The Institute for Patient Blood Management and Bloodless Medicine and Surgery at Englewood Hospital
Long Distance Special Delivery
During the 30th week of pregnancy with their third child, Michele and Clint McClure of Ulster County, NY, had a drastic change of plans for the delivery of their baby. A growing fibroid tumor attached to Michele’s placenta (which carries nutrients to her unborn child), turning her natural delivery into a complex one.
Mrs. McClure had been seeing an obstetrician in her local area throughout her pregnancy. Her doctors were watching the tumor but felt that it would not interfere with her pregnancy. However, when Mrs. McClure was seven months along, she was sent for another ultrasound. She and her husband were advised that the fibroid would most likely interfere with her delivery and to expect to have a cesarean section.
The McClure family had previously spoken with their doctor regarding the fact that as Jehovah’s Witnesses, they do not accept blood transfusions and would require non-blood alternatives. At this point, they asked their obstetrician if she felt comfortable performing the C-section without blood and if her hospital had the tools necessary to facilitate bloodless surgery. Although her doctor was willing to treat Mrs. McClure without blood, she told the family that the hospital did not have the equipment necessary to perform bloodless procedures, and that if they knew of someone else who did, they should contact them.
It was at this time that the McClures contacted the New Jersey Institute for the Advancement of Bloodless Medicine and Surgery and Englewood Hospital and Medical Center and asked for a recommendation for a doctor who would work with them and respect their wishes regarding bloodless care. Specializing in Obstetrics and Gynecology, Nofit Weiss, MD and her team stepped up to the challenge.
The McClures took the long drive to Englewood, New Jersey, from Ulster County, New York, and met Dr. Weiss who immediately prescribed Procrit, Folic Acid, Vitamin C and Iron to build up Mrs. McClure’s blood count in preparation for her procedure. Dr. Weiss decided to perform the C-section one month prior to the patient’s anticipated delivery date so that the baby would be delivered in a controlled environment to avoid excessive bleeding.
On February 1, 2005 the McClures came to Englewood Hospital to deliver their new baby. However, the anticipated routine procedure took a different turn. According to Mrs. McClure, “Dr. Weiss’ initial incision wouldn’t allow access to the baby because of the location and size of the tumor, so Dr. Weiss needed to make a second incision to deliver the baby”. Happily, 5-pound, 6-ounce baby boy, Cody, was born. It appeared that the worst was over. However, because of the size of Mrs. McClure’s tumor, it was immediately apparent to the physician that the patient’s uterus could not be saved. Dr. Weiss needed to perform a hysterectomy right then and there.
After completing this procedure, Mrs. McClure was transferred to the Recovery Room, but her condition deteriorated and she lost consciousness. Her blood count was dropping. The Department of Critical Care Medicine was on the scene providing care and direction in cooperation with Dr. Weiss and her team to help stabilize the patient. The doctors performed an ultrasound to see if there was any internal bleeding. At this point, they couldn’t find the source of the bleeding and it was not readily apparent that she needed further immediate intervention.
Nonetheless, Mrs. McClure’s hemoglobin had gone down from a normal count of 13 preoperatively to the dangerously low level of 1.8. It now became necessary to transfer her to the Intensive Care Unit. Another ultrasound was performed and excessive fluid was found in her abdomen. Dr. Weiss took her patient back into the operating room and reopened the incision to look for any source of bleeding. She reinforced the patient’s stitches and looked for seepage. A cell saver machine was used to try and salvage Mrs. McClure’s lost blood and re-infuse fluid into the patient to help raise her blood count. She was returned to the Intensive Care Unit and her blood count finally began to rise. Two-and-a-half days later, she was moved to the Mother/Baby Unit and stayed there for an additional 6 days. Finally, Mrs. McClure was going home.
When the McClures came back to the hospital for a check up one month after the birth of their son, Mrs. McClure’s hemoglobin was a very respectable level of ten.
She had no problems since leaving the hospital and continued getting stronger every day.
Recently, the McClures sent a letter of appreciation to the President and C.E.O. of Englewood Hospital and Medical Center which in part read: “We greatly value the right to select the methods of medical treatment provided. Your commitment to providing the best possible care, while respecting the patient’s right to choose, has left us deeply impressed and we will highly recommend your facility to all our friends, family and associates for years to come. The teamwork and complete dedication that we saw between doctors is vastly superior to the level of care we had been forced to accept at local hospitals in our area (Upstate New York). There is no comparison between the two. In addition, we want to mention the quality care and deep concern shown by the Labor & Delivery staff, Cardiac ICU/Intermediate Care staff, the Medical/Surgical ICU staff, the Mother/Baby Unit staff, and the Neonatal Intensive Care staff. (The doctors) gave everything they had, both physically and emotionally, to provide the highest quality care, while respecting our health care wishes. The concern, both professionally and personally, from doctors, nurses, nursing assistants, Bloodless Medicine and Surgery staff, and hospital administrators was overwhelming. Our family will not soon forget the dedication your staff has shown; it has clearly kept our family together. For this, it is not possible to adequately express our appreciation.”
The entire Staff and Administration of Englewood Hospital and Medical Center, including the Bloodless Institute, is delighted to have been a part of what turned out to be a very happy ending. We wish the McClure family the very best continued health and happiness.