A fighting patient and a skilled surgeon team up to make miracles happen at the USC Air Center

Photo courtesy of Lorna and Vai Faamafoe.

Vai Faamafoe is used to overcoming physical challenges. The former football player, shot-putter, and track athlete knows how to train his body and push it to the limits. But nothing could prepare him for his greatest challenge, brought about through a terrible bout of Covid during the early days of the pandemic.

In November 2020, Vai was working as an executive protection agent, doing his part to train a new employee at his company. There was no vaccine yet, and Covid protocols in the workplace were anything but well established. The new employee was not wearing a mask, and he was coughing. When Vai felt himself coming down with something, he and his wife Lorna feared the worst.

“A couple days later, he was complaining of being ill,” Lorna said. “We went to urgent care, he tested positive. The doctor called us the week after he started feeling symptoms saying, ‘Hey, you have Covid, but things should start feeling better now.’ But they didn’t. He got more sick.”

He was admitted to the emergency room, intubated and treated for severe Covid, even undergoing extracorporeal membrane oxygenation (ECMO) — a serious treatment reserved for only the most severe cases. But Vai is a fighter by nature, and after being on ECMO and under sedation for three weeks, he finally began to recover. He was put on dialysis for kidney failure, suffered an ulcer, lost seventy pounds, and had to leave the hospital in a wheelchair. He missed Thanksgiving, Christmas, and New Year—but still he fought, and in the end, miraculously, he survived.

Unfortunately, surviving Covid was only the beginning of Vai’s journey to recovery. Around the time of the Super Bowl, he began to have trouble breathing. As part of treatment for Covid, he’d received a tracheostomy tube, and scarring from the procedure had narrowed his airways, making it difficult to talk and to breathe.

“All of a sudden, he started to relapse. It seemed like he had a hard time breathing. It was hard to see a doctor, because everything was done by Zoom,” Lorna recalled. “They would prescribe asthma medication to open up his lungs, but none of that helped. It got to the point where he was scared to go to the bathroom without me there, it just got worse. Two days before he was hospitalized because of the stenosis, he was too scared to sleep. It was hard to breathe lying down.”

“Finally, I said, this is not right. Let’s go to urgent care and get seen.”

Vai had tracheal stenosis blocking 80-90% of the airways that deliver oxygen to his lungs, and his case was severe enough that it required a second emergency tracheostomy. The second tracheostomy resulted in a six-centimeter segment of scarred tissue, blocking 100% of his airway. This made him ultimately dependent on the tracheostomy tube and left him unable to pass air through the vocal cords to speak.

Fortunately, he had the courage and will to fight—and he found a great partner in Dr. Karla O’Dell, a laryngologist with the USC Caruso Department of Otolaryngology-Head and Neck Surgery and co-founder of the USC Airway Intervention & Reconstruction Center.

“Tracheostomy tubes and intubation are lifesaving measures,” said Dr. O’Dell. “But many people don’t realize the damage that they can inadvertently cause to the airway.”

This is what happened in Vai’s case. After asking around at various healthcare centers, a doctor the Faamafoes met while undergoing Vai’s original Covid treatment recommended he be seen at Keck Medicine of USC.

“The doctor said, ‘This is fixable. We just need to get him to a doctor who knows what they’re doing,’” Lorna said. “So I asked her for recommendations, and she said, ‘I would take him to these doctors at Keck, this is where I’d send my family.’ And with those words, there was no doubt, we were going to go to Keck.”

The Faamafoes were put in touch with Dr. Sean Wightman, a thoracic surgeon at Keck Medicine of USC.

“Once Dr. Wightman was involved, he kind of took the reins, and contacted the doctors there, got everything taken care of,” Lorna said. “Dr. Wightman was very responsive. I had his phone number, he would respond via text, so if I needed anything, he was very accessible.”

Dr. Wightman is a member of the USC Airway Intervention & Reconstruction Center at Keck Medicine of USC, a unique collaboration between doctors in various fields specially equipped to treat complex airway cases like Vai’s. The Center is the only one of its kind in all of California.

“We’re so fortunate at USC to have this special collaboration between interventional pulmonologists, otolaryngologists, and thoracic surgeons,” Dr. O’Dell explained. “We have a whole team of people who come together to take care of patients with complex airway issues that other places are not equipped to handle.”

