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'Nancy's in trouble': Healthy Indiana woman woke up gasping; weeks later, she's an amputee

Indianapolis Star - 2/8/2021

INDIANAPOLIS — That Saturday in June was like so many before. It was hot at Nancy McKinney's modest Lawrence home, hitting 88 degrees that day. McKinney was fiddling in her garden, pulling weeds, picking green beans, planting flowers. She might have baked a pie that day, the one with the fancy crust designs her family loved so much. Or made beef and noodles, homemade pasta dough she sliced up herself.

She probably did some sewing, too. McKinney loved to sew.

She always welcomed those relaxing weekends, a break from her full-time job as executive assistant to the branch manager of a financial services company.

But that Saturday in June 2019 would be the last day McKinney would ever live like that.

Sunday morning, McKinney woke up gasping for air. She couldn't breathe. Not even a shallow breath. She could barely get the words out to her husband, Mark. Take me to the hospital now.

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Before they could made it out the door to his pickup, Mark had to call 911. He was scared.

When the ambulance arrived, the driver asked McKinney what hospital she wanted to go to. Community North was closest to McKinney's home, but she asked for St. Vincent because that's where her doctors were.

Moments later, in the back of the ambulance, she felt the vehicle slow down and make a U-turn. The EMT with her looked at McKinney.

We have to go back to Community...if we don't, you're going to die before we get there.

What was going on? She was a healthy, 65-year-old woman, a woman people never believed was in her mid-sixties. A woman with minor health issues, high cholesterol. Near death?

"You know, it's a change forever — one that you don't expect ever to happen," McKinney said inside her home last month. "But it did happen and there is nothing I can do to change it. It's a lesson for someone and I just don't know who. It might be for me. I might not know this side of heaven what it is. But somebody needs to hear it."

Somebody needs to hear the story of how McKinney went from a simple Saturday in June to a quadruple amputee. Both her lower legs gone, both her hands gone.

And doctors still don't know exactly how it all began.

Legionnaires' disease

It might have been from the water misting produce at the grocery store. Or from some air conditioning system. Doctors still don't know how McKinney contracted Legionnaries' disease. How she ended up with this severe form of pneumonia that so rapidly attacked her lungs and left her clinging to life.

Legionnaires' is a lung inflammation usually caused by infection. According to the Mayo Clinic, the bacterium Legionella pneumophila is responsible for most cases of the disease. Legionella bacteria can survive in soil and water outside, but typically don't cause infections, the clinic says. But Legionella bacteria can multiply in manmade water systems, such as air conditioners or those grocery sprayers.

And it can be deadly.

Legionella was first discovered in 1976, after an outbreak among 4,000 people who went to a three-day convention of the American Legion in Philadelphia. Three days after the convention was over, Ray Brennan, a 61-year-old bookkeeper for the American Legion , had died. Days later, 221 Legionnaires, as they were called, were sick and 34 were dead.

It was one of the worst U.S. medical tragedies of the 20th century.

For McKinney and her family, it looked as if tragedy loomed, too. The odds weren't in her favor. The disease was causing her to rapidly deteriorate, then she took a turn for the worse.

Doctors said she had, at most, a 10% chance of surviving.

'Nancy's in trouble'

Leah Fayette was getting ready for church that Sunday morning when she picked up her phone to see how much time she had before she needed to leave.

On the phone was a missed call and text from her aunt. That was odd; Judy Wethington never called on Sunday mornings.

"All I could understand from the message was, 'I need you to hurry up and get to Community North,'" said Fayette, McKinney's younger sister. "'Nancy's in trouble and Mark needs you to answer questions.'"

At the hospital, Fayette found a distraught Mark McKinney.

"I was scared to death," he said, "that I was going to lose her." He was angry that he couldn't get her to the hospital, that she had to go alone in an ambulance.

In the hospital, Mark McKinney filled Fayette in on what he knew, which wasn't much. When Fayette talked to the doctor, the prognosis was dire.

"Her doctor, he would keep telling me, 'When I tell you 50/50, it's a hard 50/50' and he just kept telling me that," Fayette said. "Then after she was kind of out of the woods, he put his arm around me and he said, 'You know, when I told you 50/50, I really meant 10/90. I really didn't expect her to make it through.'"

The doctor never imagined that two months after she came to the hospital McKinney would be alive. And that he would be telling her words no one ever wants to hear.

Nancy, we need to amputate all four limbs.

'I knew they were doing it'

Because McKinney's lungs had been so compromised, she was put on ECMO the first night she came to the hospital. ECMO stands for extracorporeal membrane oxygenation. It pumps and oxygenates blood outside the body, allowing the heart and lungs to rest.

