Carl's Story

Carl Kaczor, 62, worked hard over the years running a successful fence and deck business. While it was thriving, the Strongsville resident decided to sell it in order to enjoy a relaxing retirement.

Carl was just settling into a calmer schedule when he started to feel rundown, both physically and mentally. On top of that, the typically upbeat retiree began to shed weight and was frequently out of breath.

Carl’s wife MaryAnn, a registered nurse, convinced him to visit the Lutheran Hospital Emergency Department. Doctors assessed his condition and immediately transferred him to the Intensive Care Unit (ICU). Carl was battling a septic infection—necrotizing pneumonia. The condition, a severe and rare complication of pneumonia, causes lung tissue death.

“They told me later that if MaryAnn hadn’t brought me in that day, I wouldn’t have made it,” Carl said. A lifeflight was arranged to transfer him to Cleveland Clinic Medical Intensive Care Unit (MICU) for specialized care, but tornados in the area necessitated he travel by ambulance instead—first to Cleveland Clinic Fairview Hospital ICU, then on to MICU.

Carl’s condition remained touch and go—he was placed on a ventilator which assumed the work of his lungs. His heart stopped beating and the medical team performed cardiopulmonary resuscitation for six minutes until his cardiac rhythm was restored. Carl was sedated during these events and received his nutrition and medication through a feeding tube inserted directly into his stomach. The cocktail of powerful antibiotics stemmed the flow of the infection. After a month, he stabilized and was ready to transition to the next level of care to focus on recovery. For that, MaryAnn chose Regency Hospital – Cleveland West.

“My first real memory is waking up in Regency. I had no idea of everything I’d been through, and I didn’t understand what was going on. I couldn’t move, couldn’t breathe, talk or eat on my own,” Carl said.

Carl’s physician-led, multidisciplinary team got to work on an individualized care plan with the goal of returning his functional independence.

Respiratory therapy began to dial back Carl’s ventilator settings for short, then increasing longer periods of time, allowing Carl’s lung to take over breathing. This built Carl’s lung and diaphragm strength. Nursing constantly monitored Carl’s vital signs and medications, and suctioned secretions to keep his airway clear. To enable him to speak, therapists attached a speaking valve to Carl’s tracheostomy. The valve forces air over the vocal chords allowing Carl to put his thoughts into words.

Maryann had not heard her husband speak in over a month. “When they placed the speaking valve, the first thing Carl said to me was, ‘What happened to me?’ The next was, ‘I love you,’ I was so happy to hear his voice, I immediately starting crying,” Maryann said.

Fifteen days after transitioning to Regency, Carl liberated from the machine. His tracheostomy remained in place and he received supplemental oxygen, when needed, through a trach collar around his neck.

Meantime, the former deck builder dedicated himself to physical, occupational and speech therapy.

Carl had a month of inactivity in which his muscles atrophied. To rebuild his strength, physical therapy slowly took Carl through an increasing regimen of bedside exercises – rolling from side-to-side, lifting his arms and legs, sitting upright and balancing at the edge of the bed. It was tiring but Carl was able to tolerate more each day. The encouragement of his therapist and family – MaryAnn and his sisters—helped propel him to do more. Within days Carl was doing heel-toe stretches at bedside and soon began standing up with assistance. In a few weeks, he took his first steps with a rolling walker.

“Once I got to Regency, I started to take literal steps forward. It felt incredible to see that progress. The therapists were all great—they pushed me and wouldn’t take no for an answer,” Carl said.

Occupational therapy started work on Carl’s upper body strength with arm exercises that helped build muscle and improve his stamina. With that, Carl also relearned daily personal tasks like brushing his teeth, dressing and combing his hair.

As his strength and mobility returned, Carl yearned to say goodbye to his feeding tube and replace it with real food. “I hadn’t had anything by mouth in two months,” Carl said. I couldn’t wait to get back to drinking water and eating.” To accomplish this, his speech-language pathologist (SLP) took him through a series of exercises to check his ability to swallow. A flexible tube equipped with a light and camera was inserted through Carl’s nose so the SLP could observe his muscles in action while swallowing liquid. He was elated when he passed the test and was rewarded with ice.

“Having ice chips for the first time after not having anything by mouth for so long was heavenly,” he said. “The feeling of actual water in my mouth and throat was glorious.” From there, Carl progressed to thickened liquids.

After 40 days of critical illness recovery at Regency, Carl was breathing independently. He was also improving his abilities to eat, talk and walk with assistance. He was ready to build on his gains with inpatient rehabilitation. For that, Carl and MaryAnn chose Cleveland Clinic Rehabilitation Hospital, Avon.

Carl arrived needing more work on swallowing – while he could tolerate thick liquids, soft bite sized foods were still challenging. And while Carl was now mobile, two months of hospitalization resulted in a pressure injury that was continuing to be addressed by wound care nurses. Using the same protocol as Regency, the care team at Cleveland Clinic Rehabilitation Hospital assessed Carl upon admission and customized a plan to further his mobility and self-care abilities so he could return home.

Physical therapists picked up where their colleagues in critical illness left off. They had Carl work on his upper body with light weight exercises. To boost leg strength, Carl traveled up and down a staircase alongside therapists who monitored his balance. A recumbent bike was also worked into Carl’s therapy regimen to increase his endurance. As he grew stronger, Carl moved onto gait training using a body weight-supported harness to help him re-learn to walk properly.

Speech therapists utilized a non-invasive therapeutic technique called neuromuscular electrical stimulation (NMES). Small patches were applied to Carl’s neck. Cocooned within those patches were tiny electrodes that conducted low-level electrical impulses. Those impulses activated muscles on the neck used for chewing and swallowing. Within two weeks, Carl’s swallowing ability had returned and, to his delight, he could safely resume his normal diet.

Carl was also determined to manage his personal tasks – making a bed, doing laundry, cooking and washing dishes. Occupational therapists worked with him in a suite outfitted like a home complete with a kitchen, bed and laundry area. Not only did Carl relearn to handle the tasks of everyday life but he was beginning to grasp how to adapt to his needs – learning how to carry things without losing his balance, how to rest between tasks and how to do things from a seated position. The latter two adaptations were helpful in preventing Carl from feeling light-headed when his blood pressure fluctuated.

Carl made great strides during his 35-day inpatient rehabilitation stay. By the time he was ready to go home, Carl could walk over 250 feet with a rolling walker, tackle stairs with help and manage daily living tasks modified to suit his physical needs.

After four months in an array of hospitals, Carl was delighted to go home. “I am so happy to be heading home…to sit in my own chair, look out my own window and eat my own food,” Carl said.

The challenges of his health journey behind him, Carl is ready to enjoy retirement. “I’ve always been an optimistic person, but everything seems brighter now. I love and appreciate my family even more than before, I don’t sweat the small stuff anymore and even food tastes better to me now.”