A Battle off the Court Schwab's survival nothing short of a miracle By Steve Yanda, Tribune Staff Published in The Marquette Tribune on Tuesday, November 15, 2005 It had been a relatively good morning for Trey Schwab. Thirteen days removed from undergoing a double lung transplant, Schwab was out of his bed and walking around the intensive care unit at the University of Wisconsin-Madison Hospital. Knowing he was still recovering from a mild case of pneumonia, the doctors had left Schwab on a ventilator a few days longer than originally expected. But now the ventilator was off, and any movement was a good sign. There was talk that Schwab might have been removed from the ICU later that day, March 1, 2004. It had been a good morning, a Monday morning at that. Schwab even felt good enough to go to the bathroom, and his ability to do so on his own was yet another sign that his recovery was progressing. Two steps out of the bathroom, Schwab's chest tightened. No big deal. After battling a life-threatening lung disease for two and a half years, you learn to function on short breath. Schwab took another step, or at least, that's what his brain told his leg to do. Having served him well just moments earlier, Schwab's legs had become cement blocks. His chest was getting tighter now, his new lungs searching for air that would not come. Forcing out a cry for help, Schwab got the attention of a nearby nurse, who helped Schwab back to the patient's bed. "I knew something was wrong at that point," Schwab said. "That's when all the rules changed." * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Actually, all the rules had been changing for Schwab since August of 2001. After four years as a scout for the Minnesota Timberwolves, Schwab decided it was time to step away from professional basketball. "The scouting job required a lot of traveling, and I wasn't around the team as much," Schwab said. "I was looking to be more settled." So when a position opened up on the coaching staff at Marquette University before the 2001-'02 season, Tom Crean, head basketball coach and an acquaintance of Schwab's via Michigan State head basketball coach Tom Izzo, could think of no better person to fill the role. "I knew of Trey's reputation and had tremendous respect for him. To me, that was a no-brainer situation. I had to have him in here," Crean said. "Trey is very real; no agenda. He's just a regular guy who wants to help everyone become better. He has such a big heart." There was no hesitation on either side. Schwab would make the move from Minneapolis to Milwaukee and begin work immediately as a special assistant. His new job would require him to coordinate team travel and recruiting, things he could do from the comfort of Marquette's campus and still be able to attend practice every day. Moving into his new apartment one hot August day in 2001, Schwab began to experience what would become a familiar feeling over the next two and a half years - shortness of breath. Jerry Sichting, a Timberwolves assistant coach, and his son, Jared, were helping Schwab move in that day, and both noticed that Schwab was having trouble moving around. "I told him to go inside and organize stuff in the apartment and that we would take care of the heavy lifting," Sichting said. "I just thought he was having an asthma problem." * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Lying immobilized in his hospital bed that first day in March, Schwab could only watch, wide-eyed, as doctors and nurses scurried in and out of the room. Though he was struggling to breathe, Schwab felt no significant pain, and that's what worried him the most. What neither Schwab, nor the medical staff knew at that time was that a series of blood clots were crawling up his legs and into his chest, blocking off blood-flow to Schwab's heart and new lungs. Try as they might, Schwab's transplanted lungs could only process for about a minute before they had depleted their blood supply. With no incoming blood, the lungs could not produce any oxygen, and with no oxygen, Schwab's heart could not pump any more blood. It did not take long for Schwab to lose all blood pressure in his veins. For the next forty minutes, Trey Schwab was dead. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * After moving into his new home, it did not take long for Schwab to establish close bonds with his players. Players would come into study hall to get some work done, and Schwab would be there. The team would gather for meals, and Schwab would join them. This was what Schwab had been missing all those years with the Timberwolves - a chance to become more than just a distant team representative, a mere face in the crowd. "It's supposed to be a family in basketball," Schwab said. "It was a smaller staff. We (the coaches) were really close to the players, and they were really close to us." Toward the latter part of October in 2001, Schwab began feeling run down. That energy that had become a staple of the assistant's personality