Personal Health

This page summarizes my entire hospital course, from initial presentation through stabilization and transfer to rehabilitation.
All information is derived from my official hospital documentation.

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Day −1 to 0 — Initial Illness & Collapse (Jan 6–7, 2026)

  • Presented to St. Clare’s Hospital with:
    • Severe fatigue
    • Nausea and vomiting
    • Poor oral intake
  • Diagnosed with Diabetic Ketoacidosis (DKA)
    • Glucose ~492 mg/dL
    • pH ~7.12
    • Anion gap 31
    • HbA1c ~13.9%
  • Developed new-onset atrial fibrillation with rapid ventricular response
  • Rapid clinical deterioration:
    • Hypotension despite IV fluids
    • Required vasopressors
  • Echocardiogram showed new severe biventricular heart failure
  • Cardiac catheterization:
    • No obstructive coronary artery disease
    • Critically low cardiac index
  • Transferred emergently to Morristown Medical Center (MMC) for cardiogenic shock

Day 1 — Cardiogenic Shock & Life Support (Jan 7)

  • Arrived at MMC in Stage E cardiogenic shock
  • Hemodynamics:
    • Cardiac index ~0.9
    • PA saturation ~22%
  • Required multiple vasopressors and inotropes
  • Emergency mechanical circulatory support initiated:
    • VA ECMO (femoral vein → femoral artery)
    • Impella CP placed for left ventricular unloading
  • Diagnosis at this stage:
    • Cardiogenic shock
    • Acute biventricular failure
    • Suspected myocarditis
    • DKA with severe metabolic derangements
  • Intubation avoided; remained critically ill but stabilized on support

Day 2 — Stabilization on ECMO/Impella (Jan 8)

  • Remained on full VA ECMO + Impella (ECPELLA)
  • Anticoagulation with continuous heparin infusion
  • Pressors gradually weaned
  • High-dose steroids started for suspected myocarditis
  • Insulin drip continued for DKA management
  • Acute kidney injury developed from shock (ischemic ATN)
  • Mentation fluctuated but improving

Day 3 — Early Improvement (Jan 9)

  • Hemodynamics improving:
    • Cardiac index increased to ~1.8
  • Impella removed on Jan 9
  • Continued ECMO support
  • Required blood transfusions due to:
    • Acute blood loss anemia
    • Groin bleeding at cannulation site
  • Platelets initially low, began recovering

Day 4 — ECMO Weaning & Decannulation (Jan 10)

  • ECMO flows successfully weaned without hemodynamic instability
  • VA ECMO decannulated
  • Repeat echocardiogram:
    • Normalized left and right ventricular function
  • Vasopressors discontinued
  • Transitioned off insulin drip to subcutaneous insulin

Day 5 — Hemodynamic Recovery (Jan 11)

  • Off all mechanical circulatory support
  • Cardiac output and index normalized
  • Oxygen via nasal cannula only
  • Kidney function improving
  • Continued diuresis for volume management
  • Central lines removed
  • Transferred out of CCU to monitored floor

Day 6–7 — Medical Floor & Functional Recovery (Jan 12–13)

  • Stable cardiac status
  • Diagnosis clarified as:
    • Cardiogenic shock likely secondary to myocarditis
    • New insulin-dependent diabetes
  • Appetite returned
  • Physical therapy initiated:
    • Sitting in chair
    • Assisted ambulation
  • Persistent weakness and deconditioning noted
  • Ongoing anemia but stable

Day 8–9 — Rehabilitation Planning (Jan 14–15)

  • Continued improvement without recurrent arrhythmia
  • AKI resolved
  • Physical & occupational therapy assessments:
    • Walking short distances with assistance
    • Difficulty with stairs
  • Determined not safe for direct discharge home
  • Plan made for acute inpatient rehabilitation

Day 10 — Transfer to Acute Rehab (Jan 17)

  • Medically cleared for discharge
  • Transferred to Acute Rehabilitation Institute (ARI)
  • Goals:
    • Rebuild strength and endurance
    • Improve mobility and stair safety
    • Continue cardiac and metabolic recovery

Key Diagnoses (Confirmed)

  • Diabetic ketoacidosis (new diagnosis of diabetes)
  • Acute myocarditis (suspected trigger)
  • Severe cardiogenic shock
  • Acute biventricular heart failure (recovered)
  • Atrial fibrillation with RVR (resolved)
  • Acute kidney injury from shock (resolved)
  • Critical illness deconditioning

Bottom Line

  • This was life-threatening cardiogenic shock
  • Required ECMO + Impella to survive
  • Cardiac function fully recovered
  • Survival and recovery were not guaranteed
  • Current phase is rebuilding, not healing heart muscle