Two weeks ago, John Beutlich of Escondido was the human equivalent of a finely tuned sports car badly in need of an oil change.
Because of an extremely rare blood disorder, the man who nearly qualified for the American Olympic team in 1978 had suddenly developed blood plasma so clotted that every one of his major organs was in danger of collapse.
As a result, his lungs very nearly deflated, his heart was inflamed, his kidneys were in danger of failing and he became so disoriented because of lack of blood to his brain that he couldn't even give his wife's name.
For 10 straight days, doctors at Palomar Medical Center performed a procedure called a plasma pheresis, in which Beutlich's blood was drained from his body and replenished with fresh frozen plasma.
10 Pints of Plasma a Day
That's 10 pints of new blood plasma a day--or a total of 200 pints--the entire amount of frozen plasma the hospital kept in storage.
"He emptied all the frozen plasma we had on hand," said Dr. Jerry Kolins, medical director of the community blood bank of North County. "There wasn't any left."
Just one week ago, Beutlich came so close to death that his family was summoned from Chicago. On Tuesday, however, in what doctors are calling a miraculous recovery, Beutlich was out of the intensive care unit, talking about going home in a few days.
The college runner has won the race of his life--against a deadly disorder that once killed everyone who contracted it.
Now, thanks to friends and co-workers of the U.S. Customs Service pilot, more than 250 new pints of blood plasma have been donated to the hospital in a nationwide effort to replenish the drained supply.
How does a healthy, 32-year-old father of two strong school-age boys, a track star at Loyola University in Chicago who once nearly qualified to run against the Soviets, come so suddenly, so inexplicably, close to death? The answer is thrombotic thrombocytopenic purpura (TTP), a disease that has baffled the medical world since it was first diagnosed in Philadelphia 60 years ago.
"It's like the Andromeda strain," Kolins said. "We're not sure if it's a virus, and we're not sure if it's a bacteria. But one thing is for sure--as recently as 10 years ago, if you got it, you were dead within a couple of weeks."
Doctors aren't even sure what causes TTP. The only known cure is the plasma pheresis procedure, in which the blood plasma is continually exchanged until the patient begins to show signs of recovery.
Beutlich's was the first case of TTP treated at Palomar Hospital, according to Peter Hein, the Escondido man's personal physician.
"It's very, very rare," he said. "It's not even known what triggers it, which makes a cure doubly hard to come by. Most hematologists go through their entire careers and never see a case."
40 Known Sufferers
For humans, the chances of contracting TTP are 1 in 250,000, he said.
"In a city of 3 million, for example, it might happen to 12 people over their entire lifetimes. In a city the size of Los Angeles, you might not see one case a year."
A recent 10-year study on TTP conducted by the University of Pennsylvania contained only 40 known sufferers of the disorder, Kolins said.
"We don't know what happened with John," he said. "One theory is that he was subjected to some kind of bacterial infection one week before the disease began to take effect."
The bacteria can be killed by antibiotics, but not before toxins begin to do their damage, doctors say.
"There's some evidence that the bacteria might produce a poison that causes the platelets to clump together and block the circulation of blood," Kolins said.
'It's Really Scary'
The clots occur throughout the body, affecting the brain, kidneys, heart and lungs, vital organs that cannot be deprived for long of adequate blood flow.
"It's really scary," Kolins said. "It's a mystery to think how a healthy, 32-year-old airplane pilot in the best of health could almost die just like that without us being able to do a thing to stop it."
For Beutlich, the nightmare began with a shopping trip to Tijuana with his wife and father-in-law. After a day of browsing along the Avenida Revolucion, the group ate dinner at a restaurant there.
A week later, Beutlich developed cramps at work one day and his wife, Susan, saw blood in his stool. He was admitted to the hospital.
Doctors treated him with antibiotics and he was released a few days later. But, after she got her husband home, Susan Beutlich knew something was terribly wrong.
"I asked him how he was feeling, and his response was, 'How much does a cup of chicken broth cost?' " she recalled. "He thought he was still in the hospital. He had no idea who I was."
50-50 Chance at Best
At the time, Beutlich's blood platelet level had dropped to 18,000 per cubic microliter of blood. Normal human levels are more than 150,000 platelets per cubic microliter, doctors say.
Doctors said Beutlich's chances of living were at best 50-50, Susan recalled.