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July 27, 2012
SPRINGFIELD, MO--Matt and Yvette Pearce have one hour to make the decision.
Take the heart, and their four-month-old daughter might die on the operating table during transplant surgery.
Reject the heart, and Audrey Elizabeth Pearce, who has already survived multiple heart attacks and found herself on the brink of death on more than one occasion, might get weaker by the day and spend the rest of her short life at St. Louis Children's Hospital.
Dr. Sanjiv Gandhi needs an answer. Another patient in the hospital has died with the same blood type as Audrey's, so a heart is now available. Every surgeon on staff agrees this is a medical phenomenon- the kind of occurrence that happens maybe once, if at all, during a doctor's career. They tell Matt and Yvette the chance of finding a useable heart within the very same building is probably less than one percent.
On April 22, 2010, at almost exactly 12 p.m., this phenomenon becomes a reality. Dr. Gandhi has a heart for Audrey and he cannot waste any time, so he imposes a one-hour deadline for Matt and Yvette to reach a conclusion. That's the exact length of four quarters in a college football game, like the ones Matt used to play as the starting guard for Missouri's 1993 football team. One hour. Shorter than the approximate duration of the volleyball matches Yvette used to play at Missouri, where she finished her career as one of the best volleyball players to ever wear a Tiger uniform.
When Dr. Gandhi sprints up the stairs of the hospital and bursts through the doors of Yvette's suite to confront her with the transplant decision, Matt is 200 miles away in Springfield, Mo., with their two older children. Yvette and Matt will need to make this decision - the decision that will determine the outcome of their daughter's life; well, of all their lives - over the phone.
"I kept wondering, if I say no, what happens?" Yvette said. "You don't know if you're just sending her in there to die."
It doesn't take long to decide. By 12:30 p.m., Matt Pearce hops on Interstate 44, driving 100 miles per hour en route for St. Louis Children's Hospital.
They're taking the heart.
That's all Dr. Gandhi needs to hear. Immediately, his team prepares for surgery. Bag the oxygen tank. Strip the bed. They're rushing Audrey down the hallway as Yvette paces along. She's crying. And finally, before Audrey disappears into the surgery room, Yvette kisses her one last time, right on the lips, and grabs on to her blanket.
As they wheel Audrey away, Yvette grips the blanket as tight as she can. She tugs and tugs, won't let go. It might be the last time she ever sees her daughter alive.
Two years later, on a sweltering July day with the heat index nearing 110 degrees, Dr. Matt Pearce plops down on a leather swivel chair in the conference room next to his office at Glendale High School in Springfield. This is where he was when he got the call from Yvette at the hospital two years earlier.
He's the principal at this school, a PhD just finishing up a meeting and a full day's worth of work. Minutes later, Yvette barges through the doors with Audrey in her arms. Little Audrey, now two-and-a-half years old, announces her presence by loudly imitating a choo-choo train. "Woo, woo!" she continues to roar, playing with two miniature toy trucks. She is oblivious to how unlikely her being here is, completely unaware the fact that it took a series of improbable, to put it lightly, events to save her.
"It just puts a lot of stuff in perspective," Matt says. "All that stuff, your sports, your different accolades and job titles, they don't mean very much."
Coincidentally, sports brought Matt and Yvette together in college. Matt laughs as he tells the story of the initial encounter with his future wife, crediting roommate and MU basketball player Todd Satalowich for setting the two up. All of them lived at the College Park Apartments south of Memorial Stadium (now known as Campus View Apartments), and Todd had relentlessly bugged Matt one day to go get the mail from outside.
"I was just dead dog tired," Matt said. "I didn't want to, but he said there was an apartment outside full of good-looking girls."
Luckily, Todd convinced him to get the mail and stop by that apartment. He took a liking to one of them- that's Yvette, of course, who also happened to be a star volleyball player. The two eventually began dating and formed a true power couple in the athletic department. Matt, physically intimidating but with a soft-spoken and friendly demeanor, played on Missouri's offensive line. He came as a walk-on. After his second season, coach Bob Stull awarded Pearce a scholarship, and his career blossomed from there.
"I didn't want to stop there," Matt said. "I wanted to be good and I wanted our team to be good."
Although his team only won 15 games during his five seasons in Columbia, Matt took his scholarship and translated it into a starting guard spot on the 1993 team. His success completed a lifelong dream for him, since he turned down several major scholarship offers to walk on at Missouri. Matt said Oklahoma State, for example, made him a "midnight offer," but he'd already made his decision.
"He could have played at a lot of different schools," said Mike Bedosky, a close friend and fellow offensive lineman from the same graduating class. "But he was bound and determined to be a Tiger."
Matt had to grind at the game of football. It took him until his junior year to gain meaningful snaps on the offensive line before earning a starting spot.
Things came a little easier to his wife, who played volleyball with the maiden name of Buhlig. For proof, look at Missouri's volleyball record book.
The name Yvette Buhlig appears 39 times.
