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Cactus prick to coma _ ex-Penguin’s strange medical journey

February 9, 2019

PITTSBURGH (AP) — Broken jaw. Busted knee. Broken nose. Through his 19-year career in the NHL, former Penguin Lyle Odelein was well-acquainted with pain. But none of it compared to what he went through last spring at Allegheny General Hospital, simply trying to stand up and take a step. “Nothing was like being as sick as I was,” he said. “Everything was just so hard and frustrating.”

Odelein, who lives in Fox Chapel and is retired from the NHL, had been living the good life well: a steady diet of golf, travel and socializing. But while playing golf in Arizona in March, an encounter with the porcupine-like spike of a cactus set off a chain of events that would land him — like Sleeping Beauty pricked by a spindle — in a month-long coma, a rare and risky transplant procedure his only chance at survival.

Odelein, 50, built a career in the NHL as a hard-hitting defenseman. Beloved in Montreal, where he won a Stanley Cup with the Canadiens in 1993, Odelein was known as much for his smile as for his fists, which were used so much on the ice that the arena came up with a personalized fight song for him. After leaving Montreal in 1996, he played for seven different teams, including Pittsburgh for his final season in 2005 to 2006.

Although he grew up on a farm in Saskatchewan, he stayed in Pittsburgh after retirement. “I played in a lot of cities — it’s something about the people in Pittsburgh,” he said. “It’s been great.” One of those Pittsburgh people became his second wife, Laurel Odelein. The two own 54 SuperCuts hair salon franchises in Pittsburgh and beyond.

In March of last year, Mr. Odelein was golfing with friends in Arizona when he ventured into the rough to retrieve a ball (“wasn’t mine by the way,” he laughed). He was, as he puts it, “attacked” by a jumping cactus — a spiky ball that detaches from its stalk at only the slightest touch. The cactus embedded itself into Mr. Odelein’s leg, through his pants. Impossible to pull out by hand because the spines are so sharp, Mr. Odelein and his friends used his golf club to pry it off of his leg.

About a week later, Mr. Odelein was back home in Fox Chapel complaining of leg pain and flu-like symptoms. When he decided to stay home rather than fly to Pebble Beach in California for a golf trip, Ms. Odelein knew it was serious. In California for a business trip of her own, she asked a friend to check on him. Shocked by his condition, the friend took him to the hospital, calling their mutual friend, Allegheny General Hospital transplant surgeon Ngoc Thai, on the way to let them know they were coming.

‘Sheer hell’

“His threshold for pain after his career was a blessing and a curse,” said Ms. Odelein. “I don’t think anyone else would have sat in bed as long as he did.”

Dr. Thai met them at the hospital, where it became clear that Mr. Odelein was seriously ill from a blood infection, likely originating from the cactus stick in his leg. He was taken to the surgical intensive care unit and given antibiotics, and it was assumed that he’d be going home in a few days. Briefly, he improved. And then, according to Dr. Thai, was “what we would call a crash.” For Ms. Odelein, it was what she would call “sheer hell.”

Mr. Odelein was intubated and placed in a medically induced coma. Doctors determined that the infection had attacked his aortic valve, which controls the blood pumped from the heart to the rest of the body.

“Basically it’s like a one-way check valve,” said Stephen Bailey, director of cardiac surgery at Allegheny General, who later operated on Mr. Odelein. “It allows blood to go in one direction. The heart beats, the valve opens. The heart relaxes, the valve closes.”

The infection damaged Mr. Odelein’s aortic valve so badly that half of the blood pumped out was coming back into the heart, rather than into his body. Mr. Odelein already had a mild underlying liver and kidney condition and the decreased blood flow stressed both organs, causing them to fail entirely.

Without a working liver and kidneys, said Dr. Thai, the relatively straightforward problem of a repairing a damaged aortic valve became a very complicated one — “He was very very very sick,” said Dr. Thai, sitting in his office at AGH last month. “There were only two options. Either we intervened and he got better or Lyle was going to die.”

The only option for intervention was a simultaneous triple transplant of the aortic valve, heart and kidney, an extremely rare transplant that has been performed only a handful of times and never in Western Pennsylvania.

“In the Tour de France, they have different levels of climbs, with the ‘beyond’ category for climbs that are straight up a mountain,” said Dr. Bailey. “Any kind of a risk calculator that you put on his situation — this was a ‘beyond’ category risk.”

A rare hat trick

It was risky enough for doctors to deliberate whether it was worth attempting at all — would those organs be better served going to a patient with a better chance of survival? While Mr. Odelein’s new aortic valve would come from a cow, he would need a liver and kidney from a person.

