He Had a 1 to 2% Chance of Survival. But the ICU Team Would Not Give Up.
Novant Health ICU team was there for beloved Kernersville restaurateur.
At 77, Nick Rizos was a local legend in Kernersville. The patriarch of a close-knit Greek family had immigrated to the U.S in his 20s seeking greater opportunities. He opened his first Olympic Family Restaurant in Kernersville in 1979. Rizos cooked, managed the business and loved talking with customers, especially about sports. He was an inspiration to his daughter Zoe, who worked in his diners growing up and now owns two restaurants of her own.
Though he had long since retired – his son Bill leads the restaurant in Kernersville, while his son Dino operates a second location in Colfax – Rizos stayed active. It was unusual to see him slow down. This signaled something was wrong a few days after he returned from a mountain trip in November 2020. No one was safe from COVID-19 then. No vaccine was yet available to the public.
Zoe stopped by Rizos’ home to check on her dad. Alarmed by his difficulty with breathing, she brought him to the community hospital close to home, Novant Health Kernersville Medical Center. His breathing quickly grew ragged. Within a day he was transferred into the intensive care unit and placed on a ventilator, commonly known as life support.
Rizos stayed in the hospital for three weeks under the care of Dr. Daniel Feinstein, clinical physician executive and director of pulmonary and critical care for Novant Health in Winston-Salem. Rizos “probably had a 1% or 2% chance to come off that machine and live,” Feinstein said.
Planning For a Funeral
Rizos was critically ill by the time he met Feinstein. He developed a severe lung injury known as ARDS, or acute respiratory distress syndrome.
The Novant Health team of physicians, nurses and respiratory therapists tried every medical therapy then available to fight the coronavirus. Rizos needed “many, many procedures,” Feinstein said, along with medication to induce paralysis and allow the ventilator to control his breathing. Only the most severely ill patients require such a step.
After four days on the ventilator, Rizos had to be turned on his belly to improve the distribution of oxygen to his lungs and other organs. Known as proning, the procedure was common for COVID-19 patients at that time, but it can be dangerous for someone on life support because the breathing tube might dislodge. Later, Feinstein inserted tubes in Rizos’ chest because he had developed pneumothorax, or air around the lungs.
“The mortality was extremely high for patients with COVID-19” at this stage of the pandemic, Feinstein recalled. “Patients who required the degree of support he needed typically were not surviving.”
Families were not allowed to visit during COVID’s height. Feinstein and the medical team talked daily with an anxious Zoe and her daughters Nicole, a college student with an interest in medicine, and Effie, a pharmacist. Both young women helped explain to family members some of the intricacies of the care.
The Novant Health team was giving it everything they had. Still, on Dec. 1, nurses handed Zoe a bag of her father’s clothes, plus his watch and wedding ring. “They told me he wouldn’t be needing this anymore, and to go home and prepare for a funeral,” she said.
Feinstein couldn’t help but concur. In one day during the pandemic, he lost two 37-year-old patients to COVID-19. Zoe and her family were praying for a miracle. But Zoe also spent time selecting photos they might show at her dad’s funeral.
A couple of physician friends urged Zoe and the family to move Rizos to a bigger hospital.
“I could not imagine moving him elsewhere. I had absolutely no reason to,” Zoe said.
Feinstein called her and the family daily with updates.
“We were very well taken care of. All of the staff was just absolutely phenomenal,” she said.
A Doctor’s Idea…
Rizos had been in the hospital for nearly three weeks when Feinstein had an idea. Typically, he would wait for patients to require only minimal support on the ventilator before starting to wean them off. Yet serious COVID-19 patients didn’t show the traditional signs which indicated the ventilator could be safely removed.
Feinstein knew Rizos was physically strong and mentally determined – both important for survival from critical illness. He decided to see how Rizos would fare without the ventilator.
Zoe was at a funeral in Fayetteville when she saw a familiar name pop up on her cellphone. It was Feinstein. “We just took your dad off the ventilator and he’s breathing,” the doctor told her.
Zoe teared up with joy. Yet the moment was bittersweet. She was at the funeral of her cousin’s husband. He had died in his 50s from COVID.
Rizos’ condition continued to improve, and as soon as Rizos could talk, he told Zoe, “Come get me.” He needed support to regain his strength and was transferred to Novant Health Rehabilitation Hospital in Winston-Salem. Rizos was wheeled in a stretcher, so weak that he couldn’t lift his arms off the bed. The combination of sedation, paralysis medication and steroids in his treatment triggered what’s known as critical illness myopathy, a significant and common side effect that causes muscle weakness.
After two weeks of rehab, Rizos walked out on his own. He had been intent on traveling to a beach condo he had just purchased and furnished in Greece. “He kept saying he needs to get up and get moving because he needs to see his house,” Zoe said. She drove him to an outpatient rehab center three times a week to encourage him to continue exercising and reach that goal. Two months after Rizos was released from Novant Health Rehabilitation Hospital, Feinstein received a photo. It was Rizos on a motorcycle, enjoying the sun on a Greek island.
A Grateful Family
Meanwhile, Feinstein had grown close to the family. Nicole, Rizos’ granddaughter, shadowed Feinstein on his rounds at the hospital as she explored the possibility of being a doctor. Feinstein supported her medical school application, and she is now in her fifth semester.
She’s grateful to Feinstein for saving her grandfather’s life. “His empathy and genuine concern for Papa’s well-being and recovery was truly unmatchable,” she said. “That kind of care is so crucial because it’s not just a patient going through this, but the entire family is also affected by it.”
In July, the family spent time with Feinstein on a very different occasion. They had invited Feinstein, his wife, and their three children to the Greek island of Paros for Effie’s wedding.
Rizos was alive to see his granddaughter get married. Feinstein was there to see it.