Friday, November 12, 2010

Day 14~AKA ‘Milestone’ July 4, 2010

Wait--What happened?
Mary finished her freshman year at BYU in Provo, UT and was eager to land a great job for the summer. She needed to save enough money to augment a part time job in the fall, and to prepare for study abroad in France next spring. Not a great year to find a summer job. But Mary was persistent. After 2 interviews and a month of patience, she was hired to work at Nordstrom. Not too shabby! Great hourly rate and commission on top of that. She was so excited! She has also been a nanny for several families in our area and with both jobs, she would be able to reach her goals.
Friday June 18 9pm~Mary finished up a 72 hour nanny job.  She watched a movie here with us. We hugged at midnight and looked forward to her first day at Nordstrom in the morning.
Saturday June 19 9am~Brad and I left for the day. I had a reunion. Brad had to prepare our trailer for our upcoming reunion in CA and had a lighting director assignment for a concert in Portland.
9:20am I talked to Mary on the phone: ‘Mom I have to hurry. I’m late.’
9:30am Mary printed off a map and directions to her Nordstrom training in Portland.
9:31am Mary had sudden extreme pain in her left temple area. She could barely stand up. She went back to lay down in bed.
4:45pm I arrived home and saw her car still in the garage. Odd…maybe she came home early? Maybe she lost the job? I found her sound asleep in her sister’s bed.  I stood at her side and looked at her. She was out. I decided to run 1 quick errand for Father’s Day.
5:35pm I texted Mary and reminded her we had 2 graduation parties to attend.
5:45pm Mary called me: ‘Mommy. I threw up. Will you help me?’ I had a lot of questions including ‘What about your job? Did you go today? Did you call them?
6:00pm I arrived home and found Mary, head in hands in the kitchen. She could not communicate except for, ‘Shhh Mommy. Shhh.’ I was unaware that there was a serious problem for 10 minutes.
6:10pm I had a strong feeling that I should stop and listen to her. Ask her some questions: Mary. Where do we live?  ‘Vancouver.’ What is your dog’s name?  ‘2.’ What holiday is tomorrow?  Fourth of July.  Ah-oh! Something was very wrong.
6:15pm I called Brad and he didn’t recognize my hysterical voice. He said to get her to the ER.
6:20pm Our friend and Bishop, who happens to be Mary’s primary care physician, arrived at our house. (He lives 2 minutes away and Brad called him.) We couldn’t figure out what was wrong but it appeared she was either sedated or having a major migraine. She mixed up words ie: ‘I don’t want to go to the library!’ (hospital). Mary started to fade away.
6:30pm We headed to Legacy Salmon Creek ER. My dad met us in the waiting room.
7pm After confirming that she was not a teenager who has OD’d, the ER Dr ordered a CT scan.
7:30pm As the scan came up on the monitors, I could see a large oval shape on the left side of Mary’s brain. Not good. One tech says to the other ‘Do you see that?’ He nodded. I asked, ‘You can’t say anything to me, correct?’ ‘No, but I will tell you that she will be transferred to another hospital for sure.’
8pm the ER Dr ran to the room before we arrived back with Mary. She grabbed my shoulders and said: ‘Things are going to get really crazy now. Mary has an AVM. Just remember it sound’s like ‘ATM’. It is a cluster of unnecessary blood vessels in her brain. She was born with it. One of the vessels has burst and she has a large blood clot there now too. The only surgeon who specializes in this is at SWMC. You are so lucky! He is on call tonight and he will meet you in the ER when you arrive. Also, the ambulance will have on sirens and lights so they take you right in without delay.’
11pm we arrived at SWMC ER. There was a huge team of doctors and techs. The ambulance techs stayed with us and Mary for an hour. Brad and my family arrived. While they worked to stabilize Mary, we saw a friend standing near the room next door. He had a church friend in there who had just suffered a heart attack. Age 35. On Father’s Day. We sadly learned later, he passed away about the time Mary was stablized.
12pm. We met Dr. Shanno, her neurosurgeon who had just finished another surgery. He explained a plan and promised to meet with us in the ICU the next morning.
1am Mary was in her room at the ICU. I stayed the night. Brad and family headed home.
It’s not brain surgery!
