The ICU team at Missouri Baptist Medical Center has seen more than their share of the critically ill from COVID-19 over the previous eighteen months. On April 26, 2021, they met Terrell Brown. Brown is a 38-year-old from East St. Louis and was diagnosed just a week before with COVID-19.
“I took off work because I didn't feel well,” said Terrell, a local car salesman from Illinois. “The only symptoms I had were a headache, fever, and loss of appetite. But then it became serious when I could not breathe, and we called the ambulance. That's when I was diagnosed with COVID-19.”
Brown was treated at another local hospital but needed to be airlifted to Missouri Baptist for a higher level of care. The ICU team placed a tracheostomy right away to help Terrell breathe. Despite the emergent procedure, his health continued to decline. The teams of doctors, nurses, and respiratory therapists started Terrell on anti-microbials and other critical care medications and sedations to improve his breathing, but after a few days, his condition was not improving.
“We had exhausted a lot of our options to treat Terrell after a few days," said Dr. Robert Martin, Missouri Baptist Medical Center critical care physician. “With support from Terrell's fiancé, Katrina, we placed Terrell on ECMO (extracorporeal membrane oxygen) to help his body heal on its own.”
Extracorporeal membrane oxygen
The ECMO machine supports breathing for the patient while the lungs and body heal independently and is used when other options to help the patient have been exhausted. An ECMO machine pumps blood from the patient's body into an artificial lung called an oxygenator through a very large cannula; the oxygenator adds oxygen to the blood, removes CO2, and returns the oxygenated blood to the patient.
Terrell Brown's children sent an inspiring message to their dad.
Usually, patients are supported by an ECMO machine for only a few hours to a few days. In rare cases, it is possible to require support for a few weeks, depending on the severity of the condition and its progression over time. Physicians try to get people off ECMO as soon as possible. However, some diseases and illnesses can be treated swiftly, and others cannot. ECMO has greatly improved survival for thousands of critically ill people who don't respond to typical life-saving treatments while in the hospital.
“I remember having vivid non-stop dreams,” says Terrell. “I was in different places I didn't recognize and was trying to get home. But I couldn't move and couldn't get home.”
These dreams lasted for 49 days when on June 16, Terrell was taken off ECMO.
“When I woke up, I was so thankful that I was alive; I knew it wasn't a dream anymore," said Terrell.
“While Terrell was on ECMO for 49 days, there were times that many of us were getting discouraged that he wasn't making progress as we hoped," said Dr. Martin. “With COVID-19, patients' bodies may need more or less time to recover and heal. In Terrell's case, his body needed that time to heal, and ECMO helped make that happen. We were in uncharted territory with Terrell, but we knew his body was responding. It was a great win for our team when Terrell was able to come off ECMO.
“We've seen so much loss due to COVID-19; our patients have become like family throughout the pandemic; when we lose one, it hurts. We needed this to become a success story for us, and Terrell and his family.”
Continuing improvement
Terrell has improved in the last several weeks and had visits from his mother, brother, and colleagues. His fiancé, Katrina, and their two children utilized the EICU video system to chat, and he was even able to watch his young daughter take her first steps.
Terrell Brown makes it outside with the help of the team.
“Terrell still has a long road to recovery, but he has made great progress," said Dr. Martin. “Terrell can come off the vent, and then we will remove his tracheostomy. After that, he will start to re-learn walking, eating, and showering. The many things that we all take for granted will be a struggle for Terrell as he works on his recovery.”
Terrell has spent more than 60 days with the ICU team at Missouri Baptist, and he couldn't be more grateful for the team that worked so hard for so long to save his life. He plans to get the COVID-19 vaccine as soon as possible and encourages all his loved ones to get the vaccine.
“The first thing I will do when I am fully recovered and go home is to marry Katrina," says Terrell. “I don't want to wait any longer because if there is one thing that COVID-19 has taught me, it's that I don't want to take anything for granted. This illness has changed my life forever.”