Electric Fishwrap

Virus saps woman’s strength, but not her will

Story By Kate Martin

Reporter-Herald Staff Writer

A laugh. A smile. Mumbled prayers in the dark.

Carol Koretko remembers little of her 46-day stay in McKee Medical Center’s intensive care unit.

Carol, 56, was hospitalized for 4 months at McKee Medical Center. Her life changed with the tiniest of bites: A mosquito infected her with West Nile virus in August 2003.

The virus caused a polio-type paralysis in her body. She is one of 22 people in Larimer, Weld and Boulder counties who contracted the paralyzing version of the disease. In Larimer County, she was one of 544 confirmed West Nile virus infections in 2003.

Carol drifted in a haze of dreams for much of her stay at the hospital. Loved ones and friends came and went, but Carol, sometimes responsive, couldn’t remember anything that happened.

Her first memory is of her neurologist, Dr. Eric Stevens, calling her name, hoping to revive her from her long slumber. Carol’s eyes fluttered open to see her husband, Paul, standing beside him.

The fog cleared, and Carol tried to talk.

There was no sound. Carol was breathing through a tube in her neck with the assistance of a respirator.

She tried to move. During her stay, she lost nearly 40 pounds from her 5-foot-5 frame.

She strained and tried.

Nothing happened. She was paralyzed.

Fear clutched her soul.

“I couldn’t talk,” Carol said, her voice cracking. “It’s such a scary thing, when they can’t read your lips, and you can’t tell them you’re hurting.”

She could move only the fingers of her left hand. One man in the same room, who also had contracted West Nile, could move only his eyes and his tongue. Another victim of the virus died shortly after he arrived at the hospital.

To this day, Carol cannot walk. She can move around only with an electric wheelchair and the assistance of another person. The simple act of donning a sweater can take 10 minutes.

Carol felt helpless and useless.

“I used to be such a positive person,” Carol said, sobbing into her withered hands. “For a long time, this even robbed me of that.”

Instead of Carol feeding and caring for the family’s alpacas, it is Paul or her son, Ben, 11. She cooks vicariously through her children.

“She’s the big cook in the house,” Michaela, 10, said of her mother. “She tells us what ingredients to put in and what to do.”

Carol couldn’t even feed herself at first. Someone else did that for her.

Her independence robbed from her, Carol’s thoughts grew dark.

“So many days I would cry in the afternoon,” she said. “I even doubted whether I should’ve even survived it.

“But now that I’ve seen improvement, maybe the good Lord has a reason.”

—

“I live on a mountaintop for a reason,” Paul said. “And it’s not because I like people.”

Paul, a native Coloradan, always has been an independent person. He has operated ham radios since he was 10 years old, and his homestead provides the perfect location.

His property above Masonville has a 360-degree view of the surrounding countryside.

“You can see Wyoming and New Mexico from here,” Paul said.

Paul used to fly single-engine planes. He and his late wife, Debbie Viens-Koretko, visited locations in Colorado and beyond. But a crash in Canada in 1996 left her dead and him injured. Paul hasn’t flown since.

Later that year, Paul started visiting Internet chat rooms. Online, he met Carol in the fall.

“We started writing back and forth,” Carol said. “I even got a private investigator to check him out before we met.”

Paul chuckled, “Everything we do in life is an adventure.”

They met on New Year’s Day in 1997 in her hometown of Knoxville, Tenn.

“When I saw him, it was like I’d known him all my life,” she said, her eyes fixed on a point in the past. “I never thought I would move away from my family; I just loved him so much.”

Carol has been active in clogging all her life, and she continued clogging after she left her home state. She had her knee joint repaired last summer before the bite.

She moved to Colorado and married Paul in April 1997. Even now, though her legs lie limp, she twitches her feet to the music of her home state.

“Sometimes when I hear ‘Rocky Top,’ I just want to dance,” Carol said. “That’s why I’ve got to get walking again. I still have the clogging shoes.”