over the years just wasn't up to its usual high level. Schwab also noticed he had this nagging cough. Crean began feeling the same way, and when both men developed fevers, they went to see Darin Maccoux, the team's physician. After looking both men over, Maccoux thought that Schwab and Crean were suffering some kind of pneumonia. The doctor gave both coaches the same antibiotics and told them to report back if they had any further problems. With the season fast approaching, neither coach really had time to rest and recover. There was too much work to be done. The team had just started practicing, and there was a lot of film work that needed to be prepared and reviewed to get ready for the first few games. There was no time to pay attention to some silly cough. A couple of weeks passed and Crean's body appeared to be responding well to the antibiotics. Schwab, on the other hand, was feeling as run down as ever. One morning, Schwab awoke and headed to the shower like he always did. And as had become the norm, Schwab began a fit of coughing. "Out of habit, I stuck my hand down to see what I was coughing up," Schwab said. When he looked down, all he could see was a hand full of blood. "That can't be good," Schwab thought as he quickly got out of the shower. Schwab immediately picked up the phone and called Maccoux. "Doc, I think something pretty serious is going on here." * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Dr. Robert Love, director of lung transplantation at Wisconsin-Madison Hospital, was supposed to be in the operating room all day on March 1, 2004, but a last-minute cancellation had allowed him the free time to make rounds to some of his ICU patients. Walking down the hall of the ICU, Love happened to be near Schwab's room when the patient began struggling to breathe. In a matter of seconds, Love was at Schwab's side, trying to diagnose exactly what was wrong. "Trey looked pretty panicked, and typically, Trey's a pretty stoic guy," Love said. Schwab became combative, only adding to the chaos of the situation, so a nurse injected him with Versed, a sedative that wipes out memory. "They told me afterwards that if I made it through my ordeal, they didn't want me to remember any of it," Schwab said. The nurses saw Schwab's kicking and squirming as combative; Schwab saw it as fighting for his life. His brain was running out of oxygen, and he just wanted to know what was wrong. "I'm not sure what's happening, but we're going to tube you and get some air in you," Schwab remembers Love telling him. "We'll figure this out. Don't worry. We're right here. We're going to figure this out." And then the world went blank. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * As soon as Schwab got off the phone with Maccoux, he went straight to the hospital, and still, the doctors had no answers. "They just didn't know," Schwab said. "They thought my lungs were just aggravated from all the coughing." Maybe it was just a tough case of pneumonia. A few days later, Schwab was sent in for a bronchoscopy, a minimally invasive procedure in which a tiny camera inside a tube was moved down his throat to examine his lungs. Out of the bronchoscope, the doctors extracted fluid samples from the lungs, but nothing conclusive could be determined from the results. Still thinking that this was just a bad case of pneumonia, the doctors put Schwab on high doses of steroids to go along with the antibiotics. By the middle of December 2001, Schwab had been on the steroids for a month and a half to no avail. His lungs still swollen, Schwab decided to get a surgeon to perform a lung biopsy. "I got to a point where I just wanted someone to get in there and find out exactly what was going on," Schwab said. The man was tired of hearing what a bad case of pneumonia he had. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * When you can't see what is wrong from the outside, it's hard to make a diagnosis and fix the problem. That was the issue Love was facing in the ICU, as a group of nurses were rotating to perform CPR on Schwab, just to keep the patient alive. "There wasn't a whole lot I could do at that point. I decided to take him to the operating room and open his chest," Love said. "Honestly, I didn't expect much chance for success." So down the hallway they went, Schwab lying motionless on his bed while a nurse performed continuous CPR as Love and some other nurses wheeled them toward the elevator. Because Schwab had gone into complete cardiac arrest, he stopped living whenever the nurses stopped administering CPR, so the rotation was ongoing right up until the patient was put on bypass. Once in the operating room, Love made an incision into Schwab's chest, connected the bypass machine, and opened up the right side of Schwab's heart. And then the dirty work began, as Love pulled out a 20-inch clot that had completely obstructed blood flow to Schwab's heart and lungs. "It looked like I was pulling out an entire vein from his leg," Love said.