Wash. couple grateful for organ donor

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OLYMPIA, Wash. -- Nate Gunderson's crippling headaches began April 4, on what was supposed to be one of the happiest of days: his daughter Mikaela's first birthday.

Nate and his wife Genevieve thought he might be suffering from a severe case of the flu, but the symptoms worsened despite doctors' care. Within three days, Nate, 31, couldn't walk without assistance, he was vomiting and the headaches were so bad he was almost crying in pain.

Doctors offered a stunning diagnosis: Staph bacteria had implanted on his heart's inner lining and was growing into a poisonous garden, inflaming the heart, eating a hole on a weakened heart valve and sending "vegetation" to the lungs, brain and kidneys.

The hole in the valve caused blood to pour back into the chamber every time the heart pumped, robbing other organs of the oxygen-rich blood they needed to function. The headaches actually were mini-strokes, the doctors told them, as the vegetation staunched the flow of blood to his brain.

"That was a shocker," said Genevieve, also 31. Nate was on his deathbed. His liver and kidneys had begun to shut down. Six days after falling ill, he would undergo the first of two open-heart surgeries. In short order, the couple would be waiting anxiously for the new heart that would save his life.

Nate always knew he had a heart murmur, which occurs when a valve doesn't operate correctly.

The couple don't know the origin of the bacteria that wreaked havoc on that heart. They suspect he came in contact with it while shoveling and doing other yard work a week earlier.

The stress he was under and an immune system tired after recovering from a sinus infection gave the bacteria a place to grow. Over more than four hours April 10, surgeons replaced the damaged valve with an artificial one and mowed away the vegetation that was causing problems for other organs.

Nate's condition improved, and he was allowed to go home for a few days. The couple even took some short walks about their home. But new problems emerged. Nate became short of breath. He felt a huge weight when he tried to lie down. More tests were conducted, followed by more bad news.

The bacteria still were attacking Nate's heart, despite the antibiotics he had taken. The valve continued to be under assault. In addition, a leak had sprung between two chambers of his heart, pulverizing the red blood cells being forced through and requiring blood transfusions. Already, three pints of fluid had been removed from the protective sac lining his heart because of the trauma of the first surgery or infection.

Nate underwent a second open-heart surgery shortly thereafter to replace the valve a second time and patch up the leak, but it was a Band-Aid. Surgeons told Genevieve his heart was "pulling itself apart at the seams," and he needed a new one.

She couldn't believe what she heard. "Heart transplant? That happens to old guys, not 31-year-old dads who run marathons," she said. Nate ran the Portland Marathon in 2007 and had finished numerous shorter-distance races.

"I was kind of scared," Nate said. "It was like, 'OK, how long is it going to take?'" No one had an answer. Nate's dire condition would place him at the top of the waiting list for a new heart, but it was unclear when a matching heart would become available for transplant.

With the couple's daughter in her grandparents' care, Genevieve rarely left Nate's side at the hospital. She slept there and worked from her laptop, sitting in a tattered pink recliner next to Nate's hospital bed for weeks. Genevieve, who worked as a certified nursing assistant after high school, had taken a clinical approach to enduring the ordeal.

She and her mother and mother-in-law, both nurses, acted as translators to decipher the complex medical jargon for Nate.



The couple grappled with deep questions. They knew Nate needed a new heart but realized that someone had to die to save his life. Genevieve said weekends grew morbid, as the couple knew chances for a new heart were greater as people took the roads for recreation.

They came to terms with dueling emotions.

"I see it as a gift," Nate said. "I'm appreciative of it and grateful for it, and that's all I can be."

Amid Nate's optimism, another bombshell hit. Nate, still waiting for a heart, received a layoff notice from Microsoft. The severance wouldn't occur until Nate returned to work, so the family kept its health insurance. But his short-term disability pay from which he drew 60 percent of his salary had been changed to unpaid leave. Nate had good insurance working for Microsoft. That was a blessing given his medical bills, which, including the heart transplant, were estimated at $2.5 million. But the personal expenses of living away from home for so long were mounting.

Nate's co-workers went into attack mode, as Genevieve put it, and sent protest letters to executives in Microsoft's human resources department and to chief executive Steve Ballmer. Microsoft quickly found Nate a similar position in the company. Meanwhile, Genevieve turned to social media to raise awareness among friends and family and alerted print and broadcast media about her husband's plight. Donations began coming in.

About 6 p.m. July 4, a nurse instructed Nate to avoid eating or drinking, which was code that a new heart might be on the way. Even though it was only a possibility, the medical staff had to make sure Nate was in the operating room so the heart could be transplanted immediately upon arrival. The couple already had endured one "dry run" in which no heart arrived.

They saw Independence Day fireworks out of the corner of the hospital window as they hoped to hold their own celebration hours later. Before Nate was rolled into the operating room early July 5, the couple had a final pre-procedure chat. Nate told his wife how his experience had made him appreciate life more, how much he loved her and how much he appreciated the sacrifices she had made. Then doctors rolled him into the operating room.

The doctors had told Nate he would know upon opening his eyes after the procedure whether a new heart was pumping inside him. If he was back in his hospital room, it had been another dry run. If he saw the blue and gold scrubs worn by medical staff, he had a new heart. Groggily he opened his eyes early July 6. Blue and gold. A flood of relief.

"I just knew it was done and over with," he said.

Then came a realization. This was the first day of a long period of recovery and adjustment. One day, he would resume distance running, but he would have to keep his impatience and drive in check and take it step by step, block by block, mile by mile.

Genevieve noticed an immediate difference in their first conversations after the procedure. He told her his heart felt stronger.

"He sounded normal and chipper," she said. "That was unusual because after his other two surgeries, he was exhausted and barely thinking."

The heart Nate received had belonged to a 49-year-old woman. Those were the only details the hospital would provide out of respect for her family. Nate says his initial concerns about the organ's age were eased when he was told the new heart would serve him for the rest of his life. After the transplant, surgeons told Nate his old heart would have given out within a week.

So far, everything looks good. There were no signs his body was rejecting the heart after the first 48 hours, the most critical period. Nate was moved from the intensive-care unit July 10 and discharged six days later. He still has two to three months of intensive post-op care in Spokane before the couple can think of returning home.

Genevieve said the ordeal has allowed her to find her calling in life, use her skills to return her husband to full health, and advocate about the need for more organ donors, such as the one who saved Nate's life. "I think it's just a really good reward to come out of all this that we have a renewed sense of purpose besides just surviving day to day with what we're being presented with the heart condition," she said.

The ordeal has prompted Nate to prioritize what's important and to not sweat the small stuff. He drew his most powerful lesson from the support of people who came out of the woodwork to provide money, goodwill and kindness.

Additional information:

Nasal Antibiotic Ointment Reduces Infection Risk after Surgery
Microsoft PowerPoint Risks of infection after surgery .ppt
Increased Interleukin-6 After Cardiac Surgery Predicts Infection
Patients with sternal wound infection after cardiac surgery do not
Jurevicius gets staph infection after surgery Associated Press
Managing a sternal wound infection after cardiac surgery Nursing
Blood donor selection can prevent cytomegalovirus infection after
Treating Helicobacter pylori infection after surgery is
Study Cites Way to Lower Infection After Surgery New York Times
Surgical site infection after surgery to repair femoral neck

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