All Press Releases for November 11, 2015

Kevin S. Combs, DO, to be Featured in the Upcoming Book: Top Doctors: Experts in Medicine

Dr. Kevin S. Combs, currently practices emergency medicine and internal medicine at Carilion Clinic



    ABINGDON, VA, November 11, 2015 /24-7PressRelease/ -- Worldwide Branding is proud to announce that Dr. Kevin S. Combs will be featured in the upcoming book: Top Doctors: Experts in Medicine. Being chosen from the more than 600,000 members of Worldwide Branding is a testament to Dr. Comb's level of achievement, his performance within his field, and his exemplary leadership skills. Participation in the Worldwide Branding's Expert Resource program is held among the highest honors a Who's Who member can achieve. Top Doctors: Experts in Medicine will include Dr. Comb's biographical narrative, and a Q-and-A section based on an interview with him. In addition, Dr. Combs was recently named an Elite Physician.

He wanted to share the below story, entitled "Faith" with everyone because, as he put it, "I believe that if I can use my personal tragedy as a testimony to save even one life from eternal damnation then it will all be worth it. I truly believe this has not only been a life changing event but this has also significantly altered my perception of how to practice medicine."

FAITH
The year 2006 started out to be a very promising year for my wife and myself. Unfortunately, however, some memories have been lost like tear drops in the rain. In January, I passed my final board exam for residency. This meant I could begin moon lighting for extra money. Contrary to popular opinion, residents don't get paid very much.

In February I was placed on back-up call. When the pager goes off in the middle of the night for constipation or a low-grade fever, I can now sleep and allow the intern to take care of it. My primary responsibilities were to educate the medical students and interns and to focus on the specialty I wanted to practice. However this did not mean that the nights would be eight continuous hours of sleep. I was averaging a total of one to two hours of uninterrupted sleep per night. I still had to get up for the admissions and emergency pages.

The second week of May my wife and I had the unexpected yet most wonderful news in our lives. We were pregnant! We had just begun talking about starting a family and "getting the ball rolling." Little did we know the "ball" was already rolling down hill! This was a very exciting but scary time for us. We had several problems which could really complicate a pregnancy. Lorie was a diabetic. She was on two medications one of which was a category X during pregnancy. This medication is absolutely contraindicated during a pregnancy. She was also taking medication for elevated cholesterol. This medication also had the potential to cause birth defects. The lesser problem included living space. Both of us were still working at that time to pay the bills. Our age was of another concern. I was 35 and she was to be 35 in July. We prayed that night to God to take care of our baby. I also prayed and dedicated our baby to God so he/she might know and love Him as much as we did.

Lorie was the realist of the family. She continually worried about the pregnancy. I am the optimist. I unyieldingly supported her and continuously tried to give her hope. I tried to get her to focus on the positive aspects of having a baby and rejoice that now we were going to be a complete family!

Fortunately we were able to see Dr. Gorrell, a high-risk obstetrician in Bristol, Tennessee. Not only was he an obstetrician he was also a minister. This gave us greater confidence and hope that all would be well with the pregnancy. Each night before we went to bed we prayed to God that everything would be well with our baby. When other people asked if we wanted a boy or girl we would always reply, "healthy" because we would be happy with either. After we told Dr. Gorrell the medications Lorie was taking, we asked what could happen. He told us that since the pregnancy was only two weeks along at that time, there was only a small chance of ill effects on the baby. At the end of the visit he prayed with us as he did with each appointment. Since Lorie was a diabetic and of her advanced child bearing age, Dr. Gorrell wanted to see us more often with many more ultrasound appointments than his other patients. We made every appointment, sometimes with me being post-call (up for 27 hours the day before on a busy night).

Lorie was placed on insulin injections for her diabetes. She had to check her glucose five times a day, call Dr. Gorrell with the results, and then he would tell her how much insulin to give herself at that time. During pregnancy, a diabetic becomes increasingly insulin resistant; requiring even higher doses of both short- and long-acting insulin. As much as the finger sticks and injections hurt, Lorie persisted, always saying "This is all worth it to keep our baby safe."

Everything was going well at the time with the baby's growth and development. By the 16th week Dr. Gorrell announced the sex of the baby. After several attempts, as ittle bit was being quite shy and kept her identity hidden with either crossed legs or hands in the way obstructing the view, we discovered ittle bit was an Emily! That very day we went out and bought her first "bear-bear." This was a very small pink velour blanket about 8-inches in diameter with a soft plush bear's head on top and a rattle inside. For every appointment after that Lorie carried "bear-bear" with her. Not long after that we began to buy nothing but baby girl stuff. Every time we bought something we would always hug, kiss, and rub Lorie's belly and talk to little Emily.

