Quick response, heart-lung bypass pump save new mom’s life
By the time the helicopter landed at Legacy Emanuel Medical Center in Portland, Danielle Bryant was just barely clinging to life.
The 33-year-old Albany woman’s blood pressure was in the 30s, and doctors could feel only a faint pulse, said Dr. Sandra Wanek, one of two lead physicians working Bryant’s case. “She was very close to no longer being with us.”
It was Tuesday, Aug. 13, not even two weeks since Danielle had given birth to her first baby, Christopher Rhys Bryant.
On Aug. 3, the day after Rhys was born, she and her husband, Chris, had celebrated their 11th anniversary. She was looking forward to eventually resuming her job as vice principal of Albany Christian School.
Life for the new family was just getting started, but what Danielle didn’t know was that an infection was building in her uterus that would come very close to killing her.
Quick action by her family and by Albany and Portland physicians, combined with a heart-lung bypass machine that came into use in Oregon just a few years ago, saved her life.
Danielle is now recovering at Legacy and looking forward to going home to her infant son.
“It all happened really quick,” Danielle said Tuesday in a phone interview from the hospital. “And with my faith, I just kind of firmly believe God had a plan for me. I believe he has a plan for each person, so I didn’t get nervous at all.”
Danielle and Chris went Aug. 2 to Samaritan Albany General Hospital for an early Caesarean section. Rhys’ placenta was not in the correct position and the baby was at risk of being suffocated by his cord if he was delivered vaginally, his mother said.
The C-section went smoothly, but at just 37 weeks old, Rhys’ lungs weren’t at full capacity. He was transported to a neonatal intensive care unit in Springfield for further care — which, at first, was all Danielle could think about.
“The following Friday (Aug. 9), I started not feeling very well,” she recalled. “I hadn’t felt well earlier in the week, but I thought, you know, it’s probably doing so much right away — push-myself kind of thing.”
Danielle went to the emergency room that day and doctors checked her over, doing a computed tomography test known as a CT scan. They didn’t find anything, so they gave her antibiotics and sent her home.
Wanek said later the scan didn’t turn up the infection because it likely wasn’t yet large enough to be detected. And with the antibiotics, Danielle did start feeling better.
That changed a few days later. On Aug. 13, Danielle awoke in the middle of the night with a fever and the chills, shaking so badly she couldn’t walk. Chris carried her to the car to get back to the emergency room. This time the CT scan showed an abscess the size of a tennis ball behind her uterus. A few hours later, she was in surgery.
That’s where Danielle’s memory stops for the next 10 days.
The surgery drained the abscess, but Danielle didn’t show signs of coming out of surgery the way she should have. Dr. George Giacoppe recommended she be transferred to Legacy Emanuel Medical Center, where Wanek, a surgeon he had once helped to train, stood ready to do a hysterectomy to remove the source of the infection.
Wanek and Dr. Andy Michaels are the two Extra Corporeal Membrane Oxygenation surgeons at Legacy. ECMO technology — the ability to filter and oxygenate a patient’s blood outside his body — has existed for a long time, but became feasible to use on a routine basis only about four years ago.
The Maquet system, which Legacy uses, is a smaller, centrifugal pump that doesn’t have to be primed with as much blood as the older system and doesn’t cause as much inflammation, Wanek said.
It’s not a magic bullet, she said, and it’s not without risks of its own, but it’s critical in buying time for a patient’s own body to begin healing.
The infection had overwhelmed Danielle’s systems and she was going into shock. ECMO performed her breathing for her by keeping her blood oxygenated while medications and fluids helped clear the infection.
“It’s very much an example of how technology has finally caught up,” Wanek said. “This made the difference. Without this, she would have died.”
Rhys, in the meantime, was progressing well in the Springfield center, and was soon able to go home with Chris. He now makes periodic trips north with his dad to see Danielle.
“He’s great, he’s doing really good,” she said.
Chris, who works at ATS Systems in Corvallis, said his company has given him extended leave to care for his family, and coworkers have donated sick time.
Fellow parishioners at Willamette Community Church also have stepped forward to help, which he said will make a big difference when Danielle is well enough to come home.
“I don’t know if you can say in an article how wonderful my wife is,” he said. “She cares so much about people, and that makes them care about her.”
Samaritan Albany General Hospital officials noted the partnership between the two medical centers was critical in getting Danielle where she needed to be in time to save her life.
“We have exceptionally dedicated physicians and staff here at Samaritan Albany General. We are a community-based hospital and in cases similar to the one referenced here, we work together for our patients and function as a cohesive team both internally and with any outside support necessary,” David Triebes, CEO of the Albany hospital, said in a statement. “Each professional involved in these difficult cases plays a critical role in achieving positive outcomes for our patients in any situation.”
Statistically speaking, roughly three out of every 100,000 infant deliveries results in a death from this type of infection. Wanek particularly remembers one such death, years ago, when she was an intern and Giacoppe, the Albany physician, was training residents.
“That’s what led me to this, led me down this path where I did general surgery, critical care and ended up in ECMO,” Wanek said.
Only this time, the outcome was much better, she agreed. “A lot of people did a lot of things all right.”