COVID’s no match for Paul and his special team

When COVID turned Paul Anderson’s world upside down, his wife Anna and a small army of medical professionals helped him recover. Anna needed to be Paul’s eyes and ears early in the fight, while he was on a ventilator. Today the avid golfer is back to playing 18 holes — although at a slower pace and with his portable oxygen tank handy — but he looks forward to better days.

Dr. Lynette Exum

Dr. Steven Lau

Hospitalists were crucial to Paul’s team at Bryan

When the COVID-19 pandemic hit a peak last year, the hospitalists of Inpatient Physician Associates (IPA) at Bryan Medical Center took care of some of the sickest patients in Nebraska. As physicians who are trained specifically in hospital medicine and treat only hospitalized patients, they coordinated medical care of the patients with COVID and kept their loved ones informed for weeks or months at a time. Patients came from across the state, in need of specialized equipment and care available at Bryan.

Paul Anderson of Oakland was one of those patients. Early in his eight-week stay at Bryan East Campus, he was given a minimal chance of surviving COVID and its complications. Instead, he fought through to become a success story. He survived the battle although he may deal with COVID’s lingering effects for years to come.

How it began

Paul’s family gathered for the holidays in the opening days of 2021. They celebrated being together at his home and that a new grandbaby would arrive in a few months.

Paul and Anna (both 59) were in excellent health. They planned to get their COVID vaccinations when the shots became available to the general public — one of the many precautions they took against the virus, in part to protect the health of Anna’s 95-year-old father.

After the last of the family members left on Jan. 3, Paul turned to Anna and said he didn’t feel well. When he received a positive diagnosis of COVID on Jan. 6, he left the family business — Anderson Structures LLC — and went home. Anna, a legal assistant, left her workplace and went home to quarantine, too.

They could not have known that COVID was about to upend their lives and Paul’s health for much of the coming year, with treatment and rehabilitation involving 10 Nebraska medical facilities and being sedated while on a ventilator for 79 days.

Paul’s health deteriorated rapidly, from lethargy and cold symptoms to coughing, the feeling of drowning while struggling for air, an inhaler, proning and steroids. Within a week, Paul was admitted to Methodist Fremont Health. On Jan. 19, Anna received the news that Paul needed to be sedated and put on a ventilator. Separated by COVID restrictions, she asked a nurse to read a letter she had written to Paul, and she relied on FaceTime to talk briefly with him before he was sedated.

Paul developed an air sack in his lungs, so he needed to be transported to a hospital that had an Extracorporeal Membrane Oxygenation (ECMO) machine, which could oxygenate his blood outside the body, if his condition worsened. Bryan was one of the few facilities in the region with an ECMO available.

Anna watched from her car as her husband of almost 40 years was airlifted to Lincoln.

She was allowed to stay with Paul at Bryan East Campus when he came out of COVID isolation, and their lives settled into a grinding routine on the ICU floor. Anna spent up to 13 hours a day at Paul’s bedside, often serving as his eyes and ears, then slept at a relative’s house across the street.

Hospitalists from IPA met with Anna as they cared for Paul, navigated him through complications and coordinated specialists and ancillary services.

“They always told me the plan for the day,” Anna says. They also warned her many times that his COVID journey could be long and unrelenting. It turned out that Paul

Paul says, “I’m humbled every day to think how they helped me move on to the next level. We can’t say Thank You enough.”

wouldn’t need the ECMO, although he benefited from the specially trained staff at Bryan.

“Paul was in the group of patients we knew would be in the hospital for at least a month. The prognosis was so guarded with this group — we all tried to grasp any little positives we could,” says hospitalist Lynette Exum, MD, who is in her 19th year with IPA.

When Paul coded early in February, medical staff quickly filled his room. Nurses kept the Andersons’ sons, Andrew and Alex, informed by phone, as Anna prayed with the chaplain in the hall.

Paul came through that event, a tribute to his strength and spirit and to the care he received, recalls hospitalist Steven Lau, MD, who’s been with IPA since it was formed 20 years ago.

“Paul had a long, hard pull to get through,” says Dr. Lau. “He was among the group of patients who were dying and would not have survived without the advanced health care he got. It was a lot of effort, a lot of all-hands-on-deck and a lot of staying power on his part to get through it.”

