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MY NEXT STEP
An Extraordinary Journey of Healing and Hope
By DAVE LINIGER, LAURA MORTON
HAY HOUSE, INC.Copyright © 2013 Dave Liniger
All rights reserved.
When we landed in Denver, Junior was at the airport to meet us. He's the eldest of my four children: Dave, Mary, Chuck and John. Chuck lives in St. Augustine, Florida, so we don't get to see him as often as we see the others, who live near Gail and me in Denver.
I think Junior knew I was in a lot of pain because I usually refuse to get into one of his cars. There's no good reason for that insolence other than we are both car enthusiasts and I like my vehicles more than his. But on this particular day I wasn't picky about how I was getting home as long as I was getting there quickly. Despite my fast deteriorating condition, I told my son I didn't want to go straight to the hospital—I preferred being in the comfort of my own bed.
"We'll go tomorrow," I said, agreeing to let him take me first thing in the morning after breakfast ... if I was still in pain. Somehow I was still hoping that this would pass—or at the very least, subside to a somewhat more manageable level of pain.
Everyone was pleading with me to go to Sky Ridge Medical Center, because it's such a great facility and very close to home, but I didn't want to be there overnight. Besides, the hospital in Galveston had already given me large doses of pain medication. Maybe I would just sleep this off, I reasoned. My reluctance was nothing more than sheer stubbornness and, looking back, stupidity.
Junior accompanied me to the house to make sure I was safe before heading back to his own home.
Sleep that night was completely out of the question. I couldn't move, turn over or lift my legs half an inch off the ground without assistance. The only way I could make myself comfortable was to lay flat or to pull my knees straight to my chest and prop three or four pillows underneath my calves. When I was in that position, the pain went away but the paralysis persisted. I tried not to think too much about what that meant in the long term. I was simply focused on finding a comfortable position.
By four o'clock that Sunday morning, less than forty-eight very long hours after I first discovered my paralysis, I finally caved in to the agony. I sent Ted, our house manager who lives with us, a text to come get me out of bed. It was apparent that I needed help, but I wasn't ready to acknowledge that it was time to go to the emergency room.
Ted immediately contacted Junior to let him know what was happening, with the hope that he could talk some sense into his old man.
Junior showed up in record time looking like he'd just rolled out of bed—which he had. When he arrived, I was sitting in a chair in our family room, wincing and groaning. He sat down next to me and said, "You're hurting bad, aren't you, Dad?"
"Yes." Frankly, there was no point in hiding the suffering. I finally admitted how bad I felt.
"You know Dad, you've got health insurance you've been paying for years and you've hardly ever use it. Let's go down to the emergency room to let them check you out. They'll probably just give you a shot for the pain and send you home." Junior was doing his best to convince me to do the right thing—and it worked. "It's time. Let's go." There was zero reluctance in my voice.
When we got to the emergency room, I was put in a staging area where I told the attending physicians that I was having severe back pain and needed medication for it. The team there was very attentive and kind. The first doctor I saw noticed that the color of my skin was a little off and that I was having trouble breathing. He gave me the same sedatives I'd been given in Galveston to take the edge off. The doctor felt it would be better for me to be transported from the ER to a regular hospital room that morning so they could run some additional tests.
Knowing I'd likely put up a fight, Junior took my doctor aside and asked whether it would be better for me to spend the night there or go home to rest. The doctor felt it would be much better for me to stay there until they were certain about what we were dealing with.
Although I wanted to keep my condition under the radar, several friends, colleagues and family members had gathered at the hospital within hours of my arrival to keep Gail, Junior and me company while the doctors ran a battery of tests. Chuck, Mary and John were told I was going to the hospital for back pain, which wasn't anything to be alarmed about. Junior remained in constant touch with his brothers and sister, providing updates throughout the day.
