Rachel Alexander

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"If it were my daughter, I’d get here as soon as possible."

It was a heartfelt recommendation, from one parent to another…and within hours of hearing staff nurse Linda Kulp’s words, Philip and Linda Alexander were on a flight from their Cleveland-area home to Burlington, where their daughter Rachel, a UVM freshman, was fighting for her life in Fletcher Allen’s Emergency Department.

Behind the scenes, Fletcher Allen staff were doing everything they could to make the Alexanders’ journey as easy as possible. Our Security Department had asked airport officials to allow the Alexanders to disembark before the other passengers. When they got off the plane, Steve Theriault of Security was waiting there to drive them to Fletcher Allen and escort them to the Medical Intensive Care Unit (MICU).

Within 15 minutes of arriving in the ED, Rachel’s heart stopped – for the first of nearly 30 times. Each time, Andrew Bushnell, M.D., and staff administered CPR and epinephrine to revive her.

Dr. Bushnell intubated Rachel and arranged to have the entire critical care and cardiology teams present to read Rachel’s echocardiogram. The echocardiogram revealed that the right side of Rachel’s heart was not functioning. A computerized tomography (CT) scan showed two large blood clots in Rachel’s lungs.

While a team of Fletcher Allen cardiothoracic surgeons stood by, ready to surgically remove the clots, Dr. Bushnell decided to first try the clot-busting drug tissue plasminogen activator (t-PA), prepared by Pharmacist Joe Aloi.

Fletcher Allen Interventional Radiologists Christopher Morris, M.D., and Joseph Shields, M.D., threaded a catheter through Rachel’s femoral vein, through her heart, and out into her pulmonary arteries, to deliver more t-PA directly to the blood clot. They also used a special catheter to remove more clot, improving blood flow to her lungs.

When Linda and Philip Alexander first saw their daughter in the MICU, she was bloated and pale, surrounded by tubes and beeping machines. "You look at your child," says Linda, "and you ask yourself, ‘how did this happen?’"

Over the next few precarious weeks, Rachel developed pneumonia twice. Her major organs began to fail. At times it seemed that it would take a miracle.

Ultimately, it was not a miracle – but a multidisciplinary team of specialists, including Erik Riesenfeld, M.D., who made the tough decisions that resulted in Rachel’s recovery.

"It was a true team effort," says Dr. Riesenfeld. "Our nurses, respiratory therapists, pharmacists, radiologists, our infectious disease and pulmonary specialists, and our Security Department came together for this patient and her family."

And Rachel herself played a role in her recovery. "Her determination to survive was remarkable," says Dr. Bushnell. "For every intervention we tried, she was with us, fighting every step of the way."

Today, Rachel is back at UVM, enjoying classes and life in her sorority. She sees Jon Porter, M.D., UVM’s Medical Director, for regular coumadin checks, to prevent the development of any further blood clots. She still has some lingering visual limitations, but her doctors expect this to improve.

And while Rachel doesn’t remember much of her health care crisis, she is grateful for everyone who worked so hard to keep her alive. "I know that I wouldn’t be here today if it weren’t for the expertise and caring of so many people at Fletcher Allen."