He's an Ironman. COVID-19 nearly killed him
APRIL 19, 2020 — 12:24AM
to OK the ECMO because
O’Donnell’s blood oxygen levels were critically low. His lungs
Hours later, they asked his wife by phone were
packed with fluid. He was going to die without swift action.
RENEE JONES SCHNEIDER – STAR TRIBUNE
"I want to give hope to those that are going through it, those
that have gone through it, and those that are not seeing the
light at the end of the tunnel," said virus survivor
Ben O’Donnell.
The COVID-19 mystery of Ben O’Donnell, a 30-something
Ironman athlete, remains as baffling today as it did
March 10 — when Minnesotans learned
the state’s first coronavirus case needing intensive
care was someone in
his prime.
Ironman athlete, remains as baffling today as it did
March 10 — when Minnesotans learned
the state’s first coronavirus case needing intensive
care was someone in
his prime.
State health investigators were perplexed, given the
virus’ history of hitting the sick and elderly the hardest.
virus’ history of hitting the sick and elderly the hardest.
Minnesotans lost hope, because being young and
healthy were not surefire shields against COVID-19.
healthy were not surefire shields against COVID-19.
“It made everything a lot more real,” said Haley Kramer,
an intensive care nurse who treated O’Donnell, “because
he was me, he was my husband,
he was a lot of my close friends and family. Just a young,
healthy guy.”
an intensive care nurse who treated O’Donnell, “because
he was me, he was my husband,
he was a lot of my close friends and family. Just a young,
healthy guy.”
Odds of recovery were a coin flip after COVID-19 ravaged
his lungs and forced doctors to place him on a ventilator and
an ECMO heart-lung
pump to keep oxygen-rich blood flowing in his body.
his lungs and forced doctors to place him on a ventilator and
an ECMO heart-lung
pump to keep oxygen-rich blood flowing in his body.
Today, he is home in Anoka County, still recovering but
offering hope to
a state awaiting the peak of this pandemic.
offering hope to
a state awaiting the peak of this pandemic.
“I was close as you could be to
checking out without checking out,
and here I am,” O’Donnell said.
“I want to give hope to those that
are going through it, those that
have gone through it, and those
that are not seeing the light at the
end of the tunnel.”
checking out without checking out,
and here I am,” O’Donnell said.
“I want to give hope to those that
are going through it, those that
have gone through it, and those
that are not seeing the light at the
end of the tunnel.”
O’Donnell, 38, remains an anomaly
in Minnesota, which on Saturday,
had 2,213 COVID-19 cases and
121 deaths. The average age of
confirmed cases is 54 years old
and the average age of those
hospitalized is 64.
in Minnesota, which on Saturday,
had 2,213 COVID-19 cases and
121 deaths. The average age of
confirmed cases is 54 years old
and the average age of those
hospitalized is 64.
Even among COVID-19 cases
on ECMO, O’Donnell beat the odds. Only 21 of 65 patients globally have
survived after ECMO.
on ECMO, O’Donnell beat the odds. Only 21 of 65 patients globally have
survived after ECMO.
“The reason you’re putting people on it is there is nothing left to do for
them,” said Dr. Jeffrey Chipman, a critical-care leader for M Health Fairview
and the University of Minnesota Medical Center, which has treated two
of the world’s 21 ECMO survivors.
them,” said Dr. Jeffrey Chipman, a critical-care leader for M Health Fairview
and the University of Minnesota Medical Center, which has treated two
of the world’s 21 ECMO survivors.
Chipman felt relief watching O’Donnell’s vital signs stabilize under ECMO.
It bought time for doctors to figure out what to do next, albeit for a disease
with no proven treatment.
It bought time for doctors to figure out what to do next, albeit for a disease
with no proven treatment.
Didn’t look right
O’Donnell hadn’t set out to make history when he arrived at the
U emergency room March 9. He had been worn down from a business trip
and stayed home sick for a week while his wife was on a getaway with her sister;
their 3-year-old daughter stayed with grandparents.
U emergency room March 9. He had been worn down from a business trip
and stayed home sick for a week while his wife was on a getaway with her sister;
their 3-year-old daughter stayed with grandparents.
O’Donnell didn’t look right when he picked up his wife, Deanna, at the
airport March 8 and asked her to drive.
airport March 8 and asked her to drive.
“That was weird,” she said.