When we first found out about the pregnancy one of Lorie's cousins gave her a book on pregnancy. Lorie read a chapter a week. The chapters were broken down into the weeks of the pregnancy. Lorie read to me that our baby was the size of the period at the end of the sentence. She said that was "iddy bitty!" From that time on Emily's nickname was "ittle bit." Lorie also kept a daily journal of the pregnancy. Her intention was to give the journal to Emily when she became pregnant so she would know what her Mom was thinking and experiencing each day. On the days that had no real zeal to it, Lorie would write about her concerns (and later fears). Lorie would always thank God for the miracle growing inside her.

By the 26th week of the pregnancy, Lorie was finally beginning to relax and just enjoy being pregnant. Up to this point everything was right on track and going well without any problems. That was the last time we would ever be happy again. When we went in for the 26th week ultrasound, the results were not good. Dr. Gorrell saw some fluid in Emily's belly and thought he saw the great vessels coming off Emily's heart were transposed (a condition incompatible with life outside the womb). He sent us to a pediatric cardiologist in Kingsport, Tennessee about an hour later (literally) for a second opinion. On the way over Lorie told me she had such an unusual peace unlike what she had ever experienced before. I told her it was the Divine peace of God she was experiencing. I told her I too felt like everything was going to be fine. Fortunately the great vessels were fine and the fluid around the heart was minimal. The pediatric cardiologist recommended a follow up ultrasound in two weeks with Dr. Gorrell.

We went back for the 28th week ultrasound, still no good news. The fluid in the belly was worse. There was now fluid in her lung cavity which did not allow her lung to grow as it should. We were sent to a paranatologist in Kingsport, Tennessee. He was very blunt with his findings on the repeat ultrasound. Even when Lorie pleaded with him to stop telling her what the outcome might be he still told her. He said that Emily had a 15% to 20% chance of surviving to term. After that, however, the chances of survival quickly dropped. He strongly doubted Emily would survive to her first birthday. Needless to say, Lorie was an emotional wreck by the time we finally were able to leave. I must say that I know God turns the bad to good, because this paranatologist referred us up to Children's Hospital of Philadelphia. He told us this was the best place in the Nation to not only find out what was going on but also for a possible treatment. We went home in severe distress but never gave up on God. Lorie's family came over including her aunt and uncle. We all prayed harder than we ever had before that Emily would be miraculously healed and she would be a living testimony to everyone she met of the power and love of God.

We had an appointment at the Children's Hospital of Philadelphia that following Monday. We were all on edge and scared out of our minds that entire weekend. Time seemed to slow to a crawl. Finally it was time to leave. That cold Sunday morning in November we prayed for a safe trip and again for Emily to be ok. We got up there safely that night without too much of a problem. "Map quest" took us on the long route as we found out later. During the trip it felt like the sky cried as we drove. It rained from Abingdon, Virginia all the way to Camden, New Jersey. Children's Hospital of Philadelphia had made arrangements for us to stay in a Ronald McDonald house while we were there. We thanked God for this service. We had to stay for an entire month. You can just imagine what a hotel fee would have been in Philadelphia, Pennsylvania. While at the house, we met some really good people, some of whom we maintained in contact. We also realized very quickly how small our problem was after talking with the other families there. The other family member's children and grandchildren had severe life-threatening and disabling problems

The overall impression from the first day at Children's Hospital was that they didn't know what was going on with Emily. The doctors suspected an anemia or some other congenital condition. More tests would need to be done first. Over the next month they discovered that Emily was severely anemic and required a blood transfusion. This is a very risky surgery that is carried out in an operating room in the event that an emergency delivery might occur. This procedure entailed placing a needle in Emily's placental vein through Lorie's abdomen. They told us that the risk of a spontaneous delivery increases with each additional transfusion. All together Emily received three blood transfusions via this method. God kept Emily safe in the womb for 32 weeks. This was the "magic" number the maternal fetal medicine doctors were counting on. They told us the chances of survival increased at that time from 30% to 90% in a healthy baby but, Emily was not a healthy baby. The third transfusion was given on the first day of the 32nd week. An emergency cesarean section followed that evening.

Emily Ann Combs, our daughter, was born on Dec.1. She passed away on Dec. 2 from autoimmune hemolytic anemia unknown etiology and hydrops fetalis with premature lung function. Lorie was never the same again. Some family members even said that they felt the Lorie we knew died with Emily that night.

We decided to fly back on December 6 to spare Lorie the misery of a 14 hour car ride back home. During the wait for one of the plane changes, I noticed a discomfort in my left groin. I thought it was from sitting in so many small chairs. I am 6-feet 3-inches tall. The cramping did not improve when we got home. I still dismissed it as residual plane fatigue and too many cramped spaces.

