Romero Family Fund

Hello everyone,

Our names are Stephanie and Katelyn, and we have known Megan and Brian for more than 14 years. This is their story...

Brian was first admitted to Harrington Hospital in Southbridge on January 15th, 2014. Megan woke up that morning for her normal daily routine and tried to wake up Brian but he was very incoherent and sweating. She didn't know what was wrong, she just knew that something wasn't right. After running a few tests in the ER, they admitted him straight into ICU where he was fighting complications of pneumonia with high levels of carbon dioxide, and he needed to be sedated, intubated, and induced into a medical coma so his body could fight this infection while also getting the rest it needed. After a few days of ICU at Harrington, he was transferred straight to ICU at UMass Memorial in Worcester. UMass ran a long list of their own tests and concluded that Brian was in heart and respiratory failure. Everyday  Megan and his mother Deb stayed by his side so he wouldn't be fighting this alone. Each day was a lot of trial and error with his machine settings to see if he was stable enough to try and let his body function on its own. After 2 weeks of fighting they put in a temporary tracheotomy so they could try to come off of the ventilator settings. Brian responded to treatments and on February 6th (22 days in ICU) Brian started breathing ON HIS OWN with the use of APAP (adjustable pressure) machine, and was discharged from UMass Memorial and transferred to a Vibra Healthcare in Leicester for Respiratory/Physical Therapy Rehabilitation. Brian spent 3 long weeks trying to learn how to breathe and walk before the tracheotomy could come out. He fought all the way through it, and a week later finally got to a point where he could do everything on his own, so on March 6th (52 days after first being admitted) Brian FINALLY came home!! The challenges weren't over. Brian still needed to take his time getting around, and needed to use his oxygen tank from time to time, but he was feeling better, and looking great!

For 3 months it seemed as though Brian was going to be just fine. We were so happy to have him home and enjoy his company.
Megan and Brian celebrated Megan's birthday on May 11th, and then their 6th wedding anniversary on May 17th. On May 20th, Brian celebrated his 31st birthday.

The morning of May 21st, we got a text message from Megan saying "Brian's mom just took him to the emergency room and they want to intubate him again, I will update you as soon as I can."

