A man whom doctors were given orders not to resuscitate is now walking and eating with his family after battling the Coronavirus Disease 2019 (COVID-19) for 32 days.
Jim Bello was transferred from an emergency room in Boston on March 13 to Massachusetts General Hospital after developing a 103-degree fever. This happened after hiking Loon Mountain in New Hampshire on March 7.
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A sudden turn of events
A 49-year-old lawyer, skier, cyclist, and runner, Jim was connected to a ventilator for two weeks, then to an artificial heart-lung machine for nine days. Dr. Emmy Rubin, his physician, told Kim Bello, Jim's wife, "If you're asking for an honest opinion, it's more likely than not that he won't [survive.]"
It was so bad that any touch that caused any slight movement "could send his oxygen levels into a tailspin," according to The New York Times. His doctors were worried that they would not be able to revive him if his heart would stop.
Jim's X-ray looked bone-white and had no air-filled sacs, which was one of the worst chest X-rays Dr. Paul Currier, one of Jim's doctors, has ever seen.
He was sedated and paralyzed using chemicals, flipped on his stomach to improve airflow, and connected to a sophisticated life-support machine. But one of Jim's specialists, Dr. Yuval Raz, said to The New York Times, "Even if those were things that could help him, trying to do those would kill him."
The team even tried cutting off the oxygen for 30 seconds, but they didn't think he would survive it.
Critical care doctor Peggy Lai described patients like Jim. "It's like they fall off a cliff. You see young patients getting sicker and sicker by the day despite everything that you know is good standard of care," she told The New York Times.
His condition worsened rapidly in the hospital, but something turned his condition around and doctors cannot pinpoint what. Nurse Kerri Voelkel and respiratory therapist Tyler Texeira realized Jim's lungs were so bad that they can't keep him awake.
"So we had to re-paralyze him in order to essentially keep him alive," Voelkel said.
After a call with Dr. Rubin informing Kim of her husband's critical condition, Jim's medical team lessened the amount of paralytic medication he was receiving on March 28. It proved to be effective.
According to Kim, "Jim woke up, you could tell he was trying to open his eyes." Later, he shifted his body, but he was too unstable to withstand breathing that his oxygen levels plummeted, said Dr. Raz.
The same night, Dr. Rubin told Kim to visit Jim. Wearing protective gear, Kim entered the room and did everything to make him stable. She said, "if I keep talking to him, if I talk to him for hours, maybe he'll stabilize, and maybe he'll be OK."
Although doctors cannot say the visit cured Jim, it definitely helped, said Dr. Currier.
Three days after the visit, there was some clearing in Jim's left lung. 17 days on Extracorporeal Membrane Oxygenation, respiratory therapist Todd Mover suggested Jim "might be ready to come off the machine." On the 18th day, he was disconnected from the machine, but remained on a ventilator on low oxygen levels.
A couple of days later, Mr. Bello sat on the edge of his bed and called his wife via FaceTime. On April 11, he FaceTimed his family, opening his eyes briefly and waving his hand but unable to talk because of the intubation tubes.
Three days later, Jim was taken off the ventilator to breathe on his own. He called his family again, whispering "I love you," before being wheeled out from the ICU to a regular floor. Medical staff who were initially discouraged about his condition lined up the hallway and applauded him.
Jim, after spending over a month at the hospital, came home Friday afternoon.
View this post on InstagramThe last month has been very trying, extremely emotional and very uncertain. I wanted to reach out to my friends during this time and send a message of hope, strength and inspiration. The following video shows the power of prayer, hope and joy. Let this be something we look back on and find strength to get us through our most difficult times. Here is what we are calling our miracle. ️ #encouragement #inspiration #leadership #strength #messageofhope #gratitude #kindness #jimbeatcovid #mghangels #frontlinesandfamilies In an effort to give back I decided to start a gofundme for the Angels of MGH who saved my husbands life. Our goal is $100,000 and we have just hit $50,000. The link is here if you would like to contribute. Https://www.gofundme.com/f/frontlines19 A post shared by Kim Bello (@kimbello0814) on Apr 18, 2020 at 7:04am PDT
Hospitals battling another threat
Dr. Lai said, "The tricky part with this disease is that we have nothing to follow, to know what predicts how sick someone will be and what predicts them getting better." COVID-19 brought another problem to most hospitals: unpredictability.
Doctors are experienced at treating similar respiratory failures, but sometimes "the path of patients with COVID-19 can be maddeningly unpredictable," said The New York Times.
On Jim's first day at Massachusetts hospital, his ventilator was only at 65 percent oxygen, then reduced to 35 percent the next day. Dr. Currier said Jim "seemed to be improving," until his ventilator was set to 100 percent oxygen level.
There isn't any therapy discovered for the infection, yet. But most organizations around the world are in the pursuit of a vaccine to put COVID-19 to rest once and for all.
For now, most medical institutions will have to adjust themselves and the tools that they use to suit the situation, to try and come up with a miracle.
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