“The last thing we want to do is take on somebody who is so high risk that they won’t benefit,” said Dr. Bailey. “We had the knowledge that he’s a big strong guy who could take a hit. At the end of the day, our assessment was that he had a good enough chance to survive and thrive.”

From Dr. Thai’s perspective, the odds of success weren’t great, but the alternative was worse. “It was 100 percent death or, I don’t know, 90-whatever-it-is percent death,” he said. “Whatever chance he had, the only chance he had was that we would do all of this. After the case, some people approached me and said, ‘I can’t believe you did it. I can’t believe you guys did this.’ ”

The surgery was so unusual that a case study will be published in an upcoming issue of the Journal of Cardiothoracic and Vascular Anesthesia.

Mr. Odelein was so sick that he was placed at the top of the transplant waiting list for the region. AGH said that neither his friendship with Dr. Thai nor his status as a former professional athlete affected that placement, adding that it was based on his MELD score (model for end-stage liver disease). For a week, while Mr. Odelein continued to deteriorate, they waited. “He probably had another 24-48 hours,” said Dr. Thai. “We were nervous.”

Finally, they received news that a 49-year-old organ donor had died with a healthy kidney and liver. Mr. Odelein, who by this point had spent nearly a month in a coma, was taken into surgery. The plan was for Dr. Bailey and his team to first replace the aortic valve, and then for Dr. Thai’s team to step in for the liver transplant. With his chest left open, Mr. Odelein would then rest overnight, to allow the liver to resuscitate. The next morning, Dr. Thai would transplant the kidney.

For hours, Ms. Odelein and many family members sat in the waiting room. She sat near a mirror that reflected a hallway, where she could see Dr. Thai walking even before he entered the room. Each time he came by — after the aortic valve transplant that took about five hours, after the liver transplant that took six hours, the next day after the kidney transplant that took eight more hours, it was to tell her that things had gone smoothly.

A couple weeks after the operation, Mr. Odelein came out of his coma and while he couldn’t talk yet, he was winking at the nurses and showing signs of awareness.

“About two weeks after I came in, I looked at him, I said you know, ‘I haven’t seen him move around,’ ” said Dr. Thai. “I said, ‘Lyle, can you move something?’ And he couldn’t move. He really couldn’t move. He could shrug his shoulders. From here up was OK but everything down, he had lost. He was paralyzed.”

Mr. Odelein was suffering from a post-surgical complication called critical illness polyneuropathy, in which the body becomes paralyzed following trauma or infection. “The sad thing was, as he was coming out of that delirium, and being more conscious, he was conscious of the fact that he was paralyzed,” said Dr. Thai. “That was hard. I could tell that was hard. That was hard for us.”

And then, one day in May, Mr. Odelein felt a tingle in his finger. And then the true work began. He threw himself into a rehab regimen that he said was more painful and rigorous than all the hits he’d taken in the NHL. “Every day got a little bit better,” he said. “The hardest thing was probably trying to stand up to take that first step.”

Gradual recovery

Through the ordeal, he had plenty of support from friends in the hockey world. At one point early on, former Penguins general manager Craig Patrick showed up to see Mr. Odelein in the ICU, even though Ms. Odelein hadn’t told anyone where he was because he wasn’t supposed to have visitors. Dr. Thai remembers her asking him at one point, “What do I say? The entire NHL is texting me.”

In early June, he was discharged from AGH into a rehab unit at West Penn Hospital. He began to build strength, slowly gaining back some of the 70 pounds he had lost during the ordeal. And in July, he got to go home, still unable to walk by himself. At their house, Ms. Odelein pointed to the office, which not long ago had a full hospital bed in it. Sitting on a couch in their living room, he and his wife recalled the nights when he would sit on that same couch and be unable to stand back up — on a couple of occasions, friends had to be called over to move him.

In October, Mr. Odelein flew to Montreal to attend a 25th anniversary celebration for the 1993 Stanley Cup team before the Canadiens home opener. Though he was still using a cane at home, he decided — much to Ms. Odelein’s surprise —that he wouldn’t be using it on the trip. “I’m not using a cane to walk in front of 20,000 people,” he said. “When you have to do something, your brain will overcome.”

And with Jefferson Starship’s “Nothing’s Gonna Stop Us Now” blaring over the Bell Centre arena’s loudspeaker, he did indeed stand and wave unassisted, to a huge ovation from fans.

Now able to walk with ease, Mr. Odelein is still working on his balance and hopes to soon return to the golf course. He is also in the process of exchanging letters with the family of the organ donor, and plans to arrange a meeting. And he is extremely grateful — both to the donor and to the doctors who saved his life.

“I wouldn’t be here if it wasn’t for them,” he said. “I’m very lucky.”

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Online:

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Information from: Pittsburgh Post-Gazette, http://www.post-gazette.com