Carol Baker (seated) with some of the Top Doctors who were part of her treatment. From left: Dr. Sharee Wright, vascular and endovascular surgeon; Dr. Peter Condro, nephrologist; Dr. Leo Gazoni, cardiothoracic surgeon; Dr. Brian Peppiatt, nephrologist (Photo by Sarah Walor)
She watches the screen as she moves forward, pivots, stoops into the ball and swings, steps back, pivots left and lobs a backhand across the net. When it’s her turn to serve, she arches back, controller in her right hand, and powers the ball over the net.
She’s in constant motion, working the game for about 20 minutes. It’s good for her heart, but it’s the footwork and coordination that’s the key here. Baker has two prosthetic limbs, and she’s had to learn anew how to walk, and more importantly, how not to fall, or at least how to fall without getting hurt.
Baker has been in the prosthetics since October, when she took her first steps in the devices. She’s working the Wii as part of a therapy session with David Lawrence at the Lawrence Rehabilitation Center.
He’s her cajoler, teacher and trainer.
She’s his inspiration.
Baker wants to go beyond the Wii, back to the tennis court and onto the golf course, activities the former elementary schoolteacher had planned to enjoy in retirement. She is determined to get there.
Not bad, considering that Baker twice came close to death last summer, undergoing heart surgery and then surviving a rare complication that caused her circulatory system to go haywire and produce clots where they shouldn’t occur. The clots forced doctors to amputate her feet and her legs below the knees.
It took the work of a team of doctors, surgeons, therapists, nurses and other health professionals to get her through. Baker feels their efforts were enhanced through the support she’s received from family members, the prayers of loved ones and friends, and her own competitive drive and boundless faith, which have enabled her to survive and even thrive.
“I am truly a walking, talking miracle,” she says.
A Crisis Unfolds
Baker sees God’s hand behind the scenes, nudging her and her husband, Alan, to make the move to Richmond after 42 years in Oregon.
The idea for the move didn’t spring from a burning bush; it was given voice by her son-in-law, Bill, around Christmas 2016. He and his wife, their daughter Karen, were Richmond residents, and the move was touted as a way to be closer to the Bakers’ three grandchildren.
Carol and Alan that night did an online search of homes for sale in Richmond and found a one-floor ranch near Willow Oaks Country Club that they both fell in love with. The home had been on the market for a year.
“It was like it was waiting for us,” Carol says.
They put in an offer on the property in January, then they closed in early February 2017.
The circa-1959 house was a winner. There was plenty of room for the granddaughters, and it was close to the Willow Oaks Country Club golf course. The Bakers, avid golfers, were looking forward to many hours on the links.
The house was handicapped-accessible, but they were both healthy and active, and the couple didn’t anticipate any need for the accessibility features any time soon, so spring was spent remodeling the home, removing some of the adaptations in the master bath out of aesthetic concerns.
That July, they drove cross-country for the move. But eight days after their arrival in Richmond, Carol was kneeling while working in the kitchen when she experienced a strange sensation, something akin to a “major hiccup” up and down the chest. The “hiccups” continued, they were violent and they hurt; they were not at all normal; and they wouldn’t calm down.
A call was made to 911. She was checked out by paramedics and seemed fine. An EKG showed nothing unusual, and the consensus was that maybe she had become dehydrated because of her exertions on such a warm day.
“I felt she got struck by lightning twice” —Cardiac surgeon Leo Gazoni
But after they left, she had another frightening symptom: Her leg became numb and felt as if it was becoming paralyzed. It would have been better to call for an ambulance, but in the stress of the moment, the Bakers instead decided on another mode of transportation, and Alan drove her to Chippenham Hospital.
It was her heart, and Baker was placed in the cardiac intensive care unit at the Levinson Heart Institute at Chippenham. She needed treatment for an aortic aneurysm, a bulging that can cause extensive bleeding if it bursts. She also had a rare condition, an aortic dissection, or a tear in the inner lining of the aorta that was was causing blood to leak into the pericardium and compressing her heart. It was a complicated and life-threatening development.
“It took the family and her by surprise,” says cardiac and thoracic surgeon Leo Gazoni.
Surgery was set up for the following day.
Calls were made to family members by Alan. Their two other daughters live out West, and Karen was at a beach home in North Carolina. She got up early and returned to Richmond early Saturday. Alan also activated a shepherds group, a network of prayer, for his wife. “It was such a blessing to know,” Carol says.
Cardiologist Leo Gazoni chats with Carol Baker at the Levinson Heart Institute at Chippenham Hospital (Photo by Sarah Walor)
Surgery took six or seven hours.
It was touch and go. The family passed the hours in the waiting room. They knew the outcome was positive from the smile on Gazoni’s face as he approached.
“It was very sticky,” says daughter Karen.
For Carol Baker, recuperation was all a blur, a “multitude of doctors” with various specialties making regular visits. There were hematologists, nephrologists, cardiologists and thoracic experts. Baker jokes that she told people Gazoni was her family physician, since she had only been in Richmond a bit more than a week.
