In August 2018 a beautiful young lady living in Washington, D.C., experienced a sudden and excruciating headache. Seconds later she fell unconscious to the floor.
Her dog, Lacey, sensed something was terribly wrong and began to lick her face. This temporarily revived her, and she was able to dial 911. The medics arrived promptly and she was taken to MedStar Washington Hospital Center, which was only a three-minute ride from her condo. Soon after arrival at the emergency room she lost consciousness again and stopped breathing. A prompt neurologic exam by the emergency room doctor revealed a fixed and dilated pupil as well as decorticate posturing. These neurologic signs are indicative of a catastrophic brain event.
This young lady is part of my extended family. Her name is Christina, but her family knows her as Christie. She is a very close friend of my fourth-born daughter, and they are also cousins. Our families vacation together and frequently break bread together. Her parents are both highly educated and work in the medical field. She has two brothers; one had served as an Army Ranger in Afghanistan and was working for a big tech firm out west at the time, while the other is a physician in residency at one of the most prestigious hospitals in the country. They all immediately headed to Washington, D.C., to be at her bedside.
Once she crashed in the emergency room, she only had minutes to live without heroic efforts. She was immediately intubated and placed on a ventilator. She then had a “stat” CT scan of the head, which documented a subarachnoid hemorrhage (brain bleed) and evidence of dangerously high intracranial pressures that would cause brain damage and possible death if not immediately relieved.
The neurosurgical team was “stat” paged, and within minutes they were able to place an external ventricular drain to help relieve the high intracerebral pressure. This entailed drilling a hole in her skull. This life-saving procedure cannot even be performed in many hospitals. She was already lucky that the medics had taken her to this particular hospital, and she was also very lucky she had a special dog.
Christie was admitted to the Neuro-ICU unit and the nurses immediately noticed she had low oxygen levels, despite being on 100% oxygen. This would be the first of several life-threatening complications that were being driven by the brain hemorrhage. She had developed Acute Respiratory Distress Syndrome, in which, basically, the blood vessels in the lungs leak fluid into the lung tissues.
Her brothers arrived before her parents, and they received the first reports as to how critically ill their sister was. When mom and dad arrived and their sons told them how sick Christie was, their mom collapsed into their arms, exclaiming “Why couldn’t this be me!” A selfless expression of love for her only daughter.
By now the word was out and a huge contingent of family members began to pray. Because her father and I are physicians, we have always had a special connection. I received frequent phone calls and texts from him and then relayed any new information to dozens of our family members and friends almost on a daily basis. My four daughters were all quite close to Christie and were in shock. It was just hard to believe that in just one moment a vivacious, highly intellectual young lady would be fighting for her life.
Her physician brother also sent out frequent detailed updates by email, and it is with the help of these saved emails that I am able to accurately recall and share this incredible story.
The next morning she went for a cerebral angiogram to find the cause of the brain hemorrhage. She had bled from two aneurysms found in the back of the brain. The interventional radiologist was greatly challenged, but eventually two stents and two coils were carefully deployed to help prevent further bleeding.
The ICU nurses kept constant vigil, watching for any changes in neurologic status. Critically high intracranial pressures continued and the neurologic team decided to induce hypothermia, which has been shown to help preserve brain tissue and reduce potential brain damage.
The next life-threatening complication that occurred less than 24 hours after presentation was shock (low blood pressure) requiring high doses of vasopressors, which are intravenous medications to raise the blood pressure. Echocardiography performed to assess the heart discovered that there was severe dysfunction of the left ventricle. It is also known as “broken heart syndrome” and can suddenly affect the heart during extremely stressful situations.
The hearts that were truly breaking were the hearts of her mom, dad, two brothers and sister-in-law, who were at constant vigil at her bedside.
Thankfully, during the next two weeks her heart fully recovered and her lungs showed significant improvement, although there continued to be concerning neurologic signs supporting spasm or possibly brain damage.
I recall a phone call from her father one day where he shared his worry about a new concerning neurologic finding. Christie had developed divergent eyes. This can best be described as one eye looking one way and the other looking the opposite way. His anguish over the phone was palpable.
As this father struggled to make sense of what had befallen his child, he soon received more bad news. His mother had suddenly died. For several days he pondered if he should attend her funeral or stay in D.C. His family encouraged him to fly to South Bend for the funeral, and the team of physicians assured him that his daughter would be waiting for him when he got back. He did indeed attend, and family and friends came from all over the Midwest to pray with him and show their love and support.
After the funeral Mass this broken-hearted man headed to his alma mater, the University of Notre Dame. There he would go to the famous Grotto of Our Lady of Lourdes on campus, get down on his knees, and ask Mother Mary for her intercession.
This column is the first of a two-part series. The second installment will appear in the Feb. 2 issue of Today’s Catholic.
Dr. David Kaminskas is a board-certified cardiologist and member of the Dr. Jerome Lejeune Catholic Medical Guild of Northeast Indiana, www.fortwaynecma.com.
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