In Sickness and In Health

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By Mike Scott

In sickness and in health.

Over the past six weeks, Shelby and Dan McAfee of Kahoka have had those words of their marriage vows put to the test.

Shelby grew up in Memphis, and Dan is originally from Kahoka. They met at Northwest Missouri State University in Maryville, and have been married 21 years on September 29. The couple has three children, Slade-20, Jaden-19, and Lathan-16. They also have a two-year-old grandson, Hudson.

“Miss Shelby” is a Pre-K teacher at Scotland County. Dan works for Roquette America as a Global Account Manager in the Pharmaceutical and Health Business Unit.

On Thursday, August 19, Shelby felt extreme fatigue and coughing. The onset was rapid. On Sunday, August 22, she was admitted to Scotland County Hospital with COVID pneumonia.

“The next morning, I received a call from the nurse saying that she struggled throughout the night, however she was doing really good,” said Dan. “An hour later, I received a call that they were putting her on a ventilator.”

“I remember being scared when I got to the hospital, and they stuck the BiPAP machine on her. After that the only memory I have is the doctor asking me if he could put her on life-support if they needed to,” Dan said.

I was terrified,” added Shelby.

The next day, her oxygen level had fallen in the 50’s. She needed an ICU bed experienced with COVID patients.

It took a while to find a hospital with an available ICU bed.

“I know the doctor said he called the local hospitals that would normally take patients, and then tried hospitals in Oklahoma and Texas, but nobody would take her. Everybody was full. He finally called a friend and begged for a bed. His friend finally agreed,” said Dan.

Shelby was going to be transferred to Mercy Hospital in Washington, Missouri.

“When they told me the hospital was in Washington, I had to think for a minute, because Shelby and I were in Washington in July. We came down to visit some friends, one of which Shelby went to school with, Wally Cottrell and his wife Trina. They told me that I could stay with them. At first I, did not want to for fear that if I had something, I might give it to them. However, I remembered when they showed us their house that they had added on addition to the basement. They had a bathroom, bedroom and its own entrance. It was just meant to be. It was a God thing that we ended up in Washington,” Dan said.

“They wanted her to go by helicopter but there were storms in Washington area. Then they tried to get a fix wing plane however there was confusion about whether or not they could land at Memphis airport. Scotland County ambulance could not take her that far due to the amount of oxygen required for a three-hour trip, so they had to call Adair County. Scotland County was not equipped to sustain her on life-support,” Dan said. “She was very unstable. They were struggling to keep her oxygen up, and we were not sure she could handle the ambulance ride for three hours. However, there was no other choice.”

At Washington, Shelby was paralyzed, on a ventilator, and heavily sedated. She was also isolated. Dan couldn’t enter the room.

“I remember the first day I was there. I was sitting in a chair outside her room looking in. The doctor pulled up a chair and sat right in front of me and said to me ‘I don’t want to lie to you. Your wife is critically ill’. That’s when I knew just how bad she was,” he said.

“I actually tried everything I could to get in the room. I offered to clean the room for them. When they needed to go in and do something, I said I’ll take care of it, and the nurses were very sweet and said, ‘Oh I wish I could let you in’. There was a janitor who was one of the sweetest women I’ve ever met. She went in and cleaned her room and while she was in there, Shelby’s heart rate came down and her blood pressure came down. When she walked out of the room, I said she me must like a clean room, because her blood pressure and heart rate came down. The lady said that’s because I told you were here. I instantly started crying and I couldn’t tell that story for quite a while without crying,” Dan added.

“She had tubes coming from everywhere and at least seven different IV’s and a feeding tube,” said Dan

Most of the day, Shelby spent on her stomach, in a prone position., but for a few hours each day, she would be on her back.

“When they would turn her, her oxygen would drop extremely low, and all the nurses would wait to see if it would come back up,” Dan said.

Each day for two weeks, it was the same thing–on her stomach on her back. The doctor would tell me ‘we will have a good days and bad days’, and we definitely did. He also said what’s most important is the trend, and that the trend was starting to look positive. They did eventually remove her from a paralytic and let her wake up. She had a lot of fluid in her lungs, and they tried to go in to remove it, however, when they did her heart almost stopped. They tried twice and decided she was not stable enough to do it. They then made the decision to put her back on the paralytic and sedation, and put her back on her stomach. I stood outside the door and watched this procedure take place, and I watched her heartbeat and I watched a look in the doctor’s and nurses’ eyes,” he said.

Finally, on September 3, Dan could enter her room. Originally, they thought it might happen on September 1, but Shelby had a fever.

“It was horrible being out there not being able to do anything. I completely felt helpless. At the same time, I was grateful that I was able to be there and see her because I know so many people were not allowed to do that, and some to this day are still not allowed to be in with their patient,” Dan said.

On Wednesday, September 8, Shelby had a tracheotomy.