Carol doesn’t remember when or where she was bitten by the mosquito that infected her. She thinks it happened last summer when she visited Loveland or Fort Collins to go shopping.

On Friday, Aug. 8, she started showing symptoms.

“She didn’t want to go to the doctor,” Paul said. “She just didn’t want to go.”

But Carol was dehydrated and spacey, he said. Her eyes rolled in their sockets, and she wavered from side to side as she walked.

On Tuesday, Aug. 12, Paul drove her to her physician. Carol protested the whole time.

“But I don’t remember that,” she said.

One look at Carol, and her doctor sent her straight to triage.

“The nurse took her blood pressure and took her to the emergency room,” Paul said. “They hooked her up to an IV and sent her right to the ICU.”

Doctors treated Carol for Rocky Mountain spotted fever, Lyme disease and many other bacterial infections with a wide spectrum of antibiotics.

“They were shotgunning it because they had no clue,” Paul said.

Tubes snaked everywhere. Several jutted from each arm, and one from her throat.

Paul and the Rev. Glen Schlecht of Immanuel Lutheran Church prayed at her bedside. Paul stood, stunned, unable to believe what it took to keep his wife alive.

Eighteen bags of fluid dripped liquid life into her body. Paul said seeing his wife, broken and helpless, was unlike anything he had ever seen.

Shortly after she was admitted to the ICU, Stevens was assigned as her neurologist. He saw Carol nearly every day and came to know her and her family.

“She came in very sick,” Stevens said. “It wasn’t clear what was going on.”

For much of her 46 days in the ICU, Carol was completely unaware of what had happened. Gradually, she slipped into a comatose state.

The rhythmic click of the respirator was the only sign of life in the sterile room. Stevens told Paul that she had less than a 50 percent chance of survival.

Three long weeks after her admission to the hospital, test results from the Mayo Clinic arrived: West Nile virus.

“She was touch-and-go for a long time, between life and death,” Schlecht said. “It seemed West Nile was a short track to dying.”

Carol’s recovery was a series of steppingstones, and each took her closer to her eventual goal: leaving the hospital.

With each passing day in the hospital, Carol grew stronger. First, it was breathing on her own, without a ventilator. Then, talking for extended periods of time. Sitting up in a chair by herself seemed a miracle. She moved out of the intensive care unit and into rehabilitation after 46 days.

“She made slow, gradual progress from the time she got off the ventilator,” Stevens said. “It was my job to give her pep talks.”

But sometimes, Carol dwelt on the past, comparing the body that refused to move with the body that used to clog all night long.

She found it a struggle to accept what had happened to her.

“(Having this disease) is almost like the grieving process you go through when you lose a mate,” Carol said, “because you lose a part of yourself.”

A physical therapist visited her hospital room almost daily to help Carol relearn how to move.

The treatments left her in tears, Carol said. Her arms had been immobile for so long that scar tissue had built up in her shoulders and restricted movement. That tissue had to be broken apart before she could move her shoulders again.

Carol was close to leaving the hospital, but she met the thought of using a wheelchair with tears.

Carol didn’t want to use a wheelchair. She wanted to walk. She wanted to clog.

It was like giving up, she said. Like relegating what remained of her life to a machine. Carol wept, despondent, and gave in to her fate. Forever frail.

But Paul offered her a candle in her darkest hour.

“I told her to use it as a tool, a steppingstone, until she could get to the next thing,” he said.

Carol arrived home Jan. 2. She saw her house for the first time since the summer. Draped in snow and ice, her home had one addition: a new wheelchair ramp, built by several people from Immanuel Lutheran Church on the Saturday before Christmas.

Since her return, physical and occupational therapists visit Carol and Paul three times a week in their mountain home. Carol is determined to walk by next year, and her therapists are helping her make that happen.

