By LISA EISENHAUER
Keeping Courtney Elliott alive during a COVID-19 nightmare that started just after New Year's Day and stretched into mid-March took an all-hands-on-deck effort at Mercy Hospital Oklahoma City.
"Basically every service in our hospital had some degree of interaction and care with Courtney, because that's what was required," said Dr. Jennifer Strebel, one of three physicians who shared their memories of the colossal lifesaving effort in a press
release and YouTube video.
Courtney Elliott feeds her newborn daughter as her 3-year-old son gives the baby a pat at Mercy Hospital Oklahoma City. Elliott contracted COVID-19 toward the end of her pregnancy and, after an emergency cesarean delivery to relieve her breathing,
she developed a life-threatening blood clot. She credits the hospital's clinicians with saving her life.
As Elliott's delivery doctor, Strebel was among the first to recognize how direly COVID had impacted the 33-year-old's health. Elliott was 36 weeks along when she tested positive for the virus on Jan. 3. Strebel examined Elliott on Jan. 11 and moved up
to the next day a cesarean section that had been planned for Jan. 25.
"She was having a really hard time breathing," Strebel recalled. "I consulted with her maternal-fetal medicine specialist, and together we decided the baby was full term. If we could just deliver the baby, her uterus would decompress and allow her lungs
to work more effectively."
The procedure went fine. Parker Elliott weighed in at 7 pounds, 7 ounces. Mom and baby girl went home to Elliott's husband and 3-year-old son on Jan. 16.
Elliott's return home was brief. Even with supplemental oxygen, breathing became difficult. Within two days, she went back to Mercy by ambulance.
"When she got to the ER, her oxygen levels, which should be 92% or more, were at 45%, which I truly didn't know was possible for someone who was still awake and talking," Strebel said.
Doctors admitted Elliott to a step-down intensive care unit, where they tried several oxygen delivery systems in hopes of keeping her off of a ventilator. When Elliott's horrible cough lingered and the complications of COVID continued to weaken her after
a week, the doctors moved her to the ICU for closer monitoring.
A week later, Elliott's care team decided she was strong enough to move back to the step-down unit. At the behest of an ICU nurse, they delayed the move for one day. On what was to have been her last day in ICU, Elliott's oxygen levels deteriorated so
rapidly that her doctors intubated her and hooked her up to a ventilator.
"Her blood pressure dropped so low, and the nurses immediately jumped in, but everything we tried to do to intervene medically wasn't working," said Dr. Maroun Tawk, medical director of the ICU.
Although Tawk had suspicions about what was behind Elliott's severe downturn, his patient was too unstable for a trip to the lab where imaging could offer a clear diagnosis.
In consultation with Dr. Aaron Graham, interventional radiologist at Mercy, Tawk ordered a mobile X-ray and echocardiogram to Elliott's bedside stat. The images were cloudy but Tawk said they reinforced his concern that Elliott had a blockage between
her lungs and her heart.
"This was a huge risk," Tawk said. "We had no idea what we were dealing with or what Dr. Graham would find if she even survived the short trip down the hall to the cath lab, but we had to do something. She was dying."
A photo of the blood clot, a life-threatening complication of COVID-19 infection, that a doctor removed from Courtney Elliott's chest this spring. Elliott arrested during the emergency surgery and twice after in the intensive care unit. One of her
doctors said every service line in the hospital played some part in seeing her through a nearly two-month hospitalization.
In fact, Graham said Elliott's heart stopped as he was performing the catheterization. When nurses jumped in to start compressions, Graham ordered them to stop.
"I knew I had to get the blood moving again," Graham said. "As soon as I was able to get a portion of that clot out, her heart started right back up, and it was a mad dash to pull out as much of the remaining clot in her heart and lungs as possible."
Once the catheterization was done and the full clot was removed, Graham and his colleagues were stunned by the size of the ropey mass pulled from Elliott's chest. It was about 8 inches long with shorter tendrils. The mass had been completely obstructing
blood flow in her heart and lungs, according to a press release from the hospital.
Elliott was returned to the ICU to recover. Over the next few days, her cough remained so severe that her lungs collapsed twice, causing her heart to stop. Each time the ICU team was able to revive her.
After Elliott's third cardiac arrest, her care team performed a tracheotomy to install a temporary breathing tube in her neck. After five weeks, her condition began to improve. On March 3 she was strong enough to move to Mercy Rehabilitation Hospital
Oklahoma City.
She stayed there until March 11, learning to stand, walk and bathe herself — skills she had lost along with much of her memory during her nearly two months of hospitalization. After she went home to the suburb of Yukon, she got visits from nurses and
therapists for a few weeks.
By mid-May, Elliott said in an interview that she felt she was 90% back to her pre-COVID condition. What lingered, she said, was arthritis-like pain in her hands and feet, which she attributed to muscle atrophy.
Elliott said that while she wasn't conscious for much of her medical odyssey, she is well aware of the extraordinary effort by the Mercy Oklahoma City team who saved her.
"I don't think that I could ever thank them enough for everything that they've done," she said.