Ironman strength: Former basketball coach Starkey returns home after lengthy hospital stay
There’s plenty Dennis Starkey doesn’t remember over the past six weeks or so, but the memory he and his wife, Karen, will have from Thursday morning is one they’ll never forget.
The former longtime and Hall of Fame Petoskey High School boys’ basketball coach was greeted by nearly three dozen members of McLaren Northern Michigan’s intensive care unit team, critical-care nurses, doctors and other staff as he made his way down the hall from his acuter rehab unit room to the sound of Survivor’s “Eye of the Tiger,” then rang a bell which signifies the completion of one’s stay in acute rehab.
“It’s been six weeks since I’ve been in here,” Starkey said of his overall hospital stay, which included many days in the ICU. “Obviously this is the date I’ve been looking forward to for a long time and it feels really good to be going home.
“I’ve had outstanding care here,” Starkey said. “I appreciate everything the staff at all levels have done for me, but it’s time to move on.”
Following a 45-day stint in the hospital, Starkey on Thursday walked out the doors of McLaren Northern Michigan, where he put up a heroic fight reminiscent of many of the teams he’s coached for more than 30 years at Petoskey High School.
“Mr. Starkey is one of the biggest patients I’ve ever had to take care of and it’s amazing to see him go home,” said Dr. Ronald Kembro, a critical care surgeon at McLaren Northern Michigan. “It’s truly a miracle, for me being the director of the surgical team which took care of him, it’s definitely a big win.
“He was one of the sickest patients I’ve ever had to care for.”
Starkey, who last year retired from his position as the Petoskey High School boys’ basketball coach — a career which involved a 553-260 record over 32 years, and which brought him inductions into the Basketball Coaches Association of Michigan and Michigan High School Basketball Coaches Association halls of fame — woke up early in the morning on Tuesday, March 5, not feeling well.
Originally, he thought he had a case of the flu, but he mentioned to Karen that his right side was tender. She initially thought her husband might be suffering from appendicitis.
Around 3 p.m. that day, Dennis had a CAT scan and was told there was a mass in the secum, the connection area between the two intestines and where the appendix is located. A decision was made to go in laparoscopically. After cutting into the mass, doctors found no signs of dangers such as infection or cancer, and they were confident the procedure went well.
“The pathology was clear and he was in the hospital and we thought he was getting better, he was walking around and I stayed with him to watch the Michigan State versus Michigan game and was expecting to get him on Sunday,” Karen said. “But I got a call at 6 a.m. on Sunday and said they moved him to ICU.”
When Karen arrived to the ICU it was a flurry of activity, with surgeons, respiratory, ICU nurses and others prepping Dennis for surgery. He spoke to Karen of having a high fever, uncontrollable pain and other bad symptoms.
“I was hearing he (had) sepsis and he was critical,” Karen said. “Somebody asked what should we tell him and somebody told me he was on full life support, that’s when it really hit me. He’s not here if it’s not for all these machines.”
Based on what she learned from hospital staff, Karen said her husband’s sepsis set in after the laparoscopic surgery, with his secum area not healing as expected and intestinal leakage occurring.
Karen said both her sons, Cory and Kevin, arrived soon after hearing that Dennis was on life support. The following day, Monday, Karen learned from Dr. Kembro that it was “minute-to-minute” with her husband, and staff had one last blood pressure medicine they wanted to try.
“Dr. Kembro said if it didn’t work we don’t have any other ideas, so I basically sent out a text to as many people as I could remember and said pray for a miracle, it’s minute to minute.”
Shortly thereafter, Karen said doctors told her Dennis likely faced a marathon, and then it turned into an Ironman.
“Well, Dennis graduated from Mancelona where their mascot is an Ironman, so that was my sign that he was going to make it,” Karen wrote in on CaringBridge.org, a website which allows families of sick patients to share information and receive words of encouragement, prayers and healing.
The one last blood pressure medicine which was administered to Starkey — and which ultimately began to turn the corner for him — was Angiotensin II (Giapreza), a new blood pressure vasopressor for critically ill sepsis patients.
With the severe extent of Starkey’s illness, McLaren doctorate nurse practitioner Joshua Martin said doctors’ previous attempts to keep his blood pressure up had proven futile.
“Over the past year we’ve been looking at this new drug for sepsis and Dr. Kembro and I were just talking about this drug called Angiotensin II,” Martin said. “At first the pharmacy said they didn’t have it, but then our pharmacist checked again and it turns out we did have it but because it was so new, there weren’t guidelines on how to administer it.”