2 hours after being admitted into Harrington Hospital they transported him to UMass University Campus ICU. Preliminary x-rays weren't bad, but somehow he was showing a high white blood cell count, and blood in the lungs. It was then discovered he had caught the metapneumovirus and had a secondary pneumonia infection. Despite what his body was now going through again, Brian remained alert and talking for that whole week and insisting that he was feeling fine. Doctors were going back and fourth trying to determine an underlying condition. We knew at this point he had congestive heart failure and pulmonary fibrosis, but they were throwing around ideas that it could be muscular dystrophy, multiple sclerosis, or even cystic fibrosis, however, later other tests had ruled out those as possibilities.
In 2 days, Brian's lung collapsed, twice. A bronchoscopy showed he had mucus in his lungs even though his stats were still holding good. The next set of x-rays turned out MUCH better and they were able to turn his oxygen down to 70%. He thankfully stayed steady for a couple days, but the doctors started to think he had a bacterial infection, so, to keep him comfortable they upped his sedation and so his body could finally rest. Unfortunately, that meant that Brian could no longer communicate with us. On Thursday, May 29, Megan was called in and told to get there as soon as possible. She was then told that the ventilator was no longer helping to oxygenate Brian and he was "unable to sustain life". A whole team of doctors were assembled to determine our next steps. As a "last resort" a cardiothoracic team got involved and was able to get him on ECMO (Extracorporeal Membrane Oxygenation) which is a procedure that uses a machine to take over the work of the lungs. Extracorporeal means that the blood circulates outside of the body with the help of a machine. Membrane Oxygenation, referred to as the "artificial lungs," is a special part of the machine that puts oxygen into the blood and takes out carbon dioxide just like our lungs do. The ecmo held steady for a couple days so the doctors could brainstorm and come up with a new course of action. A heart failure specialist was then added into the mix, so now Brian has a total of 4 cardiologists on his team. A TEE (Transesophageal Echocardiogram) was performed to see if there had been any changes with his heart since first being put on ecmo in hopes to try to ween him off of it. If this attempt was to fail (which they anticipated) the next step would be to transport Brian to Mass General. Dr. Okike (head of UMass Cardiology) called Mass General, and they initially responded that it sounded like he may need a lung transplant. Brian's pulmonologist got involved and was now talking to the head of pulmonary at MGH to go over his case in great detail, and Megan had to sign all the medical release papers so Mass General would have Brian's complete medical history to make the determination if he was a possible candidate. When the TEE was performed we learned that the hole between Brian's heart had expanded to 26mm (an inch) and was allowing oxygenated blood to pass over to the left side of his heart causing him to be hypoxic. He was also in right sided heart failure and was having severe respiratory restrictions. After analyzing the possibilities they finally decided it would be in Brian's best interest to repair the hole, they just didn't know how his body was going to react. On Wednesday, June 4, they did a procedure through a catheter that successfully closed the hole! His body responded EXTREMELY well to that. They tweaked a couple medications to compensate for the hole repair and was now trying to strengthen the right side of his heart. The doctors were then hoping that this will allow them to turn down the ecmo to see how the lungs would respond. A couple hours later was the first attempt to try to turn it down, Brian destated in 3 minutes. His right ventricle was still not doing much, and it wasn't pushing blood to his lungs. So, he went back on to full ecmo, and so the plan was to take fluid out of his lungs, try to control the hypertension, and to reevaluate the next morning. We were just praying that his body needs more time to get used to the repair to his heart. It wasn't the immediate reaction that we wanted, but this wasn't uncommon for the first attempt. The doctors kept him stable for the remainder of the night and just let him coast on the same settings. Thursday morning, June 5, his lungs are still not working. Mass General said he is not a candidate for a lung transplant, his chances of surviving a surgery like that in his condition were not good, and there was nothing else that they could do that wasn't being done at UMass. It was then redetermined that his right ventricle is still not pumping efficiently which is the end result of pulmonary stenosis as an infant. Brian's medical team immediately reassembled and went over every possible idea they had between the 7 of them. Dr. Okike then set up a family meeting to go over the next course of action. After talking EVERY detail over with him, he told us that the were going to keep him stable for the rest of the day and they were again going to tweak medicines in the morning. Friday morning Brian started to respond well to the new settings. They successfully turned down ecmo and he FINALLY started oxygenating over half of his OWN blood!!
Sunday June 8 he was successfully taken off ECMO and thrived the entire week and Friday June 13 he was moved back to pulmonary ICU to begin being weaned off the vent. Sunday June 15 Megan was visiting him and suddenly his blood pressure and oxygen levels began drastically dropping. It was determined he had a tension pneumothorax (hole in between lung and liner) which had been caused by cysts in his right lung. They had to emergently put a chest tube in, but in the mean time Brian went into cardiac arrest twice. Though he was brought back right away each time we were still unsure of the trouble it may have caused. Monday and Tuesday it was shown his kidney function had decreased, but that was not abnormal after cardiac arrest. Early Wednesday morning it was determined his PH levels and CO2 levels were being drastically lowered and could cause him to go into cardiac arrest again and he needed immediate dialysis. He was on dialysis all day Wednesday and his numbers were not improving and at one point were getting worse. His blood pressure was dropping even with 3 blood pressors maxed. His CO2 was up and his O2 was down. It was only a matter of time. Thursday morning at 8:05AM Brian passed away comfortably and finally at peace surrounded by family and friends. His fight was done and now he was at rest. He will always be superman.

We know most of you personally know Megan and Brian, but for those of who you don't, here is a little background information.
Meg and Bri met at Bay Path and started dating in 2003. 5 years later they got married on May 17, 2008. They have a beautiful 3 1/2 year old daughter Alexandria that was born on December 7, 2010. Megan found out in November 2013 that she was pregnant with a little boy (Brian Jr.) and he is due on July 9th.

Megan is the strongest person we have ever met. Absolutely amazing. She is a rock that holds us all together, and despite all the ups and downs through the past couple months, she goes out of her way to make sure WE all feel better. I don't know anyone that could do a better job as a mom and a wife, being 8 months pregnant and with her husband under these circumstances.

We want to thank you for your endless generosity. This was not our intention, but SO MANY of you have asked us what you could do to help them, and put this idea in our heads. Your love is overwhelming, and certainly more than we could have ever hoped for. All of your phone calls, texts, messages and comments have not gone unnoticed, and are so comforting in this time of need.
Megan and Brian's families appreciate this more that you could ever imagine.

A celebration of life for Brian will be held on July 12 at 2PM at Waterfront Mary's in webster, MA for ANYONE who wishes to pay their respects and for last goodbyes. RSVP is on Facebook.

Thank you again from the bottom of our hearts,

Stephanie Milosh & Katelyn Krikorian

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Stephanie Milosh 
Southbridge, MA
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