Saving Payton

How a team at Mary Greeley came together and pulled off a miracle.

By Steve Sullivan

Payton Shaw rests peacefully in a Mary Greeley hospital bed, gazing out the window on a Thursday afternoon in March as snow gently falls outside.

Just three days ago, she was looking out the window from the back of an ambulance, trying not to panic, trying to stay calm and just keep breathing.

Payton was in a life-or-death situation, one which would bring together an incredible team at Mary Greeley all working to save this young woman’s life. But before that team could do its work, Payton had to draw on every ounce of strength and courage she had to make it to the hospital.

“Everything lined up. One step out of sequence and she wouldn’t be here,” said Payton’s mom, Amy. “Words can't express how thankful we are to everyone who helped with Payton’s care and recovery.”

“I’ve been doing this for a long time and there are cases you know you will remember for the rest of your life. This is most definitely one of them,” said Tim Davis, Mary Greeley Cardiac Cath Lab nurse.

‘PLEASE HELP ME’

Payton, 24, teaches art at BCLUW Middle School in Union, which is about an hour from Ames. On Monday, March 6, at around 3:40 p.m., she left work and headed to her car. She tossed her bags in the backseat, and then felt a sharp pain in her chest and passed out.

“I don’t know how long I was out, but I woke up wondering ‘Why am I on the ground?’” she said. “I got up and got into my car. I knew something was wrong and I needed to get somewhere safe so I didn’t pass out again and fall on the ground.”

She managed to get into her car, and then she passed out a second time.

“I came to again and felt like I was in a trance, but my instinct was to do something fast. I called my dad and he picked up, thank goodness,” she said. “I told him, ‘I’m in trouble. Please help me, please help me; help me, Dad.’”

Payton was struggling to breathe and thought she could be having a serious asthma attack. It was far worse.

Her dad, Terry, called Amy, who alerted the school principal. He rushed to the parking lot and was able to get Payton her emergency inhaler, which was in the backseat.

“I used it, but deep down I knew it was not going to help. I knew it was something other than asthma, but I hoped it would help me calm down and help me collect myself,” she said.

AMBULANCE LIGHTS

An ambulance crew from Eldora arrived at 4:08 p.m. 

“Upon arrival at the scene, we immediately recognized the gravity of Payton’s condition,” said Tanner Wolken, an Eldora critical care paramedic. “We promptly initiated advanced life support measures and employed advanced interventions, working tirelessly to stabilize her for transport to Mary Greeley. I am proud of our team’s dedication to providing the highest level of care to our patients.”

A decision was made to take Payton to Mary Greeley, which was the closest hospital with critical care capabilities. Wolken told Payton that they would get to Ames as fast as they could but probably wouldn’t need to use the lights and siren. Payton’s mom and dad would follow in their respective vehicles.

The ambulance left Union at 4:22 p.m. Paramedics kept close watch on Payton’s condition, which was deteriorating. She was put on a CPAP machine to help her breath. She was watching for her dad’s car out the back window, fighting for air and counting down the minutes as the ambulance sped toward Ames. 

Then the ambulance lights came on, and an EMT started telling Payton that she needed to be strong and fight.

“I thought we didn’t need the lights,” she remembers thinking.

They arrived at Mary Greeley at 4:58 p.m., and Payton was rushed into a trauma room in the Emergency Department. Her parents were still thinking their daughter was having an asthma attack.

“I had pain everywhere from breathing so hard,” Payton said. “I kept telling myself that I needed to keep going, keep breathing. If you stop, you won’t be able to get started again.”

She was immediately sent for a CT scan. That’s when the potentially deadly problem was discovered: a pulmonary embolism. 

A pulmonary embolism (PE) is a blockage in an artery of the lungs. It results when a blood clot in a leg travels to the heart. A PE can block blood flow to the lungs, resulting in breathing difficulty, chest pains, and other serious symptoms. Payton had a saddle pulmonary embolism, which occurs when a large clot gets stuck where the main pulmonary artery branches off into a Y-shape that goes into each lung. Saddle PEs are rare, making up 2 to 5 percent of all PE cases. A saddle PE is particularly dangerous because it can block blood flow to the lungs, which can lead to heart failure and death.

CARDIAC ARRESTS

A call was made to Dr. Nima Golchin, an interventional radiologist with McFarland Clinic who is based at Mary Greeley. Golchin was on vacation and preparing to leave town with his family. He dropped everything and rushed to the hospital.

