5 minute read
Life-Flighted
LIFE-FLIGHTED
Boone’s team effort saves Zach’s life and stabilizes him for transport!
Zach Traylor sits across from the doctor who saved his life. The last time Zach was in front of Michael Brown, MD, MS of Missouri Heart Center, Zach was in a Pheo Crisis – a rare, life-threatening endocrine emergency.
But how did a seemingly healthy 24-year-old get to this point?
Zach was enjoying life. He was in his second year of PhD school at the University of Missouri. He loved to read, loved to cook, loved to try new recipes and especially loved to do science and his research.
In June 2022, Zach started waking up to a pounding heart – not pounding fast, just pounding hard. “It was a little concerning at first,” Zach says, “but eventually, things would get occasionally worse and that beating would go to my brain and my stomach and it would be agonizing pain.”
Zach went to his general practitioner who referred him to an electrophysiology expert in the cardiology department. He did a full echocardiogram, was put on a heart monitor for a month and nothing was found to be wrong with the functioning of Zach’s heart. With nothing to diagnose, Zach was advised to stay healthy and to come back if it got much worse.
As time went on, his episodes would last around 15 minutes. Sometimes they would be every night, and sometimes they would be months apart.
On Super Bowl Sunday in February 2023, Zach felt really sick. He attributed it to a fun weekend and thought that maybe he was hungover. As the day went on, he started feeling much worse. The pain that he attributed to his episodes was lasting for a couple of hours. Realizing this was a lot different, he headed to the Emergency Room.
Once Zach was admitted, he got rapidly worse. His blood pressure was very high, and after a couple of hours, he had his first cardiac arrest and had to be resuscitated. He tested negative for any virus, but every time the hospital staff tried to move him for more additional tests, Zach would go into cardiac arrest.
Zach was seen by cardiologist Michael Brown, MD. “Zach had a couple cardiac arrests before I got involved,” said Dr. Brown. “When Zach came to my attention, his body was in a shock state.”
Zach’s body was in Pheo crisis – a rare, life-threatening endocrine emergency.
“With Zach’s case, I knew we needed ECMO,” said Dr. Brown. ECMO –extracorporeal membrane oxygenation – is a form of life support used for adults with life-threatening heart or lung problems. ECMO provides time for the body to rest and recover by doing the work of the heart and lungs.
Realizing that Boone Hospital did not have the capability to keep Zach alive, as he was in cardiopulmonary collapse, his only hope was to be transferred to a facility capable of providing ECMO. At that time, Dr. Brown made the decision to transfer Zach to Barnes-Jewish Hospital where he could receive this treatment.
“Because Zach’s lungs had decompensated at that point, we weren’t going to be able to transfer him without being on something,” Dr. Brown explains. “We took him to the Cardiac Cath Lab and put in an Impella Heart Pump.”
The Impella heart pump is used when patients need help pumping blood for a short amount of time. This would support his heart with blood flow but would not recover his lungs.
While still precarious, Zach was transferred to St. Louis by Helicopter.
Once Zach got to Barnes, he was hooked up to every life support machine they had. Most of his organs crashed and would need time to recover. After he was stabilized, they were able to do a CT scan. Through the CT scan, a mass was found in his lower torso/abdomen. Ruled as an adrenal tumor – pheochromocytoma – a rare, usually noncancerous tumor that develops in an adrenal gland.
The tumor had been releasing hormones and all kinds of chemicals into Zach’s bloodstream. It had been mildly releasing epinephrine into his blood stream which would cause the heart pounding, headaches, and pain. When Zach crashed at the hospital, the tumor was pumping epinephrine into his blood stream continuously and it overloaded his heart.
Once the tumor was diagnosed, they were able to put Zach on medications which blocked the toxic effects of the secreted hormones. Soon, his liver, lungs and heart began the slow recovering process.
After his body had time to recover, the tumor was removed and was benign. Measuring in at 10 centimeters, it was one of the largest tumors Zach’s surgeon had ever seen. The tumor was so large that it pushed one of Zach’s kidneys down and displaced it.
As Zach and Dr. Brown sit across from each other, Zach says, “I’m really excited and happy with how things turned out. Just a few scars and a few things I have to work through – minus one adrenal gland. I do appreciate everything you did for me”.
“My pleasure,” Dr. Brown replies. “I’m just so happy it turned out positive. You were kind of the talk of the whole hospital for a while. You had a lot of people pulling for you.”
Zach is now tumor free and back to doing the things he loves. Looking forward to finishing his PhD, Zach is grateful for everything that was done to save his life.
