'He was where he was supposed to be' — A series of fortunate events saves UK patient's life

Newswise — LEXINGTON, Ky. (Feb. 8, 2024) — Weekends in the fall are chaotic in the Zuber household.

Dan Zuber coaches basketball at Woodford Middle School in Versailles. His wife Wendy, a former volleyball coach, runs a volleyball clinic in Franklin County. Their eldest daughter also plays volleyball, and their youngest rides horses. Their family calendar is a frenzy of practices, games and horse shows.

“We are literally high-fiving each other in the hallway as we run out the door in the morning,” said Wendy. “It’s a crazy time in our house.”

This Friday in September 2022 should have been a quiet one, absent of a regularly scheduled game or practice. The Zubers had planned to hang out by the fire pit at home — a couple of beers for Dan and Wendy, then off to bed. But Dan’s team had made the playoffs, so on Sept. 30, he found himself in the gym of Campbell Middle School in Winchester, as his team of sixth grade girls faced off against their Clark County rivals.

Not too many people can say that a middle school girls’ basketball game saved their life.

In the days leading up to the game, Dan doesn’t recall feeling unwell. No headaches, shortness of breath or general malaise that precedes a major medical event. He had even coached a game the night before ­— the game that qualified his team for the playoffs. In fact, he doesn’t recall anything at all. What happened next was relayed to him and Wendy by bystanders and first responders.

“I got a call from one of the players’ mothers, saying I had to go to Clark County Regional because there had been an incident and Dan was there,” said Wendy. “That’s all I knew until I got there.”

Dan had been showing some troubling signs during the game. The normally loud, boisterous coach who runs the sidelines alongside his players was subdued. His players picked up on it, asking multiple times if he felt OK. Even the parents in the stands could see something was off. When he took a knee and held his chest, spectating parents, some of whom were medical professionals, jumped into action.

While some called 911 and retrieved the AED, others continued to coach the game on Dan’s behalf. Even though the AED didn’t register a cardiac event, Dan was put in an ambulance and rushed to Clark County Regional Medical Center, where he was met by Wendy and their oldest daughter.

“They were running enzyme tests and all the standard procedures for heart attacks,” Wendy said. “The whole time, Dan was saying he felt like his chest was ripping open, like it was on fire.”

Through the pain, Dan asked about the game. Amused that it took three dads to replace him, he was less enthused to hear that his team lost in double overtime. Though his players played their best, there were more than a few tears when they saw their beloved “Coach Z” loaded into an ambulance.

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In the Clark Regional emergency department, things weren’t adding up. Every test for a heart attack came back negative. But the attending physician wasn’t buying it, and ordered a CT scan for Dan. When the images came back, Wendy was told that Dan was being flown to the University of Kentucky Albert B. Chandler Hospital. Part of the statewide Gill Affiliate Network, Clark Regional and UK HealthCare work together to connect patients with rare, severe illnesses to specialists for further evaluation and treatment.

“In that moment, I knew it was really serious,” said Wendy. “Clark Regional to UK is less than a 30-minute drive. You would normally just put someone in an ambulance. It must be life or death to have him life-flighted.”

Wendy was told to start calling family members, as well as their family minister. Upon arriving at UK, Dan was immediately prepped for surgery. Tessa London-Bounds, M.D., cardiothoracic surgeon in UK’s Gill Heart & Vascular Institute, met with Wendy and explained that Dan was experiencing an aortic dissection.

A serious and rare condition, an aortic dissection is when a tear occurs in the inner layers of the aorta, the body’s main artery. As blood rushes through the tear, the aorta continues to split, and blood flows through the split layers. Diverted from its usual path through the aorta, the brain, organs and extremities are derived of the oxygenated blood they need to survive. And if the person is experiencing high blood pressure – from coaching a basketball game, for example – the increase in force exacerbates the tear. Left untreated, aortic dissections are usually fatal.

“Dr. London came in and calmly, but very quickly, explained what happened and what they were going to do,” said Wendy. “She was very calming, very reassuring.”

“If something bad happens to your family member, you have the right to understand it and all the risks that are involved,” said London-Bounds. “I’m asking someone for the ultimate trust after meeting them for five or 10 minutes. That’s a hard rapport to build. I’m essentially asking you to give me your loved one, cut their chest open and do all things I need to do, and you’ve never met me. The only way you can do that is to make sure they understand everything that’s going on.”

During Dan’s 14-hour surgery, London-Bounds, assisted by Michael Sekela, M.D., chief of cardiothoracic surgery, replaced all of the head vessels of Dan’s heart in a procedure called a root replacement. The tear went all the way down into his heart, and the aortic valve that pumps oxygenated blood from the heart to the rest of the body and prevents backward flow from the aorta, wasn’t working at all. London-Bounds and her team replaced the root, the aortic arch and inserted a plastic graft ­– called a Dacron tube – in place of the torn aorta.

“Think of it like a labyrinth,” said London-Bounds. “The good blood isn’t going in the right tube. Instead of following its intended path and going to the brain or arms or legs, it comes to a dead end. Your aorta doesn’t have a stopping point. If there’s a tear, it could tear all way down to your toes. And the blood is going to follow the path of least resistance instead of where it’s supposed to go.”

