Doctors battle for teen's life following sixth open-heart surgery
July 2, 2013 at 2:02 a.m.
Trine Ramirez was overcome with emotion when she first laid eyes on her son after his 14-hour open heart surgery.
Typically stalwart in the face of his rare genetic disorder, she immediately understood they were about to fight battles they had never before fought.
Tito Myers survived five surgeries before his fifth birthday to increase blood flow from his heart to his lungs. The 17-year-old, who is heading into his senior year at Victoria East High School, was born with only a trace of a pulmonary artery.
Ramirez described her son as an old soul with a passion for 1980s attire, movies and music.
Tito's peers did not realize he was sick until they saw his heavily scarred chest and back. He was always upbeat and active and never let his disorder limit his life, his mother said.
However, Ramirez and her fiance, Mick Moore, noticed about a year ago that Tito was slowing down.
Frank Hanley, the thoracic and cardiac surgeon who performed Tito's prior surgeries, agreed to operate again. In 1997, Tito was among the first recipients of unifocalization surgery, which the California doctor pioneered. At that time, Houston hospitals had attempted the procedure without success.
On June 5, Hanley replaced the cadaver pulmonary artery that had served Tito for 12 years with a synthetic version.
"Surgery is not a big deal to Tito," Moore said. "He was looking forward to feeling better again."
The procedure was successful, but complications plagued Tito's body after the surgery. For 11 days, his chest lay open, covered with plastic while doctors tried to locate and stop internal bleeding.
"From the first night through the next 11 days - I had never heard, 'He's not going to make it,' so many times," his mother said.
Every day, the doctors washed Tito's lungs and removed blood clots by bronchoscopy. They put their heads together and tried gutsy remedies outside traditional medical practices to save Tito's life, Moore said. Ultimately, they removed his blood clots surgically after exploratory chest surgery and the removal of Tito's right lung.
He experienced a remarkable recovery in the first 24 hours after the removal.
Ramirez, who is hopeful and optimistic about her son's recovery, asked the doctors at Lucile Packard Children's Hospital in Palo Alto, Calif., not to give up on Tito.
"I don't see Tito leaving this way," she said. "I really feel too many good things have happened - he comes back every time."
Doctors and nurses volunteered to perform the last surgery to remove the blood clots. The anesthesiologist who met Tito before the surgery told the family they owed it to him.
Tito's sedation is lightened periodically, and he communicates by blinking his eyes and squeezing hands. Despite the network of wires connecting Tito's body to beeping and blinking machines and the critical procedures he has undergone, it was his open, crayon-yellow hands that plunged Ramirez into desperation. She left Tito's room and cried out in prayer that his liver enyzmes improve.
Another turning point, the first since the lung removal, came Thursday. Doctors saw a boost in his oxygen levels and liver enzymes.
Steadfast prayer has sustained Ramirez and her family for more than three weeks.
"I get down on my hands and knees to pray," she said. "I've always prayed but never the way I am now."
Ramirez is thankful every night that she does not receive a knock at her ICU sleeping room door.
Family, friends and strangers across the country and around the world are praying for Tito, Moore said. The family has received gifts and cards from people they do not know.
"I know my Tito has always been a miracle but now more than ever," Ramirez said.
Guilt about Tito's condition plagues his mother, even though doctors assured her that his heart would have failed without the surgery.
"Tito trusted me to make him better," she said. "He could be having the best summer with his friends before he graduates."
The next crucial step in Tito's recovery is removal from the life support machine that is working for his heart and lungs. His left lung, saturated and damaged by blood leaking from his right lung, must heal first.
"This is a critical juncture," Moore said. "The machine sustains life, but not organs, which begin to break down."
A nurse told Moore that the maximum length of time a baby is supported by the machine is typically one month, and only one week for adults.
Tito has been on the support system for more than three weeks.
As of Tuesday, he is still showing signs of improvement.
"We were able to see him open his eyes awhile," Ramirez said.
Ultimately, he must regain his strength to be eligible for a lung transplant.
Photos of Tito with his big smile fill his room in the intensive care unit. Ramirez wants the doctors and nurses to see whom they are helping to save.
"I'm thanking my Lord for even the small improvements," Ramirez said. "My heart is anxious only because I feel joy is just around the corner."