“I was hoping we could avoid that, but there was no other way,” Dan said.

But Shelby was improving–slowly.

“During the entire time, it was slow, baby steps. By the end of the week, they were talking about transferring her to another facility,” he said.

“I remember feeling excited that she was recovering, however, the days were up and down. It was a roller coaster of emotions. One day she seemed to understand things very well, and the next day she seemed very confused. All I could remember was in the very beginning, the doctor told me that she went a long time with very low oxygen and that we did not know if there was brain damage. So, I was still scared about that,” said Dan.

Shelby has no memory of being in Washington.

On September 14, she was transferred to Select Specialty Hospital at Missouri Baptist Hospital in St. Louis, to start her recovery.

“This hospital is focused on weaning people off ventilators. It is still a high skilled care facility with a little bit of rehab, but mostly skilled nursing. In the first few days, they mainly observed her. However, they decided to do a trial on Friday, September 17 to take her off the ventilator for eight hours to see how she did. She did very well so the next day they decided to do a 24-hour trial. This trial would continue as long as she could handle it and on Day 3, she was considered officially weaned from the ventilator,” he said. “She is now receiving more physical therapy than when she arrived, and the next step is to remove her trach. They did several swallow studies to make sure that she could swallow before they allowed her to start eating.”

On September 23, Shelby’s trach was removed.

Her stay there was planned to be 25 days.

“We are already talking about the next step because she is doing so well,” Dan said. “At this point, they expect her to make a full recovery, but it will take some time to get her energy back. They also said her immune system will be very weak for quite a while. She is expected to return back to work, but it this point, we don’t know when. Working in a school and with her immune system, we need to make sure it’s the right time,” Dan added.

“It is unbelievable the amount of people that showed their support and love. I received phone calls, texts, and Facebook messages from so many people. Even the doctors and nurses were helping to comfort me during that time. The first time I stepped in her room, the doctor came in and was rubbing my back and crying with me. Lexi Howard from Memphis set up a GoFundMe, and people were very generous in their donations. We also received cards and gifts from many other people. I know my kids said that they were eating very well as many people brought food by to them. I had a lot of people offer to do anything they could, and family was extremely supportive in every way they could be. Scotland County school had a hat day for students and staff. If you brought a free will donation you could wear a hat that day in school. They announced it on Thursday, and a hat day was on Friday, and they raised $1300 which is just unbelievable. I remember feeling very overwhelmed by the generosity of these two wonderful communities of Memphis and Kahoka. It really shows you how great it is living in a small town when people come together in a time of need. I also remember feeling very odd being on the receiving end,” Dan said.

Shelby’s long hospitalization has taken its toll on Dan, too, and he hasn’t been able to work.

“At first, I could not focus on anything, and could not even think about work. I used some vacation. Work then reached out to me about options and explained FMLA to me. I immediately started to panic thinking about not getting a paycheck. So then I decided I would start working when I could, because I do work remotely. Every time I would turn on my computer and start to work, my stress level would increase, and I would find myself even more upset. I finally told myself that Shelby and I have always prepared for an emergency, and this is an emergency. So I called to set up FMLA. I had to use some of my remaining vacation before I could start FMLA. So far, I’m two weeks without pay. I don’t know for sure when I will go back but I hope it will be soon. If it was not for the generosity of friends and family in our wonderful communities, I don’t think this would have been possible,” he said.

“I was completely overwhelmed by the number of people that were praying for Shelby. I heard many people talk about putting her on their church’s prayer chain in multiple locations around the country. I also had people tell me they were praying for her in France, Singapore, and Argentina. It was extremely overwhelming. The former pastor at the Baptist Church in Memphis mentioned that thousands of people were praying for Shelby. I truly believe that, and I know it is why she is here today,” Dan said.

“God answers prayers, and thanks to everyone for the prayers. I believe it is what is moving this process forward,” added Shelby. “God hears you.”

Shelby is also looking forward to seeing her family and students.

“I am anxious to see the kids, but at this point I am most anxious to see my family. The kids have sent cards and videos, which was really sweet,” she said.

Prior to Shelby contracting COVID-19, Dan had been vaccinated, but Shelby had not.

“Shelby said she should have done it. It was one of those things she had talked about doing but just hadn’t done it. And there’s so many rumors out there and information out there it makes it harder to make that decision. We both highly encourage people to be vaccinated. I saw many people in the hospital that lost their lives due to COVID. The nurses told me that probably 2% of their patients have been vaccinated, so they are seeing very few people in ICU that are vaccinated. There’s so much information out there and so much negative information about both directions. I would encourage people, if you decide not to be vaccinated, please don’t criticize the people who are. Shelby and I would also encourage you to wear masks. We know it is inconvenient at times, but they truly do save lives. I can also promise you, you do not want to see your loved one in this position,” Dan said.