A summer getaway in the Rocky Mountains was just a few hours away for St. Louis resident Dave Priebe as he landed at Denver International Airport, disembarked from his plane and texted his girlfriend, who was waiting to greet him.
The couple was supposed to head east on this warm Sunday in early July and pick up Dr. Priebe’s two sons in Nebraska before turning the car around and heading west to Estes Park for a week of vacation fun. At least that was the plan when Dave hit “send” on his cell phone, telling his girlfriend he had arrived.
“I had just gotten off the plane and remember texting Lacey, and that’s when everything started to happen. All of sudden, I collapsed … and then, it’s six days later.
“I remember waking up after almost a week and thinking I was in some kind of alien movie. My hands were tied to the bed, I was intubated, and I looked around and thought to myself, ‘How did this happen?’ I was going to Estes Park with my kids, and now I’m in a hospital bed.”
Instead of a vacation, that bed would be where Lacey, his sons, their mom, Dave’s father and two brothers would hold a round-the-clock vigil as they waited for him to recover.
Dave has no memories of the days that followed his plane flight: days when he nearly died from cardiac arrest and a rare type of pulmonary embolism; days when his family who had come from Nebraska and gathered in disbelief, despair and then, finally, hope as his UCHealth care team used an eleventh-hour treatment to save his life.
“It was just crazy,” Lacey Williams said, “And scary. No one knew if this was the last time we would see him alive. It was so shocking to see him in that state and so unbelievable because he was such a healthy person. But I refused to give up faith. I kept telling myself he was going to be OK.”
Were there signs of his rare pulmonary embolism?
A primary care physician who specializes in sports medicine, Dave had no hint of the dreadful medical calamity that was awaiting him in Denver. Thinking back, he may have been a little short of breath going up and down stairs at work (which can be an early warning sign of a pulmonary embolism), so he made a mental note to begin hitting the gym more frequently when he returned from Colorado.
Dave was born and raised in Gibbon, Nebraska, located in the central part of the state, and went to Wayne State College, located about three hours north, before going to medical school at University of Nebraska at Omaha. After his residency and sports medicine fellowship in Greensboro, N.C., he practiced for several years in Colorado, Chicago and the Northeast before landing in St. Louis for the past four years.
He works hard and was looking forward to a vacation, and he and Lacey were excited to spend time in the mountains with his sons, 15-year-old Santino and AJ, age 9.
Lacey, who lives in Parker, was waiting for a follow-up text or call from Dave after he landed in Denver when instead, she was notified by Southwest Airlines agents that he had fallen, hit his head and was being transported to the ER at UCHealth University of Colorado Hospital on the Anschutz Medical Campus.
When she found him in the hospital ER shortly after, she was relieved to see him laughing with the nurses.
“He was conscious, talking and joking with everyone: I mean, he’s a funny guy. It was a good atmosphere and a good mood.”
Dave, however, has no memory of this. He had 13 stitches in his head and had injured his right leg from the airport fall. He and Lacey were talking with UCHealth staff as they began the process of transferring him to intensive care for more tests. He was alert, chatting and felt as if the worst might be over.
Before they left the ER, there was a sobering moment when he was asked by a nurse about “what if’s,” as in, what lifesaving measures he would want if his condition became more dire.
“He said, ‘I have kids, so do what it takes,’” Lacey remembered.
That conversation would prove to be valuable and prophetic very soon.
Doctor’s condition deteriorated fast as clot travels to the lungs
A few minutes later, as the elevator door opened and Dave was being wheeled into the Intensive Care Unit (ICU), he went into cardiac arrest – the first of three times over three days.
He had suffered a rare type of pulmonary embolism that had settled between his lungs and was putting pressure on his heart’s right ventricle, which caused the cardiac arrest. A pulmonary embolism is a blood clot that gets stuck in an artery in the lungs, usually traveling from deep veins in a person’s leg.
Staff performed CPR, intubated him with a tube inserted in his windpipe to keep it open so air could get through, and they gave him heart medications to break up the blood clot. Despite these efforts, Dave was near death. Physicians told Lacey the situation was grave and that an immediate last-chance treatment was needed.
Dave’s chance to survive depended upon ECMO, an external oxygenation system that would support his heart and lungs and buy him the time needed so his organs could recover and become stronger while blood thinners did their job and broke up the blood clots.
ECMO stands for extracorporeal membrane oxygenation.
Mechanical breathing machines can injure the lungs of very sick patients with too much pressure as it pumps air into the lungs. By comparison, ECMO allows the lungs to rest as it mimics their function outside the body. Physicians thread tubes through a neck vein into the heart, which then pulls blood out of the body. Carbon dioxide is removed from the blood through the ECMO machine and replenished with oxygen, which flows back into the heart.
