Julie Gray

"As a nurse, I am able to appreciate the knowledge, time, effort and degree of caring that Mayo Clinic showed to me," says Gray.

For Julie Gray, nursing has been rewarding on a professional personal level since she entered the field back in 1983. Her career allows her to connect with patients and help them through difficult times in their lives.

"Since the third grade, I knew I wanted to be a nurse," says Gray, a 46-year-old Las Vegas resident. "I care about every patient and enjoy my time helping people. I always have thought that if I got into a medical situation that required help, I would hope that there would be someone there for me."

Needing help

In June 2005, Gray found herself in such a situation. She experienced some discomfort in her left shoulder after moving some furniture. "I was working the next day in the emergency room and started to have more pain," says the 46 year-old Gray. "I decided I should have someone in the hospital take a look at it." Gray was astonished by what the physician she had worked with every day told her next. She had fluid around her heart and lungs.

"I was hospitalized immediately and many tests were done, in an effort to diagnose the cause," says Gray, who continued to suffer and ended up being hospitalized two additional times in Nevada. "They told me they were uncertain as to what had caused my condition and had to wait for test results for some possible answers. My symptoms were temporarily controlled with medications, which included steroids. The medications were continued at home, including an effort to slowly decrease the dose of steroids, but the pain and shortness of breath steadily worsened and I ended up being hospitalized again and again."

Julie's mother, Marilyn Shapiro, who is also a nurse, says her daughter was in extreme pain. "We were having a family gathering for my birthday in Las Vegas and Julie had to leave," said Shapiro. "We were all very concerned for her. When her problems continued beyond the first hospitalization, we knew this was becoming a chronic thing."

Physicians in Nevada seemed to pinpoint Gray's condition as pericarditis, but couldn't figure out why she continued to have pain. "I wasn't working and I wasn't sleeping." says Gray. "I had constant pain and couldn't find anyone who could help me."

Miracle meeting

A physician from Las Vegas eventually recommended Gray go to Mayo Clinic for a second opinion and arranged for an appointment at Mayo Clinic in Arizona the following week.

Farouk Mookadam, M.D., a Mayo Clinic cardiovascular diseases specialist, met with Gray after being recommended to her by another cardiovascular physician she had an appointment with. "Dr. Sylvia Mamby, the cardiovascular specialist I had an appointment with, knew about Dr. Mookadam. It was like a miracle meeting Dr. Mookadam," says Gray. "He was the first medical professional that I had met since this illness had began, who really had a clue as to what I had been going through. He seemed to be able to tell me what symptoms I had been having all physically, mentally and emotionally and how it all had affected me. I didn't even have an appointment, but he agreed to see me immediately.

"Dr. Mookadam showed me an entire presentation that he had previously given on the exact disease process that I had been up against," says Gray. "As a nurse, I am able to appreciate the knowledge, time, effort and degree of caring that Dr. Mookadam showed to me."

"Julie had relapsing pericarditis, which is a very disabling and chronic disease," says Dr. Mookadam. "The side effects of medications are harsh and the disease is intractable and leads to multiple hospital admissions and ER visits. It often goes undiagnosed as the patient suffers."

Pericarditis is a swelling and irritation of the pericardium, the thin sac-like membrane that surrounds the heart. This condition often causes chest pain and other signs and symptoms. "It causes much social discord, loss of work, loss of self-esteem, loss of friends and withdrawal from social circles," says Dr. Mookadam. "You can imagine the psychosocial impact of losing all these components of your life as the disease grips your life and squeezes the joy from it."

Dr. Mookadam and Gray met with the Mayo Clinic surgical team to discuss the next steps. A decision was made to perform a complete pericardiectomy, which involves removing the pericardium. This procedure eliminates chronic fluid accumulation in the area between the heart and pericardium, which can squeeze the heart and prevent it from functioning properly, such as in Gray's case.

The three-hour procedure took place on Feb. 1, 2007.

Dr. Mookadam explains that an incomplete removal of the pericardium can result in recurrent pain and disability.

Back to nursing

"After the surgery, they explained to me that my pericardium was red and inflamed and adherant to my heart and my lungs," says Gray. "Without the surgery, I would have just continued to get worse." Nearly three months later, Gray has discontinued her daily steroid medication and is slowly working her way back to helping others again, as a nurse.

Reflecting on her experience, Gray is still amazed by the care she received at Mayo Clinic. "Dr. Mookadam deserves a crown," says Gray. "He still calls me to see how I am and checks in on me. He is a wonderful physician and human being."

Gray's mother shares her daughter's viewpoint of Dr. Mookadam and Mayo Clinic. "I have been a nurse for my entire life and I have never seen a physician like him," says Shapiro. "On a scale from one to 10, I give them a 120. I have never seen a man with so much compassion. I didn't think a person like him existed."