The first three days, she seemed to be recuperating, says her daughter. But by the fifth day, Baker was crashing.
“She just did not get well initially,” says Sharee Wright, a vascular and endovascular surgeon with Surgical Associates of Richmond.
Baker’s feet were purple. They were dying, and the problem was creeping up her legs. Doctors were puzzled and unsure what was causing this complication.
Working together, they determined that Baker was experiencing DIC, or disseminated intravascular coagulation. That means blood was clotting in spots where it shouldn’t occur, and the clots were starving the tissue in her feet and legs.
It’s a rare complication that may occur after a surgery, and it affects about 1 percent of hospital patients. It can be fatal 20 to 50 percent of the time.
“I felt she got struck by lightning twice,” Gazoni says.
It was likely Baker would die if the limbs weren’t removed, but there were no guarantees that the amputations would save her life, either. It was time for a talk.
Her team assured her, that yes, Baker could be functional and would not be left helpless. And then it was time for some closer members of the treatment team to play their part.
Alan and their daughters, Karen and her sisters Kristin and Katie, discussed the options, weighed benefits and drawbacks, and helped Carol to see the big picture, that there could be a life for her beyond her current state.
“It takes family to sit down and talk about it,” Wright says. “Because they accepted it so well, it helped transition her to make the decision.”
Wright performed the amputations. The first was on Aug. 9. The second followed a week later, to give Baker time to regain strength and recoup between the surgeries.
There was one other complication to deal with: Carol’s kidneys were also fouled up because of DIC.
“Kidneys are the innocent bystanders to DIC,” says nephrologist Brian Peppiatt of Richmond Nephrology Associates. Fortunately, solid organs such as kidneys are durable, Peppiatt says, and if they survive the initial acute kidney failure, the organs may well recuperate and regain function.
Baker was placed on dialysis, but she wasn’t responding initially. She was switched to a longer but gentler type of dialysis, and that worked, but there were questions regarding whether her kidneys would again function independently.
“No one expected my kidneys to come back,” Baker says.
She asked another of her nephrologists, Peter Condro, a partner of Peppiatt, how many people he had seen in a similar situation regain independent kidney function, and he told her it was only a few.
“I want to be one of them,” she told him.
Condro encouraged her to engage in a bit of positive thinking, hoping for the recovery. He joked that Baker needed to “have her kidneys talk with one another.” That inter-organ dialogue must have occurred, because the following night, her kidneys were working.
“Sometimes you have to wait it out,” Condro says. “She got a remarkable amount of kidney function back.”
Baker’s stay in the hospital extended to 42 days and ended in August.
Her husband, Alan, who worked for the Secret Service before retiring, became her “caregiver extraordinaire,” as Carol told friends and relatives in their Christmas newsletter for 2017.
Physical therapist David Lawrence has been working with Carol Baker on her balance and mobility as she adjusts to her prosthetics. (Photo by Jay Paul)
Back on Course
Having to learn how to walk again is daunting at any age, and it would seem a near impossibility to most 71-year-olds, but Baker doesn’t want to simply get around, she wants to get on the tennis court and out on the golf course, too.
That’s where David Lawrence joined Team Baker.
He’s the founder of the Gait Center and Lawrence Rehabilitation Specialists, and he was drafted for the team after Baker learned of his work through a family friend who had gone through a situation similar to hers, losing limbs from an illness and treatment complication.
Baker has worked with Lawrence since the fall. He notes that Baker is driven and pushes herself. In February, she was learning how to safely navigate going up and down stairs on her own, and she was working ladder drills, stepping in and out of box-like obstacles to improve her agility and mobility.
“Carol is awesome. She’s done great,” Lawrence says.
It’s all part of completing the building blocks to get her back on the tennis court and onto the golf course. For now, Baker plays tennis on a Wii.
She may soon be back to her golf game. Lawrence can help with her balance, but he’s no golfer, so he’s also getting her to work with a golf pro on keeping her balance. Lawrence says she may well begin hitting balls in April, hopefully moving on to actually playing in May.
“She’s a superstar,” Lawrence says.
Gazoni notes that most people in Baker’s situation would have been in total despair, but throughout it all, he and other members of Team Baker were amazed and inspired by her attitude.
Her positivity always shined through, Wright says.
Condro also was impressed with her upbeat outlook and smiles, even in the depths of her illness, which can be a great help in healing. “Attitude is everything,” he says. “We were very fortunate that she got better.”
Wright says the outcome would have been different without the team. Communication was the key, and the fluid collaboration of all the professionals involved helped Baker survive and thrive.
“It’s definitely a focused team effort, absolutely,” says Peppiatt.
As Wright told Baker, she wasn’t supposed to live, “but you did. We worked together as a team.”
“They all helped me get my life back,” Baker says. “I’m just a miracle baby.”
