Intercepting danger: UK physicians tackle football coach’s life-threatening condition

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LEXINGTON, Ky. (Nov. 26, 2024) - “COVID saved my life.” 

That’s not something you hear often, but for Shan Housekeeper, it’s a reality. The 44-year-old husband, father of three, and college football coach found himself facing a life-threatening medical condition during a time when the world was grappling with its own health crisis.

Like many during the pandemic, Housekeeper was forced to slow down. 

“I had been having symptoms for months — tunnel vision and lightheaded spells up to 25 times a day,” said Housekeeper. “But, like many men, I brushed it off. I thought I just needed more water or rest, and I’d fix it myself.”

However, the pause created by the postponed 2020 football season gave him the time to act. Housekeeper, then an assistant coach at his alma mater, Georgetown College, visited a local eye doctor after his symptoms persisted. What started as a routine visit turned into a life-saving intervention. The ophthalmologist, alarmed by his test results, urged him to go to the University of Kentucky Albert B. Chandler Emergency Department immediately.

Critical Diagnosis

Housekeeper learned he had dangerously high pressure behind both eyes. 

“It wasn’t how I planned to spend a Friday night,” he joked. “But the urgency from my eye doctor made it clear I needed to get to UK since they have a neuro-ophthalmology department.”

After his initial workup in the emergency department, Housekeeper was diagnosed with intracranial hypertension. 

“I didn’t necessarily meet the normal demographic for that, but I was ready to move on with treatment plans for that condition and a referral to neuro-ophthalmology,” he said. 

Meanwhile, Brian Adkins, M.D., an UK HealthCare emergency medicine physician, reviewed Housekeeper’s tests and decided to run one more test — a CT scan with contrast. That decision potentially saved his life. The scan revealed a blood clot in his jugular vein, causing the intracranial hypertension. The clot was blocking normal blood flow, creating pressure in his brain that could have led to a stroke — or worse.

“Dr. Adkins’ attention to detail made all the difference,” said Housekeeper. “Without the dye contrast, they might not have found the clot until it was too late.”

A spinal tap relieved some of the pressure, but Housekeeper’s journey was far from over. He was placed on blood thinners and medication to manage the brain pressure while specialists at UK HealthCare’s Kentucky Neuroscience Institute, including neuro-ophthalmologist Padmaja Sudhakar, M.D., began piecing together the cause of his condition.

Dr. Sudhakar saw the swelling in Housekeeper’s optic nerves and began exploring underlying causes. 

“He didn’t fit the usual profile for this condition — he’s healthy and active — but the blood clot was a clear danger,” said Sudhakar. “If left untreated, it could have caused a stroke or other severe complications.”

Sudhakar was able to manage the brain pressure and bring the levels down with medications, but they knew they still had to do something about the blood clot in his jugular vein. Over the course of several months, Housekeeper was responding to the medications, his pressures stayed in an acceptable range, and on some scans the blood clot seemed to be improving. 

“Then he came back for an eye exam and the optic nerve swelling was back. We were confused and wondered what else could be going on,” said Sudhakar. “I was able to get him right over to neurosurgery. They did an investigative procedure called an angiogram so they could see if the clot cleared out or if it was still somewhere in the vein that we couldn’t see in the MRI.” 

Through that test, neuro interventionist Shivani Pahwa, M.D., located an arteriovenous fistula (AVF) between Housekeeper’s arteries and veins supplying the skull and brain. An AVF is an abnormal connection between an artery and a vein. The causes for developing an AVF can vary and can occur anywhere in the body, but are most common in the head, neck, spine and liver.

A New Chapter

This whole ordeal transpired over the course of many months. It all coincided with the world adjusting to and living with the reality of COVID-19. As programs resumed and businesses reopened, Housekeeper and his family were in the midst of their own major change. 

In December of 2021, Housekeeper was presented with a dream opportunity — a head coaching position. Just after the start of 2022, he was introduced as the new head football coach at the University of the Cumberlands in southeastern Kentucky. As he got to work in the offseason, Housekeeper continued undergoing various treatments and procedures hoping to get everything resolved. 

Dr. Pahwa and her team were hopeful they could do that with one procedure, but his case would ultimately require three. “They used what was called Onyx, which was described to me as like a lava-type material that goes through all the vessels that need to be closed off,” said Housekeeper. One pass of that provided some success, but doctors decided they should do a second pass and place some coils to try to get rid of the fistula. 

A few weeks later, on the Monday following his first win as a head coach, Housekeeper underwent his third procedure. 

“Everyone in that neurosurgical unit is outstanding,” he said. “I was very fortunate, a unique case for them. I had to stay in the ICU overnight after each of these procedures because of the complex nature, but I got to walk out. That’s not something they see out of that unit a whole lot, and that’s not lost on me.” 

Following the third procedure, Housekeeper was scheduled for another angiogram to check on things, and they also scheduled him to undergo Gamma Knife radiosurgery. It is a procedure more commonly used for cancer treatment. For Housekeeper, they intended to use the technology to laser off the remaining fistula. 

“It didn’t sound too exciting, but I fully trusted them,” said Housekeeper. 

As they looked at the initial evaluation and angiogram, doctors discovered that what they had done previously had finally killed off the remaining fistula. 

“I was super thankful,” said Housekeeper. 

Grateful for the journey

Housekeeper’s vision is consistently 20/20 now, and his brain pressure stays within the normal range. Doctors continue to monitor Housekeeper, and he undergoes regular checkups. Everyone involved knows his story could have taken a much different path. 

“This could’ve been catastrophic. The clot could’ve extended, this all could have led to a stroke which then could have caused motor weakness, sensory loss, or even death,” said Sudhakar. 

“These doctors saved my life and my quality of life,” said Housekeeper. “I’m very, very thankful for each one of them.”

Each of the doctors are thankful that Housekeeper sought care at UK, as they believe that played a huge role in the positive outcome. Having patients like Housekeeper receive care at an academic health system — where multiple specialties are available in the same place — helps lead to a best-case scenario, says Sudhakar.

“This is very, very rare. Many times, when you have a fistula, if it is not found doctors treat the swelling with repeated lumbar punctures and sometimes when repeatedly doing those the brain can herniate and risk the patient’s life. So, I’m extremely thankful that through all of our specialties we have robust treatment options to offer our patients,” said Sudhakar. “From the first contact in the emergency department, we have the appropriate tests and protocols to offer and catch things like blood clots. Not being seen on time or not getting the correct set of testing can be detrimental to care. We are extremely lucky that we have everything right here at UK.” 

Doctors are still unsure what exactly caused all this to transpire for Housekeeper. They are continuing to investigate if the blood clot happened first and led to the fistula, or vice versa. Ongoing research into his case is another key aspect in his treatment taking place at an academic hospital. 

Housekeeper is wrapping up his third season leading the University of the Cumberlands Patriots. Throughout his health journey, Housekeeper leaned on the discipline and resilience he honed as a football coach. In many ways, the traits that defined his coaching — strategic problem-solving, trust in his team and a focus on incremental progress — mirrored the approach his doctors used to tackle his condition. 

“As a coach, I tell my players to focus on the process, not just the outcome,” Housekeeper shared. “That mindset helped me during this time. I had to trust the experts around me and take things one step at a time, just like we do on the field.”

 As the game of football teaches players to fight for every yard, Housekeeper says his journey has taught him to fight for every moment. And when looking back on his family’s time in Williamsburg thus far one word comes to mind: Thankful.  

“The team of doctors gave me this gift of health,” he said. “I hope to use that gift every day — to impact my players, my family, and my community.”