Martin, along with critical care pharmacist Dan Gerard and registered nurse Katy Sharp, came up with a game plan on how to introduce the medication for Starkey, and within minutes they witnessed dramatic results.
“We had to call one of the principal investigators of the drug on a conference call and they walked us through some steps,” Martin said. “There was a Athos-3 trial which specifically showed how to implement this drug.”
“If you could take out the benchmark indications of how and who to use this drug, Mr. Starkey met all of them,” Martin said. “It was the right team, the right patient, the right drug.”
Gerard said the fact Starkey walked out the hospital doors on Thursday is amazing considering how ill he was just weeks prior.
“This is the biggest thanks I could ever get,” Gerard said. “Seeing this man who has a wonderful family and who is so well-known — a Petoskey community supporter — walk out of this hospital intact was wonderful. We really had doubts if that would happen.
“You hear of these miracle stories and being a pharmacist, to provide that medication and to see an immediate result within minutes to see his blood pressure respond, that’s when we knew we had a fighting chance at that point.”
Gerard said he and Dr. Jeffrey Washington pushed hard to have Angiotensin II on the shelf at the pharmacy.
“As part of the McLaren system, we’re the only ones who pushed to get it, we had to fight to get it here,” Gerard said. “It was denied the first time through and it’s only available in about 300 hospitals across the country, but the crazy thing is we had it on the shelf but we didn’t have the infrastructure around it. These days a lot has to happen with computer files to be built and programs. We had a plan to do it, but when this happened to Dennis, all we had was the drug on the shelf and we made it work.
“Now, the full plan is built,” Gerard said. “I’m hoping this will increase awareness throughout the community and through McLaren that there is a role for this medication.”
Kembro noted once Starkey was administered Angiotensin II, the critical care team was able to take him off several other medications.
“That’s when things started to turn around,” Kembro said. “It worked wonderfully and being brand new, it’s still something working it’s way into people’s arsenal. I don’t know if a lot of pharmacists are carrying it.”
Karen Starkey said at one point there were so many machine and IVs hooked up to Dennis she could hardly be by his bedside.
“At one point there were between nine and 12 IVs, he was on the ventilator for 13 days,” Karen said. “Once he got off the ventilator he could swallow right away.”
Karen said she also appreciated the quality of care throughout her husband’s stay.
“They didn’t sugarcoat it,” Karen said. “When he was bad, they told me and even though I didn’t want to hear that, I needed to know. They were honest with me all along, they’d always answer my questions and it was truly amazing. They saved his life.”
The Starkeys also received an outpouring of support throughout the community and Karen documented Dennis’ progress daily on CaringBridge.org.
“We’ve always said we’ve been blessed to live here and the community support has always been super supportive of Dennis especially with him coaching,” Karen said. “Because of that he’s built so many relationships with so many kids, so many families and so many people at the high school. We’ve been really lucky.”
Martin said to have someone who’s a pillar in the community have such a wonderful outcome is something he’ll forever cherish.
“The continuum of care from him getting sick to overall well wasn’t just one medication, one trauma surgeon, one MD or whoever, it was all the way through rehab,” Martin said. “Knowing they’ve educated him and his family moving forward it really neat. I think we do an amazing job of education families moving forward.
“I could tell right away his family and the community around him support him,” Martin said. “We brought in pictures and tried to make his room feel more at home and more human like and I learned a lot about him and learned how important he is to so many people here.”
Several McLaren staff members referred to Dennis as “Miracle Man” before he was released from the ICU on Thursday, and Martin believes that term isn’t far-fetched.
“I think miracle is very accurate, and outlier, a chosen one,” Martin said. “Everything kind of fell in line for him and the stars literally aligned to care for this gentleman.”
Dennis said he has a lot more work to do, but he’s beyond happy to once again sleep in his own bed.
“It’s going to be a lot of work yet and time to get my strength and my endurance back, a combination of home therapy and outpatient therapy before I’m fully ready to go,” Dennis said. “I’m looking forward to having a different routine. This has been helpful, but I want to get up and do some stuff on my own that I can’t do here.”
Much like he’s stressed to his basketball teams and countless athletes over the years to build on progress and make goals for achievements, that was his own mantra over the past six weeks.
“My initial reaction was how’d this all happen and how do I get it back?” Dennis said. “By day-by-day you make a little progress and you have to look forward to small achievements. I have a long way to go, but I’ve seen the progress. Karen has kept me going.
“She’s been great.”