Savoring life anew
UC Irvine's critical care team saves chef from sepsis, caused by hernia surgery complications at a desert hospital
September 18, 2011
Philippe Caupain puts the Belgian in Belgian waffle. The Brussels native is the seasoned chef behind the crisp and yeasty waffles that have been selling like hotcakes since his restaurant, Bruxie, opened in Old Towne Orange in November 2010.
That was a sweet finish to an otherwise dire year. Just five months earlier, the La Quinta resident was unconscious and near death when he was rushed 110 miles by critical care transport from a Coachella Valley hospital to UC Irvine Medical Center in Orange.
Caupain needed help breathing and his temperature was soaring as an infection raged through his body, the result of complications from hernia surgery. His wife, Edith, feared he wouldn’t survive the trip. But when doctors at the desert hospital asked if distance was a problem, “I said no, whatever Philippe needs, wherever the best hospital is, take him there. They sent him to UC Irvine.”
“They saved my life at UC Irvine,” says Caupain, 57, who is now fully recovered.
In all, Caupain was on a ventilator and comatose—heavily sedated on painkillers and other medications—for nearly nine weeks. He spent a month in UC Irvine Douglas Hospital’s specialized intensive care unit under the constant watch of specially trained critical care doctors and nurses before improving enough to finish his recovery at a rehabilitation facility.
Prior to his medical crisis, Caupain had been in good health and had worked for 18 years as the executive chef of a Rancho Mirage country club. In June 2009, he had elective surgery for a ventral hernia in his upper abdomen at a desert hospital, followed by a second minimally invasive hernia repair there on June 2, 2010.
Caupain went home the same day but returned to the hospital a few days later, in pain and with trouble breathing. “Just before they inserted a tube, I said to my wife in French, ‘This is not good. I have a bad feeling about this.’” That’s the last thing he remembers.
Caupain had developed sepsis, an infection that overwhelms the body’s ability to maintain its basic functions. Synthetic mesh used in the hernia repair—which remains in the body to hold tissues together—had become infected by a bowel injury. For more than a week, doctors in the desert tried in vain to control his many complications.
When community hospitals have patients in need of a higher level of care, they turn to a university-affiliated medical center for specialized expertise. At the UC Irvine Health surgical intensive care unit (SICU), there is at least one trained critical care doctor on duty at all times and many more on call, in addition to round-the-clock nursing care. When Caupain arrived, trauma and critical care surgeon Dr. Cristobal Barrios and the SICU team immediately worked to combat the sepsis. Over the next month, they carefully drained his abscessed abdomen and removed pieces of the problematic mesh bit by bit through Caupain’s open hernia incision, all the while providing respiratory support, intravenous feedings, pain killers, antibiotics, other medications and continual monitoring.
Edith Caupain remembers how reassured she was that Philippe was getting the best possible care. The doctors and nurses gave her husband nonstop attention, had a plan for every possible complication and kept her fully informed at all times. “They talked to me constantly, they answered all my questions. You have no idea what a difference that makes. I had confidence that he was in exactly the right place.”
Five weeks later Caupain—still unconscious—was well enough to be transferred to a subacute-care rehabilitation facility, where he was weaned off the breathing apparatus. He woke up in early August 2010, thinking it was still June. He could not talk and had lost 40 pounds. He also suffered another blow—while he had been battling for his life, the country club where Caupain was a chef had replaced him. Worried about the uncertainty of his future, he was determined to regain his health.
Coincidentally, while Caupain was ill and jobless, his business partners were hatching a plan to open Bruxie. The new venture—creating a Belgian-American mash-up of Caupain’s waffles with gourmet sandwich fillings—provided a positive outlet for Caupain.
Caupain recovered his strength quickly. On June 17, 2011, Caupain underwent one more surgery—to finally repair the hernia that had been the starting point for his near-death journey. This time, Barrios used biomesh, made from animal tissue, to prevent any adverse reaction.
Today, Caupain is healthy and back to hiking in the desert. Several months ago, he and Edith visited the SICU to thank the nurses and doctors, even though he had no memory of his stay or the people who took care of him. Then he heard something recognizable that immediately brought a tear to the usually reserved chef’s eye. He turned to meet one of the nurses who had cared for him; her voice had reached him, even when he was unconscious.
“Then they were both crying,” Edith says.