The final chapter, continuing from above:
The next few days were a blur of more tests, more proof that he was back (he still couldn't remember the day of the race but remembering all kinds of things), and a move to the CIU step-down unit and then to a private telemetry room. He was stable and recovering but a bit sad and scared as the reality of his situation settled in.
His leg is still open from the fasciotomy with a wound pump affixed, and he will require surgeries to debride the dead muscle and to put a skin graft over the two openings....he doesn't have much feeling in the lower leg and can't really move his toes yet, but the blood flow has improved so much he won't even lose a part of a toe, let alone his forefoot.
After an MRI, a CT scan, and a contrast angiogram, they discovered without a doubt that the attack was caused by the pinching of his anterior descending coronary artery...the fix is most likely a single bypass that should remove all risk of a recurrence going forward (pending reviews by a few other cardiologists at other renowned hospitals), but that surgery will have to wait until the leg heals a bit and he is done with rehab. He is on the road to improvement and I am so thankful he is here to hang out with me still.
So here are the last few links in his luck chain...the clinical ones:
There are 6,000 hospitals in the country....only 300 or so have the Arctic Sun technology to lower a patients temp accurately and in a monitored way...and the hospital he was brought to is the only hospital in our area with the machine...that 24 hours of cooling helped protect his brain function, but as importantly they believe, helped keep his leg healthy enough to survive the surgery and let the blood flow return almost to normal.
There are 6,000 hospitals in the country....only 100 or so have the TandemHeart and ECMO combo technology and the experience to use it...the hospital he was brought to is the only hospital in our area with the technology and a doctor who can use it - the interventional cardiologist they pulled in that first weekend is the only one at the hospital who has used it...in fact, he is the one that brought the technology with him when he came to this hospital a year ago...there is no question the time and support the combo intervention provided allowed my son to live through that first night critical night....
The parent/doctor who stayed with my son for the first 72 hours is one of the top surgeons in this city, and he was so emotionally invested in my son's care that he called in a bunch of favors to get the right vascular and plastic surgeons to be put on his case, and he called the head of the renowned rehab centers in the area to "encourage" them to take him on for inpatient rehab on his leg…his constant attention and compassion pulled us and my son and the other doctors and nurses through the first tough few days.
My son is receiving absolute top-notch care from the only place in the area that could have saved him, but was by luck, not by any “consumerism” on our part - we didn't Google "teenage arterial switch survivor with heart attack" or pull up HealthGrades to find the best hospital or doctors to treat him....we have benefited from the kindness and skill of a community of health care providers affiliated with a hospital that was uniquely situated to help him, but the only choice we had in this was what hospital to drive him to.
I don't know how often this kind of story happens in the U.S....or how much our connections the parent/doctor helped us get to the right place at the right time for the right care from the right providers...I want to believe we experienced a normal level of care or attention, but I don't know if another 17 year old would have been swarmed by a whole hospital of care givers and given a chance to have the best people available help him purely by luck...it scares me a bit to think how different this would have turned out if we hadn't landed at this hospital...if he hadn't collapsed at a meet at his well-prepared and wonderfully staffed school....if all the random and independent coincidences and factors hadn't lined up perfectly, in the right order, to create the chain that kept him alive and now thriving.....it is amazing and scary all at the same time.
His story isn't over....but the trajectory of his recovery and the continued excellent care he is receiving gives me a significant amount of hope that this will all have a very happy ending....