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Muskogee man praises doctors following battle with COVID-19, double lung transplant

For Skylar Green, 36, a patrol lieutenant for the Muskogee County Sheriff’s Office, the first few days of being ill with COVID-19 felt like the flu. He had body aches and a fever. But by days five and six, congestion had settled in his lungs and he was having difficulty breathing.

That’s when his wife, Aariel Green, took him to the emergency room at a nearby hospital, where a COVID test confirmed that he was positive for the coronavirus. Skylar Green was diagnosed with COVID pneumonia.

The couple was sent home with a pulse oximeter, a device that uses light beams to estimate the oxygen saturation of the patient’s blood. The higher the number, the better, especially when around the normal level of 95%.

The next day, when Skylar Green’s oxygen saturation only reached 65%, Aariel Green immediately took him back to the hospital where he was admitted and stayed for the next 10 days. The congestion in his lungs kept increasing, so the doctors put him on oxygen and then a ventilator to help him breathe better, but neither helped. His breathing difficulties continued and became more serious every day.

Transferred to Oklahoma Heart Institute

His doctors then referred him to Adam C. Betz, M.D., medical director of the extracorporeal membrane oxygenation (ECMO) program and Daniel Hopkins, M.D., a cardiovascular critical care specialist, at Oklahoma Heart Institute. Under their care, Skylar Green was placed on an ECMO machine, which allowed oxygen-rich blood to circulate while they used medications to reduce the inflammation in his lungs.

The ECMO machine works by inserting a plastic tube into a large vein in the neck, chest or groin of the patient. This tube allows for the patient's blood to flow out into an oxygenator (artificial lung) before being returned to the patient. The machine does the work of the lungs, which in Skylar Green’s case, was crucial because of all the inflammation.

“Skylar's COVID pneumonia was as severe as one could possibly get," said Betz. “COVID had damaged his lungs so severely that there was not enough recoverable lung left to ever come off the ECMO machine without a transplant.”

Through it all, the doctors kept Aariel Green well informed about his condition and daily developments.

“Dr. Betz and Dr. Hopkins let me ask many questions and be involved in Skylar’s care,” said Aariel Green. “I learned more than I thought I would need to know about anesthesia and medicine in general.”

Skylar Green stayed on ECMO in a medically-induced coma for many weeks while his doctors contacted medical centers for his lung transplant. They also worked to wean him off the sedation and come out of the coma but he remained too sick to even tolerate awakening without his oxygen levels getting dangerously low.

Finally, they tried an aggressive approach to weaning him off the sedation and he regained consciousness. He remained on ECMO, as it gave him sufficient lung function until the transplant.

He faced a lot of work to regain his strength after weeks in the coma.

"It really takes a special person (and spouse) to push themselves through such critical illness to meet the physical criteria necessary to get a lung transplant,” said Betz. “Walking in place with minimal assistance may not sound like much, but when you’ve been bed-ridden for a month and a half and have to do it without lungs adding much help, it becomes a hugely impressive feat."

Major surgery – double lung transplant

Still connected to ECMO, the OHI mobile ECMO team helped transport Skylar Green to the renowned Baylor Medicine Lung Institute at Baylor St. Luke's Medical Center in Houston for the transplant.

During the surgery, doctors worked on one lung at a time, removing each diseased lung and replacing it with a donor lung. Each new lung required a connection to his bronchial tubes so oxygen could flow freely into the lungs. Each lung also required connections to his heart so oxygenated blood could flow throughout his body.

The transplant surgery was a success and Skylar Green is nearing the end of his rehabilitation period. He has been very weak and has had to regain his balance and get stronger to stand and walk again. He still has a lifting restriction, which means he can’t lift anything over five pounds for the first three to six months. But with physical therapy starting soon in Houston, he is hopeful to regain more strength soon.

“I feel a lot better today than I did yesterday,” Skylar Green said. “That's kind of a trend that I hope continues.”

In addition to the many medications he takes to guard against infections and rejection of his new lungs, he has now been fully vaccinated against the coronavirus.

Generous community support

The Greens admitted they are homesick for their own home and their friends and family around Muskogee. And while he looks forward to returning to work in the sheriff’s office, he doesn’t think he will be returning to patrol duty any time soon.

“Because of my suppressed immune system, I don't believe patrol would best for me during this first year back,” he said. “I want to pass along what I learned to newer patrol officers and help out with investigations.”

The couple is especially grateful to the community, their co-workers and neighbors for all of their support, such as selling bracelets to support the family and holding a prayer service for him. Some in the sheriff’s office even donated personal time so he could be paid for those days.

“Our neighbors are great too,” said Skylar Green. “They cleaned our house and kept our dogs fed, walked and cuddled every night. We couldn't have a better place to live.”

Most of all, they appreciate the medical teams at all the hospitals who cared for them.

“It was the time that they were willing to spend with us and the one-on-one care that I valued the most,” said Skylar Green. “The nurses were on top of their jobs too. I really felt their emotional connection to my needs. “I couldn't have asked for better care.”

“They literally kept me alive.”