Thursday, Feb. 26, was a step in the right direction. Therapists Teresa Leonhardt and Johna Cabrera of Banner Health arrived at the door with smiles on their faces. They had brought Carol a present: a manual wheelchair.

It took several minutes to transfer Carol from the electric wheelchair to the manual one, but Cabrera and Leonhardt finally wheeled her onto the hardwood floor. Carol’s hands fluttered above the unfamiliar silver push rims.

“So, can you run that thing?” Paul asked. He leaned back in his chair and folded his arms. “Show me.”

Her arms were too weak to grip the push rims, so Carol walked her hand up the rear wheel with her fingers in slow but determined movements. The wheelchair moved forward an inch. And then another. Soon, Carol moved back and forth on the hardwood floor, her face focused in thought.

“That’ll tighten up some arms,” Paul quipped. “You should get some muscles that won’t quit.”

“It feels good,” Carol said. “I can tell my shoulders are going to ache.”

But to follow her dream of clogging again, Carol has to learn to stand. With the assistance of Cabrera, Leonhardt and family friend Josh Millholland, she did.

Very little was on her own power. Her legs, shaking like a newborn filly’s, were held silent with a steady hand. Her body lay limp as a rag doll across the front of a machine they modified to help her stand.

Her feet were lifted and placed beneath her. Hands held her hips still. Whispers of encouragement floated in the air.

But Carol was scared. She had no control over her body other than to tell someone else what to do with it. She tried to still the trembling in her legs, to no avail. Josh moved his hand to her knee and gave it a reassuring squeeze.

Paul reclined calmly in his chair, watching the process as a smile slowly grew across his face.

After Carol’s legs were in place, Leonhardt leaned forward and helped Carol stand erect. She placed a steady hand at the small of Carol’s back.

Carol stood tall, a grin of mixed terror and excitement on her face.

The weight through her legs, she said, was exhilarating.

“This is off-the-scale exciting,” Paul said. “I’ve been waiting for this since August.”

“I can paint the ceiling,” Carol said.

—

Carol zips down the sidewalk of Immanuel Lutheran Church in her electric wheelchair. She said she practices at home with the manual wheelchair, but for reliable transportation, this is the better way to go.

She explores the world outside her home slowly. Carol went to church in early March, her first outing since she had returned from McKee in January. She attended a West Nile virus support group meeting in late March. Eventually, she said, she wants to return to her home state of Tennessee, where much of her family lives.

Carol said she and Paul plan to sell their mountaintop home.

“June is going to be packing month,” Carol said. “I don’t have any idea how long it will take the house to sell. We’re thinking about selling the herd (of alpacas). We want to sell them as a herd.”

Paul didn’t bat an eyelash at the prospect of leaving his treasured mountaintop.

“It’s another adventure,” Paul said.

Stevens believes Carol is tough enough to survive what is ahead for her. Most people who have suffered the polio-type paralysis that Carol has have never recovered fully.

While Carol is optimistic, she also is realistic.

“You just gotta pick yourself up by the bootstraps and go on,” she said.

Stevens is very familiar with Carol’s determined spirit in the face of adversity.

“To persevere against a threat to your survival, you have to be pretty tough,” Stevens said. “Most things we confront, it’s over pretty quickly; the dread and anticipation.

“But for her, it dragged on, and on, and on, with no end in sight.”

To mentally combat the disease for that long, Stevens said, was an incredible feat.

“People usually get sick and die or get better and go home. They don’t slowly improve, where every day is a bit of a fight,” he said.

Her fight continues to this day. Carol said her muscle control in her torso is improving. She can now feed herself with both hands, brush her teeth and style her hair.

Just last week, she was able to dress her lower half for the first time.

But she still cannot transfer herself from the wheelchair to the bed. That will take time, she said.

One step at a time.

“I’d love to get back into clogging when I get back to Tennessee. I really enjoy it,” Carol said.

“Once I put those shoes on, I can’t stop dancing.”

Originally published June 13, 2004.