A main artery ruptured. Her heart stopped. She credits her survival to a ‘wonderful, supportive’ staff and a surgeon who wouldn’t give up
BY AMBER SMITH
For 12 hours, the chief of cardiac surgery worked to repair an aortic dissection that threatened the life of his patient, a middle-aged teacher brought by helicopter to Upstate University Hospital.
Most people don’t survive a rupture of the main artery in their body. It poses one of the most challenging cases for even the most experienced surgeon. But this patient would survive.
The woman had a tear along the length of her aorta, from where the vessel exits the heart all the way to her pelvis, a much greater area in need of repair than for most aortic dissections. Her tissue was thin and uncooperative. Blood collected in her chest. A team lead by G. Randall Green, MD, surrounded her in the operating room, working diligently.
Finally, shortly before dawn, Green completed the repair.
That’s when the woman’s heart stopped. Using medications and chest compressions, Green and the team brought her back. Her heart stopped again. And again, they brought her back. Her blood was not clotting the way it should. She had lost a lot of blood. Her heart rhythm was abnormal. It did not seem like she would survive.
“There was nothing more that we could possibly do,” Green recalls of Kim Gutfleish Sklow.
Her family was in the waiting room, having hurriedly traveled hundreds of miles. Green spoke to them, explaining that he wanted them to be able to see her, but he wasn’t sure Sklow would survive from the operating room to the intensive care unit.
After the surgery, in which much of her aorta was replaced by synthetic fabric tubing, inflammation was so severe that Green could not fit her heart back into her chest. So her heart rested atop her chest. Staff from the operating room carefully covered Sklow with sterile sheets. They gave her more medications to help her blood clot. She remained unconscious and connected to multiple machines.
Green kept close watch of his patient and her vital signs, while loved ones said their goodbyes. Suddenly, he asked everyone to clear the room. Sklow’s blood pressure was improving. Maybe her blood was clotting now. He wanted one more chance to save her.
For eight more hours, Green ordered small adjustments to her medications. She received transfusions. She got more medications and more adjustments. Slowly, it started to seem like Sklow might survive.
That was in June 2019.
Now, Sklow has a renewed life, and she’s giving back. “I mean, they saved my life,” she says of Green and his colleagues at Upstate.
The family mantra while she healed had been to put one foot in front of the other. With that in mind, Sklow planned to walk a 5K on the June 26 anniversary of her near-death experience. But because she injured her ankle, family members instead pushed her in a wheelchair and collected about $12,000 to donate to the hospital. They also had a reunion on a Zoom call with the doctors, nurses and staff who cared for Sklow when she was hospitalized.
Sklow, 57, speaks with a raspy voice now, a consequence of being on a ventilator for so long. She is an eighth-grade teacher who lives in New Jersey, and she directs a summer sleepaway camp at Raquette Lake in the Adirondacks, about 45 minutes east of Old Forge. She considered herself in good health.
Arrival in the nick of time
In June 2019, she prepared for her 14th year at camp by posing with the entire staff for a photo the evening before campers would arrive. As the photos were snapped, Sklow felt a strange sensation. “I thought maybe this is what it feels like when you’re going to faint.”
Her right side became numb. She developed a severe backache. Sklow was in so much pain, she lay on her side in the back of an ambulance for the 1½-hour drive to a hospital in Utica.
Relatives got word to her children, 22-year-old twins.
They had both graduated from college, and her daughter, Charlotte Sklow was in Dallas, helping her son Kenan Sklow settle into an apartment. The pair raced to the airport.
They flew standby to New York City, borrowed a car and drove to Syracuse.
Sklow was flown by helicopter to Upstate after tests revealed the aortic dissection.
“She got here right in the nick of time,” Green says, noting that Upstate physicians care for 30 to 50 people with aortic dissections each year.
Robbie Birnbaum, Sklow’s significant other, rode in the helicopter with her to Upstate. He says it felt like an episode of the television show “ER.” He was escorted from the helipad. Then Green was explaining to Birnbaum how he would take care of Sklow, while the anesthesiologist was accompanying the patient to the operating room.
That anesthesiologist, Syed Ali, MD, would later tell Birnbaum that in his 25 years of service, he’s never seen a case like Sklow’s, where a patient with such a lengthy aortic dissection pulled through.
Of course, Sklow’s memories are fuzzy. In her postoperative fog, she imagined she was at the camp’s dining hall, and she called nurses by the names of camp staffers.
In reality, she was recovering in the intensive care unit, her heart atop her chest. As her body healed and the swelling reduced, Green took Sklow back to the operating room to sew her heart back into her chest.
“Dr. Green was beyond amazing,” she says. “The entire team, the nurses on the cardiac intensive care unit were not just wonderful to me, but they were especially wonderful and supportive to my family. None of us are from Syracuse, so some of them were there for a month, staying in a hotel.
“Everybody did everything they could to just make it as easy as they could for us.”
It was about three weeks later when Sklow was well enough to get out of bed. She made it to the door of her hospital room, turned around and returned to the bed, exhausted.
She was discharged to a rehabilitation center closer to her home in Englewood, New Jersey. She completed three months of cardiac rehabilitation. When she was well enough, she returned to teaching eighth grade at a private school in Manhattan. Then the pandemic hit, and, like her colleagues, Sklow began teaching from home. Her summer camp was cancelled for 2020.
Over the last year, she has had follow-up appointments with a variety of medical specialists. She’s told the story of what she went through to each of them. She says, “Every single doctor and nurse has had the same reaction: They say, ‘And you’re alive?’”