They had me in a very nice room on the sixth floor —one that resembled a suite at the Four Seasons more than a hospital room. Those rooms are a little more expensive than the other rooms in the hospital, but for me, they're worth the extra price. Sky Ridge is a first-class modern facility with every comfort and amenity a patient could wish for to make a stay pleasant—even enjoyable, as strange as that may sound. The section of the hospital I was in gives new meaning to "hospital food," offering filet mignon instead of the usual I'm-not-sure-this-is-really-steak surprise you find at many places, and other fine meals cooked to order. If you want someone to stay the night with you, they will fold out a bed from the sofa in your room and make it up for your guest. It's first class all the way. If you're going to be sick, this is the place to be.
When I first got to Sky Ridge, the doctors weren't totally convinced that my paralysis and pain was exclusive to my pr e-existing back problems. The doctors and nurses on duty came in and out of my room, drawing blood and running a battery of tests. I remember being told they wanted to do an MRI, but I have no recollection of it taking place because they had administered heavy-duty sedatives to keep me comfortable and still. There were several times when I felt as if I was falling into the rabbit hole as I slipped in and out of consciousness.
The last thing I strongly remember from that first day is the love and support I felt as everyone gathered in my room, keeping me company while we anxiously awaited the results of my tests. The group included RE/MAX friends like Margaret; Adam Contos, a former police officer who's now a Vice President; Vinnie Tracey, our President, who's been with us for thirty five years; and Bruce Benham, one of my senior officers, who's been with us for twenty years. They're just some of the people who were there from the very start, and they remained by my family's side throughout this ordeal. Many of my good friends from outside of RE/MAX were there too, including Dan Predovich, Chris Mauter, Dave Fisher, John Metcalf, and Bob Fisher, who was with RE/MAX from the very start but retired in the 1990s. Everyone's care and concern overwhelmed me and brought great comfort to my family.
Day turned into night. Eventually, everyone except Junior went home. He stayed by my side that night so I wouldn't be alone. He began sending updates to my other kids as well as emails to close family friends to let each of them know I was in the hospital for my back and would likely be there until Dr. Prusmack could see me the next day.
This is the part of my story where others have filled in the details for me. Many of the events that took place over the course of the next seventy-five days are reflected through their eyes and experiences. I have very little personal recollection of all that transpired, but I've been given enough information by them to piece together and share my story with you.
Around two o'clock that Monday morning, I began mumbling something about how many ribs we needed to make per person for the party. Gail and I had been planning our annual Super Bowl bash the following weekend, so maybe that's what was on my mind, but under the circumstances, it made no sense. Junior thought I was just talking in my sleep from all of the medication I was on and laughed off my drug-induced babble at first. But then he noticed that my breathing was becoming noticeably shallow and thought I might be taking a turn for the worse. The doctors decided to insert a ventilator tube to help me breathe. I have a gag reflex issue so it was clear that I wasn't going to tolerate their efforts well. Even when I visit the dentist, it takes a lot of nitrous oxide and some good Doors music on my headphones to make me relaxed enough to sit still in the chair. It's a good thing I was in a semi-conscious state, because they wouldn't have been able to get that tube in any other way.
By Monday afternoon, Mary and John arrived at Sky Ridge to see me. John immediately recognized that I was having a very hard time getting out of bed to go to the bathroom, and suggested that the doctors insert a catheter to keep me more comfortable and still. My paralysis made it all but impossible to stand on my own, so as painful as it was to insert, it was the best solution for when nature called. John has a wonderful understanding of critical medical issues and is very tuned in to information of that sort. He grew up with a hereditary condition that I am a carrier of, called Factor 5 DNA, which means we have a propensity for blood clots. As a result, John has spent many years studying blood. He also had a girlfriend who sustained a spinal injury in a terrible car accident, so he had heard much of what the doctors were talking about regarding my back issues before. With all of this knowledge, he became an instant advocate for me, not just as my son, but also as someone who had enough understanding and experience dealing with hospitals to be an effective liaison for the family. He could talk to the doctors in a language they both understood, taking in each morsel of information and giving it meaning for everyone else who couldn't grasp the severity of what was really happening He could also suggest alternative treatments that the doctors might not have considered. I'm told he was a significant factor in making sure I was medically well taken care of early on.
