Doctor uses simple elements to save man's life

HOUSTON

This is a story about ice, water and sand, and one of the three was slowly robbing Rafael Shabot of oxygen and his life.

"You start, like, fading, and it's difficult because your chest hurts and you cannot make any type of exercise," he said.

Shabot was diagnosed with a rare disease called pulmonary alveolar proteinosis. It produces a build-up of protein in the lungs and granules that coat the lining, like sand. In a few months, he went from a seemingly healthy 46-year-old husband, father and businessman to a man who could barely walk.

"I had to sleep with oxygen, work with oxygen and have portable oxygen to go all around," Shabot said.

Fluid was removed from his lungs last year but the condition returned worse than ever, so he called on a Houston specialist his wife knew, Dr. Joseph Varon with University General Hospital.

"He couldn't do any normal activity. Not in Mexico City, where he's from, not in Houston, when he came in with an oxygen tank. He couldn't move with oxygen levels very low," Dr. Varon said.

In March, Shabot was admitted to University General Hospital in the Medical Center. The treatment was to clean his lungs, essentially drowning him. It's called lavage, and during the procedure, a machine supplies oxygen to the blood, keeping the patient alive.

But it carries a big risk.

"Strokes, clots, he could lose his legs or he could bleed into his brain," Dr. Varon said. "It's not an easy therapy so we had to come up with an idea that would allow us to draw his oxygenation without having brain suffering."

And that takes us from sand and water to ice. Dr. Varon is a leading practitioner of hypothermia, chilling the body while the body heals from trauma. Usually it's done with full body cooling blankets. This time, he tried something different.

As Shabot was under anesthesia, his head rested on a lot of bags of ice, cooling only the brain so it would use less oxygen and lessen the chance of bleeding and blood clots. Then gallon after gallon of water was poured into one lung and then suctioned out; a vibrating vest helped dislodge the debris that had made breathing all but impossible. A few hours later, Shabot was awake, and the process repeated the next day on the other lung. One day later, he was allowed to leave the hospital and this time walking with his wife.

"The next day he was discharged to the Galleria," Dr. Varon said.

"To the Galleria?" we wondered.

"Yes, his instructions were to go contribute to the Houston economy," Dr. Varon responded.

The biggest contribution though to medical science was what Dr. Varon called selective brain hypothermia. It's what he considers to be the next stage of cooling therapy. Already, a collar has been created with a special cooling pack that can be used, for example, on stroke victims before they arrive at a hospital. This can potentially lessen brain damage.

"Using devices like the one we use is so simple. It's pretty much brainless," Dr. Varon said.

Water and ice and a doctor's skill has Shabot back to a full life, and he'll never take that for granted.

"He gave me my breath back and gave me my lungs back," Shabot said.