“That’s when things really ramped up fast,” said Amy. “We knew it was very serious.”

Payton was extremely sick, Golchin said, and “looked like she was dying.” He quickly met with Payton’s parents to deliver heartbreaking news.

“I told them her condition has a high mortality rate. There was a 50 percent chance she would survive,” he said.

“That was really hard,” said Amy. “This all came out of nowhere. They were taking her to surgery right away and she may not survive. I leaned over and told her I loved her. It was all I had time to do.”

Payton was taken to Mary Greeley’s Cardiac Cath Lab, where a team got her ready for Golchin. He had to insert a catheter into a femoral vein in her right leg. He then had to navigate the catheter through the artery, into her heart’s right ventricle and then to the pulmonary arteries where the clot was. It is a procedure that requires intense focus and precision.

“My goal is to get there and break up the clot or suck it out,” Golchin said.

The procedure started at about 6:45 p.m. and at about 6:50 p.m., Payton suffered cardiac arrest. CPR was immediately administered to get her heart started again.

Payton’s parents were in a nearby waiting room and heard the code announced over the intercom.

“I thought we had lost her,” Amy said.

Crystal Kemmer, a patient care technician, had just arrived at work when she walked by the waiting area and saw the Shaws.

“I saw the parents completely distraught and in tears trying to comprehend what was happening to their daughter. I decided to stop and see if I could help console them or sit with them,” she said. “Amy was in tears when I approached her and her husband was making phone calls. I asked what was going on and Amy proceeded to tell me the situation. She said she was told her daughter had a 50/50 chance of surviving the procedure that she was enduring. Amy just kept saying she couldn't lose her daughter. I asked them if it was ok to pray with them and they were more than ecstatic that I had asked that. So we prayed for her daughter, the care team and the parents.”

The code brought a team of people racing to the Cath Lab. At one time, there were upward of 20 people in the room, taking turns administering CPR, watching her vitals, delivering medication. The Mary Greeley team was doing everything to make sure Payton lived.

Dr. Jeffrey Drawbond, a McFarland Clinic anesthesiologist, intubated Payton. Her heartbeat returned, and Golchin continued with the procedure. He reached the clot and was able to suction some out when Payton arrested again. By this time, Dr. Snehitha Vijaykumar, a McFarland Clinic cardiologist, had joined the team. She was leaving for the day when the first code was announced. She immediately returned to the Cath Lab to help. Once Payton’s heart started up again, Golchin was able to suction out most of the embolism.

“There were so many people in the room with the same goal. It was a great example of our team running like a well-oiled machine,” said Randi Stephens, Cath Lab radiology technologist. “Everyone knew what to do, where to go, and what to grab. It was so busy at one point that Dr. Vijaykumar scrubbed in to assist me so we could work faster for Payton because every second counted.”

ALIVE

The successful procedure took about 90 minutes. 

“She seems to have made a miraculous recovery,” said Golchin.

Payton later woke up in the ICU, where she was greeted by her parents and her beloved younger brother, Jackson.

“That is what really got me awake, even though there was a tube down my throat,” she said.

“I am always so proud of our team in these situations; it makes me happy to come to work every day. Visiting Payton in the ICU the next morning and seeing her sitting up and talking was a wonderful feeling and very emotional as well,” said Stephens.

Payton is now back at work. She’s keeping an eye on her condition, and when she’s strong enough she will need to be treated for an aneurysm in an artery near her spleen that was found during the CT.

“It’s difficult to explain but it doesn’t feel like it happened,” she said. “I know it did and that it was a big deal, and I almost didn’t make it. But right now, I’m happy to be here.”

Congrats Dr. Golchin

Dr. Nima Golchin, the McFarland Clinic interventional radiologist who played a central role in saving Payton Shaw’s life, has been named the recipient of Mary Greeley’s 2023 Innovation & Excellence in Medical Practice Award.

Golchin was selected for the honor on the basis of nominations submitted by his colleagues.

Here are excerpts from two of those nominations:

“We nominate innovative physicians for this award. After watching him practice, he’s done more than innovate. He offers patients and physicians fearless service.”– Dr. Doug Lake, McFarland Clinic radiologist

“Besides being able to thread a catheter into any location in the body, he is kind and compassionate with patients! He is always available, even on his days off, to discuss a patient or even come in and do an emergency procedure.” – Dr. Jacob Alexander, McFarland Clinic nephrologist and winner of the 2021 Innovation & Excellence in Medical Practice Award