A foot-long blood clot. A heart that ‘just gave up.’ How a N.J. cop survived dire odds.
Published on Apr 30, 2022
The COVID patient in Room 2102 was nearing the end.
Frank Talarico Jr. had been through so much already. And now his heart was failing.
Dr. Hitoshi Hirose wondered how much more the Merchantville Police sergeant could endure, laying in the coronary care unit as his heart and kidneys betrayed him.
“This patient was the sickest in the ICU…” said Hirose, director of cardiac critical care for Virtua Health. “His heart just gave up.”
Talarico, 47, had gasped for breath in December, his lungs filled with the coronavirus as the omicron variant surged through New Jersey. He spent 26 days in Virtua Our Lady of Lourdes Hospital with pneumonia, fighting for his life.
Then a new crisis emerged, one that few doctors at the Camden hospital had ever seen at that magnitude.
A COVID-related blood clot more than 12 inches long and as thick as a finger — one of the largest they had ever treated — was wedged in a major artery in his lung. The pulmonary embolism blocked blood flow and weakened his heart on Jan. 26, just days after the husband and father had finally come home from the hospital.
His heartbeat “was very, very faint, very, very slow and very, very weak,” said Dr. Joseph Broudy, an interventional radiologist.
The clot’s rare size pushed Talarico’s mortality risk to “well over 50% to 60%,” said Dr. Vivek Sailam, a Virtua clinical cardiologist. No one, including his doctors and nurses, thought the Pennsauken resident was going to make it.
“We don’t see a lot of the patients in his situation pull through,” said Shawn McCullough, a Virtua ICU nurse.
But he did.
After 49 days in the hospital, 15 in the critical care unit and 11 on a ventilator between the two stays, Talarico returned home Feb. 18. The Our Lady of Lourdes staff members, normally not prone to using the “M word” — miracle — began referring to him as their “miracle patient” in the days before his discharge.
“Because of everything I went through, a lot of the doctors and nurses — and even my wife — didn’t think I’d make it out of the hospital,” said Talarico, who was unvaccinated against COVID-19 because he had safety concerns.
“We don’t see a lot of the patients in his situation pull through.”
Shawn McCullough, an ICU nurse
But Talarico’s ordeal is more than a morality play on the importance of inoculation, or how his harrowing story forced a change of heart and convinced others to get vaccinated. And it’s more than a triumph of the human spirit after COVID-19 twice nearly killed him. His saga also serves as an alarming reminder of the looming threat blood clots pose to COVID-19 patients, even after they seem to recover.
Talarico is one of an untold number of coronavirus patients who developed a life-threatening clot during or after their initial infection, experts say. People with COVID-19 face a 33-fold greater risk of serious pulmonary embolisms within 30 days of getting sick, according to a Swedish study published this month in the journal BMJTrusted Source. Even those with asymptomatic or mild cases are at increased risk.
Another disquieting study found a high risk of developing heart and vascular issues as long as a year after being diagnosed, signaling that a potential cardiac crisis looms, experts say.
The life-threatening complication has been largely crowded out of the public discourse surrounding the coronavirus, replaced in the pandemic’s early days by debilitating pneumonia and the loss of taste and smell, and in recent months, by its damaging impacts on the brain and long COVID. But clots and other vascular issues remain an ever-present threat — whether patients suffered from a spectrum of coronavirus ailments or didn’t even know they were infected.
Once rare, massive clots have become more common during the pandemic, a byproduct of the inflammation caused by the coronavirus, according to Sailam.
“We’re still learning about what COVID does,” Hirose said. “Not only does it affect the lungs, it affects other parts of the body. Other viruses, such as the flu, are different. COVID affects systemically. It affected the lung, caused blood clots, and he temporarily lost kidney function.”
Talarico was saved by the swift action of the Virtua Our Lady of Lourdes staff, a life-support device that has found a new purpose in the pandemic and his quick-thinking wife, Christine Lynch.
“I was on the edge of my seat not knowing whether he was going to make it, and I worried that he wasn’t going to keep fighting.”
Christine Lynch, Frank Talarico’s wife
Lynch — a physician’s assistant who works part-time in the Our Lady of Lourdes emergency department — quickly recognized that Talarico had a pulmonary embolism. And she acted fast.
But even then, his odds of survival were slim.
Lynch, 33, has seen many patients’ families agonize as they watched their loved ones cling to life. For weeks, she lived the same experience.
“I was on the edge of my seat not knowing whether he was going to make it,” she said, “and I worried that he wasn’t going to keep fighting.”
Life & death
The call came just a few days before Christmas.
A member of the Merchantville Police Department had tested positive for the coronavirus, Chief Rich Grassia told Frank Talarico.
He was going to have to quarantine.
Talarico, who’s been on the force for 24 years, had returned to work just a week earlier, after recovering from back fusion surgery that kept him home for two months.
But he was young, healthy and active, a bicyclist and golfer. He would be fine, he thought.
The symptoms of COVID-19 began soon after. A light fever. A cough.
By Christmas Eve, Talarico was struggling to breathe and rushed to Virtua Our Lady of Lourdes. He was critically ill and nearly placed on a ventilator, hospital officials said. Lynch, who was vaccinated, also contracted the virus, but had a mild case.
“A lot of times, people ignore their symptoms and come in when it’s too late.”
Dr. John Schwika, Talarico’s nephrologist
Talarico spent the holidays alone, unable to have visitors because of statewide restrictions at medical facilities amid the omicron surge.
“I missed all the holidays with my family,” he said.
“My daughter [Alyssa, a 19-year-old college freshman] was home for Christmas, and I couldn’t spend time with her,” he added.