They had been mindful of COVID-19 — staying separated when O’Donnell
first got back from his work trip and keeping the house sanitized — but
figured he would just go to the ER to receive fluids and rehydrate and
then go home.
first got back from his work trip and keeping the house sanitized — but
figured he would just go to the ER to receive fluids and rehydrate and
then go home.
Instead, that was the last day for a month that husband and wife were
together.
Isolated because of his likely infection, O’Donnell signed “I love you”
through a window to his wife before she left.
together.
Isolated because of his likely infection, O’Donnell signed “I love you”
through a window to his wife before she left.
It was the U’s first COVID-19 case, and Minnesota’s third. O’Donnell’s
health cratered. The next morning, doctors snaked a tube down his
throat and placed him on ventilation.
health cratered. The next morning, doctors snaked a tube down his
throat and placed him on ventilation.
packed with fluid. He was going to die without swift action.
“His chest X-ray when he came in was abnormal,” said
Dr. Meghan Rothenberger, a U infectious-disease specialist.
“Within two days of his hospitalization, it was terrible — the kind of terrible
that when I looked at it, I was like, ‘ohhh.’ ”
Dr. Meghan Rothenberger, a U infectious-disease specialist.
“Within two days of his hospitalization, it was terrible — the kind of terrible
that when I looked at it, I was like, ‘ohhh.’ ”
ECMO historically came with heavy sedation to keep patients from
moving and injuring themselves. These days, doctors try to keep
patients conscious and moving so they aren’t “wet noodles”
when they come off the machine, Chipman said.
moving and injuring themselves. These days, doctors try to keep
patients conscious and moving so they aren’t “wet noodles”
when they come off the machine, Chipman said.
Odds are better when people are young and strong, and O’Donnell had
that going for him. He finished the 2017 Ironman in Madison, Wis., and
was training for another one.
that going for him. He finished the 2017 Ironman in Madison, Wis., and
was training for another one.
‘Don’t stop, don’t quit’
O’Donnell’s hallucinations as he
faded in and out of consciousness
were dark. His masked caregivers
were evil captors to him. His vision
was not of a hospital but of a den of
human trafficking that was grooming
him. He was in danger and needed
to escape.
faded in and out of consciousness
were dark. His masked caregivers
were evil captors to him. His vision
was not of a hospital but of a den of
human trafficking that was grooming
him. He was in danger and needed
to escape.
In hindsight, with counseling to
deal with the trauma, O’Donnell
came to see the positive
interpretation. His brain was
telling him he was in a bad place
physically, and he needed to
fight to get better.
deal with the trauma, O’Donnell
came to see the positive
interpretation. His brain was
telling him he was in a bad place
physically, and he needed to
fight to get better.
“I was somewhere else mentally,” he said. “It was a pretty terrible place,
but I now know the entire time my mind was looking for a way for me
to be able to escape.”
but I now know the entire time my mind was looking for a way for me
to be able to escape.”
O’Donnell woke one day to see his sister, Dawn Inman, a Mayo Clinic nurse,
who was permitted to visit. Confused, he wrote her a note: “human tr?”
who was permitted to visit. Confused, he wrote her a note: “human tr?”
“No,” he recalled her replying. “You’ve been here the entire time.
You were really, really sick. You’ve started to get a little bit better.”
You were really, really sick. You’ve started to get a little bit better.”
It was March 17, the last day she was allowed in the hospital under new visitor prohibitions. The state now had 60 COVID-19 cases, and epidemiologists were two days from acknowledging that the virus had
reached broad, community-transmission levels.
reached broad, community-transmission levels.
Inman ducked into the room one last time to hug her brother.
Reality became clearer after that, O’Donnell said, and he believed
he was going to be OK.
Reality became clearer after that, O’Donnell said, and he believed
he was going to be OK.
“Don’t stop, don’t quit, keep moving forward,” he thought,
repeating the mantra that fueled his Ironman finish.
repeating the mantra that fueled his Ironman finish.
The hospital had prepared for COVID-19 but was not expecting
a first case so bad in someone so young. Rothenberger said some
people feared walking by his room, but his nurses never hesitated to
don protective gear and treat him.
a first case so bad in someone so young. Rothenberger said some
people feared walking by his room, but his nurses never hesitated to
don protective gear and treat him.
