Life-Saving Primary Care

When a cold starts, most people break out a box of tissues and get ready to sniffle and feel crummy for a few days. 

That's certainly what Dottie Doering, 81, prepared for when she developed a runny nose and cough last February. 

Unfortunately, Dottie’s cold symptoms didn’t go away—they got worse. When she woke up one morning and found herself short of breath, she was concerned. The summer before, she’d also thought she had “just a cold,” but a trip to the hospital revealed pneumonia.

This time, she knew she needed to get checked out. Her husband took her to a non-Saint Luke's hospital near their home. 

Dottie’s X-rays showed that her lungs were clear, so doctors thought she might have a hiatal hernia, which could press on her lungs and cause difficulty breathing. They recommended she consult a primary care physician. Dottie visited Saint Luke’s Perryman Primary Care–Plaza, where she saw Randyn Wertz, FNP-BC, a family nurse practitioner with an interest in geriatric medicine.

Dottie recalled that, after conducting an examination, Randyn came straight to the point.

"She looked at me and said, ‘Dottie, I want you to go downstairs to the Emergency Department,’” Dottie said, adding that she'd preferred to check in at the hospital near her home. But Randyn insisted that Dottie’s condition could not wait that long.

"She said, ‘You might not make it there,’” Dottie said. “’You need to go down now.’”

Randyn suspected that Dottie’s breathing difficulties were not being caused by a hernia, but by a pulmonary embolism—a blockage in the arteries to her lungs. This life-threatening condition requires immediate treatment.

After Randyn explained the seriousness of the situation, Dottie was convinced. A few minutes later she was in Saint Luke's Hospital Emergency Department, where a series of tests confirmed Randyn’s diagnosis.

Dottie actually had several blood clots in her lungs, including a bifurcated, or “saddle,” embolism. This relatively uncommon type of embolism is situated at the dividing point, or saddle, where the main artery branches into the individual lungs. Some months earlier, during her bout with pneumonia, Dottie’s physicians had discovered a blood clot in her leg. It is very common for such clots to dislodge and travel to other parts of the body, including the lungs. Now, in its dangerous position at the artery saddle, if the clot were to shift in position, it could completely block blood flow and potentially be fatal.

Dottie met with Saint Luke’s Andrew Schlachter, MD, a specialist in pulmonology and critical care medicine. He scheduled Dottie for a thrombectomy, a procedure that involves inserting a catheter and removing the clots by extracting them through the tube. This type of surgery is minimally invasive, and requires less recovery time than a traditional open surgery.

Dottie said that Dr. Schlachter gave her and her husband the time they needed to fully grasp her condition and necessary treatment.

"He is so amazing,” she said. “He never rushed us, and took the time to explain everything in language that we understood.”

Her praise extended to the entire Saint Luke’s staff, including the nurses and assistants who tended to her while she was in the Emergency Department.

"I just had to ring the bell and they would come right in and help me,” she said. “They must have been sitting right outside my door. I had never been treated that well in a hospital before.”

Dottie received her thrombectomy the next morning. Her husband, daughter, and sons were there to support her—as was the Saint Luke’s team. “They wheeled me in, opened the door, and everyone started clapping,” she said. “They said, ‘We’ve been waiting for you.’”

Dottie was nervous, but a nurse stayed right beside her to make sure she was okay during the two-hour procedure.

"I can’t tell you the difference I felt," Dottie said. "I felt 10 years younger. I could breathe! I felt so good, I couldn’t believe it.”

Before, Dottie had experienced neuropathy (nerve numbness) in her legs and feet, but after the procedure, it improved.

"This was really a life-changing thing for me,” she said.

Now, with the help of iron infusions to combat anemia and regular blood thinners to prevent the formation of new clots, Dottie is doing great.

"I cannot tell you a single person at Saint Luke's that didn’t go above and beyond their regular duties to take care of me,” she said, offering special thanks to Randyn, the nurse practitioner who first recognized her condition. 

“She laid it on the line for me. It’s plain and simple— if it hadn’t been for her, I wouldn’t be here today. I feel like I have experienced a miracle.”