Finally, after 26 days in the hospital, Talarico was discharged Jan. 18. He was still weak, relying on supplemental oxygen and growing winded after just a few steps.
But eight days later, things got much, much worse.
Talarico woke up short of breath and feeling pressure in his chest. Lynch checked his heart rate, which was elevated, and his oxygen level, which was low.
“I didn’t want to go back to the hospital,” Talarico said. “I didn’t realize how bad it was.”
But Lynch immediately suspected a blood clot, knowing they are common in COVID-19 patients.
Time was short.
“A lot of times, people ignore their symptoms and come in when it’s too late,” said Dr. John Schwika, Talarico’s nephrologist, in a statement. “If a [pulmonary embolism] is not treated, they’re deadly.”
The couple, married only last summer after dating for four years, was again facing a crisis. And everything Talarico had endured up to this point paled in comparison to what lay ahead.
The clot had traveled from his leg and completely blocked his right pulmonary artery, the bridge carrying blood to the lungs.
Talarico was in shock, and his heart was about to fail.
“There wasn’t time for other treatments that would take hours,” Broudy said. “We needed to take immediate action.”
They needed to surgically remove the clot.
Talarico’s oxygen levels immediately improved after the clot was extracted, but damage had been done. His heart almost stopped during the procedure. His kidneys were also failing, and he was put on dialysis.
Doctors placed him on an extracorporeal membrane oxygenation machine, an advanced life-support system that basically functions as a heart and lungs outside the body.
ECMO therapy, which Hirose brought to the hospital last year and is not widely available, involves pumping blood from the body into a machine that removes carbon dioxide and then pumps the oxygenated blood back through the patient. Originally developed in the 1960s to support newborns and infants in respiratory and cardiac distress, ECMO has emerged as a critical tool in the pandemic.
It has cut the risk of dying from COVID-19 in half by allowing the heart and lungs to rest and heal, according to a February study by Vanderbilt University researchers. But many patients are unable to receive the treatment because of a lack of machines and trained staff, the study found.
Talarico was on the ECMO machine for two days and intubated twice during his second hospital stay.
“He was very emotional about how long he had been in the hospital,” said McCullough, the ICU nurse, “and disappointed he’d wind up back in the hospital after two weeks at home.”
Coming out on top
The bond was formed over the alphabet, and later, a love of wings.
Shawn McCullough first met Frank Talarico when he was intubated and unable to talk.
“He still had his breathing tube in,” the ICU nurse said. “Often, we can’t get to speak with patients when they’re as sick as he was. I was struggling to understand what he was saying.”
The nurse decided to do something.
McCullough drew an alphabet chart one night and asked Talarico to point to letters in response to his questions. They used it for days.
The connection grew stronger when Talarico no longer needed the breathing tube and they could actually talk.
“It was wonderful hearing his voice, being able to have a normal conversation,” McCullough said.
The nurse wanted to keep Talarico’s spirits up, and focused on life after the hospital. McCullough asked what he planned to do after going home.
That’s how he found out Talarico plans to retire in June and move to Vero Beach, Florida, where he and Lynch have a home.
And they found common interests — like a favorite chicken wings place in Maple Shade. Talarico told the nurse he favors honey garlic wings, while McCullough is a honey barbecue man.
Slowly, Talarico improved. His breathing became less labored, and he regained enough strength to take a few steps.
Before he was discharged, physical therapist Wendy Hardesty asked him how many steps he had to climb to get into his home. There were three.
Once he conquered those, she prepared him to climb the stairs to his bedroom.
Finally, after a total of seven weeks in the hospital between the two stints, Talarico came home for good on Feb. 18. He walked up those three steps unassisted into his home, and later, up the staircase to his bedroom.
“I was a lot stronger than I was the first time I came back home,” he said.
Talarico, who lost 40 pounds during his hospitalization, now plans to get vaccinated against COVID-19 as soon as his doctors allow it.
He should have antibodies through his recovery phase, said Dr. Peter Curreri, a pulmonary physician associated with Virtua Health. Doctors told him to wait because vaccination could trigger another inflammatory response if Talarico isn’t fully healthy.
And he is not yet 100%. He attributes part of his long recovery to the weeks he was immobile in the ICU.
Talarico concedes he learned a hard lesson. He had misgivings about the vaccines, concerned about the speed in which they were developed and approved.
“I think if I’d had my vaccine, it wouldn’t have been as bad as it was,” he said.
A cousin who was opposed to vaccination had a change of heart after seeing how the coronavirus pummeled Talarico. A few of his friends also have softened their views and are considering getting the shot, he said.
But Talarico is hardly a vaccine evangelist.
“If people want to use my example, they can,” he said. “I still think it should be a person’s preference.”
Lynch wonders why Talarico — a healthy man, despite high blood pressure, who worked out regularly — suffered such a severe case and she did not.
“We just don’t know enough,” she said. “Was it because I was vaccinated? Was it because I’m 14 years younger? Or is it just that he got unlucky and I got lucky?
“I know so many cases of patients older than him, with more comorbidities, who didn’t get nearly as sick.”
Talarico undergoes physical therapy at home three times a week and pulmonary rehabilitation twice a week at Virtua Physical Therapy & Rehabilitation in Moorestown.
He also works out at his gym nearly every day and is slowly seeing the results. He no longer needs supplemental oxygen or a shower chair and has resumed driving.
But Talarico still feels winded at times, especially when climbing steps.
“I just sit down and regain my breath,” he said. “I’m still not as strong as I used to be.”
But his heart and kidneys are functioning normally, and he is expected to make a full recovery within six months, hospital officials say.
Talarico still plans to retire June 30. He’s taking blood thinners to prevent additional blood clots, and they prevent him from returning to the police department.