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Tyler and Amber Lintz share with us how Tyler was admitted for severe septic shock, pneumonia, and ARDS and eventually needed ECMO but was still allowed to keep walking. Tyler also shares with us how he returned to being a firefighter 3 months after ECMO.

 

Episode Transcription

Kali Dayton
Tyler, Amber thank you so much for joining us today. Today we have Tyler Lintz with us. He was admitted to the ICU over a little over a year ago, right? As a 32 year old with septic shock due to Group A streptococcus pneumonia. And he came in and had been life flighted from another hospital in another state. He was already intubated. As soon as he got to this hospital, he was woken up, sedation was taken off. Yet he was still in severe septic shock, and required impressive vasopressor support and was up the next day with severe ARDS and required pronation, paralytics, and sedatives.

He was just not getting better with pronation, everything that was being done, and it was decided to send him to another hospital for ECMO. And fortunately, at that other hospital that cvicu, They also continue to keep him awake on ECMO and mobilized. And he’s had amazing outcomes.

And I feel so fortunate to be in their kitchen right now, talking to Amber and Tyler about Tyler’s crazy journey, and what it was like to be awake and walking on the ventilator and on ECMO. So Tyler, thank you so much for joining us.

So when you were just talking about when you first came into the hospital, and were woken up in the setting of septic septic shock, you weren’t totally with it. But yet Amber was saying that you were able to be dangled at the bedside, you got up and walked even 75 feet, even with the vasopressors and the high ventilator support. You were writing notes joking with your co workers. Amber, what it was like that like for you to see that?

 

Amber Lintz
So he was awake for most that day. And it was very encouraging to me because I felt like, okay, things are gonna be okay, he’s awake, he is answering questions. He’s making jokes. And it was just an encouraging moment of his gonna be okay. And it, you know, gave me hope that he was still there, and that he was himself.

 

Kali Dayton
Do you remember any of that Tyler?

 

Tyler Lintz
No. So kind of a timeline of events. I woke up the morning of December 8, with just a sore throat. I knew I had a fever and just general weakness. I couldn’t. I told myself a strep throat. I can go another 24 hours I’ll be home. Go to the doctor get my zpack. Well, by 2am that evening is when I was throwing up blood, coughing up blood, severe diarrhea, severe vomiting. And I crawl to where Amber’s sleep and woke her up. And that’s when we drove to Evanston.

Just sitting in the ER in Evanston. I was aware that I was there, but I couldn’t talk to the doctor and explain my symptoms to him. It was very hard to get up just words. So at that point, I realized okay, things aren’t good. I can barely communicate. And then the doctor we did an x ray. I tested positive for strep. And he said I have pneumonia. He’ll be here for a couple days to go home. They put me on CPAP right away, and then went to BiPAP. And being on BiPAP when you’re struggling to breathe, is the worst feeling. If you’ve ever been felt like you’re in a confined space and you can’t breathe, so I felt so they gave me Ativan. After that there was a solid…. next time I remembered anything was December 23. So many days is that December 8 to the 23rd is when I don’t remember 16 days, I think. Yeah. So between all that timeframe. I remember very, very little things that I would bring up to Amber and she took care that didn’t happen. So there’s a few episodes that I do remember, but in the meantime was just all very vivid, lucid, long lasting dreams.

 

Kali Dayton
And what were those like? Cuz I know that you mean, I think you were delirious from the septic shock. Also, you were proned for, say, two or three days, maybe longer,

 

Tyler Lintz
I remember was about for four days. And then we were transferred with that..

 

Kali Dayton
Okay, so that whole time you’re on sedation. Yeah. Um, what were those dreams like?

 

Tyler Lintz
The best way I can explain it when people asked is thing thing, when you have a dream at night, and you’re sleeping, you wake up. And if you don’t tell somebody right away about your dream, you forget about it, and you just move on to your day. But to this day, I can, I can tell you details smells. The people that are in these dreams. There’s about four distinct dreams. It lasted a very long time. I can’t tell you when the dreams happened during my experience, other than maybe one of them was just a quick brief of it.

I am on the our team with the fire department search and rescue team. And we got deployed to New York, there’s a big storm that happened to national team. So we got sent there just to run my loved one calls from New York. I was put on an engine company with a crew we ran calls we went to the station is just a normal, normal station life running normal calls. The storm was so bad in the streets, we ended up rolling our engine.