Dr. Wightman brought Vai’s case to the airway team, and it was decided that Dr. O’Dell would be the best choice to handle his case.

Dr. O’Dell told Vai to get himself ready for surgery, a task for which he was well prepared.

“She told me, ‘I need you, Vai, to get ready for this operation we’re going to do for you, this resection,’” Vai reported. “So I said, ok. I started exercising, I started doing whatever I could, I started lifting weights, I did as much cardio as I could. It was really hard to breathe and exercise with that trach on, it’s like breathing through a straw. But I did the best I could, and by the time the surgery came around for the resectioning, I was ready, mentally and physically. All I needed to do was put my trust in Dr. O’Dell and let her do what she does best, you know?”

The surgery was to be approximately four hours in length, and was considered high-risk. Because Covid may have already weakened Vai’s lungs, along with the difficult nature of the surgery in general, many of the previous doctors outside of USC that the Faamafoes consulted would not take his case. But Vai was only 49 years old, with a tracheostomy stoma in his neck, unable to communicate or breathe easily.

“He was able to talk in light whispers, but a lot of our communication was mouth reading, texting, and white board writing,” Lorna said. ”That was very difficult for Vai, he’s a social guy. He felt very self-conscious, with the trach on him, he was still coughing, healing from Covid.”

Dr. O’Dell was not going to allow him to live with suboptimal quality of life for the next twenty or thirty years.

“A lot of other doctors, they didn’t want to touch me as far as my trach,” Vai said. “They said, ‘Vai, you’ve got to live with that trach for the rest of your life.’ But Dr. O’Dell said, ‘There’s no way in the world I’m going to let you walk around, Vai, for 20, 30 years with a trach on. This is crazy. I’m going to fix this.’”

“And that gave me a chance at life, a chance for improvement, it gave me courage,” he continued. “So I said, ‘Dr. O’Dell, you go forward, and I’ll follow you.’ So whatever she wanted to do, I was going to follow blindly, and I needed someone like that, who was so at the forefront of technology, someone like that there for me.”

“When you lose the ability to talk, when you’re dependent on a tracheostomy to breathe, you lose so much from your life,” Dr. O’Dell explained. “You can’t work, you can’t communicate with family. So even though these are complex airway problems, and Vai in particular was high risk because of Covid pneumonia and his lung status, the alternative of living with a trach and not talking forever is so bad that it’s worth the risk.”

“So many of my patients have gone back to work after not being there, moved out of facilities and back home – there are so many cases of patients with these kinds of problems where they stop their life because of it,” she said. “It’s worth the risk to restore that for somebody.”

Although the surgery was slated to be four hours, the unique nature of Vai’s anatomy and condition brought it to six. By the end of those six hours, though, the surgery was a success. Vai’s hard work preparing as a patient, along with Dr. O’Dell’s courage and expertise, combined for a successful surgery.

“I was a football player, I threw shot put and track, I was always a physical type of guy, so for me, taking walks was hard, but you know it was in my DNA already. I knew how to push my body and learn how to be a good patient as far as doing all my PT work,” Vai said. “The devil’s in the details. You do those little things and the big things will fall into place.”

Today, Vai feels that he is as good as new.

“Yes, as far as my strength, it’s about 90%. But if you ask me, I’m back,” Vai said. “I’m really happy for what they’ve done for me and really appreciative of the team there at Keck. You know, Dr. O’Dell’s team, they’re a great staff, anything I need at all, they’re there in a heartbeat. They never make me feel like I’m a burden to them.”

Thanks to his hard work as a patient and the expertise at the USC Airway Intervention & Reconstruction Center, Vai is back in action, able to communicate, exercise, and live his best life.

“I have so much to be thankful for, for USC and their medical staff. They embraced me with open arms,” Vai said. “All I had to do was just fight every day, take baby steps. And that’s my part, because they did their part, they made me feel like I was family, and they never met me before. And I’m just thankful that God put them in my life.”

Learn more about the USC Airway Intervention & Reconstruction Center here. Learn more about the USC Caruso Department of Otolaryngology-Head and Neck Surgery here.