Lonely Ride to the Hospital
Skip Morris is a music teacher at Eastern Wayne Middle School in Goldsboro, North Carolina. He is 59-years-old, the father of three sons, and became a first-time grandfather in December 2020. He has been a teacher for 25 years and retiring at the end of his 26th year. Throughout his years as a teacher and a church music director, he has touched the lives of many in his community. It is then no surprise the outpouring of support he received during his battle with necrotizing pancreatitis and the complicated recovery that followed.
In late May of 2020, during the height of the pandemic, one night, Skip headed upstairs to get ready for bed. He was feeling unwell. He rushed to the bathroom and vomited. For two hours, he dry-heaved while covered in cold sweats. His wife, Melanie, checked on him and, at his request, called EMS. The ambulance arrived and transported Skip to the Emergency Room at Wayne UNC Health Care in Goldsboro, NC. Melanie shared the following sequence of events with Skip since he had no memory of what happened until he woke up after surgery.
“I honestly don’t remember anything after walking down the stairs to get into the ambulance,” Skip recalls. “I don’t remember the ambulance ride or the ER. The next thing I remember is waking up at UNC Rex in Raleigh. People who I know because I’ve worked and taught in this community for 25 years, former students and parents of students who are medical staff at Wayne, they’ve told me we had conversations while I was there, and I have no recollection of it.”
During COVID-19, hospitals put restrictions in place in which family and friends could no longer ride along with loved ones in ambulances to the hospital. They could not visit or be by the bedside. Watching their loved ones drive off for wives, partners, sisters, brothers, children, and others is heartbreaking because they don’t know if they will see them again.
“My wife said one of the most difficult things was watching me go off in that ambulance, and she couldn’t come,” shares Skip. “She can hardly even talk about it without tearing up.”
Transfer to UNC Rex in Raleigh
The team at Wayne tried to help Skip. Over five days, they treated him and his symptoms, but due to the severity of his condition, they decided to transfer him. UNC Medical Center in Chapel Hill was at maximum capacity and did not have an available bed so he was routed to UNC Rex. Before his transport, the nurses called his wife to come and pick up his belongings, including his watch, wallet, and wedding ring. She met the nurse in the lobby.
“The nurse told Melanie to come with her,” says Skip. “She snuck her into my room. Melanie said I was very restless. The wonderful woman who is my wife and a soprano crawled into bed with me, held me, and sang to me. She said I calmed instantly.”
After Skip transferred to UNC Rex, Dr. Peter Milano, a Trauma and Emergency Surgeon, evaluated him and decided that he needed surgery immediately. Skip was diagnosed with necrotizing pancreatitis with shock which lead to part of his colon receiving too little blood flow and dying. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. It produces enzymes that help digestion and hormones that help regulate the way the body processes sugar. Pancreatitis is when the gland becomes inflamed.
“The biggest symptom of pancreatitis is a pain in the abdomen radiating to the back,” explains Dr. Michael LeCompte, a hepatobiliary surgeon with a specialty in liver and pancreas malignancies. “Other signs are vomiting, nausea, fever, and weakness. 90% of pancreatitis cases can be treated with early medical care and require a day or two in the hospital with fluids. However, Skip’s case was the highest degree of severity which occurs when portions of the pancreatic gland actually die and become necrotic leading to a high mortality rate. These cases require specialized multidisciplinary care which was provided to the team at UNC Rex.”
His necrotizing pancreatitis meant he was on a much different medical journey than a few days in the hospital. Due to his high blood pressure and low blood flow, his colon and pancreas essentially died. He also went into kidney and renal failure. During his emergency surgery, Dr. Milano removed 1/3 of his colon. With consultation from Dr. LeCompte, Skip would need to come back in for additional surgeries to clean out the pancreas. He was too sick, and doctors felt it was too early for the other surgeries he would need.
During the surgery, doctors needed to reroute his bowels to let the body heal, so they created an ostomy, a hole in the abdomen that allowed stool or urine to leave the body, and fitted him with a bag. They created a new exit route for waste because he couldn’t poop the way he usually would.
