Doc's Near Death Experience

[Peter]

Doc, Echoing the sentiment of everyone else. Glad to hear that you are getting better. And have the heart to share such a personal story with us.

Have been reading your (very insightful) posts for more than six years now. And every time i learn something new. Thanks for taking time (from your busy life) to post (educate, inform, entertain) so many of us.

Our good wishes are with you always. If there is anything we can help with, just ask.

[arjun2761]

Very glad to see you back! Your insightful posts and self deprecating humor make for some of the best reading here.

Wish you a speedy recovery and look forward to many decades of your wonderful insight and humor...

[BSharma]

Rightly said Doc.

However, one question remains - who is this "I" who is going to make it?? Is it the body, mind, intelligence or something else...

With due respect to you, your profession as well as my wife (also a physician), modern science has not yet reached the point where the differentiation between mind & intelligence can be established.

Regards
Sanjay

I do not know who is this "I". For me, it was the person who is the husband of my wife, father of my children and friend of my friends. I went through hell to survive and although I was heavily sedated, my mind was very clear and I kept telling myself that I am not going to die. The ICU nurses and Respiratory Therapists and the doctors taking care of me told me that they had not seen a patient with so many IVs, tubes and machinery attached than me. Since I was intubated and on a ventilator for over two weeks, I could not talk, but I would write notes to people. Thankfully, the nurses kept all my notes and gave them to me when I was leaving the ICU. I have read the notes now and it is amazing how my mind was able to tell the doctors about medical stuff, my wife about what to do, and to the nurses about my care.

More about my experiences in ICU...

[BSharma]

ICU Stay in Tulsa:

After angioplasty and the episode of V-tach (ventricular tachycardia), I went into cardiogenic shock (heart was unable to maintain adequate blood pressure) and my kidneys stopped working. The physicians were puzzled because no form of treatment was working. It took a day to figure out that the septum (wall) between the two upper chambers of the heart had burst open because of pressure changes following the massive heart attack. A pediatric cardiologist inserted a patch through a blood vessel in the groin and placed it in between the two upper chambers of the heart. However, I remained in cardiogenic shock. A balloon pump inserted into the heart through a blood vessel in the groin did not work also.

I do not remember anything because of heavy sedatives, but my wife told me recently that I would give her instructions about many things.

With my condition getting worse, I was intubated and put on a ventilator. My friend/cardiologist felt it was time to send me somewhere where there was better expertise to deal with my condition. He had trained in Salt Lake City, Utah and remembered that one of his professors had moved to Oklahoma City recently and he is the leading expert with this type of problem. Dr. Long reviewed all my data and asked that I should be transferred right away. My wife was worried that I was going to die on the way, but my son, a medical student, convinced her that she should sign the consent forms and get me going. I was sent by a medical helicopter and I do not remember the trip at all. My hospital has two medical helicopters and I have seen them take off or land daily and I have wondered what it is like taking a ride in a helicopter, but when my turn came, I was completely out.

[kujo]

My hospital has two medical helicopters and I have seen them take off or land daily and I have wondered what it is like taking a ride in a helicopter, but when my turn came, I was completely out.

Good to see your familiar style of humor in that post!
For the benefit of your wider audience I pulled these descriptions from Wikipedia:

Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively.
Since this is a category of shock there is insufficient perfusion of tissue (i.e. the heart) to meet the required demand for oxygen and nutrients. This leads to cell death from oxygen starvation, hypoxia. Because of this it may lead to cardiac arrest (or circulatory arrest) which is an acute cessation of cardiac pump function.[4]
Cardiogenic shock is defined by sustained hypotension with tissue hypoperfusion despite adequate left ventricular filling pressure.

The Intra-aortic balloon pump (IABP) is a mechanical device that is used to decrease myocardial oxygen demand while at the same time increasing cardiac output. By increasing cardiac output it also increases coronary blood flow and therefore myocardial oxygen delivery. It consists of a cylindrical balloon that sits in the aorta and counterpulsates. That is, it actively deflates in systole increasing forward blood flow by reducing afterload thus, and actively inflates in diastole increasing blood flow to the coronary arteries. These actions have the combined result of decreasing myocardial oxygen demand and increasing myocardial oxygen supply.
The following situations may benefit from this device.
* Cardiogenic shock when used alone as treatment for myocardial infarction 9-22% survive the first year.

[prasen9]

This is incredible. It is a joy to read you write again. Welcome back.

[jaydeep]

Thanks Doc, great to hearing from u.

