Thursday, January 29, 2004

UC transplant doc receives new liver


'You couldn't write this story ... nobody would believe it'

By Tim Bonfield
The Cincinnati Enquirer

[IMAGE] Dr. Steve Woodle (right), director of University of Cincinnati's transplant division, goes over rounds with Dr. Todd Merchen and others Wednesday.
(Meggan Booker photo)
Every day that Dr. Steve Woodle makes his rounds at University Hospital he passes a room on 6-Northwest, a wing where people recover from organ transplant surgery.

Woodle knows Room 6364 better than any other room in the hospital - it's where he almost died.

"When I go by, I just close my eyes and thank God I'm still here."

During his 16-year career as a transplant surgeon, Woodle has helped pull hundreds of patients from the brink of death. In October, Woodle became one of the few transplant surgeons to get an organ transplant.

Along the way, Woodle - the director of the University of Cincinnati's transplant division - faced dilemmas other patients never worry about.

He had to choose whether to be treated at his own program or go out-of-town for care. He worried about the pressure he was putting on employees and colleagues by placing his life in their hands. He worried about how he would assure a skeptical public that he wasn't using his position to jump to the head of the waiting list.

That wasn't the end of it.

The transplant was successful. But days later a blood clot formed in his lungs, leaving him gasping for air, calling for help on his cell phone, and issuing medical orders.

"You couldn't write this story as a novel, because nobody would believe it," says Dr. John Edwards, chief of vascular surgery at University Hospital - and one of the people Woodle credits with saving his life.

Now, Woodle a fast-talking, hard-charging, 50-year-old native of Texas, is back on the job and talking about his experience.

He is holding a press conference today to thank a family who donated the liver of a loved one - and all the people who were involved in his care.

And he wants to send the clear message that people can lead active lives after getting a transplant.

"I know what it is to be at the complete mercy of God and the people taking care of you," Woodle said. "But I also want people to know that, after a transplant, they can go back to the lives they had before."

Cancer found

Woodle's story began in 1999, a few months before he started work at the University of Cincinnati.

He was working for the University of Chicago, and he had been suffering discomfort from a hernia. He was putting off the operation to wait for a surgeon in Houston to build up experience with minimally invasive techniques.

With a new job about to start, Woodle decided it was time to get the problem fixed.

When his surgeon peered inside, he discovered two cancerous tumors on Woodle's liver.

"The first time you are told you have cancer, it slaps you right in the face that you're mortal," Woodle said.

Woodle had two-thirds of his liver removed, and he kept his illness as quiet as possible.

In Cincinnati, Woodle took on a busy schedule of treating patients, training and recruiting doctors, and managing the division. Twelve-hour days were routine.

But last spring, he started feeling unusual levels of fatigue.

The cancer was back. This time, he would need a transplant.

Everything 'by the book'

To buy more time, liver transplant surgeon Dr. Steve Rudich inserted a tiny device into the cancerous growth that emitted high-powered radio frequency waves. The heat kills nearby cancer cells without destroying the surrounding organ.

It was a treatment, not a cure.

Woodle's cancer qualified him as a potential transplant patient. Just to be sure, Rudich had Woodle's charts reviewed by the chairman of the United Network of Organ Sharing liver committee in Boston.

"There has been a lot of talk about celebrities getting organs. We definitely discussed that," Woodle said. "Everything had to be by the book."

But where?

Officials at the UC Medical Center told Woodle that the last thing he should worry about was making the program look bad if he chose to be treated somewhere else.

"I was worried that the emotional factor would be a burden. If I had heard the slightest hesitation from people, I wouldn't have done it," Woodle said.

He opted to have the transplant at his own program.

Woodle spent nearly 60 days on the waiting list - about twice as long as the Cincinnati average of 28 days.

Near-death experience

Woodle got "the call" on a Saturday afternoon at his home in Symmes Township.

"I remember I was watching Texas getting beat by Oklahoma. I was just about to turn off the TV when the phone rang, and they said an organ had become available," Woodle said.

The operation went well. The liver was functioning perfectly.

But six days into recovery, in Room 6364, disaster struck.

"I knew almost the second it hit me what had happened. Immediately I felt incredibly short of breath. I was breathing very fast, almost uncontrollably," Woodle said. "Right away, I started making cell phone calls."

One of those gasping calls went to Rudich, who recalls hearing Woodle utter, "Steve, I'm having a P.E."

Pulmonary embolism is the medical term for a blood clot in the lung - the No. 1 cause of sudden death after surgery. This problem kills 50,000 to 75,000 people a year nationwide, Edwards said.

"If the embolism is massive enough, it can kill you almost instantly," Edwards said. "(Woodle's) was not quite that bad. But it was close."

If Woodle was not a doctor, he easily could have died.

"What's incredible about this is that Dr. Woodle diagnosed himself and directed the initiation of his own 'code,' " Edwards said.

Fighting to stay conscious as oxygen levels in his blood plummeted, Woodle instructed staff to start an EKG, order a chest X-ray and a blood gas test.

"I knew I was in pretty big trouble. Dying crossed my mind a couple of times," Woodle said. "I just tried to stay focused on what we needed to do."

Things got worse.

During treatment, Woodle's heart reacted badly to a catheter that Edwards had snaked into the lung to emit a dose of clot-busting medication.

Doctors had to shock Woodle's heart - twice - to make it beat normally again.

Last month, Woodle started working part time. He says he's "about 95 percent" recovered.

For the rest of his life, he will take antirejection drugs to protect his donated liver. For the next few years, he also will get regular tests to see if his cancer returns.

Now, Woodle speaks with profound experience to other patients with liver cancer who await their own transplants.

"In some cases, I've gone back to a patient's room to say, 'I've had cancer too.' I try to convince people to control the worrying.

"Every minute you spend worrying about cancer and worrying about dying is a minute you could have spent living life," Woodle said.

About two weeks ago, Woodle sent a letter via the LifeCenter Organ Donor Network to the family who donated the liver he received.

"I wanted to say how much of a difference it made in my life and in my family's life."

E-mail tbonfield@enquirer.com




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