Sometime late on Monday, Junior suddenly noticed blood in my urine bag. He didn't have the same medical background as John, but he knew enough to understand that blood in the urine meant my kidneys could be failing. Shortly after that, my kidneys did completely shut down. The doctors put me on dialysis right away, but this development worsened my condition to critical. My body was quickly giving way to whatever was happening inside, which still remained a deep mystery to us all.
From the time I arrived at Sky Ridge, my body temperature was steadily over one hundred degrees, sometimes spiking upwards of one hundred and four. This was a sure sign that in addition to my back issues, I was fighting some type of infection. I had been traveling a lot prior to getting sick and my body was severely fatigued. I'd been on planes and in hotel rooms all over the country for several weeks at a time. I was physically and mentally exhausted, which wasn't exactly helping my body battle off potential germs. Even with these fluctuations, by the time Tuesday morning came, I had stabilized enough to give Junior the confidence to go home, take a shower, walk his dogs and get a little sleep. I don't think he closed his eyes once in my hospital room during those first two nights. He had to be on the verge of exhaustion himself.
Since my children were working in shifts those first few days, John and my good friend Adam took over when Junior left that morning. That's when one of the doctors on duty noticed that my urine now had an unusual cloudy appearance. He tested it, suspecting that something much bigger was brewing than just a back issue. Around seven-thirty that morning, he called John over to look at the results of the test. He said there was some type of severe infection in my body that was becoming rampant. He wasn't sure what it was, but he was positive it was quickly spreading and shutting down my organs. He strongly suggested that I be moved to the ICU as soon as possible. John didn't hesitate in making that decision. He was educated enough to see that there was a real problem growing by the minute. Knowing his siblings would agree, he approved that decision on the spot. The doctor told him it was obvious I was very ill.
From what I've been told, everything seemed to go into fast-forward when my urine test results came back. I was still in a semi-conscious state, so I had no way of knowing what was happening. I fell asleep in the comfort of my suite and awoke in the ICU. I was disoriented, confused and too drugged up to comprehend that I was likely dying. There was a lot of scurrying around, which made everyone nervous. While I was being transferred, John and Adam sent a text to Junior to get him back to the hospital as soon as possible. They sensed that decisions were going to have to be made quickly.
The early stages of being in the ICU are spent trying to get the critically ill patient under control. For me, that meant heavy doses of medication for the pain, which put me in a drug-induced semi-coma. I wasn't really aware of anything happening around me. Whenever I came to, I would try to talk, but I was terribly incoherent. With the ventilator tube down my throat it was nearly impossible to speak above a whisper. Still, my first question was always the same: "How's Gail?"
The doctors said they weren't sure if I had somehow contracted spinal meningitis or something worse. They would need to perform more tests to know what they were dealing with and how to treat it. Sometimes I'd wake up and beg whoever was in the room to get me out of there. I'd plead with them to unhook the tubes and free me before falling back asleep unable to remember what happened five minutes before that. I've never been the kind of man who likes to feel confined. Even in my altered state, I had enough sense to understand that I was someplace I didn't want to be.
The results of some blood cultures can take several days to come back, so everyone was extremely nervous as they waited for answers. With every passing hour, my organs began shutting down. When you're in shock, everything in your body can fail except your brain. You can actually comprehend that you're in danger, even if you're unconscious.
Well before going into the hospital, I had been diagnosed with type 2 diabetes. I knew I was at risk for coronary disease because I wasn't exercising as much as I should have been. In the past, I had worked out, lifted weights, climbed the rugged canyons in Lake Powell and always felt strong. But now, I'd never felt so weak or helpless.