I ended up breaking my neck, they transported me to a hospital in New York. And when I woke up, which I think was December 23, I thought I was in New York with a broken neck injure. And that took several days before and we’re kept repeating the story of why I’m here. So just that was the only dream I can kind of relate timeframe that had been towards the end. And I started waking up because I truly thought that that’s why I was where I was and what happened.

 

Kali Dayton
And you were on ECMO, right?

 

Tyler Lintz
Yeah. Yeah. And woke up on ECMO still have the ET Tube place. Still strapped to the bed, complete confusion, Very anxious.

 

Kali Dayton
So scary to wake up without any context.

 

Tyler Lintz
Yeah, can’t talk. Mm hmm. Can’t do anything can my weakness in my arms was pretty intense.

 

Kali Dayton
And and how long after that until you were mobile and oriented? Or were you or was he walking when he was coming around?

 

Amber Lintz
Like, when we first got to the hospital for ECMO, he would start coming off sedation and then you’d had to get like a chest to place and so he’d be sedated again for that. And then he’d start coming off that and then we’d have another chest too. You ended up with four chest tubes. And so it was just that first week was kind of hard because it was constant.

Okay, he’s almost off sedation, okay, we need another chest to continuous cycle of that. But once we were off that cycle, he was doing the bike exercise bike in bed almost immediately. And he was still kind of loopy, but he was giving it his all and I think he biked like a mile that first day. And then from then it was constant. Every day was a different exercise, or something even just like getting up in bed or sitting up or standing. And then from then on. It was just constant. And he was awesome at hitting those every week. And but he started almost instantly right when he was off of sedation.

 

Tyler Lintz
And it wasn’t just the physical therapy. They would do cognitive skills with me, they show me pictures, and it’s a point to what you see, imagine this car. So there’s a lot of I was already making me start to think use my brain, you know, that it’s just I only remember that so very, very little. So had to be early on in my time at the U.

 

Kali Dayton
Yeah.

 

Tyler Lintz
But when I really started to come around cognitively was Christmas day because I knew I was scheduled to get my trach. I was excited to get this tube out of my mouth. And they just kept delaying the surgery time because they had other patients with high priority. So I just remember being stressed to this thing done. As soon as a trach was placed. I felt like that’s when things just got better quicker.

 

Amber Lintz
Yeah, I agree.

 

Kali Dayton
What did you see mobility do for his brain during that time?

 

Amber Lintz
Um, I just I felt like it pushed him and I think it made him work like made his mind work with his body. And I felt like I could see in his eyes. It was hard a lot of times, but it also felt like it was gratifying for him. Because when it got to where he was walking more, he would be so like bragging about how far he walked, and how what he did this day. And so the competitive nature and him and the, you know, fighting nature, I think came out. And I think it gave him you know, things to do to get out of there. And I think he knew that.

 

Tyler Lintz
I appreciated about the physical therapy team, then the nurses before I would do PT that say, this is what you did yesterday, this is how far you got this circle today. So there already is a “k, going to be my goal”. So that was good. And they were just 100% supportive. It was a huge mental game with myself and just trusting the staff. And because if I didn’t have their support and their recommendations and their past stories, they told me other patients that would do it. And I don’t think I would have done. It was so mental because I went from being extremely healthy and active and can do half marathons and workout seven days a week to now I’ve lost 35 pounds. I can’t even sit up in bed.

 

Kali Dayton
And that happened in what span of time that you got that weak?

 

Tyler Lintz
From December 8 to Christmas. Yeah. I literally lost… I couldn’t even squeeze a stressball- I was that weak.

 

Kali Dayton
And that’s such a drastic example because not all of our patients are young, healthy… not all are 32 year old firefighters that come in. And yet you- that healthy could become that weak in that amount of time. Most of our patients are geriatrics that come in, that are already on the fence of immobility- that are already weak.

I know that we get nervous me ICU to get those people mobile and active. But this is a good example of why that’s important. Because if they, from their baseline, slide back over those few weeks, intubated, then will they ever get back to where they were?

So that’s that’s pretty impressive. I remember you were you were so muscular that I had at the corner of my eye. I think my subconscious I knew that you had it you on a PEEP of 20- That’s, that’s really high. So I think pneumothorax is always on the radar and the corner my eye, I saw an elevated pectoralis and I- just for a split second I kind of gasped inside of me, I’m like, “Oh, no! Pneumothorax!” Then I realized, “No, he’s just really muscular like that.” And yet, after a few weeks, you got to the point of not being able to sit or squeeze the stressball.