The days after surgery were very touch and go for Skip. He was extremely sick. He was intubated and on a ventilator for several weeks. Eventually, his condition finally stabilized, and he was transferred from the Intensive Care Unit, ICU, to the step-down where PT could support him and help him regain his strength and movement. During this time, the hospital relaxed some of their restrictions and allowed Melanie to visit. “I was so weak I couldn’t feed myself,” recalls Skip. “My wife had to feed me. I tell you; I would probably have been in the hospital an extra week if she wasn’t there because she was the best medicine.”
Skip was in the hospital for about six weeks but made it home in time for the 4th of July. The hospital wanted to send him to a rehab center, but he declined due to the pandemic. Instead, he headed to a hospital bed on the first floor of his home with the plan for him to get stronger for the next phase of treatment.
Back to the Hospital
Doctors performed multiple tests before his discharge, including a doppler on his right leg, checking for blood clots. Tests came back negative. During his recovery, Skip received help from Home Health workers who would support him. He was home about 11 days when his left leg swelled, and the nurses felt that Skip had developed some clots, so an ambulance took him back to Wayne.
Skip’s left leg developed four blood clots while his right had three. Doctors started a course of treatment for his legs, but they found something disturbing going on with his lungs during their examination. They had filled with fluid, so doctors aspirated his lungs and drew out a liter of fluid. He was transported to UNC Rex and remained there for about a week. During this visit, he was monitored by Dr. LeCompte, along with Physician Assistant, Sally Corse.
“That visit is when I really remember meeting Dr. LeCompte,” says Skip. “He and his PA, Sally, would come in to check on me. Because of masks, all you see are the eyes. You can really tell when they’re smiling because their eyes show it and I saw a lot of smiles from them. Wonderful and kind people.”
The blood clots slightly accelerated the next phase of Skip’s care. In August 2020, he was admitted to the hospital for the first of two surgeries performed by Dr. LeCompte. With his specialized hepatobiliary training, Dr. LeCompte performed a procedure known as VARD – videoscopic assisted retroperitoneal debridement.
“Previously, doctors used to perform a big open operation where they would open the abdomen through a big open incision,” explains Dr. LeCompte. These big operations would often lead to collateral damage, bleeding, and poor post-operative healing “There was about 20 to 25% mortality rate associated with that procedure. So instead, we perform a minimally invasive VARD procedure. We cut a 1-inch incision in the side of the abdomen and using a tiny camera, I went in and cleaned out the dead pancreas that had turned into liquified, infected material. If this sits in there, festers, and forms an abscess, it can lead to sepsis and death. So that’s why we do this specialized debridement procedure for him. It sometimes takes two operations. So, for Skip, we did part one in August and completed part two in October.”
Over the next few months, Skip worked hard to recover.
Steps to Recovery
His recovery started with small steps beginning with ten to fifteen paces from the bed to the front door and back. He was able to do it twice a day. Then three times a day. Then five times a day. He graduated to a walker, then to the rolling walker, then to a cane. He would go outside and walk a little, first to the community mailbox, and then he started walking across the street and around the cul-de-sac. Little by little, he regained his strength.
In February 2021, Skip went back into the hospital for an ostomy reversal, his fourth and final surgery. Doctors removed his bag and closed the hole in his abdomen. On the day of the surgery, the team in the OR was surprised when they removed the bag. Skip had written a special note to Dr. LeCompte, “What’s up doc?” The procedure was successful but left Skip with a few extra scars.
“I have some wicked scars,” says Skip proudly. “You can quote me on this; scars are a sign of healing and of battles won. When I first came home, working with Home Health, who are wonderful people, it dawned on me that I am responsible for my own recovery. I had a good team. I had an amazing team. But ultimately, I had to do the work. Dr. LeCompte warned me that it was a marathon, not a sprint. Some days, you feel like you can climb a mountain, and some days, you don’t. My primary motivation to get well was the expected arrival of my first grandchild. I wanted to hold him and I wanted him to know me.”
“I tried to have a positive outlook, but there were times I was whimpering on the couch. Those were the moments that I had some heart to hearts with Jesus. There were days I cried in the night. My mom’s a retired nurse, and she would come down from Raleigh and help my wife take care of me a few days a week. Very humbling when your mother has to hold the urinal for you in the middle of the night or help give you sink baths. We had some funny moments.”