First all-time in kills. Fourth in hitting percentage. Second in service aces. All-Conference in 1992, member of the USA National Team in 1990, All-Academic in 1992. Growing up in Alma, Mo., a town of fewer than 400 a little more than an hour from Columbia, Yvette also never wanted to attend any other school. Like her husband, she didn't see any reason to leave home.
"It was always in my heart," Yvette said. "Any other school would have been a hard sell."
A few years after graduating from Missouri, the two got married and then eventually had two children: Logan, now 14, and Emma, 12. Yvette and Matt aren't shy to point out the age difference between their first two children and Audrey, who was born in 2010.
"She was a surprise," Yvette says. "We were like inexperienced parents all over again."
Logan and Emma had typical American childhoods: normal and rather uneventful. No major drama. Audrey was born on Dec. 1, 2009, and the first few months of her life were relatively normal, too-- until mid-March of 2010. Yvette said she began to get fussy, she wouldn't eat and sweated excessively. She set up an appointment with her pediatrician, and he asked her to bring Audrey in for some tests. After examining an X-ray, the pediatrician requested Audrey see a pediatric cardiologist.
That's when an echocardiogram revealed Audrey had a rare birth defect: Anomalous Left Coronary Artery From the Pulmonary Artery. It's called ALCAPA for short, and in layman's terms, it means exactly what it sounds like. Audrey's left coronary artery was supposed to attach to her aorta, but it instead attached to her pulmonary artery. Left untreated, 90 percent of ALCAPA patients die within a year. With immediate surgery, though, doctors told the Pearces their daughter would most likely make a full recovery.
Still, it was not good news.
"We went from noticing she was being a little fussy on a Monday, to getting a weight check on a Tuesday, to having open heart surgery on a Friday," Yvette said. "We didn't have time to process. We got thrown into the situation, and we were mostly in disbelief."
The initial corrective surgery for the ALCAPA defect was a success, but Audrey was not yet stable. On Saturday, just hours after the operation, she had three heart attacks. Later, in her journal on the popular medical website CaringBridge (you can view Audrey's site right here), Yvette summed up the whirlwind of emotions.
I came in to Audrey being given chest compressions. She had had a heart attack and they were trying to bring her back. I found myself yelling her name--telling her to come back?
By all accounts, she should never have made it back--the physicians aren't shy to tell us so....but she did.
My Lord, I have a fighter!!!
At this point, a heart transplant was still a distant option for the Pearce family. For the next several weeks of March and April, Audrey's condition fluctuated on a day-to-day basis. Yvette became a prisoner to the hospital, stuck in the facility almost 24/7 while Matt shifted back and forth between Springfield to help keep an eye on Logan and Emma at home. Matt said he worked at Glendale about three days a week, all while his daughter fought for her life 200 miles away in St. Louis.
"The first few days, it was so hard. My mind was literally somewhere else, but my body was here," Matt said. "I think there was only one day where I didn't come to work when I was here. I just couldn't do it."
There were times when he explained to Logan and Emma that their baby sister might not survive. Doctors had told Matt and Yvette that almost all ALCAPA patients' hearts recovered with time, but that did not appear to happen with Audrey. She needed constant procedures and medical care, and she was on and off life support at times. On March 24, in the middle of the night, Audrey took a turn for the worse.
It takes her 30 minutes for her to recover. Thirty minutes of 5 people staring at her numbers hoping they recover. Thirty minutes of wishing/hoping/praying.
At this time I don't even know how to feel. Matt and I sit in silence. We would probably rather curl up somewhere and wish ourselves 6-7months in the future where everything would be alright--but will it?
That night, Yvette realizes her daughter has once again come back from the dead.
I am writing to you all with a very heavy heart. For the 3rd time since we have been at this hospital, Audrey has been saved.
Matt and I have asked the medical staff if they would be completely honest with us in that if they didn't think there was anything to do, to tell us.
Dr. Checcia said he would.
By the time April 22 rolled around, Audrey's condition had stabilized somewhat. But that improvement doctors kept anticipating- it simply hadn't happened. There had been talk of a transplant, but even the mere suggestion of it rattled Matt and Yvette.
It was a risk. Although Yvette called her team of surgeons at Children's "The Dream Team," even one of the nation's leading hospitals could not guarantee Audrey's health after a transplant.
"That's a life of uncertainty," Yvette said.
Transplanted hearts don't last forever, so Audrey would probably need another operation at some point. Plus, there would be mountains of endless medical bills. If Matt and Yvette could just wait it out, maybe Audrey's natural heart would get better, like doctors originally said it would.
So when Dr. Gandhi slammed through those doors on April 22 and told Yvette he had a new heart to give her daughter, her decision wasn't, say, as easy or decisive as one of her kills in a volleyball match. She and Matt could take the risk and save Audrey's life in surgery, or they could pray for her heart to heal, even though all signs pointed to her health failing.
"Her whole body was shutting down," Yvette said. "She was dying. Her heart was so sick, this was just exactly what she needed."
