CentraState - Healthy Directions

B rianna Bove has been singing her whole life, but the 18-year-old can't remember a more meaningful performance than her rendition of the standard "Dream a Little Dream of Me" for a Valentine's Day event in February. Her family and many of her classmates from the Performing Arts Academy in Lakehurst were in the audience to support her. Like Brianna herself, they could hardly believe she was performing at all. The show was less than a month after Brianna had been released from CentraState Medical Center after suffering a dangerous lung condition that had left her unable to breathe on her own. For five difficult days, she was on a medical ventilator in the hospital's Critical Care Unit. "It was kind of an emotional performance, but I think it went really well," says Brianna, who is a vocal major at her high school. "It was really just wonderful to be back on stage and singing again." CARRIED INTO THE HOSPITAL Brianna first became sick in mid-December 2015 with fever, fatigue, and other flu-like symptoms. She was diagnosed with mononucleosis, a common infection that often requires weeks of recovery time. Her health improved around the holidays, but started to go downhill again at the beginning of 2016. "She got progressively worse at home," says her mother, Teri Bove. "We couldn't break her fever, she became very lethargic and eventually she could barely even get out of bed. We assumed she was still fighting mono." Unable to bring down her fever, her parents took her to the Emergency Department at CentraState on January 4. Brianna recalls her mom needing to almost carry her into the hospital, as she was having extreme difficulty breathing. "It felt like when you lose your breath from sprinting across a field, except I couldn't take in enough air to catch my breath," Brianna recalls. Doctors and nurses quickly administered oxygen treatments but decided that she needed to be intubated and placed on a ventilator. "It was just a very, very scary situation for us," Teri says. "Brianna had been healthy her whole life, and we had never experienced anything like this before." ADVANCED CARE IN THE CCU Brianna was diagnosed with a serious case of pneumonia that had developed into a condition known as Acute Respiratory Distress Syndrome, or ARDS, says Nirav N. Shah, DO, medical director of the Critical Care Unit (CCU) at CentraState. ARDS is a severe inflammatory response in the lungs that can occur in some patients who develop pneumonia. "It causes the lungs to become extraordinarily stiff and unable to take in enough oxygen to sustain the body," says Dr. Shah, who is board certified in internal medicine and pulmonary and critical care medicine and part of Monmouth Ocean Pulmonary Medicine. "It's very uncommon to see ARDS in a young, healthy adult like her." Brianna was admitted to CentraState's CCU, a 16-bed, state- of-the-art unit dedicated to treating the hospital's most seriously ill adult patients. The unit provides multidisciplinary care—a team including physician specialists, nurses, physical and respiratory therapists, nutritionists, and pharmacists rounds on each patient, each day, to develop the most effective care plan possible. "We are a community-based hospital, but we aim to provide a level of critical care that is comparable to the large, academic medical centers," Dr. Shah says. "I think local families appreciate having these services here because it allows them to stay closer to home for care." Because Brianna was a senior in high school, her family was offered the opportunity to transfer her to a children's hospital. They decided to remain at CentraState. "I knew that once I saw the doctors and nurses there, and how well they worked with Brianna, that this is where she needed to be," Teri says. "They were fabulous. Every nurse treated her like she was their daughter." A FAST RECOVERY Brianna's treatment in the CCU included antibiotics to treat her infection and a specialized ARDS protocol to protect and strengthen her lungs. "The treatment of ARDS requires a prompt diagnosis and specialized care, including a team approach involving specialized physicians, nursing care, respiratory therapists, and support staff," Dr. Shah says. "Our team was confident that with time and patience, Brianna would make a great recovery." Within five days, Brianna was taken off the ventilator and moved to a room on a hospital medical floor. In addition to the speed of her recovery, she most remembers the personal caring she received in the hospital—some of her CCU nurses even came down to visit her on the medical floor. "They treated me like they'd known me for years," Brianna says. "I wasn't just another patient. I definitely felt like they truly cared about me getting better." Brianna was discharged from the hospital on January 14, just 10 days after arriving at the Emergency Department. ARDS patients can return to normal activities, but generally there is a period of rehabilitation. Brianna says her recuperation was actually helped by her vocal training, which includes a lot of exercises to strengthen the lungs. She recalls climbing up and down the stairs of her Jackson Township home while trying to sing and hold a high note. In the early spring, Brianna was back to a full schedule of performances while waiting to make her decision on which college to attend. She hopes to study theater arts and eventually work in the theater as a performer, designer, or technician. "I've been so surprised and happy with how fast I have recovered," she says. "It was a scary experience, but everyone at the hospital was so helpful and reassuring that I felt comfortable and knew that I was going to be OK." For more information about CentraState's emergency services, visit www.centrastate.com/emergency-department. HD Nirav N. Shah, DO, board-certified pulmonologist www.centrastate.com Summer 2016 5

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