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Life-threatening illness transforms doctor’s perspective on his job

Now he has more empathy for those in his care

 
By Jennifer L. Boen

Twenty years ago, I watched actor William Hurt play a successful, self sufficient surgeon who develops cancer and finds himself on the receiving end of care. Playing the role of Dr. Jack MacKee in “The Doctor,” Hurt was quite the pain in the patootie as a patient.

It’s unnerving when a doctor — or anyone — finds his own patootie sticking out the back of the hospital gown. Truth be told, most doctors who have never been hospital patients could benefit, personally and professionally, from the experience. The fictional Dr. Jack MacKee did, as did Fort Wayne family practice physician Dr. Peter Jakacki.

Hustling to the hospital

Jakacki was seeing patients on Jan. 13, 2010, in his Brookyln Medical Associates practice, now part of Lutheran Medical Group, when he became light-headed and nauseous with severe abdominal pain. The night before, he delivered a baby and recalls, “I was tired. I’d been up all night.”

Age 48 at the time, Jakacki was in good health except for a short bout of some unknown illness that occurred in August 2009. At that time, he became suddenly ill with stomach pains and very low blood pressure, even passing out. Doctors initially thought he’d had a seizure, then perhaps a tumor in his abdomen or bowel, but no definitive cause for the symptoms was found. In a couple of weeks, he was back to his 80-plus hours-a-week workload, caring for patients and delivering babies.

As he continued to feel sicker that January day, he asked one of his office nurses, who is his mother, to check his blood pressure. It was low, and she asked a doctor in the adjacent office to check her son out. That doctor recommended Jakacki head to the hospital.

“I went in the back door where I usually go in to make rounds. By then, I was doubling over in pain,” he says. “I remember seeing one of the ER doctors who I know. That’s all I remember until a week later, when I woke up in the hospital when they extubated me,” a procedure in which a ventilator tube, used to assist critically ill or surgical patients with breathing, is pulled out of the windpipe.

Life at risk

Unbeknownst to Jakacki, he had endured major surgery in which two sections of bowel were removed as doctors looked for an abscess or other reason for his symptoms. Nothing significant was found. While he was unconscious, other procedures were done and multiple medications given to raise his blood pressure.

“They gave me 70 pounds of fluid to get my pressure up.” One of the medications given is a “last ditch” one, he says. “I developed a 103 (-degree) fever and was acidotic.”

When tissues do not get enough oxygen, lactic acid builds up in the bloodstream. At very high levels, it can be life threatening. A trauma surgeon consulting on Jakacki’s case told him he had never had anyone survive with a lactic-acid level over 10.

“Mine was 17 1/2 .” Jakacki later learned he had less than a 1 percent chance of survival.

Help hard to find

“When I woke up, my abdomen hurt horribly,” he says. “I was so weak. I couldn’t speak because the tube had been in for seven days.” After the breathing tube was removed, he began feeling hungry.

“I hadn’t eaten for a week.” Liquids, then soft solids were given, but two days later severe abdominal pain recurred. Still being in the doctor role, he asked for blood tests and told a nurse, “‘I need to talk to the doctor. Something bad is going on.’”

But it was the weekend and, he learned, “On weekends, you can’t get a hold of anyone.” Eventually, a doctor came to see him. A scope of Jakacki’s stomach discovered all the food he had eaten was still sitting in his stomach.

“It hadn’t moved. I had developed pancreatitis,” caused by one of his medications. “I had taken care of patients with pancreatitis. I knew it was painful, but had no idea how painful until then. It was horrible, agonizing.”

Trained as both a chiropractor and a medical doctor, Jakacki has heard plenty of accounts of people’s pain. As a chiropractor, he was frequently told by patients that their doctors told them, “‘The pain is all in your head.’” Jakacki was experiencing real, unrelenting pain and says, “I have more compassion now when people talk about their pain.”

Coping with depression

As days turned into weeks in the hospital, depression took hold at times.

“Everywhere I turned, things seemed to go wrong,” he says. Though a man of deep faith, he had not read his Bible since he entered Lutheran Hospital. Reading his favorite verses lifted his spirits. He was told how his own patients had been praying for him and many of them, as well as his family, had asked others around the country to pray.

“I wasn’t scared to die,” he says. “It was the journey that was so disconcerting. I had all this happen, and no one knew why.

“Being in a hospital, you lose all control, lose all dignity. It really puts you in your place. It is very humbling. You’re not in your home, not in your own clothes. It’s a terrible feeling.”

Just when he thought things were looking up, his fever shot up again. An infectious disease doctor recommended new antibiotics, but Jakacki’s veins were collapsing.

“I told the (infectious disease) doctor I felt like I was going to die,” he recalls. She ordered a CT scan, which detected a life-threatening blood clot at the base of his heart. The clot was caused by his body reacting to the blood thinner heparin, given following his first surgery. The heparin attacked his platelets, which caused the clot to form.

Watching the procedure

“If the clot had broken off and gone to my lungs, I would have died,” he says. A different blood thinner was needed immediately, but getting it into his body required placement of a central line, which is a tube surgically placed into the jugular vein. Because the first blood thinner was still in his bloodstream, surgically implanting the central line in the jugular vein carried a risk of uncontrollable bleeding.

Jakacki insisted on watching everything on an overhead screen. The radiologist spoke calmly and with confidence. Jakacki, a proponent of patient education and empowerment, was further reminded of the importance of taking time to thoroughly answer patients’ questions and concerns.

The new blood thinner was $8,000 a dose, a chunk of change even for an insured doctor who still has co-pays and deductibles. As he entered the third week of hospitalization, he was reminded of the “Footprints in the Sand” poem and painting: “You say, ‘God, where did you go?’ And he says, ‘I was carrying you.’”

Appreciation for nurses

Jakacki is grateful for the good care provided by his doctors and nurses. He has a new appreciation for nurses, saying, “If it weren’t for the nurses, I don’t know where I would be today.”

The cause of Jakacki’s original pain and extremely low blood pressure remains a mystery. Further tests have not provided answers.

“I was in such bad shape I had to go home on oxygen and with a walker,” he says. It took six weeks of rest, good nutrition and home rehab before he could return to work part time.

Though he’s in full swing again, life for him today is a more balanced one. He is sleeping more, drinking lots of water and eating organic foods. The father of five children, ages 26 to 11, he and his wife will celebrate 29 years of marriage with a long-overdue vacation this summer just for the two of them.

“God called me to be doctor, but he also called me to be a husband and a father,” he says.

Jakacki has recorded the memories and thoughts from his experience so he never forgets, and points out, “You have to live each day like it will be your last. It very well could be.”

See story  http://www.news-sentinel.com/apps/pbcs.dll/article?AID=/20110530/LIVING/105300307

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