A Spider Bite and the Benefis Cardiac Team Changed Choteau Nurse’s Life

CHOTEAU  Shelly Rulon considers herself a “walking miracle.”

As Shelly put on her muck boots one morning on her way to feed the chickens, she felt pain as though her foot had encountered a glass shard. She shook out the boot and screamed.

A spider that would prove to be a brown recluse dropped from the boot.

Shelly didn’t connect the spider with the pain in her foot until hours later when a red streak shot up her leg. The bite had morphed into what looked like a reptile eye.

shelly rulon in hospital

She called Doug Casperson, a certified physician assistant at Benefis Teton Medical Center (BTMC) and neighbor. She caught him on vacation, but he reviewed a picture of the wound and started her on a three-week course of medicine.

Despite the medication, Shelly felt terrible as the three weeks ended.

“I felt short of breath. I couldn’t walk,” she said.

Doug met her at BTMC for an examination. A chest X-ray showed congestive heart failure. Shelly was shocked. She was fit and only 56 years old.

Cory Jackson, a visiting echo technician from Benefis in Great Falls, performed an echocardiogram.

“I’ve seen a thousand echocardiograms, and I was still very nervous,” Shelly, a nurse, said.

A Benefis Heart and Vascular Institute cardiologist weighed in. The news wasn’t good. Shelly had the “no squeeze disease,” more formally called low ejection fraction.

Healthy hearts have an ejection fraction of about 55-70 percent, measuring how much blood pumps out of the left ventricle with each heartbeat. Below 55 is a low ejection fraction, and 35 and below means a high risk of heart failure. Shelly’s heart was at 19 percent.

So Shelly became one of cardiologist Miroslaw Sochanski’s first patients in Montana, and she was skeptical. She said nurses like her often make the worst patients and push back with doctors the way other patients usually don’t.

Dr. Sochanski took the time to build a relationship of trust with her, she said. He still goes out of his way to greet her no matter what brings her into Benefis for treatment.

shelly rulon

Shelly doesn’t do well with painkillers or anesthesia. She was semi-awake as Dr. Sochanski tried to put in stents. She heard him say as he looked at her heart, “We can’t do it. Call Dr. (Steven) Bailey for open-heart surgery.” She tried to argue with Dr. Sochanski through her daze.

As Dr. Bailey and physician assistant Jennifer Decker reviewed with her the heart surgery she needed, Shelly put her fingers in her ears to avoid hearing about possible complications.

“I was yelling at the man who was going to be holding my heart in his hands,” she said. “I just had a moment and lost my mind. I was so scared I was shaking.”

Dr. Bailey was gracious and caring, and Jennifer talked her through the process and in time became a friend. Shelly had the surgery and woke three days later with her heart beating too fast.

“The care those Fifth Floor nurses gave me, well, they’re like golden nurses with a direct route to heaven. They prayed with me, they sat with me, they comforted my family. They would have painted American flags on my toes if I’d asked them to,” she said.

Dr. Hanna Konarzewska implanted a defibrillator to fix Shelly's heart's low ejection refraction. 

Shelly has been a nurse since 1991 and works in a Fairfield assisted living home and a Choteau psychiatrist’s office. Gaining a patient perspective has made her a better nurse.

“The care there was unbelievable, and that’s coming from a nurse,” she said. “They treated me like I was their family. They were so respectful and cared about my dignity.”

shelly rulon hunting

She also sang the praises of the schedulers at Benefis, who found ways to accommodate her when her condition became dire.

Shelly went home on oxygen. She couldn’t get up the four steps to her house. Doug came by twice a day to check on her. Shelly developed fluid in her lungs. They had to be drained four times through a procedure called thoracentesis, which can range from “some discomfort” to in her case “20 times worse than my C-section.”

Benefis pulmonologist Jason Kjono coordinated with the cardiac team and figured out that she had a very rare drug reaction. Throughout her care, Shelly wonders how things might have gone differently without the skill and compassion of providers such as Jason, Dr. Sochanski, and the rest of her team.

Shelly doesn’t know if the spider bite damaged her heart or only revealed that her heart wasn’t working. Approaching a year after heart surgery, Shelly plans to celebrate her “Rebirthday.” She feels fantastic and was fit enough to drag a buck out of the mountains.

“Don’t have heart problems just because of how good the cardiac team is,” she said. “But know they treated me as they would want to be treated. They treated me with such respect and built trust. They let me argue with them. They’ve gone way beyond for me. They’re all friends now.”