provide temporary privileges to any doctor that we wanted to bring in.”
But no one was suggesting treatment any different than what was being done.
On Sunday, she was told to prepare herself; her son wasn’t going to make it.
“We had done everything that could be done for him,” said Dr. Edward Arsura, the hospital’s chief medical officer. Not only was Rogers not taking in oxygen, he was not excreting carbon dioxide, a very grave condition that Dr. Arsura explained occurs in a small percentage of cases.
The standard procedure is to minimize oxygen requirements and carbon dioxide production. In addition to “maneuvers” with the ventilator, the patient is immobilized and sedated to prevent resulting anxiety, temperature is controlled and nutrition limited.
“Despite everything, it was not going in the right direction,” said Dr. Arsura.
But the Richmond Medical physicians were not about to give up. While family and friends kept vigil at Rogers’ bedside, Dr. Jay Nfonoyim, chief of critical care, found the option of treatment by an ECMO machine.
The doctors contacted New York-Presbyterian Hospital/Columbia University Medical Center, one of the few specialized centers where ECMO technology is available.
ECMO stands for extracorporeal membrane oxygenation, a scientific description for a kind of lung dialysis. The patient’s blood is pumped out to the machine which removes the carbon dioxide and supplies oxygen for the blood to return through the body, giving the patient’s lungs a chance to rest and heal.
The device has been used for newborns since the 1960s, but its use for adults had limited success. However, advancements in the last several years have “escalated the use of the technology and treatment of more patients like Kevin,” according to Dr. Cara Agerstrand, a physician with the Medical ECMO Program at NY-Presbyterian/Columbia.
Drs. Dan Brodie and Matthew Bacchetta, directors of the hospital’s Center for Acute Respiratory Failure, have done pioneering research in the use of ECMO and the development of the center’s mobile unit which is critical in patients like Rogers, who would not have survived the trip.
“They came in hours,” said Dr. Arsura.
The highly trained team that arrived included Dr. Bacchetta, a thoracic surgeon and Army reservist, who inserted the catheter to transport Rogers’ blood to the machine and back as they provided critical care during the 20-plus miles to NY-Presbyterian/Columbia.
“Different place, different time, he wouldn’t be here,” said Evelyn Rogers, asking, “How does this happen when it is only 40 minutes away from us? We hope more and more doctors become aware of this machine and what it can do.”
It was the first time Richmond Medical had employed the ECMO machine. Like Kevin Rogers and his mother, Dr. Arsura believes it’s important to get the word out, commenting, “Doctors should be re-educated in its role in the management of ADRS and other conditions.”
Rogers was weaned off ECMO after two weeks, longer than the average seven to 10 days.
“Even for ECMO patients, he was one of the sickest. He was in shock with renal failure, ARDS and severe pneumonia,” said Dr. Agerstrand, a pulmonologist and part of Rogers’ medical team.
In addition to his medical condition, he needed to re-learn how to swallow and regain the ability to talk in addition to balance and walking. In the intensive care unit for a month, he celebrated the Fourth of July with a move to a step-down floor and spent two more weeks finishing rehabilitation.
With physical therapist Corinna Malakidis, “kicking his butt,” Rogers set a goal to get to the annual Tri-County family golf outing. He was discharged on July 30, and on Aug. 2 he was in Ocean City, Md. to hit the first T-shot and enjoy the rest from the sidelines.
Full recovery is months away; Rogers has a lot of residual soreness and is still building back his strength. He returns to NY-Presbyterian/Columbia for check-ups.
“Every time I see him, it’s a very awe-nspiring, heart-warming experience,” said Dr. Agerstrand. “He looks better and better every time. His recovery has been incredible.”
BACK TO NORMAL
Nearly dying is not something Rogers dwells on, but it helped clarify some priorities for him. He now is attending Lincoln Technical Institute’s two-year program in HVAC (heating, ventilation and air conditioning) to add expertise to the skills he’s learned with Rucci Oil.
After Hurricane Sandy hit, Rogers joined the relief effort, volunteering with his mother and her staff to provide food in New Dorp Beach for residents and volunteers.
“It was my first time doing any kind of work,” he said, observing, “It felt good. It felt normal. That’s my main goal. Get back to who I was, what I was doing.”
And he hopes to help make sure someone else will get the chance to do that too.