Throughout the process, Skip tried to understand what may have caused his pancreatitis. “Skip’s pancreatitis was idiopathic, meaning we never really identified the cause,” says Dr. LeCompte. “A common cause in our country is alcohol and alcoholism leading to a stigma. People think if you have pancreatitis, you brought it on yourself. However, Skip doesn’t drink. The other common cause is gallstones. Gallstones can slip out of the gallbladder, go down into the bile duct and plug up the ducks to the pancreas and it can lead to pancreatitis. That didn’t happen for Skip because his gallbladder was removed years before. But there are a hundred other possible causes of pancreatitis, including autoimmune issues, certain drug interactions, and side effects and genetics.”
“I tried to figure out what was going on,” says Skip. “What was I learning? What was God trying to teach me through all this? My faith is very important to me and has given me a lot of strength through this difficult time. I have had so many people from all over praying for me. I learned a lot about Grace. I don’t know why this happened. I don’t mind talking about, maybe what caused it. But I’m not one of those ‘Why me, God?’ types. Bad things happen to good people all the time.”
Skip worked hard day in and day out to regain his strength. His wife Melanie remained by his side throughout the ordeal. In severe cases like these, patients are usually transferred to a long-term rehab center and spend months recovering. Due to COVID-19, they chose to work through his recovery at home. While he received some help from home health nurses and Skip’s mother, Melanie took on the primary caregiver role. She managed his diabetes, took care of his drains, and nursed him back to health.
“I realized how well I married. When your mother tells you, you chose wisely, she knows what she’s talking about. I often tell my wife, she’s more than I hope for, better than I deserve. What I’ve gone through has been worth it to know what I have with Melanie. And it’s a very emotional thing to say. It would have been easier for her to walk away. Just take me to rehab, let someone else take care of me. That’s not who she is. I think if there’s a hero in this story, it’s not me. It’s her.”
Throughout his recovery, people that he has touched in the community have followed his journey through a Facebook page that was set up for him. “I was given a very, very precious gift. Many people go through their whole life and never really know the impact and the difference they make on others. And the outpourings of friendship and affection and support I have gotten throughout this whole ordeal. It’s a tremendous gift. Tremendous gift. Former students. Adults when I was doing Church choirs from 37 years ago. They’re all praying for me. Precious gifts: to understand Grace, to realize how much you are loved, and what a difference you’ve made in life to so many.”
The UNC Team
Patients with severe forms of pancreatitis have a long journey to recovery if they survive. There are roadblocks in front of them, and for Skip, he had more than most due to the added hurdles brought on by the pandemic. But things fell into place for him, starting with his transfer from Wayne to UNC Rex in Raleigh. The transfer allowed him to receive a higher level of care with specialized experience for individuals with severe pancreatitis and pancreatic disorders. The team includes surgeons with specific expertise in pancreas surgery, including Dr. Hong Jin (HJ) Kim, Ted. B. Seagroves Jr. Distinguished Professor and Chief of the division of surgical oncology at UNC in Chapel Hill and Dr. Michael Meyers, a surgical oncologist with a specialty in gastrointestinal surgery. “Having that level of expertise, I think, is critical for good outcomes in pancreatitis,” says Dr. LeCompte.
“I want to tell you right now, I had exemplary care at Rex,” said Skip. “Almost everyone I encountered were wonderful, great, and compassionate people. I tell you, if it wasn’t for the Hospital staff or medical personnel, that was my socialization for the year 2020. The care I received from Dr. LeCompte and his PA, Sally Corse, has been wonderful. And I didn’t feel I was just a case. I feel that I’m a person, and I know there are boundaries between patients and staff, and they’ve been nothing but professional, but I don’t feel that I’m a just patient. I feel like they’re friends. When I don’t have to go back and see Dr. LeCompte and Sally, I’m going to miss them terribly. Dr. Milano and his team saved my life. Through Dr. LeCompte’s care, I have been able to regain my life. The best way I know to thank the doctors and staff is to live well. And I aim to do just that!”