A local physician has been named the Integrity Healthcare Professionals Lifesaver of the Month for his involvement in the treatment of Pete Schrag.
Dr. David Schmeidler was nominated for his quick response and outstanding care of Schrag, who works as a paramedic in the emergency room (ER) at South Central Kansas Medical Center.
His wife, Deb Schrag, who is a physician’s assistant in the ER at SCKMC, thinks Schmeidler’s early recognition of critical symptoms ultimately saved her husband’s life and avoided a catastrophic outcome.
“You don’t get any sicker and (still) live,” she said.
Integrity Healthcare Professionals oversees the administration of the ER at SCKMC.
Fair-ly surprising diagnosis
In August, Pete Schrag was admitted to the ER with severe abdominal pain.
Test results indicated a need for admission, continued care and further testing.
He ultimately was diagnosed with Escherichia coli (E. coli) bacteria.
“We still don’t know where he got it exactly,” said Deb Schrag.
The Kansas Department of Health and Enviroment (KDHE) told Schrag that five cases occurred in Cowley County around the same time.
KDHE also said that the illnesses all had been linked back to the Cowley County Fair. They assured Deb Schrag they would find the origin.
“It could have come from the animal barns, or several other places,” she said.
E. coli dangers
The nastier strains of E. coli represent a dangerous, life-threatening situation.
“It takes a very few of the bacteria to make you sick. In comparison to other food-borne illnesses, it’s very potent,” said Deb Schrag.
It has to be ingested. Most people eliminate the bacteria from their systems before it takes hold, but some people do not.
There is no way to predict how the toxin E. coli creates will affect an individual who becomes sick from the bacteria, according to Schrag.
Pete Schrag’s symptoms started with severe abdominal pain.
When he went to the ER on Aug 11, his lab work looked fine and he didn’t have a fever, but his CT scan showed an inflamed colon.
Blatchford steps in
Another local physician who assisted in Pete Schrag’s care was SCKMC surgeon Dr. Tyson Blatchford.
“Dr. Blatchford played a big part in (Pete’s treatment), too,” said Deb Schrag. “He came in every day that we were here.”
Blatchford’s concern was the condition of Pete’s colon
Because the bacteria attack the colon, the tissues become very delicate. If the tissues had been torn, Pete could have lost up to two-thirds of his large intestine.
His later lab results indicated that Pete soon would be in trouble because they showed the very beginning stages of kidney failure.
His labs showed a change overnight from Aug. 15 to Aug. 16, showing a drastic change in the rate at which his kidneys were filtering — their productivity was cut by nearly half.
This is sometimes a result of E. coli 0157 that is known as Hemolytic Uremic Syndrome (HUS).
That Thursday, Schmeidler had Pete transferred to Wichita because he suspected Schrag would need to go onto dialysis. When the bacteria developed into HUS, Schrag had become confused and disoriented.
The syndrome causes red blood cells to explode in the body and the fragments start to clog the smallest vessels in the body — those in the kidneys, liver and brain.
On dialysis, under threat
Dialysis was a daily occurrence for Pete Schrag after he arrived in Wichita.
On Aug. 19, more than a week after he originally was admitted, the family was told that Pete would not survive the night.
However, they were given the option to give him a very rare, very expensive medication.
Pete was breathing on his own, but he was not responsive, and his kidneys and liver were not working at all.
The family decided to go ahead with the medication. The next day, his liver started to work again and his kidneys began to improve.
Pete received four doses, once on each Sunday night for four weeks in a row.
“If he hadn’t been active, healthy and disease free, he wouldn’t have made it,” said Deb Schrag.
She was in constant communication with Schmeidler and Blatchford, both of whom responded during the crisis.
Rehabilitation and homecoming
As his 26-day stay at Wesley drew to an end, the doctors wanted to put Pete Schrag into a rehabilitation facility.
“He had a catastrophic illness,” said Deb Schrag. As a nurse, she spent much of her time advocating for her husband.
So when this was brought up, she sat down with Schmeidler because she thought she couldn’t be objective about this particular decision.
“When you know patients, and patients’ families, you can make these decisions,” Schmeidler told her.
“He is going to do better at home. Bring him home.”
Schmeidler sees Pete Schrag every week for follow-up.
While Pete’s kidneys still are under watch, his prognosis is excellent and his recovery is well ahead of the projected recovery time.
“The nice thing about having a small hospital, with our doctors, is that (patients) get one-on-one care,” said Deb Schrag.
“There wasn’t anything wrong with the care in Wichita, but it was very impersonal. Every morning, I would come in and it was a new introduction to a new nurse. We never had the same nursing staff two days in a row.”
“We lose so much personal contact (in a large hospital),” she added. “The staff at SCKMC becomes emotionally involved in the patient. Unless you get into a situation like this, you don’t understand the difference. My mantra through this has been: God is good.”