That's not to say Matt and Yvette felt fully confident about their decision at the time. On the phone in Springfield, Matt demanded to talk to the surgeon to make sure he and Yvette were making the right choice. Yvette said she was "hysterical" and could barely make audible comments over the phone when discussing the matter, but doctors continued to reassure her she was doing the right thing.
"Everything happened so fast. I still remember Matt calling me," Bedosky said. "He says, 'Mike, they've found a heart. On the way to the hospital right now, I'll let you know.' It was that fast."
But for that heart to be in that facility at that specific moment, a myriad of events needed to first take place. Another patient had to die at Children's Hospital. It was a patient Yvette said she probably encountered at some point when she frequented the hospital. The patient had to die at that exact same facility and needed to have the exact same blood type. And the heart had to match Audrey, not the patients above her on the transplant list.
It fit perfectly. Doctors in St. Louis measured her chest cavity at 13.3 centimeters. This heart would take up 10.9 centimeters.
"I remember asking, 'is that going to work?'" Yvette said.
It did work. By the time Matt arrived from Springfield, the operation had almost ended. Four hours after surgery, still mostly paralyzed and on heavy narcotics, Audrey began to move her legs up in the air toward her chest, a feat she'd never been able to accomplish before the surgery. The doctor said he hardly ever saw this happen so shortly after a transplant.
It then became apparent Audrey Elizabeth Pearce was no normal patient.
"In her original heart, because it wasn't pumping very well, at any time it could have burst," Matt said. "She would have been off the transplant list, and that would have been that. Her kidneys and stomach were beginning to shut down.
"To have it the way it happened was just truly a miracle."
She wasn't alone in this fight. Two other patients needed transplants at the same time as Audrey in that hospital on April 22, and the same surgeon successfully gave all three patients three new hearts.
"When they say things happen in threes," Yvette said. "Things happen in threes. You develop a camaraderie with a lot of the individuals in there."
A little boy named Nolan was one of the patients who received a heart that day. At the time, it seemed like a cause for celebration. It certainly was for Audrey, who now lives with fairly minor complications two years after the fact. Her heart is healthy and secure for the time being.
Nolan almost got that heart, but his chest cavity wasn't the right size, so he got another heart.
"Nolan, God bless him, the heart he got wasn't a good heart," Yvette said. "He died. There's always that chance of rejection. That's created a lot of perspective in my life."
"There are no guarantees."
To this day, Matt and Yvette have no idea who donated the heart to Audrey. Yvette has stayed in constant contact with the hospital and often writes to the doctors looking for answers, but it has not helped.
"For me, what would close the chapter on the whole story, would be to find out who it is," Yvette said. "But, maybe that's for us to never know, because sometimes, those aren't good stories."
Since receiving her new heart, Matt says "it's been nothing but uphill" ever since for Audrey. She has a slightly visible scar on her neck, and she needs a blood draw every three months and a visit to the cardiologist every six months. Other than that, though, her complications are limited.
Yet, uncertainty remains.
"We don't know what the future is going to be for her," Yvette says. "The average transplanted heart lasts about 15 years. So you start doing the math? how many times in her life would she need to have a heart transplant?"
Even so, Yvette begins to explain how technological advances in the medical field could actually alter that scenario. If doctors find a new way to treat her condition, maybe Audrey won't need another transplant. Immediately, with the same optimism, Matt jumps into the conversation.
"You've got to remember, they've only been doing infant transplants since 1989," Matt says. "And they have some kids that have not had to be re-transplanted, and some kids that had to be re-transplanted twice."
So that's a hopeful sentiment for Audrey, even though her path ahead may seem more difficult than a normal little girl. If she begins to compete in sports - and, with her parents' genes, that's a pretty sure bet - Yvette says she'd need to take special precautions. But no matter what she encounters, she has a fan club in Springfield and all over the state. Matt even says a person from California had commented on Audrey's CaringBridge section.
"There's lots of people who are going to have struggles with their life that don't always turn out well, but just keep hope. Keep one foot in front of the other. Some of the lessons we learned at Mizzou about hard work and persistence, maybe that's what kept us going," Matt says.
For now, the Pearce family has returned to a semi-normal life, regardless of Audrey's trips to various doctors. There were times when Matt and Yvette thought this day would never come, but here they are on a hot summer day, watching Audrey run around Glendale High School with a purple balloon.
"I have a purple balloon, and I squeeze it!" she mumbles. Audrey continues to play with her toy cars, the same toys Logan played with almost 14 years ago.
For someone who flirted with death on so many occasions, it is an unbelievable sight in the most mundane of situations.
"She's getting a little wise about it, but she won't be able to comprehend what's happened to her for a long time," Yvette said.
If only Audrey knew what her mother had written in her journal about her as she fought for her very existence.
I really don't know how this kid just doesn't just throw in the towel.
I look at her and am amazed at her strength.
People talk about strength so topically, but this girl has really shown some incredible strength to be here today.
She is our little rock star, and I hope she continues to keep plugging away.
Audrey will know. Someday. That alone is a miracle for the Pearce family.
"Talk about survival," Matt said. "It's just a story of hope."
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