Christmas text led to life-saving gift
A year ago, a doctor called Marsha and Tommy Coulter into a hospital conference room and suggested that they might want to consider taking their 14-year-old daughter, Hannah, off a ventilator and letting her die.
It was Christmas Eve, and Hannah had been in a Dallas hospital for 20 days after struggling for years with her breathing. She met with five specialists before one determined surgery was the best way to relieve pressure on her trachea, which was constricted by an artery.
After Hannah’s surgery in early December, the Coulters were devastated because she would have to live on a ventilator for the rest of her life — especially since she has severe autism and would have to be restrained so she wouldn’t try to remove it.
Now, a doctor was urging them to say good-bye to their youngest daughter. Marsha Coulter sobbed through the night, and begged God to intervene.
On Christmas morning, a friend sent a text to Coulter that gave her chills: a link to a video about a procedure that had saved the life of a baby at C.S. Mott Children’s Hospital at the University of Michigan. It turned out to be a gift because the Coulters, who live in southeast Texas, began a journey to Michigan that aligned the stars for Hannah and saved her life.
“This year, Christmas is more meaningful than it ever has been because we have her with us,” said Marsha Coulter, 52. “Last year around this time, we didn’t know that if she was going to be with us or not, if she was going to be alive.”
Hannah survived because of a custom airway splint that was created with a 3-D printer. The technology, developed by a UM surgeon and engineer, has saved the lives of four infants. Hannah was the first teenager to get the device after Dr. Glenn Green got emergency clearance from the Food and Drug Administration to surgically implant a custom splint around her trachea, opening it so she could breathe.
Developed in 2005, then applied for the first splint in surgery seven years later, the 3-D printer that created Hannah’s airway splint borrows from technology already being used in the auto and aerospace industries. All of the Detroit automakers use the technology to rapidly manufacture car parts and make prototypes.
At UM, the 3-D printer is used for surgical models for a variety of devices for student and patient education, said Scott Hollister, a UM bioengineering professor. But the airway splint is among very few implantable devices.
It was developed after a UM colleague introduced Hollister to Green, an ear, nose and throat surgeon. Hollister’s lab was studying material that breaks down in the body and Green had been trying to find an intervention for infants with tracheobronchomalacia — a rare condition that weakens airways, leading them to narrow and collapse. Until the airway splint was developed, there wasn’t a cure for severe forms of the disease that claimed the lives of children.
“It was serendipitous that we came together, and were working at the same university,” said Hollister. “It worked beyond our wildest imagination that this device was created that can save kids’ lives. We had no idea it would be as successful as it has been thus far.”
After negotiating with the insurance company to cover Hannah’s flight from Texas to Ann Arbor, the Coulters arrived at Mott in early January. Hannah was still recuperating from her surgery and battling numerous infections.
She arrived just in time, Green said.
The opening of a human trachea is less than the size of a quarter, the surgeon said. Before the airway splint was implanted in Hannah, her trachea was less than 2 millimeters open — a straw couldn’t have fit into it. Green estimated that it would have been a matter of weeks, perhaps days, before Hannah’s trachea closed completely.
“She was at imminent risk for death,” Green said.
The surgery, on Jan. 23, took about eight hours. But afterward, the Coulters saw Hannah in a way they hadn’t seen her in more than a month.
“We felt confident that we were going to get our Hannah back,” Marsha Coulter said. “We had new hope, new strength.”
During the surgery, Green used the airway splint to separate Hannah’s windpipe from her artery. Then he took the compressed windpipe, put it into the correct position and opened it.
“When we had it in, I knew the windpipe was wide open,” Green said. “It saved her life. Her breathing was much better than it had been for years.”
UM signed an agreement this month to commercialize the technology, which will begin the process for a clinical trial for 30 patients with similar conditions. It’s likely the trial won’t be complete for five years, Green said, but if it gets FDA approval, it could have applications for patients with less serious conditions, such as those on home ventilators or those with less severe problems with their tracheas.
Meanwhile, Hannah has returned to her home in Portland, Texas, near Corpus Christi.
She made a stop at a children’s hospital in Houston for rehabilitation for a few days in early March. But after 101 days in a hospital, her parents decided to get rehabilitation services in their own home.
Hannah’s life is more challenging than ever, said her father, Tommy Coulter. Now 15, she no longer walks, and her parents help her eat by giving her small bites and her fluids through a syringe.
But this Christmas marks a time they didn’t expect to see.
So the Coulters will wake up in the morning with Hannah and their other daughter, 19-year-old Hayley, and visit two sets of families.
At some point, Tommy Coulter, 56, plans to look back on the messages he posted last Christmas Eve on his Facebook page and ponder the gift they’ve been given this year.
“I feel a lot of joy in my heart that God has still blessed us with her,” he said, “and not with just a memory.”