 

Tyler Lintz
It was very depressing. I literally had to learn to walk again, I couldn’t remember how to walk. You know, there was, “Put your right foot out, put your left foot out… your gate is too linear… spread, spread your hips…” and it’s just so frustrating, you know. Then on top of that you’re exhausted, you can’t breathe, you’re on a ventilator, you’re you can feel your blood pressure through the roof.

You know, like, Oh, your pressures at 180 over 110. We got to take a break. And then I started thinking, “Holy crap, I’m gonna stroke out” – just with the ECMO and everything else. “Are they pushing me too hard? You know, because I’ll keep going… But should I not keep going??” It’s just a mind game.

 

Kali Dayton
And you had enough medical background to worry about those things.

 

Tyler Lintz
that’s the bad part two is I write on the whiteboard, because that’s how I communicated. What are the vent settings? The PEEP? The o2? They’d tell me I’d be like, “Oh my God.”

 

Kali Dayton
What does it mean to you to be able to be informed about those things? Ask questions? I know that we we as medical professionals, think that this is going to be too traumatizing for people to be aware of their critical illness… that it’s better for them to be sedated and quote unquote, “asleep”. But you’ve already experienced. So what was it like? Or what does it mean to you to have been informed and be able to ask questions and communicate during that time?

 

Tyler Lintz
Those are the most important. I think, if if I didn’t know what was going on, it would stress me out. You know, I would see the… I don’t know how many drip rates I had going at a time but… I try to figure out what meds I was on. “Okay, I’m on pressors. I’m on diuretics. I’m on Heparin or I’m on Coumadin” or, and then the nurse would come in and then you know shine their light and ECMO oxygenator and say, “Oh, we got a lot of clots in here”, you know, and I’m just like, I would stress out about it, I knew that they were on top of it.

 

Kali Dayton
And you could express your concerns.

 

Amber Lintz
He struggled a little bit, once I’m in whole time on ECMO, he wasn’t able to talk. He didn’t get his speaking valve with his trach until rehab. And so he relied heavily on the board. But for me, when he was able to finally start asking questions and vocalize himself, it was huge, because I wanted him to make a lot of decisions. And I appreciated that, like he asked for his trach they were gonna put it off, and I was gonna put it off. I didn’t know if that would be something he wanted. But he was alert. And he said, No, I want the trach. And I was thankful because I was like, good, you picked it, that’s your choice. And after that, he made all his decisions, which was nice for me, because that was hard for me to make those.

 

Unknown Speaker
There’s the majority of the nurses or the doc’s, they do the rounds in the morning. And then it comes down to what the plan is for the day. I’m the type person is not the plan for the day- “What we’re gonna do? What are the goals?” And then if I didn’t get that I was, “What are we doing? Something, Right?” So it’s nice to have the plan the goals, if any surgeries were planned for the day, just to mentally prepare, it’s such a mind. Right mental game. That’s crazy.

 

Kali Dayton
And it sounds so miserable to have to go through all of that and be aware of the peril that your life is in. But whereas you’ve experienced both being sedated, having delirium, and then being awake for some of the worst of it. What is your preference?

 

Tyler Lintz
Being awake. Just because there were times where I would come off the sedation, and then whatever we were doing the bike or trying to sit up or just something, and then all of a sudden, they’d be like, I remember, “We’ve got to sedate him again”- and I’d just go back into delirium mode, hallucinations. I remember being awake, semi consciously, but I would see things in my room. You know, it wasn’t comforting, very anxiety ridden depression.

 

Amber Lintz
I feel like whenever he was sedated to it took so long for him to come out of it. That it was just I just felt like it was just wasted time. And it was frustrating to me. And then once he was off sedation, we went through a week where he wasn’t sleeping at all. And then we were like, “Okay, now he’s up all night.” And so then we had to give him sleep meds at night. And then we were just going through the problem of now he’s not sleeping, so he doesn’t have any energy because he’s not sleeping. And so it was just like,

 

Tyler Lintz
and, and coming off the meds is horrible. You feel like a drug addict. They go through withdrawals, and you have the foggy head and you’re just just feel like crap, and you don’t want to do anything, you know. So I didn’t want to be sedated. I didn’t want to be given pain meds, because just the coming off it was was miserable.