In Nancy’s case, while the ECMO oxygenated her blood, it did so in her “core." Doctors, she said, told her there was poor blood flow to her limbs, a rare side effect of ECMO treatment.

The lack of blood flow to her limbs caused gangrene in her arms and legs, a type of tissue death.

McKinney doesn't remember anything her first two months in the hospital. But by August, she was waking up. When she did, she saw the skin falling off of her legs and her hands. Her hands and feet were black as coal. It looked as if she was a burn victim, she said.

The doctor came in and made marks on her legs. She agreed to the amputation. She agreed, but in reality, she had no other choice.

"They had to be taken off to keep me alive," she said. "So, I knew they were doing it. I knew that it was coming."

She didn't know then, she could not have known, how drastically it would change her life.

'Nothing I could do to change it'

The little things bring her more joy. The big things don't bother her as much.

"It's like a wakeup call. This really could have happened. I really could have died," McKinney said, nearly 15 months since she came home from the hospital in November 2019. "It's left me with a greater appreciation for small things."

Smelling the flowers outside, watching the hummingbirds at the bird feeder, seeing the squirrels in her backyard sitting on the mini wooden picnic table Mark McKinney built for them.

The amputation took both of McKinney's lower legs, below the knee, and parts of both of her hands. She misses being able to walk without a walker or cane. But she misses her fingers the most.

When she can't reach the top shelf in the kitchen cabinet and get the glass she wants. How she can't cook the way she used to or sew the way she used to.

She has prosthetic legs and feet, but those come with their own challenges. Walking on them can be painful, when her own legs rub the top of the prosthetic. Her hands are a work in progress. She has a myoelectric hand, which is battery powered, and fingers from Naked Prosthetics that work on a pulley system. Neither allows her to do things the way she used to.

Inside her home, much has changed. McKinney had to get a new stove, so the controls are on the front instead of the back. Her house was remodeled to enlarge the bathroom to make it handicap accessible. She got a blow dryer on a stand so she doesn't have to hold it. Mark McKinney built a closet big enough for McKinney to get into with her walker or wheelchair.

She can't cut her own meat. Her husband does that for her. She can't wash the dishes; that's her husband's job now.

But there are so many things she can do. McKinney can put on her own mascara and hold silverware to eat. She can use a pen to write.

Day by day, she gets a bit of her old life back. Her prosethic feet were made so she can wear high heels. Her toe nails can still be painted.

Quirky things have come with the amputation. Her feet, which are not there, still sometimes hurt. She has practiced driving and can feel the pressure when she puts her foot on the pedal.

People ask McKinney over and over whether her new life makes her sad or depressed.

"It happened," she said. "There is nothing I can do to change it and there's no reason to be sad or mad at anyone. Every day there is a new challenge, but somehow I figure out how to get over it."

And so she moves on to her next challenge: conquering walking on her own.

'She's resilient'

It's like being on stilts. That's how McKinney describes walking on her prosthetic legs.

But every Tuesday and Thursday at her therapy sessions at Community Health PT and Rehab Neuro Specialty Program, she makes great strides, said Curtis Wainman, her physical therapist.

"She's doing phenomenal," he said. "Nancy rarely ever says, 'I can't do something.'"

McKinney is fiercely independent and determined. That, coupled with her willingness to try anything, makes for a great prognosis, Wainman said.

On a Tuesday last month, McKinney practiced standing up from a bench without using her arms. She did step ups and downs on a block. She practiced walking with a cane, with Wainman's assistance, around the gym.

"If you walk like that, I'd throw that in the Dumpster," Wainman said, pointing to the walker.

At occupational therapy on this day, Kristin Lawton focused on making a splint McKinney could wear at night to try to help form her hand from cup-shaped to flat. They worked on putting on a grasping cuff that allows McKinney to hold the cane handle.

In past sessions, Lawton said, they have practiced cooking, spraying a cleaning bottle, opening and closing things, sewing on buttons, cracking an egg.

"We live in a two-handed world," said Lawton, an occupational therapist, "so it's not easy when you don't have that. But she is super adaptable."

And she's resilient.

"She has learned to do things I don't know either one of us thought she would be able to do," Lawton said. "But she learned how to do them."

McKinney smiles as Lawton talks. She smiles a lot. She has a twinkle in her eyes. It's amazing, really, to those on the outside the joy she has in life.

"It's because I have a God that's bigger than me and he keeps me strong," she said. "It's because of him that I'm here."

Follow IndyStar sports reporter Dana Benbow on Twitter: @DanaBenbow. Reach her via email: dbenbow@indystar.com.

This article originally appeared on Indianapolis Star: 'Nancy's in trouble': Healthy Indiana woman woke up gasping; weeks later, she's an amputee

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