Over the next weeks Paul inched forward in his marathon race to survive. With even the slight improvements, the hospital staff shared their joy, Anna says.

“They would get excited, too, if something good happened. Even when separated by all the shields and barriers needed for treating those patients, they’d raise their arms to celebrate.”

Still feeling thankful

Anna and Paul strive to be grateful in all circumstances, and the medical staff and Bryan employees topped their list of people deserving their thanks; that includes the “amazing, comforting support” of the chaplain, the employees who took time to talk with them as they cleaned COVID gear and changed batteries on machines keeping COVID patients alive, and the respiratory therapists and biomed techs who worked continuously to keep the crucial ventilators in working order and patients as comfortable as possible.

“They saw suffering, dying, tears. They gave families terrible news. Then they would leave and go out in public, where other people weren’t wearing masks,” Anna said. “They had to be strong.”

Dr. Exum worked with Paul near the end of his stay at Bryan to reduce his doses of

oxygen and sedatives.

“Anna was anxious for him to be awake and know she was there. I worked to get him off those heavy sedatives so he was more alert and able to move on to the next level of care,” she says.

That next level involved grueling weeks of rehabilitation at two Omaha facilities. It’s hard to describe the depth of recovery from COVID, Paul says. Pre-COVID, he was used to the physical labor involved with construction and was a healthy 6 feet, 2 inches, 250 pounds.

“When I got off the ventilator and finally regained consciousness, I literally couldn’t move,” Paul says. “The only thing I could move was my head. I didn’t even have enough strength in my hand to press the nurse call button.”

After months of lying flat, regaining the ability to sit up took weeks. It was a miserable period, transitioning to solid food again, adjusting to seeing the world from an upright position again and working to gain strength. He was often sick to his stomach, exhausted and sore — “Like my whole body had gone through a tornado.”

The first day Paul was able to stand upright, with the help of a mechanical lift in Omaha, was a milestone.

“I felt like I was 20 feet tall,” he says. He returned home on May 28 — after 134 days of care at seven different medical facilities — to continue his rehabilitation in Oakland and West Point.

Lots of changes

He knows it is rare to come off of a ventilator after 70-plus days. Paul continues to rehab at home, building up strength and reducing his reliance on the portable oxygen machine. This avid golfer has returned to play a casual 18 holes — relying on his golf cart and having bottled oxygen handy, but finishing the round, nonetheless — and is back in the office, managing his construction business, although he doesn’t expect to ever have the stamina to spend days hammering nails at a job site again.

Paul is grateful to be home and continuing to make gains. He says, “I wasn’t expected to live, but everyone gave their all, so when Anna and I came back to visit Bryan last summer, it was humbling to realize how much they cared and appreciated seeing me so improved.”

Paul Anderson was one of the patients whose outcome provided a much needed boost to care givers during a dark time. Dr. Lau adds, “For all of us who worked with the COVID patients, it was an unrelenting, trying time, so it was very gratifying to see people like Paul do well — because not everyone did.

“Those victories really go a long way for us.” n

IPA marks 20th year

In August, Inpatient Physician Associates (IPA) celebrates its 20th year.

Hospitalists practice exclusively in the hospital setting and work with primary care physicians to assume care of hospitalized patients; they provide a summary so that primary care doctors can continue follow-up care when the patient is dismissed.

Brian Bossard, MD, was one of the first in America to provide hospitalist services. He began offering hospital medicine in Lincoln in 1993 and founded IPA in 2001.

Scott Heasty, MD; Steven Lau, MD; and Vivek Kulkarni, MD, began practicing at Bryan West Campus in 2002, and the practice expanded in 2003 to include Lynette Exum, MD; Randall Plambeck, MD; Tamer Mahrous, MD; and two other physicians at Bryan East Campus.

Today the practice has 41 doctors and 28 advanced practice providers. IPA provides around-the-clock service at Bryan as well as hospitalist services at Grand Island Regional Medical Center. Over the past 20 years, IPA has provided consultative care to patients referred from every county in Nebraska.

IPA founded hospital medicine programs at Great Plains Health in North Platte in 2009 and at Columbus Community Hospital in Columbus in 2010. These programs continue to grow and serve all adult medical inpatient care needs in those communities. n