Indiana man thanks hospital for response amid rare emergency

ROME CITY, Ind. (AP) - Had things gone a little bit differently, Steve Parrish might not have been around for Christmas this year.

As he sits in the living room of his Rome City-area home, he fiddles with the plastic tube protruding from his neck. The little purple cap on the end allows him to speak clearly. As he talks and breathes, there's a wet sound, kind of like pushing air through a plastic drink straw.

It's the job of doctors to save lives and the purpose of the hospital emergency room to help people in a crisis. But when Parrish and his wife walked in Dec. 20 with his tongue swelled up several times its normal size and choking off his airway, they felt like they were springing an unusual surprise on the staff at Parkview Noble Hospital.

They weren't totally wrong. The type of emergency he walked in with was one of those top 1 percent most serious cases.

But you never would have known that, they said. The way nurses and doctors swarmed in, stayed calm and took care of very rare and very serious business over the next few hours felt above and beyond the call of duty.

A few different decisions, a few minutes of hesitation and Parrish might have died. Instead, he was home for Christmas Day this year.

"To me what makes a difference - it may not make a difference - how often does this happen to them?" Parrish said. "But to me this has to be fairly rare for them to not get any heads up, walk in desperate like that, walk in and diagnose. They were fantastic."

"You've got to get me to the ER," Parrish told his wife Sharon the morning of Dec. 20.

After waking up and starting his morning routine to head to work in Ligonier, Steve felt something was off. It felt like his tongue was swelling in the back of his mouth and he had a sense that it was going to get bad fast.

In the few months prior to December, he had a few allergic episodes, maybe brought on due to a reaction to a prescription medication. Once, his lips swelled up to comical proportions. A few times before his tongue had swelled up, but usually in the front and usually only for a little bit.

But this one felt different and Steve sensed he was in trouble.

"I could tell immediately because he was talking like he had a mouthful of food and then he was gagging because he couldn't swallow his own spit," Sharon said.

They didn't call an ambulance - not wanting to wait for it to arrive - but instead hopped in the car to speed off to Kendallville. Around 7 a.m., they strolled through the doors of Parkview Noble Hospital's emergency room.

The registrar quickly got them checked in and before she was even done, nurses were waiting and took him immediately back to a room. Sharon recalls hearing the nurse tell someone else to "make sure the doctor stays" as Parkview was in the middle of a morning shift change.

Steve's tongue had swelled so large that it was forcing him to hold his jaw open. With the back of his tongue swelled, he was having a hard time breathing, kind of like having a bone stuck in your throat and not being able to get it out.

"I remember the tongue sticking out of my mouth. It was massive," he said.

About a dozen people swarmed into the room, led by the emergency physician on duty, Dr. Tracy Rahall. She told him they were going to try to get a tube down his throat to help him breath if she could see his vocal chords.

Steve remembers gasping for air. Then he blacked out.

When he awoke later, he was in a hospital bed in Fort Wayne.

In the middle of the crisis, with medical personnel swarming around, Sharon began taking photos.

That's probably not the reaction most people would have in the midst of a medical emergency, but staying occupied helped to keep her calm as the doctors began to work on her husband. Also, she knew her husband would want to see what had happened later, so she started snapping.

His tongue was too big to intubate him, so doctors needed to cut him a new airway immediately.

The room they were in didn't have a tray of tools to perform the emergency procedure. As medical staff went to get it, Sharon said it seemed like there was some issue about whether they had all the equipment on hand.

In the swarm of activity, Sharon recalled how calm Rahall seemed in the middle of all of it. As staffers talked about going in search of more equipment, Rahall took control and exercised command of the situation.

"She said, 'I'm telling you, I have everything I need. We're set to go.' And she came over to me and said 'I'm going to ask you to leave the room now,'" Sharon said. "I couldn't even get mad and say 'I'm staying' because she was just so polite and calm and even. And that's when they kicked me out, she did tell me, this is what we're going to do."

What they were doing as Sharon stood in the hallway was a cricothyrotomy - an emergency procedure to cut into the throat to open an airway in the windpipe.

Sharon snapped a picture from the hall. A curtain was pulled across the door, so all she could see was the ankles and shoes of the medical staff in the room moving around. At certain points, she would see their feet lift off the ground up onto the bed and she got panicked, wondering if they were giving Steve CPR. After a few minutes, they let her back into the room.