Brain damage is a concern for ECMO patients, but O’Donnell’s pupil
responses and reflexes were good during initial sedation. Later, he
amused caregivers with a middle-finger gesture when a nurse tried to
put mitts that he didn’t want over his hands. O’Donnell was still in there.
responses and reflexes were good during initial sedation. Later, he
amused caregivers with a middle-finger gesture when a nurse tried to
put mitts that he didn’t want over his hands. O’Donnell was still in there.
“It was amazing how much he remembered,” Kramer said.
The dilemma was what to do with the time ECMO bought. Doctors
tried an anti-malaria drug, hydroxychloroquine, based on reports that
it worked against COVID-19.
tried an anti-malaria drug, hydroxychloroquine, based on reports that
it worked against COVID-19.
Hospitals worldwide reported immune-system overreactions in
some bad cases, and O’Donnell showed signs of a cytokine storm
— an excessive release of cytokine proteins to fight the virus.
some bad cases, and O’Donnell showed signs of a cytokine storm
— an excessive release of cytokine proteins to fight the virus.
Hematologists at the U have treated that problem in cancer patients
with tocilizumab, a drug that blocks the Il-6 cytokine, so the doctors tried it. Coincidentally, O’Donnell, a chemical company executive, had worked earlier in his career on a blood test for Il-6.
with tocilizumab, a drug that blocks the Il-6 cytokine, so the doctors tried it. Coincidentally, O’Donnell, a chemical company executive, had worked earlier in his career on a blood test for Il-6.
“We saw him really turn around,” Rothenberger said, though
the drug is only one possible reason.
the drug is only one possible reason.
O’Donnell was strong enough to stand while on ECMO, which
was removed March 22, and he continued in therapy exercises until
his discharge April 6.
was removed March 22, and he continued in therapy exercises until
his discharge April 6.
O’Donnell wasn’t the first U.S. COVID-19 case on ECMO, but he was
the first survivor to get off it. Doctors flooded the U with questions
about what worked. The case will soon be featured in a medical journal.
the first survivor to get off it. Doctors flooded the U with questions
about what worked. The case will soon be featured in a medical journal.
‘Tiger germs’ are gone
Back home, Deanna and their daughter grew hopeful. They had been
quarantined for two weeks because of their potential exposure to the virus
but never tested positive.
quarantined for two weeks because of their potential exposure to the virus
but never tested positive.
Daily video chats were limited to waves and hand signs at first, but soon
O’Donnell was talking. To make the infection understandable, Deanna told their daughter that her father had “tiger germs” clawing him.
O’Donnell was talking. To make the infection understandable, Deanna told their daughter that her father had “tiger germs” clawing him.
Some of the talks stung. O’Donnell recalled his daughter saying,
“ ‘Daddy, I wish you never went to work to get those tiger germs.’ ”
“ ‘Daddy, I wish you never went to work to get those tiger germs.’ ”
Over time, the girl could see her father’s progress — first his intubation
was gone, then a large nasal cannula, and the feeding tube.
was gone, then a large nasal cannula, and the feeding tube.
After discharge, O’Donnell’s sister drove him home. Father,
mother and daughter embraced for the first time in a long time
on their driveway. The tiger germs were gone.
mother and daughter embraced for the first time in a long time
on their driveway. The tiger germs were gone.
Treatment had been frightening and complicated. Twice, O’Donnell
had to be reintubated — the first time when his breathing tube clogged,
and the second when he coughed so hard he forced it out of his throat.
He needed periodic dialysis for his kidneys, and suffered internal
bleeding because of anti-clotting medication.
had to be reintubated — the first time when his breathing tube clogged,
and the second when he coughed so hard he forced it out of his throat.
He needed periodic dialysis for his kidneys, and suffered internal
bleeding because of anti-clotting medication.
Full recovery remains possible, with patience. The Ironman lasted
.4 miles on a treadmill this week, and needed supplemental oxygen f
or only half of a 15-minute walk.
.4 miles on a treadmill this week, and needed supplemental oxygen f
or only half of a 15-minute walk.
Now, O’Donnell is looking to help. Researchers are studying his
blood and genetics, trying to figure out what made him vulnerable
to such an attack. He hopes to donate blood plasma to treat others
with COVID-19.
blood and genetics, trying to figure out what made him vulnerable
to such an attack. He hopes to donate blood plasma to treat others
with COVID-19.
“As terrible as it was,” he said, “I would do it again if I could stop
someone else from being sick.”
someone else from being sick.”
jeremy.olson@startribune.com 612-673-7744
78
