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Second chances: Gavin’s story

By The Health News Team | March 12, 2020
Second chances: Gavin’s story

It takes a village: Gavin (center in maroon shirt) is surrounded by his family and Sharp Grossmont Hospital care team.

It was 5:20 am on a winter morning when Amiee Kondyra found her 18-year-old son, Gavin, collapsed over the side of his bed.

“I got up to go to work. I noticed his door was shut, but he always leaves it open,” recalls Amiee. I opened it. And we found him.”

Amiee’s boyfriend, Allen, woke from her screams and began CPR.

“He had no pulse. No heartbeat,” says Amiee. “We called 911. We moved him from his bed to the floor. We started CPR until the medics came. The medics worked on him for 30 to 40 more minutes. Nothing.”

Paramedics took Gavin to Sharp Grossmont Hospital’s emergency department where clinicians continued CPR and got his heart beating again. Gavin had overdosed on fentanyl, a strong opioid. Despite reviving his heart, doctors were uncertain of Gavin’s fate.

On life support
Gavin had experienced cardiac arrest. Being deprived of oxygen for a long time sent his organs into shock, leading to multisystem organ failure. His blood had also thinned, causing bleeding throughout his body.

Gavin was transferred to the intensive care unit (ICU) where he was given life support treatment, ventilators and drips. But he was still deteriorating. As a last resort, his care team considered extracorporeal membrane oxygenation (ECMO).

“ECMO is treatment in the form of a machine that takes over the work of the heart and lungs to allow perfusion and oxygen delivery to the body,” says Dr. Alexandra Kharazi, a cardiovascular surgeon affiliated with Sharp Grossmont Hospital. “The machine allows the heart and lungs to rest and recover, while still supplying blood flow and oxygen to the other organs so that they could also recover and start working again.”

But the choice to put Gavin on mechanical support had its risks.

“We were very cautious in making this decision, because the machine would thin his blood further, putting him at an even higher risk for bleeding,” explains Dr. Kharazi.

Both the care team and Gavin’s family carefully weighed the risks and benefits.

“Although Gavin’s likelihood of survival was extremely low, his family wanted us to do everything we could for him, and that is what we did,” says Dr. Kharazi.

After several days on the heart-lung machine, Gavin’s organs showed signs of improvement, and he was weaned off ECMO.

However, he was still in a vegetative state — unresponsive and unaware of his surroundings.

“After a long ICU stay, Gavin had survived. But he remained dependent on the breathing machine, feeding tube, dialysis and other forms of life support, and he was not awake at all,” says Dr. Mouhib Naddour, a pulmonary and critical care medicine specialist affiliated with Sharp Grossmont.

Gavin’s family faced tough questions: Do they keep him on life support and put him through additional interventions if something were to happen and doctors needed to revive him? Or do they take him off?

“You go back and forth. We definitely weren’t ready to give up,” says Amiee. “We knew he was still there.”

Amiee and Allen never left Gavin’s bedside once he was admitted to the hospital. Each day they remained beside him, going home to shower and sleep in alternating shifts.

“When we were in the ICU, his eyes were always open,” says Allen. “We did not know if he was conscious or not. We always believed that he could hear us. No one could really tell us for sure. But there were moments when he would lock his eyes with mine, and he looked so deep into my eyes. It was something I never felt before. His eyes were talking to me. Like he was telling me something: ‘I am here, just don’t give up.’”

A turning point
For 33 days, Amiee’s only child lay in the ICU with a ventilator and other machines to keep him alive. Then late one night, she received a call from Gavin’s nurse. Gavin had woke up.

“It was 12:40 am and he was talking over his trach tube. He asked the nurse to ‘call my mom please.’ You could hear him so clearly,” recalls Amiee.

Amiee and Allen immediately rushed to the hospital to see Gavin.

“Some people never come out of a vegetative state, while others wake up five or 16 years later and speak only one word,” says Allen. “Here we were, having full conversations with Gavin the next day.”

“We were all pleasantly surprised,” adds Dr. Kharazi. “It is rare to encounter a patient who was so extremely sick, with multiple organ failure, little neurological activity and a very low chance of surviving to essentially recover the way he has. It was amazing.”

Adds Dr. Naddour, “When Gavin woke up and voiced words, it was a mix of happiness and joyous tears. I told every doctor and nurse that took care of Gavin that he was awake and talking, it was a day that I will never forget.”

Looking forward
Gavin is now working with therapists at Sharp Grossmont Hospital’s inpatient Rehabilitation Center.

“It is impressive to see how strong he is and how amazingly he is regaining strength, especially knowing what he had been through,” says Dr. Naddour. “The recovery phase will be long, but Gavin has showed us how determined he is and we are amazed by him and glad to see him progressing the way he is.”

“I want to be able to do stuff by myself and walk,” says Gavin. “So far the process is like as if you were a baby again. I am relearning everything.”

His family reflects on the care Gavin received over the last few months.

“We are so very thankful because he came in here dead,” says Amiee. “Everybody from the doctors, nurses, ICU, OR, transport, anesthesia, respiratory, rehab and cleaning staff are really good.”

Gavin’s second chance at life has motivated him to share his experience with other young people. He plans to join Jake’s Projects, a nonprofit organization created in memory of a family friend who died of fentanyl poisoning.

“I wish I never put myself in this situation and that this did not happen,” says Gavin. “It is really good to have my mom and Allen here. They are really supportive. I want to visit schools and communities and share what I went through and help other kids.”

Talk to your doctor if you are concerned about your or a loved one’s use of opioids or other substances. Sharp McDonald Center, Sharp Grossmont Hospital and Sharp Mesa Vista Hospital all provide substance abuse programs to help define a recovery path that works best for you.

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