Known as aortic insufficiency, the blood that was trying to go forward out of the heart was flowing backwards during Dan’s heartbeat. When blood is stuck in the “labyrinth” too long, it can cause irreversible organ damage or failure as the organs are starved for oxygenated blood. According to London-Bounds, this is a typical outcome for patients with aortic dissections. The tears can be repaired and blood vessels replaced, but not in time to save the affected organs.

Dan was lucky. The quick actions of the parents of the basketball game, the intuitiveness of the physician at Clark County Regional and the expertise of London-Bounds and Sekela all ensured that he had a good outcome. For Wendy, who was supposed be sitting with Dan by the fire pit that night, it was one serendipitous event after another.

As she sat in the waiting room during Dan’s surgery, she was approached by a UK police officer who asked if she needed a ride home in his squad car, or if she wanted something to eat. At the time, UK hospitals and clinic still required all visitors to wear masks, so Wendy was touched at the kindness and generosity of this stranger. But as he pulled down his mask, Wendy recognized him as the father of one of the girls on Dan’s team.

The connections didn’t end there. A family friend whose daughter plays volleyball with Dan and Wendy’s daughter is a nurse in the intensive care unit (ICU) where Dan went after surgery. An administrator in the UK Department of Surgery has a daughter on Dan’s team. And one of the nurses in the Clark County emergency department was wearing a Pittsburgh Steelers shirt – a welcome sight and reassuring sign for Dan, a Pittsburgh native and a lifelong Steelers fan.

“I think back to that Friday night, and I’m just super blessed he was coaching a game that night,” Wendy said. “He was where he was supposed to be, where there were medical professionals around who knew what to do and acted quickly. We were told numerous times that timing was of the essence. Had he not gotten surgery then, he wouldn’t have made it. If we had been at home, he would have gone to bed and more than likely never would have gotten up.”

As Dan’s surgery continued through the night, Wendy rallied herself for her daughters. It was their younger daughter’s 10th birthday, and a family friend swept in to make the day special. As Dan recovered in the ICU, Wendy split her time between being at the hospital with Dan and home with their daughters. In yet another fortuitous twist, it was the girls’ fall break and they were able to stay with friends while Wendy was with Dan.

“We had lovely friends who stepped in and basically adopted our daughters and got them where they were supposed to be,” said Wendy.

Friends and strangers rallied around the Zubers. Dan’s players decorated posters to adorn his hospital room. “There was so much glitter,” said London-Bounds. “You could definitely tell he coached a girls’ team.” Past members of his team called, visited and sent cards. Even his team’s rivals at Campbell Middle School sent a gift basket. After the trauma of surgery and toll of a lengthy recovery, basketball is the one thing Dan would get out bed for ­– literally.

“In the weird haze of medication, the only thing that got Dan energized and talking was basketball,” Wendy said. “His mentor that he coached under for 12 years in Pennsylvania called him and he lit up like a Christmas tree, talking a mile a minute. One of his nurses played college basketball and she was able to get him to talk to her. Everyone else he would give one-word answers to. I had to get someone to talk to him about basketball just so he would eat.”

Would Dan be able to coach again? That weighed heavily on his mind, as well as Wendy’s.

“In my mind, I’m thinking, it’s the one that you love more than anything, and if that’s what kills you, so be it,” she said. “If the doctors are going to be adamant against it, then I guess we find new doctors.”

After 10 days in the hospital, months of cardiac rehab and numerous follow up scans and tests, Dan and Wendy saw those three magic words in his chart notes: cleared to coach.

As for the cause of Dan’s aortic dissection, it was initially a mystery. Aortic dissections are rare, occurring in about 30 people out of a million each year. Dan is only 49 years old, active and a nonsmoker. He didn’t have any of the risk factors typically associated with heart disease. But then Dan took a look at his own family tree. His father and uncle were both diagnosed with aortic dissections; his father managed his with medication while his uncle underwent a surgery similar to Dan’s. London-Bounds connected Dan with Mary Sheppard, M.D., a vascular surgeon in the Gill Heart & Vascular Institute, who studies the genetic components of vascular conditions. Dan enrolled in her aortic dissection study, and both of his daughters will undergo genetic testing to determine their risk.

More than a year later, Dan is back on the court. Many of the parents of his players expected a more subdued Coach Z, but no one was really surprised to see him running the sidelines and encouraging his team.

It was a long recovery, but now Dan and his family are grateful to be on the other side with the help of a supportive community.

“The basketball community here in central Kentucky really came together and rallied around us,” said Wendy. “Because of great timing and great surgeons, and everything lining up for whatever reason, he’s still here.”

UK HealthCare is the hospitals and clinics of the University of Kentucky. But it is so much more. It is more than 10,000 dedicated health care professionals committed to providing advanced subspecialty care for the most critically injured and ill patients from the Commonwealth and beyond. It also is the home of the state’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, a Level IV Neonatal Intensive Care Unit that cares for the tiniest and sickest newborns, the region’s only Level 1 trauma center and Kentucky’s top hospital ranked by U.S. News & World Report.

As an academic research institution, we are continuously pursuing the next generation of cures, treatments, protocols and policies. Our discoveries have the potential to change what’s medically possible within our lifetimes. Our educators and thought leaders are transforming the health care landscape as our six health professions colleges teach the next generation of doctors, nurses, pharmacists and other health care professionals, spreading the highest standards of care. UK HealthCare is the power of advanced medicine committed to creating a healthier Kentucky, now and for generations to come.