It started this time with a sneeze.
Gabe Sanchez was driving to Kingman High School to pick up his son from a basketball game in January when he sneezed, then felt a small pinch in his abdomen. It took several moments before he felt a warm, wet feeling creeping across his stomach. He looked down to see he was covered in blood.
Sanchez's sneeze had torn scar tissue on his stomach from when his gall bladder had ruptured nine years ago. He had so many complications from the resulting surgeries and his condition was so dire, that doctors eventually told him that his recovery was between him and God. But Gabe battled back from the illnesses that stole years of his life and put him $2 million in debt.
He remarried, rebuilt his life and thought he had put it all behind him.
That was until the sneeze in January.
At a time when health care reform is being debated at the highest levels of government, Gabe Sanchez and his wife Tina Tapia's story shows how individuals and families struggle with the high costs of the care that their lives depends on.
Hospitalized for months
Gabe was leaving for work one morning nine years ago when he told his then-wife that he didn't feel well.
"Something's not right," he remembers saying before he collapsed.
He woke up more than six weeks later and learned that his gall bladder had ruptured. His only warning had been minor stomach cramps that came and went a few times in the months prior.
Over the next 21 months, Gabe pretty much lived at St. Joe's Hospital in Phoenix. He had eight major surgeries. The ruptured gall bladder caused his spleen to become infected and also explode. That led to all of his major organs becoming infected with gangrene. There were multiple blood transfusions and a section of his stomach lining and muscle, along with eight feet of intestine, were removed. He spent a total of six months in an induced coma and when he awoke, the news wasn't good.
"There wasn't anything they thought they could do," Gabe said. "My doctor said it was between me and God."
The first eight months of recovery were spent on bed rest with extreme restricted movement to allow the surgical wound on his stomach to heal. After that, it was months of rehabilitation relearning how to use his muscles to sit and walk. Talking was also a struggle after having undergone a tracheotomy.
At the time, Gabe had insurance that covered 80 percent of his medical bills, but his share was still $2 million. He declared bankruptcy, which evidently didn't clear all his debts since he still has creditors garnishing his wages after all these years. He also lost his home and eventually his marriage.
But Gabe wasn't bitter; he was humbled.
"It put me in my place. It showed me I wasn't as physically powerful as I thought," he said.
While he was hospitalized, Gabe's friend Tina came to visit him. During his recovery, the two began dating and eventually married.
"We were starting at rock bottom and I knew that going into this relationship," Tina said. "It's taken us a long time to get to where we are and now we're afraid of losing it all."
The sneeze in January started a series of events that have dramatically changed Gabe and Tina's lives. It took hospital staff multiple tries to close the wound that had opened when Gabe sneezed because of the thin scar tissue that surrounded it. Several days later, Gabe noticed a red bump growing out of the top of his sutures. It started as a dot, then grew to the size of a gumball. When the fistula ruptured, it turned out to contain bile from the lower intestine. Somehow when the wound had been sutured, Gabe's intestine had been nicked, causing bile to leak into his stomach.
The intestine had attached to the lining of Gabe's stomach, creating a large abdominal hernia that caused Gabe's stomach to grow to what he describes as his "Franken-belly." He's gotten more than a few comments from people who don't know about his medical condition and think his enlarged stomach is simply the product of being obese, even though the rest of his body is that of a lean 40-year-old.
"It's embarrassing," Gabe said. "It's devastating for me to look at."
In a twist of fate, Tina posted on Facebook about her husband's condition and received a response from the wife of a doctor who turned out to work at St. Joe's.
The doctor, Kevin Potter, and his wife, Crystal, are both Kingman High School graduates. Kevin specializes in hepatobiliary, pancreatic and gastrointestinal surgery and thought he might be able to help Gabe.
Dr. Potter recommended a surgery that would essentially push everything back into the extended cavity of Gabe's hollow stomach. The surgery would last at least eight hours and Gabe would have to be put into an induced coma since the pain would be too traumatic for his body to process and has the potential to send him into shock.
He'd be looking at a minimum stay of 10 days in the hospital with at least two months of intensive recovery.
Gabe and Tina have already amassed about $225,000 in medical bills. The surgery would likely more than double that amount.
Gabe is the manager of the IHOP restaurant on Stockton Hill Road where's he worked for four years. He has health insurance, but his claim is being reviewed because his latest problems may be considered a pre-existing condition.
If the insurance doesn't pick up the cost, St. Joe's has offered to potentially cover the surgery as a charitable endeavor.
"St. Joe's has a long history of charitable care, especially for patients they already have an established relationship with," Potter said.
Meanwhile, the couple is trying to keep up with the mounting costs of weekly supplies that total upwards of $1,000 a month.
Gabe and Tina have four kids, ages 15, 12, 9 and 4. Tina would work if she could, but has been sidelined with her own medical illness. A year ago she had lung surgery after a bout of Valley fever and learned she had polycythemia, a lifelong blood disorder. The overproduction of red blood cells requires a hospital visit every two months to have her blood drawn and monitored.
Tina has become a medical professional of sorts, both as a result of her illness and her husband's. Every other day she visits Uptown Drug for new supplies. The ostomy bags that collect the waste out of Gabe's stomach cost around $300 a week, even though the bags are made out of thin plastic. The specialized tape to hold everything in place and prevent leaks is another $100.
With so many bills, luxuries like dinners out and entertainment for the kids are now non-existent.
The couple also lives in fear of losing their home. They are in a unique rent-to-own lease at $1,200 a month they said was graciously arranged by the owners upon learning of the family's previous medical and accompanying financial issues. The couple said they owners are aware of their situation and have been more than understanding, but that they don't want to get to a point where they are behind on their payments.
"We aren't behind but we have no backup," Tina said. "They deserve their lease payment, too."
That sense of responsibility is strong with Gabe and Tina, who have been each other's source of support throughout their ordeal.
"We're just doing what we have to do," Tina said. "We just make it work."
The couple is looking into fundraisers like car washes and the like, but are at a loss as to how the get the ball rolling while still managing their conditions. In the meantime, Tina has set up an account at Wells Fargo under the number 8507500224 for friends and family to make donations.
Gabe and Tina have been honest with their children about Gabe's condition and the difficult road that lies ahead. Tina said she herself is struggling with the "what if's," but said losing her husband is not an option.
"I can't go there," she said. "I can't process that, my fear of not having him here. He's our whole world. He's the love of my life and a great father."
Gabe struggles with everyday tasks. When he does manage to fall asleep, he wakes up nearly every hour to empty his ostomy bag. He's swallowed his embarrassment when the bag has accidentally disconnected and caused a mess.
His immune system never really recovered from his first hospitalization almost a decade ago. His system has become so compromised that what for others is a simple cold turns into a two-month long illness for Gabe.
Gabe said he was given a second chance after his first round of surgeries nine years ago and refuses to give up.
"I am a firm believer in God," he said. "He gave me this life back. If I gave up, it would be a waste of that second chance."
But more simply, Gabe said he's just doing what has to be done.
"At least I'm here to deal with it," he said.
Gabe and Tina said they welcome feedback from the community. They can be reached by emailing the family at firstname.lastname@example.org.