The pandemic has given us plenty of heartbreaking stories, so it’s nice to tell one that looks like it will have a happy ending.
Back in December, I wrote about Jill Hansen Holker, a mother of three and an intensive care nurse at Utah Valley Regional Medical Center. Holker was healthy, active and had been working her tail off for months, helping to care for the coronavirus patients in her hospital.
Then, in the fall, Holker contracted COVID-19. By Nov. 5, she was admitted to the hospital and days later a tube was inserted into her trachea to help her breathe.
Her condition worsened and she was put on an ECMO — extracorporeal membrane oxygenation — machine, which is used in place of a patient’s lungs during transplant surgery but has become a last-ditch effort to keep coronavirus patients alive.
On Dec. 6, Holker was flown to Gainesville, Fla., where, if a donor could be located, she would receive a double lung transplant.
Now here’s the good news: On Jan. 20, Holker got her transplant and is on the road to recovery — although after such an intensive surgery, it could be a long one.
The University of Florida is one of just a couple places that perform lung transplants on patients with coronavirus infections, said Dr. John Stringham, surgical director of lung transplant at the University of Utah. There have only been about 15 performed nationwide.
Stringham’s team was consulted on Holker’s case, but the hospital currently doesn’t pursue transplants with patients on ECMO, since the outcomes are so much worse. “She was really, really sick,” he said.
The typical transplant, Stringham said, begins with trying to get the recipient healthy enough for the surgery and identifying a good donor candidate. Once a donor is identified a surgical team will open the donor’s chest, inspect the lungs and, if they’re suitable for a transplant, remove them and put them on ice.
Meantime, another team prepares the recipient, opening the chest cavity and removing the lungs while the ECMO machine functions in their place. COVID-19 can complicate that process, Stringham said, because the tissue surrounding the lung can be inflamed making it harder to cut.
Once the donor lungs are in place, the windpipe and a large vein and artery are attached. When the lungs are inflated, Stringham said, they start to draw in oxygen and turn a bright pink color.
“Once that happens, hopefully you’re able to come off the cardio-pulmonary support and they’re able to breath on their own,” Stringham said. “It’s a big operation. It usually takes anywhere from six to seven or eight hours.”
Recovery can take time, too. Patients are put on a cocktail of medications to suppress the immune system to keep the body from rejecting the new organs. The patients are moved off of oxygen and undergo physical therapy to strengthen the new lungs.
Holker was breathing on her own by Feb. 1, according to Holly Pike, her friend and fellow nurse, and she was moved out of the intensive care unit shortly after.
“She says she’s feeling good. It’s definitely a transition,” Pike told me. “Right now I think we’re taking it one step at a time.”
Holker has been able to talk to her kids — which she hadn’t been able to do for months — and will have to stay in Florida (where she has a brother) while she continues her recovery.
“She’s just working on getting stronger, physical therapy, working on those short term goals,” Pike said. Her next goal: Get out of the hospital.
One of the advantages Holker has going for her, Stringham said, is apart from her bout with COVID-19 she is young and healthy.
In a recent photo, Holker is waif thin and gaunt, but sitting upright and smiling. It’s a stark contrast to the image of her from December, unconscious in a hospital bed with a tube down her throat and wired to machines with her daughter at her bedside.
“As long as things go well and she’s got a good pulmonologist, she’ll probably keep doing well and have a good, long life,” Stringham said. “She has a good chance of living many more years and having a good quality of life and being able to hike and ski and do all those things we all want to do.”
Holker has traveled a remarkable road and she is luckier than some. Of the nearly 18,500 Utah health care workers who have tested positive for COVID, 446 have been hospitalized and 16 have died.
It’s a stark reminder of the sacrifices our health care workers have made during the pandemic — the grueling hours, the strain on families, the staggering emotional toll of daily death, the risk to their own well-being, and for many serious illnesses and even death. We all owe them a debt of gratitude.
Thankfully, for Holker and her friends and family, it appears there will be a happy ending.
Friends of Holker have set up a GoFundMe page to help pay for her children’s expenses. Donations can be made at.gofundme.com/f/because-jill-is-everyones-hero