In March 2013, Bobbie Warner was scheduled for hiatal hernia repair surgery to address ongoing swallowing and digestive issues but a defect discovered in the 66-year-old's diaphragm caused her surgeon in Lufkin, Texas, to abort the procedure and seek additional intervention. In May, a local thoracic surgeon stepped in to perform a left thoracotomy to remove part of Bobbie's lung and repair her diaphragm plus a hole found in her esophagus.

After 177 days at Texas Health Dallas, Bobbie Warner was wheeled out of the hospital.

While recovering in the Intensive Care Unit (ICU), Bobbie experienced further issues including a large esophageal perforation, a leaking gastric tube and severe esophageal reflux. The insertion of a jejunostomy tube for feedings left Bobbie with an infection and prompted her primary care physician to refer her on to Texas Health Presbyterian Hospital Dallas - a decision that would take her nearly four hours away from her home for treatment, but would ultimately save her life.

Ready, Willing and Able

It was June 27, 2013. At Texas Health Dallas, Bobbie was met by an experienced medical team that included gastroenterologist Dr. Michael Nunez of Texas Digestive Disease Consultants, general surgeon Dr. James Sanders of Southwest General Surgical Associates and cardiothoracic surgeon Dr. David Fosdick, who serves as the hospital's chairman of the Department of Thoracic Surgery and practices privately with Cardiac, Vascular & Thoracic (CVT) Surgical Associates on the Texas Health Dallas campus. The team picked up where surgeons in the Lufkin area were hesitant to go: with a more than five-hour surgery to repair the hole in Bobbie's esophagus.

"Mrs. Warner's arrived with a difficult problem requiring complex surgical management," said Dr. Sanders. "Not every surgeon was prepared to take on this case, but Dr. Fosdick was very capable of intervening."

Although the procedure brought Bobbie some initial relief, she continued to be plagued by a gastric bronchial fistula, which caused recurrent inflammation of her esophagus, along with drainage that developed due to a mediastinal abscess. The abscess caused fluid to build up in both sides of Bobbie's chest, requiring the need for Dr. Fosdick to then perform a total lung decortication - a procedure to remove the membrane covering the lungs in an effort to alleviate the fluid build-up and subsequent infection.

Bobbie underwent additional surgeries, including an abdominal procedure that used part of her colon to build a new esophagus, but the outcome was always the same. She would experience nausea and her lungs would fill with fluid.

A Healing Force

"Everyone was getting tired, except Mr. Warner," according to Tamara Holt, a critical care nurse practitioner with CVT Surgical Associates and member of the extensive medical team that cared for Bobbie during her stay in the hospital's Hamon Tower. "He stayed and stayed by her side; always smiling and pleasant to the staff. Mrs. Warner was depressed and giving up. There were many days that I couldn't get her to want to walk in the halls. I could see that even the nurses were losing hope, but they would never show this with the family."

By now, it was late November and Bobbie continued to have drainage and another mediastinal abscess. But in the Hamon Tower at Texas Health Dallas, she was receiving support in a place devoted to providing intensive care to some of the region's most critically ill patients. Dr. Fosdick's sheer determination combined with the hospital's advanced diagnostic technologies and a specially designed ICU program guided by board-certified critical care physicians on the medical staff would prove to be a strong and healing force.

"It was back to the operating room to clean out abscesses and reinforce the gastric closure from prior surgery," said Dr. Fosdick. "Then, we began to see a change in Bobbie. She interacted more and was less nauseated. The chest tubes that she had had for weeks were one by one removed, and she was able to eat small amounts. The goal became to get her home by Christmas and, on Dec. 20, it happened."

Home Bound at Last

After 177 days at Texas Health Dallas and one birthday later, Bobbie Warner was wheeled out of the hospital amongst a sea of nurses and physicians who lined the hallways of the critical care unit with flowers and signs and raised their arms over the 67-year-old wife and mother.

"When I called the nurses station at the hospital to make sure they knew it was my mother's birthday (on Oct. 22), the nurse told me they had it covered," said Bobbie's daughter Marcia Warner Morgan. "They were passing a card around, balloons were waiting, a cake had been ordered and they were going to sing 'Happy Birthday' to her. It just made me cry. I will be forever grateful to the countless doctors and nurses at Texas Health Dallas who devoted their time to making my mama better. Each of you need to know that you make a difference in your patients' lives every day. You make a difference - period."

Bobbie is now home in Brookeland, Texas, and continues to progress. She still has a feeding tube to assist with food intake and remains under the care of Dr. Fosdick.

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