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Because of Siskin Hospital, I can be Roland again!

December 14, 2021

Roland Butler, 66, had traveled to Stevensville, Michigan to participate in a refueling outage at the Cook Nuclear Plant.

As a radiation protection specialist, it was his job to help confirm and determine the extent of any radiation hazards that might occur during the thousands of inspections and maintenance activities taking place. The second COVID-19 pandemic wave was heating up by the time he arrived in September 2020, and though mitigation precautions were in place and adhered to, Roland realized one day that all was not well. Breathing was becoming difficult and he felt lightheaded. He collapsed as he reached the plant EMT station, unable to speak or move. He was immediately taken by ambulance to a nearby hospital while the rest of his team quarantined. Transporting EMTs gave him a breathing treatment and found his temperature was greater than 103 degrees.

In the ER, his COVID-19 test came back positive and he was admitted. He did fairly well for a couple days, not requiring significant oxygen, so the physician considered discharging him home.   When Roland protested he wasn’t feeling well enough to go home, they agreed he could stay. It turned out to be a good decision: within 24 hours he was requiring high flow oxygen and moved to ICU.

His respiratory status continued to deteriorate and when they discussed ventilator support, he called to ask his wife, Casandra, to come to Michigan. She arrived just before he was intubated and placed in a medically-induced coma. Doctors told Casandra there was a 50-50 chance of survival when COVID-19 patients had to be intubated. Roland would later say she stayed to “make sure I came back home in some fashion, whether alive or in a coffin.”

He was weaned from the ventilator October 21. Respiratory status again deteriorated and on November 4 his heart stopped, requiring full resuscitation by the Code Blue team who replaced the ventilator tube and performed chest compressions. Since his heart rhythm had flat lined, the only options were the chest compressions and intermittent epinephrine to kick-start the heart. It took 20 minutes until he got a pulse and was placed on multiple medications to stabilize the rhythm. An EEG showed moderate to severe brain encephalopathy.

The attending physician recommended that Roland be changed to Do Not Resuscitate and Hospice status, which Casandra, a physician herself, declined. She knew from her research that statistics showed a one percent chance of functional life in a patient being “down” for more than 15 minutes. But she wanted Roland to have every chance.

The doctor initiated hypothermia protocol, which chilled Roland’s body to about 90 degrees and slowly rewarmed him after 24 hours. When his sedation was temporarily suspended, he was alert and able to respond to commands. He was continued on the ventilator and had a trach tube and feeding tube placed after two more weeks.

Roland was sent to a specialty hospital to wean off the meds and ventilator. He had lost 45 pounds – mostly muscle – and was so weak he needed two people to perform any care. He couldn’t walk or do anything for himself. By mid-December staff told Casandra they had done all they could and that they would arrange transfer to a skilled nursing facility.

Casandra balked. She had practiced internal medicine in Chattanooga for 23 years and knew that if she could just get Roland home and into Siskin Hospital, he would receive the therapy he needed to maximize his functional status. Admission required medical transport from Michigan to Siskin Hospital, so Roland made the nearly 600-mile trip in an ambulance.

What Roland remembers most about his inpatient stay at Siskin Hospital is the people who cared for him.

Dr. Manalo is one of the greatest doctors in my life (besides my wife),” says Roland. “He was magical! He knew exactly what I needed – he observed me so closely and tracked my therapy progress, making changes as necessary.”

Most importantly, he was up on his feet again.

“The folks here got me walking again,” says Roland. “In Michigan, I didn’t even know who I was. Everyone at Siskin Hospital seemed to understand my condition and made me feel as if I was their only patient.”

After three weeks, Roland was discharged home, continuing outpatient therapy at Siskin Hospital’s Hixson clinic for six months. It was during this time that a pulmonologist specializing in COVID-19 saw Roland for lingering breathing problems. After several respiratory tests, the pulmonologist told Roland he would be on oxygen for the rest of his life.

The prognosis dashed all of Roland’s hopes for a full recovery. Not only must he depend in perpetuity on an external O2 supply, he faced an early retirement and the expectation of never again pursuing some of his favorite pastimes. A former sea captain, water was his life-blood – he was an accomplished swimmer and scuba diver. He felt his life was effectually over.

Seeing his depression and listlessness, Roland’s outpatient therapy team assured him that he would adapt to his new situation. “It’s not over,” they told him, but Roland wasn’t sure he wanted to live on O2 the rest of his life. Also, he really wanted to swim again.

Michelle Henry, COTA, suggested they do his last few therapy sessions at the Siskin Health & Fitness Center, where there was a pool. That turned out to be a total game-changer for Roland, both in mind and body. He was willing to give in to retirement, but couldn’t fathom never getting into the water again. With Michelle’s help, he learned to navigate working out in the pool while using his O2 supply.

When Roland got into the water again, he was like a kid smiling from ear to ear,” says Michelle. At first, she gave him some simple exercises to do while in the water, but it wasn’t long until he progressed to laps.

Roland’s enthusiasm and energy returned and he now looked forward to his therapy with eagerness.

“I could not wait until the next pool session with Michelle!” he says. “She was bringing back the old Roland.”

Roland knows it’s a miracle he’s alive – in fact, many of his practitioners have told him so after reading his medical history. Today, he’s back to swimming, gardening, and writing his autobiography.

“Because of Siskin Hospital, I can be Roland again! Roland Butler was not Roland Butler until Siskin Hospital made it happen.”

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