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Woman's Unexpected Diagnosis Results in Specialized Surgery at Local Hospital

Dec 04, 2017

Tracee Bessinger thought it was a little strange when one day she ran out of breath walking from her bedroom to her bathroom. She figured maybe she was just out of shape, but the breathlessness continued with even less exertion and fewer steps. "Maybe I'm coming down with cold," she thought. Her doctor thought maybe she had asthma.

After several months on medication for asthma, nothing had improved. In fact, Tracee's condition continued to decline. A lung CT revealed pulmonary embolism (PE), a condition in which one or more arteries in the lungs become blocked by a blood clot.

Several additional medications were recommended, including blood thinners, but nothing helped. Every day Tracee's condition became worse, even to the point of coughing up blood. Despite her worsening condition, she continued to show up for her job at a manufacturing company in Northern Utah, because "that's what you do." Finally, her pulmonologist became convinced she was in congestive heart failure because of the severe water retention in her legs. He suggested she find a cardiologist immediately.

This proved a difficult task. After a four-month search, Tracee finally ended up at University of Utah Health's Cardiovascular Center and met with James Fang, MD, who recommended she be admitted to the hospital while they ran more tests. He was particularly suspicious after Tracee mentioned she'd had PE.

Tracee was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH), a relatively rare disease where pressure in arteries inside the lungs increases. Only 5,000 people in the United States are diagnosed each year. This condition is relatively rare—only 2 to 4 percent of people with PE ever actually develop CTEPH—making it extremely difficult to diagnose accurately.

CTEPH is a serious disease that becomes worse over time. If left untreated, it can cause fatigue, chest pain, and shortness of breath. In later stages, CTEPH can cause fainting and heart failure symptoms.

Fortunately, there is a 'fix' for CTEPH—an intricate surgery called pulmonary thromboendarterectomy (PTE)—that involves removing each of the clots in the lungs, as well as the thickened wall of the blood vessels. And, luckily for Tracee, she just happened to have found herself at the only cardiothoracic program in the region that is accredited by the Pulmonary Hypertension Association to perform this critical procedure.

Tracee was assigned to a team of specilists at U of U Health, including Craig Selzman, MD, and John Ryan, MD. She and her husband Michael learned that PTE is a serious surgery that requires the patient to be placed on a heart lung machine throughout the procedure while cooling the body to 20 degrees Celsius. It is complicated procedure that can last many hours and is performed only at specialized centers.

The PEA had to be performed sooner than later. That was good news and bad news, according to Tracee. The bad news was that she'd need to take time off work, and she hadn't really had time to prepare for the realities of what lay ahead. The good news was that she hadn't really had time to prepare for the realities of what lay ahead, so she did not face anxiety or second thoughts associated with a complicated surgical procedure.

Since there was no second option or alternative course of treatment, Tracee took a leap of faith. She was confident that Selzman was the right surgeon for the job. "I have never dealt with a better, kinder, friendlier group of people than my care team at University of Utah Health," she said. "When you're going through something so uncertain, that makes it a lot easier. It really makes a huge difference."

Michael was just relieved to have a diagnosis. He knew something was off; Tracee didn't seem like herself and couldn't do all the things she ordinarily did without a second thought.

From the beginning of Tracee's illness, Michael had to coax her to put herself first and figure out what was going on. "I had to force her to go to the doctor to even get looked at in the first place," he said. "I knew when she couldn't take two steps without gasping for breath that something wasn't right."

From Tracee's perspective, she just kept thinking that eventually she'd get better.

They finally got Tracee set up with a team of specialists who knew exactly what was needed to treat her rare condition.

For Michael, the waiting during the lengthy surgery was pretty unbearable. Then Selzman showed up with a grin on his face and shared a photo of the blood clots and debris that he'd just taken out of Tracee's lungs.

They were the size of his fist.

Within days after the surgery, Tracee started to feel better, and by the time she left the hospital she was circling the unit ¾ without running out of breath. Three months later, Tracee was back to her old self, back at work, and doing her usual routine.

Tracee is proud of what she's been through and says it's taught her an incredible lesson about what people are capable of surviving when faced with a serious challenge. She's also proud of the scar from her PEA surgery and views it as a symbol of her strength.

Post-recovery, she's found the strength to do something else as well: watch online videos of PEA surgeries to understand the procedure she endured. When she was first told about the surgery, Tracee says she didn't want to know any of the details, because the thought made her anxious and more than a little queasy. Today, she doesn't mind watching and learning more about it. And she's even more grateful and relieved knowing that this team of experts was in her backyard all along.