Multiple BCH specialties work together during Lindsey Brown’s unique case
When he first met Dr. Austin Poole, it was difficult for Lindsey Brown
to walk. His legs had swelled due to massive blood clots. Worse yet, some
clots had broken free due to a hole in his heart, causing small strokes.
At the start of 2019, Brown had been healthy and active – skiing,
riding his bike and going to the gym three times a week. Brown then started
to have “annoying little discomforts in my chest” that turned
into chest pains that sometimes made it hard for him to breathe. On May
1, 2019, Brown had bypass surgery (not at BCH) after he learned all the
arteries going to his heart were blocked.
He was in and out of area hospitals for the next few months as his condition
deteriorated - strokes, bleeding ulcers, dehydration as well as the swelling
in his legs that made mobility difficult.
“I had a doctor at a different hospital ask me if I wanted to die
because of a stroke or because I bled to death,” said Brown, who
is a retired school bus driver and firefighter. “The doctors I had
consulted didn’t want to do anything because one way or another
it would have killed me.”
One physician assistant had a recommendation for who the 69-year-old Dacono
resident should turn to: oncologist and hematologist Dr. Austin Poole
with Rocky Mountain Cancer Centers.
“Dr. Poole looked at my legs and just shook his head,” Brown
recalled. “He went and got a wheelchair and wheeled me over to Foothills
Hospital and admitted me right on the spot.”
After Brown was admitted to Foothills Hospital, a team of BCH physicians
worked quickly to determine a plan of action to prevent his legs from
developing life-inhibiting post thrombotic syndrome, a condition that
can cause chronic pain, swelling and other symptoms as the result of deep
vein thrombosis. Complicating Brown’s case was the fact he couldn’t have the
standard treatment of blood thinners because of extensive bleeding in
Physicians from Cardiology, Interventional Radiology and Oncology/Hematology,
as well as many other BCH team members, collaborated for several hours
to meld their specialized techniques and technologies into a comprehensive
Cardiologist Dr. Srinivas Iyengar, Boulder Heart’s Structural Heart
Program Director, said specialists at other area hospitals would not treat
Brown because of the risks associated with performing the necessary, demanding
“We felt, given the collegial nature of BCH as well as our shared experience, that
we had to try and give (Lindsey) our best shot,” said Dr. Iyengar,
who recalls Brown’s case as one of the most challenging of his career.
Dr. Iyengar closed the hole in Brown’s heart to prevent additional
clots going to his brain and fixed Brown’s vein graft. Notably,
Dr. Iyengar also performed the advanced Patent Foramen Ovale (PFO) closure
through the neck, since Brown’s veins were blocked in his legs.
This technique is done in less than one percent of all PFO closure cases
worldwide. Dr. Poole then started Brown on a carefully managed treatment
of blood thinners. Only then could BCH interventional radiologist Dr.
Thomas Fahrbach perform a mechanical thrombectomy (one of the newest procedures
available at BCH) to remove the clots and reconstruct the veins in his
legs, pelvis and abdomen – relieving the massive swelling and setting
Brown on the road to recovery. Dr. Fahrbach also removed a filter that
another medical facility placed in Brown’s chest to eliminate the
possibility of blood clots getting to his brain.
“More than any other place I’ve worked, BCH has created an
environment that fosters collaboration between all specialties without
the silo mentality often found in medical facilities” Dr. Fahrbach
said. “When you have good people working together, it’s amazing
what can be accomplished.”
‘I’m Absolutely Thankful to BCH’
“I was just very thankful for BCH,” Brown recalled. “If
it hadn’t been for Dr. Poole, I might not be sitting here right
now. All the BCH doctors as a team played a valuable role in my recovery,
but Dr. Poole was instrumental in everything.”
From the team at BCH, Brown learned that he has a unique propensity to
develop ulcers and blood clots. Dr. Poole is still managing his blood
thinner treatments, but Brown doesn’t have any other medical procedures
in his future.
“This case taught me the value of interdisciplinary teamwork and
how it can directly lead to success with patient care. It’s so much
fun to work with other great physicians and members of the health care
team who do amazing things in their realm of medicine,” Dr. Fahrbach
said. “The day we stop learning from others in medicine is the day
we stop progressing.”