The cramping became increasingly worse over the next couple of days. On December 8 in the shower, during a monthly self exam, I noticed the left testicle was about three times the size of the right. (Yes, guys need to perform monthly self exams for testicular cancer just as women have to perform monthly self exams for breast cancer). The left testicle had an irregular shape to it and was firm. These findings concerned me but I was in such a state of grief and depression over losing Emily that I dismissed it for then. Later on that day Lorie noticed I was getting up off the couch in an unusual way. She asked me if everything was alright. I couldn't lie to her and I didn't want her to worry about me too. I tried to avoid the subject. For any of you gentlemen who are married can attest this didn't work at all. She probed even more diligently until I had to tell her everything and assured her I would have it checked out Monday after Emily's funeral on Sunday.

I was diagnosed with a very aggressive form of testicular cancer on Dec. 8 with surgery the next day. I had a nonseminomatous tumor. The majority of the tumor (90%) was embryonal carcinoma, 7% seminoma, 3% teratoma and 2% choriocarcinoma. The urologist was shocked to hear that I was going to wait another few days to week before going to the doctor. (As my wife could attest doctors really do make the worst patients). He told us that if we waited even just a few more days the cancer could have spread considerably further. Over the next four weeks the tumor markers slowly decreased to normal. Lorie unfortunately was not around when it came time for my second surgery to stage the cancer.

I called her on my way home from work at 3:00 that afternoon. We talked for a few minutes. I told her I loved her and would see her soon. She told me she loved me too. Everything seemed fine without any sign of trouble or distress. I arrived fifteen minutes later only to be met outside by her niece who told me to come quickly. Something was wrong with Lorie! When I got inside she was slumped on the couch drenched in sweat and very lethargic. Her parents, niece, and nephew were all around her with extreme worry in their eyes. The ambulance had already been called but wasn't there yet. I thought her glucose was low. Her parents told me all she ate all day was two pieces of pizza after taking her Glucophage. I checked her blood sugar. Her glucose was 197. Lorie regained consciousness after her parents shouted at her to wake up. She said, "Pepsi" thinking her sugar was low as well. That was the last word my wife ever uttered on this Earth again. One second after that she collapsed in my arms. I moved her to the floor and checked for breathing and a pulse. Neither were found. I began cardiopulmonary resuscitation in extreme denial that my beloved wife was no longer with us. It felt like an eternity before the ambulance finally arrived. They did everything they could but she was in a pulseless electrical rhythm on the monitor (a quasi normal rhythm but no true heartbeat). We loaded her into the ambulance and sped off to the nearest hospital. All the while I am in the back still performing chest compressions. When we arrived at the hospital she was pronounced dead on arrival. After everyone cleared out of the emergency department room, I said my final goodbyes and told her that it was ok and I release her to go to the Light and be with Emily and Jesus in heaven. My wife, Lorie Wynne Combs, passed away on Jan. 2 from a lethal pulmonary embolus.

Even as I type this story two and one-half months later I still break down and cry uncontrollably. Some people have told me this is a good way of coping with the loss. Honestly right now I don't know. Maybe later when I look back on this story, I may feel differently but for now I just don't know.

I underwent an open retroperitoneal lymph node dissection on Jan. 23. This was to stage the original cancer and prevent further spread. All 19 lymph nodes came back negative. This meant NO chemotherapy or radiation only surveillance chest X-rays, tumor marker blood work, and yearly chest CT's over the next ten years.

As you can see I have been through more than most people have in two lifetimes. The things that have helped me get through it all are the following:

1) Knowing and trusting in the almighty living GOD above.
2) Lorie went the way she wanted to go- before me, quick, and painless.
3) She as well as Emily are both healed of all illnesses and are in heaven. Emily was baptized just before she passed away. Lorie was baptized when she was a teenager.
4) Knowing she was now with Emily. (When we returned from Pennsylvania, she was not the person that went there 1 month before. I, as well as most of the other family members agree, believe that her desire to live died when Emily passed away and it was only a matter of time before her body caught up to her mind).
5) Mom told me that she felt Lorie should have died from a massive pulmonary embolism 2 year before (in November) but GOD spared her life long enough so that she could have Emily and would not be alone in heaven.
6) Knowing that I will someday join them and again be a complete family at a time of GOD's choosing, NOT my own.
7) Strong family support and very caring supportive coworkers.
8) I await the day to see how GOD will use all of this misery for a greater good. This is my answer to the "why all of this?" question.

Dedicated to the loving memory of my beloved wife and mother, Lorie and precious daughter, Emily.

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