Father saved by donor-funded ECMO machine after lifelong battle with cystic fibrosis
Before Nick Kanaan was even born, tests from his mother’s amniotic fluid determined Nick suffered from cystic fibrosis (CF), an inherited disorder that would cause irreversible damage to his lungs and leave him on the brink of death in 2019.
His mother and father had already buried two of their children — young girls — from the same disease; sisters Nick would only ever learn of through stories.
This is why when Nick was three months old his parents decided to move to Canada. They wanted to give their son a fighting chance in a new country renowned for its health care. And for nearly 30 years Nick thrived.
But in October 2017, while on a work trip to Toronto, Nick started having difficulty breathing. He was getting ready to fly home to Vancouver, but he couldn’t even leave his hotel. Instead, his parents — who reside in Ontario — came and drove him to a nearby hospital.
“I entered through the emergency room and a nurse immediately hooked me up to oxygen and said, It’s good you did not get on that airplane,” says Nick. “I could barely breathe.”
Nick was hospitalized for two and a half months. His lungs were failing; the disease was winning.
While Nick eventually made it safely home to Vancouver and to his pregnant wife Lindsay, he had the sense this was just the beginning.
Gasping for air
Fast-forward. January 2019. Nick has been meeting regularly with doctors who have informed him a lung transplant may be necessary. Tests of his breathing strength and capacity show discouraging results. And as with CF, they said, it was only a matter of time before the disease won.
And then Nick caught an infection.
“This time I was like, You know what? Let’s just deal with it right away,” says Nick. “I got hooked up on home IV. And after a couple weeks I was starting to feel a little better.”
But his positive feelings wouldn’t last long, as during the midst of his treatment, Nick woke up one night and started coughing up blood.
Lindsay roused to the sounds of Nick coughing, choking and gasping for air. Nick felt like he was drowning.
“I’ll never forget that,” says Lindsay.
“I honestly thought I might die right then,” says Nick.
For a month after the incident Lindsay would shoot awake at the slightest noise Nick made. She even started dreaming about it.
This would be the first of three episodes of coughing up blood Nick would have to live through. The medications weren’t working as everyone had hoped.
He needed a lung transplant. And he needed one fast.
The brink of collapse
Fast-forward. March 2019. Nick is hospitalized again; his lungs are on the brink of collapse.
“I would be sitting in the hospital bed and just getting winded from nothing,” says Nick. “The most exercise I could do was walk to the washroom, and that simple act was beyond exhausting.”
Nick was using six to seven litres of oxygen per day and was still struggling to breathe. He had no appetite. Nick would try to force food into his body, but during this time he lost nearly 70 pounds.
“Then at the end of March my upper lobe on my left lung collapsed,” says Nick.
Nick was given a bronchial tube to help breathe. Meanwhile, doctors were actively seeking a suitable lung donor. They thought they had a pair for him at one point, but it turned out the lungs were infected with influenza and the risk was too great to proceed with a transplant.
They needed a suitable replacement as soon as possible. But while they waited, Nick’s health was rapidly declining. It was a race against time.
“I had another episode of hemoptysis — the worst I’ve ever had,” says Nick. “Close to two cups of blood came out of my lungs. At this point I was so unwell my family was afraid to leave me in the hospital alone, so there was constantly somebody sleeping in my room.”
Nick’s lungs were deteriorated and infected with multi-resistant pneumonias. The damage had started restricting his breathing to the point where he needed something more than oxygen. He needed a way to breathe without his lungs. He needed ECMO.
ECMO is a portable, donor-funded heart-lung machine that oxygenates the blood reinfuses it into the body, essentially taking over the role breathing and allowing the lungs to rest.
And there is only one hospital in BC capable of this procedure — VGH.
A life-saving bridge to surgery
“The function of Nick’s lungs was essentially destroyed,” says Dr. Hussein Kanji, Nick’s primary physician at VGH. “We knew there was no ability for the lungs to recover. So, we asked ourselves how do we get him to a point where we can keep him strong enough, provide the nutrition, and get him in the best basic physiologic state so that he can be a good transplant recipient. And the only way really to do that was to provide ECMO.”
The procedure was a success, and for the first time in Nick’s life, his lungs could rest.
Three and a half weeks later VGH received a lung donor. It was a match.
Breathing in new life
Dr. John Yee performed the double-lung transplant. The surgery was textbook.
“Dr. Yee, one of the most amazing people I have ever met at VGH, called me after the surgery,” says Lindsay. “He’s like, Hi, Lindsay. I just want to let you know the surgery’s done. It was flawless. It went so well. It’s going to take him some time to recover, but be patient, give him time. He will get through this.”
Two days later he was taken off ECMO. Nick was breathing on his own with a new set of lungs.
The past year was filled with ups and downs, but despite the incredible hardships Nick has endured he adamantly states he would do it all again.
“Absolutely,” says Nick. “To get to this point where I am now? To be healthy and able to think of a future where I don’t have to worry about the closest hospital, or where my medications are? I get to be a normal person because of the care I received.”
These days Nick is nearly back to a normal life. He still has to take it slow to encourage the proper healing, but the family is planning on taking a trip for their daughter’s birthday in March. A family first.
“For the first time in my life I laid on Nick’s chest and I listened to him take in these deep, wonderful breaths,” says Lindsay. “I can’t describe that feeling.”