Kelsey Salmon

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So, my wonderful friend Cara asked me to create this site to keep everyone updated.  So, here it is!

Kelsey was at her sister Lauren's soccer game about 4 weeks ago (Aug. 12), she complained about shortness of breath while walking from the field to her car.  

Fast forward to September 11, almost three weeks later and Hurricane Irma was headed towards Savannah/Statesboro area.  The school was closing and advised students to head home.  Kelsey and I argued back and forth about bringing her cat with her, I succumbed thinking I'd rather have her home where she was safe, than for her to be flooded and alone at school.  Best damn argument I ever lost.  All was well until Sunday afternoon.  She complained about inner leg pains on her thigh.  I suggested a hot bath, thinking it was a sore muscle.  She woke Monday morning complaining about her leg again, her leg was twice its normal size and red, almost purple.  


We called our friend, Rose that's a nurse, she suggested heading to the ER.  Irma was on its way, the news was telling everyone to stay indoors; what better place to be during a storm than the hospital?  No chance their lights were going out!  So, we headed to Children's Hospital of Atlanta Scottish Rite.


ER doctor checked out Kelsey, he immediately thought her swelling could be from clots in her leg.  Then she mentioned the chest pain weeks before, he had a grimace on his face I'll never forget.  Immediately started bloodwork, got a CT scan, and an MRI.  The bloodwork showed she had increased levels of whatever means you have a blood clot, chest CT scan showed Pulmonary Embolisms (PEs) and her legs had clots.  Hematology admitted her and started blood thinners.


After the CT scans we found out she has what is called May-Thurner Syndrome.  The main artery (iliac artery) in her leg is compressing on her vein, causing blood clots.  This, along with the fact she is on birth control, to help reduce her cystic acne, are the reasons she is going through this!


The doctors recommended a procedure called thrombolysis.  After the procedure, the patient needs to be in ICU to be under constant watch.  However, Scottish Rite did not have any rooms available and we were moved to Egleston by ambulance on Tuesday afternoon.  No sirens, much to Kelsey's dismay.  :(


On Wednesday, (Sept. 13) she went in for a procedure to resolve the clotting.  Thrombolysis is performed by an Interventional Radiologist, it is basically inserting catheters into her leg with strong medicine that helps break up the clot and is done under sedation.  The medicine, TPA, is administered overnight through the catheter and should have worked well.  They also put in a stent to help future clotting.  When doctors went in the next day to check the success of the medicine, Kelsey's blood oxygen levels failed.  One of the doctors rushed to us and told her she had acute hypoxia and she would need an emergency, life-saving device called an Extra Corporeal Membrane Oxygenation (ECMO).  We said, what?  How could this happen?  We signed the consent, said yes, please do what you need to do!  


We are freaking out at this point, obviously!  We asked the chaplain to pray with us, as soon as we started praying, the doctor walked in and said her levels suddenly came back and we were okay for now.  However, the next day, her blood oxygen levels plummeted and she was placed on the ECMO machine.  


Over the next several days her doctors opted to keep Kelsey on ECMO to give her heart and lungs a chance to recover from the trauma sustained during this emergency.   The ECMO machine is a system whereby cardiac output of the heart and lungs is bypassed through an artificial lung outside of the body.   Leaving her on ECMO was thought to be her best chance with the least risk compared to major open chest surgery.   Only time could tell.   After several days on ECMO we ran a trial to move her off ECMO only to find that her body could not sustain the level of oxygen needed.   Meanwhile her heart was dilated from all the pressure of trying to push the blood through the clots to her lungs.  Her heart cannot bear the burden of long time pressures.


ECMO day five proved to be a turning point.   A major clot developed in the output side of the ECMO system.   A surgical team was rushed to her bed side to repair and replace the ECMO system.   Kelsey did surprising well during this period but the team of doctors were left with the stark reality that more dramatic measures were going to be needed to resolve the underlying clots and pulmonary back pressure into the right side of her heart.   All the while during our stay the doctors at CHOA were working with the doctors at Emory who are more specialized in these types of procedures.  The doctors from Emory visited us on Thursday, Sep. 19 and gave us their opinions.  They've never done this procedure on someone so young, typically patients are 50-70 years old! So she has her age and youthfulness on her side!


We are left to consent on a few options, two  with enormous risk.   The first option is leave the PEs alone, hoping they'll resolve on their own, not a likely scenario.  Second option, open chest surgery to cut open the lung to remove the clots.  Lastly, go in with larger catheters through her groin into her lungs through her heart and mechanically remove/break up the clots.  The Interventional Cardiac doctor has done 50 of these procedures in the last year, CHOA has only performed two.  We were told it's worth the try to start with the third option before attempting surgery.


Kelsey is on a few days of rest, then she will be transferred to Emory, through an underground tunnel when they have an ECMO bed available.  Most likely the procedure will be done Monday, if unsuccessful, the surgery will be performed the next day.  


Our expected time in the hospital will be 3-4 weeks and she will have a lot of rehabilitation and recovery time.  Even after we have left the hospital.


We medically withdrew Kelsey from Georgia Southern for the semester.  We will talk with her about next semester when she wakes!