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Article published January 06, 2006
Mine survivor shows improvement in blood tests, heart

A doctor this afternoon reported "considerable improvement" in blood tests and heart function for the lone survivor of the Sago mine disaster, although concern remains about the miner's lungs.

Dr. Richard Shannon of Allegheny General Hospital said blood tests show that proteins that had been damaging Randal McCloy's muscles are rapidly leaving his system. In addition, Mr. McCloy's heart has showed continued improvement today to the point that he now has "very normal cardiac function."

Mr. McCloy was taken to AGH Thursday from Ruby Memorial Hospital in Morgantown, W.Va., in critical condition with multiple organ failure. Although the transfer was done because AGH has a hyperbaric chamber capable of handling a patient on a respirator, that intensive oxygen treatment is considered secondary to addressing Mr. McCloy's more pressing problems.

One of the biggest is the function of his lungs, one of which collapsed during his 40 hours in the West Virginia mine following an explosion Monday morning.

Dr. Shannon said Mr. McCloy was given a dialysis treatment today to remove excess fluid in his lungs. The buildup was likely caused by the intravenous fluids Mr. McCloy has been receiving to flush impurities from his system. He also received a dialysis treatment in West Virginia to get rid of high potassium.

Dr. Shannon said doctors remain concerned about inflammation in the lungs and airways, likely caused by inhaling gases and dust in his last hour in the mine, when he wasn't conscious enough to protect himself.

He said it remains a "serious issue" as doctors work to try to wean him from a respirator.

Dr. Shannon said Mr. McCloy's wife, Anna, today was buying a Hank Williams country music disk, her husband's favorite.

He said Mr. McCloy was not given another session in the hyperbaric chamber, and the next one would not come before this evening.

At a press briefing this morning, doctors said they have twice given Mr. McCloy treatments in the chamber, which provides pure oxygen within a pressurized chamber, since his arrival yesterday. They said he tolerated the treatments well and they intend to give him several more.

But they cautioned that the benefits of the treatment will probably be long-term, rather than immediate. His carbon monoxide levels were already reduced at West Virginia hospitals.

Doctors said the chamber is an adjunct to the main treatment, which is keeping his physical condition stable so his organs and brain can recover.

AGH doctors said it may be weeks before the extent of Mr. McCloy's neurological problems are known.

Brain scans found swelling in the back of the brain in regions that control sensation and possibly vision. But until a series of scans can be taken and compared, doctors won't know if the swelling is increasing, decreasing or staying the same, said Dr. James Valeriano.

Dr. Shannon said tests this afternoon showed no change in his brain. Until doctors can talk to or at least observe Mr. McCloy out of a coma they won't know how much damage there is. Mr. McCloy is being kept in a medically induced coma to help rest his brain and keep him from removing a breathing tube.

When drug levels fall, Mr. McCloy bites down on the tube and his eyelids flicker, but doctors said that appears to be reflexive and they can't read too much into that. They won't know until the drugs are withdrawn whether he will remain in a physical coma.

The first lady of West Virginia, Gayle Manchin, said this morning that six or eight of Mr. McCloy's relatives are with his wife in Pittsburgh during the treatment. She said Anna McCloy is realistic but optimistic.

AGH doctors said they would consult with doctors from Ruby Memorial.

Mr. McCloy could return there over the weekend following several more hyperbaric treatments. Dr. Antonios Zikos said those treatments are designed to prevent long-term neuropsychiatric problems that sometimes have been shown to arise months after a brain injury.

Doctors today repeatedly said that Mr. McCloy's youth and good health likely contributed significantly to his survival.

After Mr. McCloy was transferred to Pittsburgh Thursday, Dr. Shannon said, "I am not expecting Mr. McCloy to jump up at the end of this treatment. Complete recovery will take a long time and we plan to keep him here until we have exhausted the benefits [of the treatment]."

Hyperbaric chambers surround patients with pressurized oxygen. They have been in use for decades, generally for treating people with acute carbon monoxide poisoning or for treating deep sea divers suffering from decompression sickness, known as "the bends."

Other uses have been proposed for hyperbaric therapy, such as speeding healing and helping the body fight infections.

Allegheny General's hyperbaric chamber is a clear plastic cylinder about 3 feet in diameter and long enough to accommodate an adult. Patients are slid into place through a hatch at one end of the cylinder.

Mr. McCloy spent more than 40 hours 260 feet underground, and was likely deprived of oxygen for a period of time no one has yet determined. A series of tests in Morgantown indicated "mild ischemia," meaning inadequate oxygen.

It's not clear whether hyperbaric treatment is of help when the brain has been deprived of oxygen.

"There are no big studies looking at that," said Dr. Kevin O'Toole, director of hyperbaric medicine at the University of Pittsburgh Medical Center. "It would be my guess that they're doing it to pull out all the stops."

Dr. O'Toole added, "There's probably little downside to trying it. If it helps, that's great."

When taken to WVU, Mr. McCloy had a collapsed lung that doctors first assumed was a result of the blast inside the mine. But Dr. Lawrence Roberts said they found no other injuries suggesting Mr. McCloy received the force of the blast.

He speculated that Mr. McCloy's collapsed lung could have been the result of lying on his left side for the extended period of time he was unconscious inside the mine. His lung had reinflated and was functioning properly yesterday, the doctors said.

Lying in the same position for a long time also led to muscle breakdown and the release of proteins that injured Mr. McCloy's kidneys. Dehydration may have contributed to the problems.

Dr. Roberts noted that Mr. McCloy was not medically stable enough to consider transporting him to Pittsburgh any sooner.

Read more in later editions of The Blade and toledoblade.com.


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