[ajay]

Like everyone, I was also shocked and relieved that you are back here. Wish you a speedy recovery! I'm glad that after such a serious episode you are back amidst us. Your enthusiasm and lively personality is a big inspiration for everyone. Just like you have supported many people in their tough time, I just want to express that all of us support you and we are behind you during these difficult times.

Thank you for sharing your experience. Power of mind is an amazing thing and you are a gff. The way you fought thru this serious incident is noteworthy and an example to everyone This reminds me of the famous quote "Hope is on the way." Never give up hope and always give yourself a second chance. As you mentioned, there will be one more surgery soon. Our goodwill is with you. Go Bhushan!!!

[BSharma]

At Baptist Medical Center, Oklahoma City: Part I

I reached Baptist Medical Center via a medical helicopter at about 5:30 pm on 12th January and the team of doctors headed by Dr James Long, MD, Ph.D. started working on me. My family and friends drove to OKC after picking up supplies from home. I had gained 18 kg (yes eighteen kg) of weight in two days because my kidneys were not working and the fluids given to correct cardiogenic shock (thanks kujo for explanation ) were accumulating in my body.

Dr Long decided on doing an ECMO in which the heart and lungs are put to rest for several days and a heart-lung machine takes over the work of the heart and lungs. Although sedated, I heard ECMO being discussed by the doctors and I used sign language to intimate that I wanted to write on a paper. I wrote to them that I have been involved in doing ECMOs in newborns with severe lung infection at my hospital. For some reason I felt at ease hearing that ECMO would be done on me; however, I should be getting scared to death because ECMO is procedure of last resort in heart attack patients, and the results in adults are not as good as in newborn children.

Through my sedation (it is amazing how the mind can sometimes hear important things) I heard a doctor say to give me two antibiotics (Meropenem and gentamicin) to prevent infections since it is a common and fatal complication of ECMO. I again got the piece of paper and wrote that I take care of several children with severe Methicillin resistant Staphylococcus Aureus (MRSA) infection and asked the doctors to add an antibiotic for it and they did.

As soon as ECMO was started, my blood pressure went up and I began to make urine. Over the next week, I lost the 18 kg of fluid weight.

I was heavily sedated for the ECMO so that I would not remember it, but my mind would wake up at times and I would hear, “It is not your time.” I was determined to live for my wife, children and friends, and I would repeat to myself to fight and fight. At times, I would hear my wife and children talking to me although I could not make out what they were saying, but it felt comforting. It validated my theory when I ask the parents of my patients on ventilator and heavy sedation to talk to them.

I was worried about developing pneumonia and Adult Respiratory Distress Syndrome (ARDS) because that would be the end of my life. Every time I would wake up from sedation, I would ask the nurses and respiratory therapists to suction my wind pipe. It is a painful procedure because a suction catheter is pushed through the endotracheal tube (ET) into the wind pipe and lungs and the respiratory secretions are suctioned out. It makes a person to cough, but the ET tube in the throat prevents a person to cough. Later when the ET tube was removed, the nurses and RTs told me that they had not done as much suctioning as they did on me. Fortunately, I did not get pneumonia or ARDS.

Heparin (prevents blood from clotting) is added to the blood during ECMO and I started bleeding into my eyes and nose. An ENT surgeon came and packed my nose daily, and boy is it a painful procedure or what! It was worse than getting my ET tube suctioned. Luckily I did not bleed into my brain, lungs, or other vital organs. The blood from my eyes has cleared and I can see clearly.

[suresh]

Bhushan,

It is indeed a relief to see that you did recover from a life-threatening situations. Welcome back. I am travelling and just got see this thread.

Suresh

[Varma]

Top-10 reasons why our dearest Dr.Sharma heard a clear commanding voice, "This-is-not-your-time"

- Varma

[Sandeep]

Shocking to hear about this Bsharma. I hope you will recover and will be back to normal in as fewer days as possible.

[x_y_Z_a]

Bhushanji

I am glad and relieved that you fought bravely and got out of a serious illness. I pray God that you get well soon along with all the Forumites.

In fact I was wondering what happened to you since your regular posts were missing. For some reason this topic did not show up in my unread posts till today.

Even in describing your dire situation, you maintained your sense of humor.

Best wishes for a speedy recovery.

[Kumar]

Hi Doc,
Very glad to hear that you survived a near death experience... Shows your typical sense of humor to make light of such a experience...

[punarayan]

Dr.Sharma, I was wondering about the absence of your wonderful comments and insight. I may not write much, but read all the posts here as this is my gateway to tennis news and opinions. So you seem to have reached the "pearly gates"and decided that heaven is on earth with your loved ones! I'm glad you are on the way to a full recovery and wishing you the best of health. Quite a brave performance!