By Susan Scutti
Given the choice between his wife possibly dying in her bed or on an operating table, Chris Benoit chose an experimental, first-of-its-kind surgical procedure. The surgeons would remove not just one but both of Melissa Benoit's lungs.
The Burlington, Ontario, woman was was so sick, she could not speak for herself.
"I was unconscious at this point and had been for some time," Melissa Benoit said. "So (my family) made the decision based on my previous wishes -- just knowing who I am."
Chris Benoit remembers the moment of decision in April. He, Melissa's mom, dad and uncle all spoke at once. "It didn't take very long for us to insist that Melissa would want to go right to the end and fight with experimental surgery," he said.
In fact, Melissa Benoit, then 32, had been suffering for years. A cystic fibrosis patient, she had been struggling with an on-again, off-again infection that had ravaged her lungs over the course of three years. An inherited disorder, cystic fibrosis affects the cells that produce mucus, sweat and digestive juices, and causes damage to the lungs, gastrointestinal system and other organs of the body.
She'd been taking antibiotics intravenously, but then she came down with the flu, which triggered coughing fits so terrible, she fractured her ribs.
In mid-March, she landed in St. Michael's Hospital in Toronto.
"They thought they'd just do a quick switcheroo with antibiotics," she said. "Unfortunately, that didn't happen. The last day I remember was Easter Sunday 2016, where I was waiting for an ICU bed."
While she was unconscious, the infection could not be controlled, so in early April, she was transferred -- sedated and on a ventilator -- to Toronto General Hospital's Surgical Intensive Care Unit.
She was suffering from "severe bacterial infection involving her lungs, and the bacteria was very drug-resistant, so despite being on antibiotics, it was not very well-controlled," said Dr. Atul Humar, director of the transplant program at Toronto General Hospital and president of the Canadian Society of Transplantation. Humar was not directly involved in Benoit's care.
Drowning in the blood and pus that filled her lungs, she had been gasping for breath -- grasping for life -- for days. It was clear Benoit needed a lung transplant, but a conventional ventilator was not enough to help her breathe until donor lungs became available.
To help her breathe and to gain more time, physicians placed her on Extra-Corporeal Lung Support, a temporary life-support medical device often used to help bridge patients waiting for a transplant.
Amanda Spriel, a perfusionist at Toronto General who was involved in the procedure, explained that this machine functions as the lungs normally do. It drains blood from the body, oxygenates it and removes the carbon dioxide, and then pumps the cleaned blood back into the patient.
For other patients waiting for a lung donor, this machine is enough to help them survive. In Benoit's case, her condition only worsened.
The infection took over her lungs, spilled into her bloodstream and caused septic shock, she said, adding that it "meant they couldn't do a lung transplant. You cannot transplant someone who is in septic shock."
She would die if nothing was done.
Conferring with her family, a "radical decision" was made, said Dr. Shaf Keshavjee, surgeon-in-chief at University Health Network. "Because her lungs were so infected, we took both lungs out ... and that had never been done before."
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