Fighting for Their Lives

Daniel & Elizabeth Ezra with their son, Leo

For Daniel Ezra, March 3, 2012 suddenly turned to every husband and expectant father’s worst nightmare.

It began one evening when his wife, Elizabeth, who was five and a half months pregnant with their first child, began spotting.

“My pregnancy had been incredibly normal,” says Elizabeth, or Lizzie as she is known. “There was no harbinger of anything wrong. I had just had a good check up and was cruising along.”

She was sure the spotting was “nothing,” but to be on the safe side, she went to a hospital emergency room in Manhattan. It turned out she was dilated and immediately admitted to the hospital for strict bed rest. Lizzie wasn’t allowed to go to the bathroom or even sit up to eat. She happily obliged and settled in for what she hoped would be a 12-week stay but knowing that her immediate goal was to reach 24 weeks, the minimum age for a baby to be viable.

One night two weeks after her admission, the last thing Lizzie remembers is waiting for her husband to find the Knicks game on tv. The next thing she knew was that days had passed, she had nearly died, and she was in a different hospital entirely: NewYork-Presbyterian Hospital/Columbia University Medical Center.

Months later Daniel recalls that night, although it’s still difficult. “When I turned around, she had bolted up in bed, gasping for breath, and couldn’t talk. I panicked and screamed for a doctor. Finally one came in and after Lizzie finished seizing asked her if she knew who I was. She pointed to me and whispered, ‘That’s my love.’ Those were her last words before losing consciousness. It was a beautiful, tragic moment.”

Staff started trying to resuscitate Lizzie, whose heart had stopped and whose lungs had failed. Meanwhile they knew they needed to deliver the baby, whose pulse was dropping rapidly. After performing an emergency C-section, the baby was alive but in critical condition. Doctors then told Daniel that Lizzie had massive blood clots in her lungs. On top of that, amniotic fluid had escaped into the bloodstream, causing a rare and severe reaction that led to Lizzie nearly bleeding to death. The doctors said she could die. For hours her blood pressure was in the 40s and her oxygen levels perilously low despite every effort to resuscitate her. There was nothing else they could do, so the doctors called Daniel Brodie, MD, Director of the Medical ECMO Program at the NewYork-Presbyterian/Columbia University Medical Center.

“What they described on the phone suggested that, according to our normal criteria, it was already too late. Lizzie had been all but dead for hours despite efforts to save her,” said Dr. Brodie. With no time to review her case to decide whether they could help, Dr. Brodie activated the ECMO Transport team and sent them out to get her. His first call was to Matthew Bacchetta, MD, a thoracic surgeon, and Director, Adult ECMO Program. When Dr. Bacchetta picked up the phone, all he heard was: “get in your car, I’ll call you in a minute,” Dr. Bacchetta recalls. He did. The next call came 15 minutes later. He was driving south to the city but didn’t know where he was heading. Dr. Brodie had activated the team, told him about Lizzie’s tragic situation and, together, they decided that, despite the dire circumstances, they had to try to help.

Dr. Bacchetta brought the ECMO machine to the hospital by 11 a.m. that morning. Lizzie had no blood pressure, her heart was barely pumping and her lungs were completely filled with fluid. Dr. Bacchetta quickly placed her on venoarterial extracorporeal membrane oxygenation (ECMO), a device that replaced the function of her failed heart and lungs and yet the blood pressure barely rose. He realized she was bleeding in to her abdomen. Surgery, right there in her ICU bed, to remove the blood was the only option. Following the emergency surgery, her blood pressure on the ECMO rose. Lizzie was placed in the ambulance with her blood circulating outside her body through the ECMO device and brought to NYPH/Columbia where Dr. Brodie, Dr. Jennifer Cunningham, the ICU attending, and the rest of the team managed her care. Nearly all of her organs had failed. She was in and out of consciousness for two weeks.

“When I woke up at Columbia,” she says, “I didn’t know I wasn’t pregnant anymore or how much time had elapsed or that I was even in a different hospital. I had no inkling of having gone through anything unusual. This sounds incredible, but I thought I had gone to sleep, and just woken up the next morning.”

It was only when she looked at her husband and family and saw the “pain written all over their faces” that she realized the extent of the trauma. And although she felt “fine” at that point, she wasn’t allowed to see her son for nearly two months. At three days old and weighing just one and half pounds, he had been transferred to NYPH/Columbia’s Neonatal Intensive Care Unit, where he stayed for the next five and a half months. Lizzie didn’t want to risk infecting him or any of the other babies in the unit.

To make matters worse, after surviving the first round of life-threatening health issues, Lizzie contracted pneumonia and went into septic shock. At the end of April, she went home with a private nurse and a “load of antibiotics.” In May, she finally got to hold her baby, and in August, she and Daniel brought him home. Mother and baby are now doing well and improving daily.

The couple is beyond grateful to the whole NYPH/Columbia staff but three doctors stand out. “Dr. Bacchetta saved my life. Dr. Brodie, who followed up day to day with me in the hospital, is a rock star in my family’s opinion. Dr. Schecter, my hematologist is a miracle worker.”

It took two miracles for Lizzie and her baby to survive. The odds of survival for a 24-week preemie are incredibly low. Lizzie says, “It’s been a tough battle for us. But we had named our son Leonidas after the Greek king who fought against the entire Persian army with only 300 men. Little did I know I was picking a warrior’s name. I needed him to be a fighter, and so far he has truly lived up to his name.”