Harrowing Medical Drama Leaves Couple with Special View of Hoag
“I have no doubt that if we had landed at any other hospital, Mark
wouldn’t have made it,” Cindy says. “It sounds corny,
but Hoag is special.”
Twice during Mark Holechek’s 25-day hospital stay his adult children
were called in from out of state to say their final goodbyes. A
brain aneurysm
rupture had caused his heart and lungs to shut down. Doctors could not
yet assess if he had suffered brain damage, as he had spent weeks in a
medication-induced coma, and he simply couldn’t breathe.
Thankfully, the kids’ trips home were unnecessary. When Mark was
rushed to the hospital from his Corona del Mar home on April 13, 2012,
he was taken to
Hoag. And that, Mark’s wife, Cindy, says now, is why he is sitting next
to her, listening to her recount his harrowing story.
“I have no doubt that if we had landed at any other hospital, Mark
wouldn’t have made it,” Cindy says. “It sounds corny,
but Hoag is special.”
Hoag is also home to some of the most experienced neurologists, cardiologists
and pulmonologists in the region – three specialties that Mark’s
highly unusual case required.
When he was first admitted to the hospital, Mark was a cardiac patient.
After stabilizing his heart, doctors placed him on the Arctic Sun©
cooling protocol, a therapeutic hypothermia that helps preserve brain
and vital organ function after the body has experienced a loss of oxygen.
“Hoag is so amazing that they have the ability to do these things,”
Cindy says, as her husband listens. “Mark doesn’t share the
story because, as he explains, ‘I wasn’t really there.’”
During the bulk of the 25-day ordeal, Mark was kept heavily sedated as
specialists from across the hospital worked together to unravel his mysterious
case and save his fragile life. A close family friend of the Holechek’s,
gynecologic oncologic John (Jeb) Brown, M.D., even got involved and spent a great deal of time checking on the family
and offering support.
Once Mark’s heart was stabilized, a
CT scan
revealed the aneurysm that had caused all this mayhem.
“That’s something you never want to hear,” Cindy says.
“I looked it up, and you read all these statistics that your chances
of survival are 30 percent.”
At that moment, five days after entering the hospital, Mark became a neurology
intensive care patient, and critical care physician Abhinandan A. Bharne,
M.D., and interventional neuroradiologists
Binh Nguyen, M.D., and
Wallace Peck, M.D., took over his care.
Many hospitals rely on open brain surgery to repair an aneurysm, but the
Hoag Neurosciences Institute
offers state-of-the-art facilities and highly trained
interventional neuroradiologists
who were able to perform a coil embolization, the intricate procedure
that eliminates the need for traditional invasive and potentially debilitating
brain surgery.
A catheter was gently guided through an artery in Mark’s groin all
the way up to his brain. When the catheter reached the weakened vessel,
a fine filament was released to pack up the rupture from the inside. The
surgery went well, but after an aneurysm it is common for the blood vessels
in a person’s brain to narrow erratically, a condition known as
vasospasm. Vasospasms were limiting blood flow to Mark’s brain cells,
and two days after his first brain surgery, Mark needed a balloon angioplasty.
Dr. Nguyen performed the procedure, in which blood vessels are mechanically widened.
“The doctors were amazing, and we got through that. But then they
said, ‘Now, it’s his lungs,’” Cindy says.
The aneurysm rupture had caused both his heart and lungs to shut down.
And so much fluid had filled his lungs, he was drowning. Fortunately,
Hoag is one of the only hospitals in the area with a special Rotation
Bed that flips patients 180 degrees to take the pressure off the lungs
and help remove the fluid.
At that point, Cindy was optimistic enough to send her children back home.
But then two days later Mark experienced another terrible vasospasm, and
was rushed in for another angioplasty.
Hoag Neuroscience Institute Executive Medical Director and The Ron and
Sandi Simon Endowed Chair, Michael Brant-Zawadzki, M.D., F.A.C.R., who helped bring intracerebral intervention for vasospasm treatment to
Hoag performed additional intra-arterial infusion of an anti-spasm drug
after noticing that three tiny strokes had occurred. Dr. Brant-Zawadzki,
noted that Mark’s case was particularly complicated, and physicians
could not predict how well he’d respond to the treatment.
“The doctors said, ‘You need to call your daughters back.
I want this to be a false alarm, but it’s serious,’”
Cindy says.
Thankfully, the procedure worked. Mark was stabilized, and instead of
saying goodbye to their father, Mark and Cindy’s children were able
to say hello.
In fact, five days later Mark’s daughter Nicole was at his side
when the 63-year-old restaurant owner came out of his medically induced
coma. Two weeks had passed since his aneurysm.
“He was peaceful. His face was relaxed and he was looking around,”
Cindy says. “He still couldn’t speak because he had a tracheotomy.”
He also still couldn’t breathe on his own, but after a few weeks
in a sub-ICU, Mark was able to leave Hoag and begin the process of weaning
off the ventilator, and going through physical therapy to relearn how
to swallow, walk and talk.
Mark had lost 25 days of his life and nearly as many pounds. All of his
muscles had atrophied, but he was alive. And, thanks to Hoag’s skillful,
resourceful team, he hadn’t suffered any significant brain damage.
A motivated patient, Mark finished his physical therapy and got back to
his passion of remodeling homes. A year after his ordeal, the couple remodeled
a vacation home in Arizona. And recently, they built a new home for themselves
from the ground up on the Balboa Peninsula.
“We chose the location because we wanted to be closer to Hoag,”
Cindy says. “From the back deck, you can see the hospital.”
It’s a view that gives them comfort.
“It’s funny, we were sitting on the deck of the third floor,
and I said, ‘Look, over there. It’s my old house,’ and
it was Hoag,” Mark says. “I drive by the hospital every day,
and I just feel so lucky. It is amazing.”