Volume 7 | Issue 6 | through September 24, 2013

STAFF
UCH Insider Central
For the Clinicians, Managers & Staff of University of Colorado Hospital Bill Sonn, Publisher Tyler Smith, Editor Todd Neff, Joelle Klein, Contributing Writers Teresa Claus, Distribution Taylor Carpenter, Art Director To submit story & column ideas: Tyler Smith (tyler.smith@uch.edu). UCH Insider covers clinical, business and staff news at the hospital. The object is to provide a credible, accurate source for news in and around the hospital community.

This Hospital Life

After Long Journey through Illness, a Run into the Light

On a February morning this year, Victor Carlos set out from his central Denver home with a modest goal: to complete a short jog. No more than 10 yards into the run, however, Carlos hit the wall. Everything was off, said Carlos, 42, wincing slightly at the memory as the sunlight of a hot September afternoon streamed into his dining room. Just a few weeks before his abortive jogging effort, Carlos was lying in a bed at University of Colorado Hospital. He was hooked to a machine that kept him alive by doing the work his badly damaged lungs could not: circulating oxygenated blood to the organs in his body. He was suffering from acute respiratory distress syndrome (ARDS), which had started with a bout of flu. The infection spread, attacking his lungs and bringing him to the edge of death. That Carlos survived for nearly a month on the ECMO (extracorporeal membrane oxygenation) device and emerged with his mental capacity intact is remarkable. That he has recently completed 20- and 23-mile runs and is training for Octobers Denver Marathon might be called miraculous. I dont because to call it a miracle would be to diminish the willpower of Victor Carlos; the determination of his providers, especially cardiothoracic surgeon Ashok Babu, MD; and the unwavering support of his wife, Brenda, and his extended family. Dark days. The last time I had seen Vic before our meeting last week was January in a room on the Cardiology Unit. Hed been off the ECMO machine only a few days at that point. He wore
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Victor Carlos spent nearly a month on an ECMO machine after a lung infection threatened his life.

The run was jarring, he said. I felt the loss of muscle mass. I was out of breath. It was humbling. Those of us who have steadily dug ourselves into the couch potato community might think we can relate to the bodily rebellion against physical activity Carlos experienced. But in reality, there are few people in the world who can.

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Volume 7 | Issue 6 | through September 24, 2013 | Page 2

a bemused look on his ashen face as he struggled to put together what had happened to him. Brenda told me most of the story that day. She continued to tell it to Vic after he came home from the hospital. He was still wrapping his head around what had happened while he couldnt speak or communicate, Brenda said. Vic was worried about the after-effects of ARDS, she said. Would there be posttraumatic stress disorder? Would he have brain damage? She described to him in detail what had happened the emotional trauma, the steadiness of Babu, who remained calm, helping her through the difficult medical decision making.

The road back. Vic, in turn, committed to helping himself get stronger physically. Far from a couch potato before his illness, he was a dedicated runner who had completed several marathons. But getting back to that point seemed like climbing a steep mountain as he stood gasping for air that February morning.

Carlos training for a recent long-distance run.

Trying to run that block was a horrible feeling, he said. But hed already seen what he could do with steady effort. After coming home he had begun walking, the first time pulling the oxygen tank along as his brother-in-law from New York joined him. They started with a block along Eighth Avenue, continuing until Vic saw his oxygen saturation dip. But the distances steadily increased. When he got up to a half mile, he pulled the cannula from his nose and put the tank away for good. So no matter how discouraging he found that first jog, he had a formula to improve beginning the journey with a single step. And the ECMO ordeal hadnt wiped out his memories of how it felt to run free and easy. In my memory, I knew I could run, he said. It was a motivating factor to remember what that feels like. Steady progress. It would take time to make it happen. The price of meeting his first goal, running one block, was standing bent over, gasping and his head pounding. But he kept at it, following his old training regimen of jogging a block and walking a block. He slowly built his distance to three blocks, then started three-minute runs followed by one-minute walks. By March, he ran/walked three miles. It took him 55 minutes.

Carlos, left, on short walk with his brother-in-law Paul Voglewede shortly after Carlos returned from the hospital. Note the oxygen tank.

He missed six weeks of his life, Brenda said. I think the stories helped him. There were other emotional bridges to cross after he returned home. Nurses had warned Vic that hed be so weak that walking to the laundry room would be exhausting. He didnt believe them until he tried it. He was tethered to an oxygen tank for weeks. Brenda found herself trying to support him physically and emotionally while keeping their two girls, 7 and 11, on track. Support of family members and some time off from her job as a freelance graphic artist helped, but she finally bent under the pressure. He was very weak, very needy for the first couple of weeks after he came home, she remembered. I couldnt do it all. Instead of burying the frustration, she confronted it. I said to him, You have to help me help you.

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I survived, he said. I felt that with the support of Brenda and my girls I had everything I needed. I had no regrets, I was only grateful for the support of family, friends, neighbors and people who just showed up. It was a wonderful expression of humanity. Before I went in the hospital I always saw the negative things in people. My experience changed that and it has changed me forever. Tyler Smith. Smith is editor of the UCH Insider. To comment on this story, email tyler.smith@uchealth.org or uch-insiderfeedback@uchealth.org.

Carlos and wife Brenda Voglewede in early September, happy to be home after their winter ordeal.

Babu, meanwhile, had been in his corner, telling one of Carloss friends that getting back to running marathons was important to his patients rehabilitation. The big breakthrough came on a May morning when he set out on a non-stop three-mile run of a course hed long followed through the neighborhoods north and west of his house and back. The run took him 35 minutes, right at the pace hed set before landing in the hospital. When I finished, I thought, Did that really happen? Carlos said. It was a wonderful feeling. It was hard to imagine that not long before, I hadnt been able to run a block. After that, it felt better every time and I wanted to build on the success. He has done that. This past Saturday he ran 23 miles, starting from his home to Cherry Creek State Park, lapping the reservoir and returning. He continues his workouts, sandwiching training time around his at-home job as a computer programmer. The training was the best thing he could have done, Brenda said. Without it, he couldnt gauge where he was. He has accomplished every goal. He has confidence that he has healed. A different place. We can admire the physical distances Carlos now covers. But they represent something more profound: the winding path to recovery that few people make alone. Carlos today is many miles, physically and emotionally, from the frail man who lay in the hospital bed in January. He is quick to smile a long-distance runner who is anything but lonely.

What You Read, Sept. 10

1. Board Approves First System Incentive Payout 2. Schroffel, Stacey Announce Resignations from UCHealth 3. Quality Patient Care Is Guiding Light for Interim UCHealth Chief 4. Around UCH 5. ED Staff Rolling with Big Change 6. Novel Vertigo Maneuver Pushes Patient Volume to Dizzying Heights 7. FNS Finds Its Way to Operating Room Staff through the Stomach 8. UCHealth Shells out a Cool Mill for Health Assessments 9. UCHealth Finalizes Systemwide Vaccination Policy 10. Past Meets the Present in New CeDAR Extended Care Residence