They got my heart beating normally. In subsequent doctor visits, I discovered that my heart didn’t actually stop. What happened was my aorta had a 100% blockage and when I raised my arms, my heart started beating faster and faster to try to get blood flowing through. Only, it couldn’t. So the beats per minute were something like 300 – my heart was basically vibrating.
It was at this time that the doctors put a stent in my aorta. They also had me on a life support system called ECMO. ECMO stands for extracorporeal membrane oxygenation. Let’s break it down. Extra – outside, corporeal – of the body. Yes, they were oxygenating my blood outside my body. ECMO is used when a person’s heart and lungs are unable to provide adequate oxygenation to their organs. Wikipedia says that “Generally it is used either post-cardiopulmonary bypass or in late stage treatment of a person with profound heart and/or lung failure.” (Wikipedia, 2017) Let that sink in “profound heart and/or lung failure.” Basically, the ECMO was acting as my heart and lungs. It was not a pretty site. I was sedated, intubated, and my blood was circulating outside my body.
When a person is on ECMO, their heart continues to beat, but the work is made easier by the pump in ECMO taking on the work of the heart. The pump pushes the blood through an oxygenator, filling it with oxygen and removing the carbon dioxide, then returning the blood to the patient. This allows the patient to rest and heal.
Once I was on ECMO, they brought my husband and sons in to see me. I was surrounded by the four saddest men ever. Though my heart was healing and the machine was keeping me alive, I was not responsive. Doctors told my husband that my kidneys had shut down and, if I recovered, I’d be on dialysis for life. They also told him that they did not know the extent of brain damage I might have suffered.
They began watching.
While ECMO is a wonderful life support system that undoubtedly saved me, there are many complications with its use. (Niklaus Children’s Hospital, n.d.)
- Internal bleeding may result since the blood must be kept from clotting. A drug called Heparin is given to thin the blood which can lead to bleeding problems.
- Whenever a tube is inserted in a blood vessel, there is an increased risk of infection, surgical complications and stroke, which may occur since the procedure involves tying off two major blood vessels, typically the carotid and the internal jugular vein.
- Blood clots are another complication of ECMO that can occur even though the circuit is monitored visually for any signs of clots or air.
- Transfusion-related infections may occur due to the fact that patients will be receiving blood and blood products transfusions.
- Technical failure or malfunction can occur just as any piece of equipment can.
So, while the ECMO was helping to keep me alive while my heart tried its best to heal, there was still a lot to do.
First, I was on a lot of drugs to keep me sedated and I was not responding to medical staff who would try to get me to squeeze their fingers or react to a sharp stroke on the sole of my foot. The doctors told my family to talk to me because hearing is the last thing to go. So, my husband made a “mix tape” – okay, mix CD of songs that were meaningful for the two of us and played it for me. My middle son made a CD of classical music that he felt i would like and that was played as well. One of my doctors shouted in my ear every day. I remember none of this. In fact, from the moment I went through the doors in the ER, all I know is blackness.
An internet search on ECMO and survival will quickly make it clear that it is used as a last resort for patients that would likely die without it. It’s also not a long term solution because the longer a patient is on ECMO, the less likely their heart will take over when ECMO is removed. So it is hardly surprising that after five days, the doctors came to my husband to have him sign the release forms allowing them to remove me from life support. The felt that my body could handle it on its own, and it was time to get my heart and lungs to do the work if they hoped to wake me and have me survive.
They took me off ECMO, and patched me up (saving your life sure does mess up your body!) and then tried to take me out of sedation. I started to gag on the intubation and, fearing I would aspirate my own vomit, they put me back under. With my strong gag reflex, it was a careful balancing act of removing the sedation and extubating me before I was fully aware of the tubes in my throat.
The blackness started to recede around February 20th-21st. I wasn’t prepared for what followed.