 

Kali Dayton
Yeah, that’s so interesting. We just don’t get that insight.

 

Tyler Lintz
Like I would almost rather deal with the pain. And there are some days that I did. They asked me if you like something for your pain and I’d say, “No, I’ll just deal with it.”

 

Kali Dayton
And that’s the nice thing to know when a patient can tell us if they’re in pain, and what they want. That way we know that pain is being treated, and what the patient wants. And if it’s we don’t have to give so much pain medication, just assuming because the pain medication itself, the narcotics can cause delirium, hold everything back, cause all the other problems.

 

Tyler Lintz
I requested more anti anxiety meds than I did pain. Like high doses, just right, because being confined to the bed not moving just nobody wants to do that.

 

Kali Dayton
No. And anxiety in those situations is real. And what I hear from survivors is that even when they’re sedated, they have anxiety. So I want to know from my patients, are they having pain? Are they having anxiety?- and the only way to really know is for them to tell me.

 

Tyler Lintz
Reminds me of.. I remember the time it really stated. I start to come up down from the sedation. I knew when a family member was in the room who was crying grieving, you know grabbing me and I can’t fight. I could feel my anxiety go up. Whereas someone would come in and just hang out, hold my hand or talk to me Tell me a story. It was very relaxing. Even with the staff, you know. I know specific family members that came in my room that just drove me nuts. A negative situation is not helpful.

 

Kali Dayton
Interesting. That’s really good to know.

 

Amber Lintz
That was not me.

 

Tyler Lintz
I get it. I’ve seen the family members coming in, er rooms that are just hysterical. It’s it’s not.. I get it. They’re upset and so worried about their loved one, but it’s not helping anything. It gets staff worked up, it gets… security gets involved… it gets bad.

 

Kali Dayton
You can feel it. Yeah. Even when you’re sedated?

 

Tyler Lintz
Yeah.

 

Kali Dayton
That’s really interesting. What did um, what did it do for your anxiety? Remember, when Tyler was awake?

 

Amber Lintz
It definitely, I much preferred him awake. Because he was showing me that he was making steps to get out of there. And I needed those small little things to show me that he was progressing. Even like, you know, squeezing my hand, or opening his eyes, things that small were huge to me, because it was just like, okay, he’s doing something when he was preowned, or when he was sedated. He just didn’t get better. And everyday, it was like, okay, 24 hours. Nothing has happened. Let’s try again. Same thing, same thing, but when he was awake, I felt like I had things to look forward to each day. Even if it was just okay, those blood pressure’s a little better today or Okay, his he’s, you know, sad the end of the bed and moved his legs a little but like things like that were just huge. I think any family member to have something to say, okay, he’s making progress. Still there. Yep.

 

Kali Dayton
And what was it like to come into the ICU and see Tyler, so different? I know that when he second he got to that hospital, he was hooked up to lots of IV drips and maintenance, support. And we were very frank about how sick he was. What was that likefor you?

 

Amber Lintz
It was way hard. I think the first day, the night that we got there was just shocked because I walked into the room. And he was intubated. And it was just me, and the air med nurse came in and just got me. There were so many… so many staff in the room, there was so many drips, there’s the vent, it was just a lot going on. And I think going from a small hospital, where it was just the nurse and the doctor and the respiratory therapist to that. I just hit me like, Wow, he’s really sick. And I think that whole a realization of what is going on, because at the other hospital, it was just kind of like, oh, he has pneumonia, who he’ll be fine in two days. And then getting there was a whole different ballgame.

 

Kali Dayton
And when you were told by how sick he was and that he was going to stay awake, and hopefully keep moving.

 

Amber Lintz
Yeah,

 

Kali Dayton
What ran through your mind?

 

Amber Lintz
It was just complete trust in you guys. And just… “Perfect. I want him awake. And if that’s what it takes to get him out of here, then do it.”- and I was all for it. And even when we transferred on ECMO, they came in and explained the same thing that he’s going to be doing a lot of physical therapy. That’s just what we do. And I was just like, “Do it. Let’s go for it. Let’s start it right now.” And to do it while he was asleep. No, I was very happy with it. And I felt like it did. Every day he was doing a little better, which helped me and I thank him.

Transcribed by https://otter.ai

 

Tyler Lintz

 

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