Medical staff reached Dave’s father in Nebraska, who gave verbal consent: they would begin ECMO, and by the next day, Dave was in the hospital’s cardiothoracic surgery service unit, or CTICU, being cared for by a specialized and highly trained multi-disciplinary team assembled for this very type of situation, one of its leading team members being Dr. Joseph Cleveland.
“ECMO is certainly intended to be a rescue-type therapy – it gives people a chance not to die,” said Cleveland, who specializes in thoracic and cardiac surgery and is a professor of Cardiothoracic Surgery at the University of Colorado School of Medicine
“Dave was previously in good health, and he was a good candidate for the treatment,” he said. “For patients like him, it’s really a bridge to their recovery.”
Dave makes an amazing recovery with his family and ECMO by his side
ECMO helps between 60 and 100 UCHealth patients each year coming from within Colorado and surrounding states, including Texas, New Mexico, Wyoming, Montana and Arizona.
“It’s the highest level of care reserved for the highest level of need,” said Mark Lucas, ECMO Program Supervisor.
“We provide all the needed resources to care for these patients and have built a seamless pathway that’s initiated from the very beginning with the EMT call, to an integrated system in the hospital with an ECMO team where everyone’s a strong player.”
With Dave connected to ECMO, they were irretrievably linked, one relying on the other to breathe and keep him alive long enough so that his heart and lungs could heal while his loved ones waited for him to wake up. That included his father and brother, as well as another brother who stopped over in Denver on his way home from an overseas trip. All were coming to grips with the seriousness of the situation.
“I realized it might be the last time the boys might see their dad, so I brought them into the room and told them to hold his hand and tell him they loved him. And I kept thinking, ‘Maybe he can hear their voices. Maybe he can hear that we are by his side,’ ’’ said Dave’s ex-wife Angeline of their children.
“The presence of family and friends makes a difference. I’ve seen it before, and I knew he had to fight,” she said.
Their eldest son Santino, a high school sophomore who plays football and basketball, said he was scared to see his father in the hospital and “just wanted him to get better.”
His younger brother AJ, a fourth grader, agreed: “I was really sad, and I just held his hand and told him I loved him.”
Mom Angeline is a nurse near her home in southwest Nebraska. She had thrown a suitcase in the car and drove with them to UCHealth as soon as she heard the news.
“In my job, I’ve dealt with really ill patients. Now, I’m trying not to think like a nurse, but I looked at him and saw the huge cocktail of life-saving drugs he’s on and the ECMO, and I’m thinking, ‘This doesn’t look good.’ ’’
Yet Dave defied the odds with his body’s response to ECMO, and by day two and three, he was making major progress. He was following commands, responding properly to questions, opening his eyes and squeezing family member’s fingers. His care team was so encouraged after a positive EEG that they canceled a scheduled CT scan. By Thursday of that week, just 72 hours after being hooked up, he was removed from ECMO, and by Friday, he was well enough to breathe on his own without even a ventilator.
“We were all so happy about his progress,” Lacey said.
On Saturday, she ran home to change clothes and shower. While there, she got a call from a nurse that someone wanted to speak with her: It was Dave.
“They put him on the line, and I just started crying. It was amazing,” she said.
Later that day, his progress continued to astound his family as he was sitting up, eating clear broth and speaking:
“We went from living minute by minute to him talking about wanting to eat solid food. If he ever needed to be in the right place at the right time for the wrong thing to happen, it was this time for him when he landed in Denver. We are so grateful for all his doctors, nurses, and his caring staff,” Lacey said.
Dave continued to convalesce and rehab at the hospital during the next two weeks with physical and occupational therapies, along with some speech pathology. He is still doing PT for his hip and will likely be on a blood thinner medication for the remainder of his life.
“I’m doing fantastic,” Dave said, a month later. “I actually probably need to slow down a little bit, but I’m trying to build my stamina up before I go back to work because I want to be 100 percent.”
While he has little memory of his time at the hospital, Dave has great respect for the lifesaving care he received and the support of his “great family.” Once he was discharged, he drove back to St. Louis and stopped along the way to spend time with his sons in Nebraska.
Despite his Colorado “vacation” being unlike anything he could have imagined when he originally planned his summer trip, he thinks about all the scary possibilities, as in what if he’d collapsed in a rural area, or in inaccessible mountain terrain, as any medical delay could have led to a far different outcome of his story.
“I want to appreciate all I have and live each day …. although it might be a while until I make it back to Estes Park.”