There was blood on the floor. A nurse was standing next to the bed bagging air into the tube in his throat because they couldn't connect him to a ventilator. Since Parkview Noble isn't a trauma hospital, they told Sharon they were going to have to airlift him to the main campus in Fort Wayne.

When Samaritan's crew arrived, they came in and attended to Steve, getting him prepared for the flight to Fort Wayne. Once they got him to the hospital, they'd roll him in for another surgery.

"Andy and Matt, helicopter crew, they were awesome," Sharon said. "He came over and he was really sweet. ... He said, 'Don't race me. I will win every time,' and they took wonderful care of him and they explained everything they were doing."

She took a video on her phone of Samaritan lifting off around 9:30 a.m. and got into her car before the emotion finally hit her. She called her son and drove down to Fort Wayne.

She didn't see her husband again until 2 p.m.

Doctors who work in the emergency department are kind of adrenaline junkies at heart, Dr. Thomas Gutwein, medical director for Parkview Health's emergency departments said.

At least, adrenaline junkies who then can lock in, focus and get the job done under incredible stress.

ER doctors do handle a wide array of emergencies on any given day, from broken arms to heart attacks. At face value, the Parrish's sentiment that they felt like they dropped a bombshell on the Parkview Noble staff isn't typically the case.

But in this instance, the emergency the Parrishes came in with was unusually rare and serious, Gutwein said.

"What this gentleman came in with was probably the top 1 percent of severity and emergency," Gutwein said.

The "crike" procedure they had to give Steve? That's only needed a handful of times per year across Parkview facilities, Gutwein said.

While the emergency was a little out of the norm, Gutwein said Sharon's reaction to how the staff handled the emergency is exactly what doctors strive for.

Doctors go through years of med school and then anyone interested in emergency medicine does three years of residency in a hospital emergency department, Gutwein said. But Gutwein admitted that for the first couple years in the business, it's normal for doctors to come into work with butterflies not knowing what may walk through the door that day.

With time and experience, emergency doctors develop a steely resolve in a crisis, he said. Like a soldier, a police officer or a firefighter, frequent training and preparation goes a long way.

Parkview's emergency staff also rotates around the system, so doctors get some experience in facilities outside of Fort Wayne.

"I think the more patients you see, the more difficult situations you're put in, the next time you're able to not get (overly) worked up about it," Gutwein said. "If you're not calm, then the whole room isn't calm. Then you just kind of focus hard on what you're doing."

For emergency docs, not knowing what's next is part of the fun, while being able to handle whatever it may be is the core of the job.

"You don't know what you're going to get in the next half hour walking through the door. Most of us are adrenaline junkies. We do thrive on some of that adrenaline. We don't like too many humdrum days," he said.

When Steve woke up later that afternoon in a bed in a strange room, with multiple tubes connected to his body, the first thing he wanted was to see what he looked like.

Sharon snapped a photo and showed it to him. When they gave him a pad of paper and a pen so he could write - he couldn't talk connected to the machines - he wrote the following.

"Overkill. I'm fine."

It took a few days to recover, but Steve made a good bounce back. He convinced the staff to unhook his breathing tubes and was breathing on his own through his new plastic airway.

They missed their Christmas plans with family that Saturday, but by Christmas Day, Steve was back at home.

He's still not sure exactly what triggered the episode. He's still following up with an allergist to figure that out. Now he carries an epi-pen with him in case of a flare-up. He thinks his trach tube is "ugly and nasty and gross," but the recovery has gone smoothly and he should be getting it removed soon. Some people end up having it for life, so it's good, positive progress.

Telling the story of his harrowing experience, Steve downplays the drama but is happy to talk up the job doctors and nurses did to save his life. That's his biggest takeaway from the incident.

"I'm just trying to thank these teams. They were freaking fantastic," he said. "As far as I'm concerned, I was within a few minutes of dying, so I feel very fortunate. All those teams, everyone I came in touch with was fantastic.

"It's got nothing to do with me. It's all about them," Steve said.

For Gutwein, the appreciation is well-received. Lots of doctors help patients manage conditions to help prevent a major episode years down the road, but emergency docs get the opportunity to fix a problem right away and see the results.

"It really is gratifying to see patients that benefit from what we're doing," Gutwein said. "We enjoy seeing patients benefit from our care right away and when patients say thanks, that means a lot."

___

Source: The News Sun

___

Information from: The News-Sun, http://www.kpcnews.com