In the midst of this, the doctors diagnosed me with high blood pressure and atrial fibrillation, also known as a-fib (an irregular heartbeat). My heart rate was fluctuating all over the place. A normal heart rate sustains a bpm somewhere in the sixties. Mine never got below the low eighties, and sometimes went as high as one hundred eighty. It would go up and then down, causing my blood pressure to be out of control. My liver began to fail too In all fairness, I can't say that enjoying a drink or two throughout my sixty-seven years helped much. Joking aside, these conditions were serious enough on their own. When combined with my current state, they became extremely dangerous. It had to be terribly disconcerting for everyone to watch my body being ravaged in this way.
When the blood cultures finally came back, the news wasn't good. Dr. Prusmack told my family that I most likely had methicillin resistant staph aureus (MRSA), a run-of-the-mill staph infection in my body that had become septic. Staph aureus is one of the five most common types of staph infections, affecting as many as half a million patients a year. One-third of us carry this type of staph in our bodies, especially in the nose, back of the throat or on the skin. Thankfully, this kind of staph infection is generally considered insignificant because it's a type of bacteria that is easily treatable with the right antibiotics.
When staph hits the body, it can migrate to your heart, lungs or bones. In my case, the infection was looking for a place to attach itself. Since I had lower back damage from prior injuries, the infection manifested itself mainly along my spine. This made my case a bit more complicated than most. The MRI images came back showing sacs of pus all along my vertebrae. When doctors conduct an MRI exam, they start at the spine and go through all four sections from your lower back to your brain stem. Each one had an abscess formation. It is not uncommon to have the infection in parts of the spine, but it is extremely rare to have it along the entire spine and into the brain stem. Worse yet, my blood tests showed that the infection had spread to my blood too, making it mobile throughout my body. I was later told this was the first time my medical team had ever seen this type of infection affect the entire spine. Although they had treated similar cases, mostly the thoracic and lumbar parts of the spine, they hadn't seen anything quite like the infection that ran along mine from top to bottom. As they say, go big or go home.
Now that the doctors were able to identify the type of staph infection I'd contracted, they could figure out the best method for treatment. They agreed that antibiotics would be their initial course of action and administered heavy doses to start reducing the presence of the pus sacs that were creating pressure on my spine. While there might be the need to perform surgery down the road, they first hoped to control the worst of the infection through the use of drugs before making the decision to perform delicate surgery that could cause permanent damage along my spine.
Now that my disease had a name, everyone was trying to figure out how I might have contracted my sepsis in the first place. As I mentioned, I traveled all of the time and slept in various hotel rooms, so it was possible that I picked it up sometime during my travels. One of the doctors also talked about several studies linking MRSA to Vietnam vets, especially those who may have been exposed to Agent Orange during the war, as I was. But then, someone in my family recalled that I had a cut on my arm that wouldn't heal for weeks. I collect cars and had recently acquired an electric car called a Tesla. It's a two-seat sports car that can go from 0-60 mph in 3.2 seconds. Even with that power, it's really like a suped up golf cart because there are no gears, and when you step on the accelerator, it makes very little noise. It's so quiet that you feel like you're driving a stealth vehicle. Like a golf cart, the Tesla has to be plugged in to be charged. I had put an extension cord on the ground of our garage, and made it a point to tell everyone to be careful not to trip over it. I meant to tape it to the floor but before I could, I forgot it was there and tripped over it myself. I landed pretty hard and though I managed to roll out of my fall, I cut my arm from my elbow down toward my wrist. The wound wasn't deep enough to need stitches but it took quite a while for it to mend completely. I didn't think much of it at the time, but looking back, that was the most likely source of my infection—a simple slip and fall in my garage!
Excerpted from MY NEXT STEP by DAVE LINIGER. Copyright © 2013 by Dave Liniger. Excerpted by permission of HAY HOUSE, INC..
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