~Mary was born with an AVM (arteriovenous malformation) in her left temporal lobe. We had no idea she had this. You usually don’t know you have it unless it bleeds. It is not genetic.
~One of the vessels in the AVM bled for approximately 10 seconds and immediately formed a clot the size of a business card. This could have been fatal.
~Because of the location of the AVM, after her angiogram, they discovered that surgery is not an option. The carotid artery goes right through there as well as other vital blood vessels. Surgery would be far too risky and can only be a last resort.
~Mary spent 12 days in the ICU and 2 days on the floor. Managing her pain and keeping her vitals stable were the goals.
~Her Dr’s said ‘Once she gets to day 14, we will breathe easy.’
~She still has the AVM, the blood clot and swollen tissue. It will take up to 6 more weeks for the blood clot to resorb. The swelling reached it’s peak around day 13 and has began to subside.
~She will have another CT scan in about 6 weeks. When the clot is gone, she will have Cyber Knife radio surgery (sounds like a Star Wars procedure…) It is all exterior and will ‘kill’ the AVM. If this procedure appears successful, they will also perform an embolization to the area which will prevent any bleeds of the AVM. Even after the radio surgery, it will take up to 3 years for the AVM to ‘die.’ There is a 4% chance of another bleed every year until the AVM is gone.
*With most brain AVM’s, the surgeon is able to surgically remove the AVM and the blood clot. This was not an option for Mary.
Hallowed ground
When you walk into Mary’s hospital room, you immediately can sense that you are in a special place. Even when she has been in agony, she almost always finds a loving or complimentary thing to say: ‘You are so beautiful. You are amazing. Your skin looks so good. I love you~do you believe me? That I love you?’
Even today, spend just 15 minutes with Mary and you will walk away a happier, better person. You will laugh and you will feel ‘verklempt’ at least once. Mary is now sweet, innocent and without guile. She has experienced a sort of 'hell' in this ordeal and came back to us angelic.
Selective Memory
The location of Mary’s AVM and blood clot controls all of her language skills. It has been a wonder to us how Mary does not remember certain words or people’s names, yet she can still entertain us with impersonations and recall actor’s names and details of movies. We were quietly discussing a new release in her room and she perked up and said, ‘Oh! Knight and Day. That movie was just released a few days ago.’
She still has trouble with vocabulary and some names. Today she couldn’t remember ‘pillow’ or ‘deck’, ‘text’ or ‘gum’ (‘You know, the small shape you put in your mouth and go ‘chomp-chomp’?) And yet…in the throws of agony, once when I was desperate for any way to give her some comfort, we tried to help her visualize someplace beautiful and relaxing. Hawaii. I was weak and told her that when she is all better, we will take her to Hawaii to celebrate.  She reminds me of that every day!
Miracles On ICU
I do not profess loudly. I am quite discreet (publicly) about my political and religious opinions and viewpoints. However, I would be a hypocrite if I did not tell you that we have witnessed 2 miracles within 2 weeks.
Mary should not have survived her AVM bleed. Her doctors would say, ‘We look at these scans and we look at her. As bad as she is, she does not even come close to the severity of the situation. She should not even be conscious, let alone able to speak.’
Mary has almost total recall of not only what happened the day of the bleed (any neurosurgeons interested in amazing details of an AVM bleed?!) but also of her life before. Certain words and some cognitive abilities are not clear yet, but with therapy and time, they expect a full recovery. Mary survived!
A few days ago, Brad called me and said, ‘I’m OK…’ Not the words you want to hear when your life has already been turned upside down. He had been rear ended by an SUV going 45mph on Hwy 14. He was pushed to the concrete Jersey barrier and went on 2 wheels along that. He then went 100 feet, pushed under the rear of a small pickup truck. She was uninsured.  Brad survived! Not even a sore neck. “Miracles happen everyday, change your perception of what a miracle is and you'll see them all around you.”

There’s no place like home…There’s no place like home…
Wednesday night Mary slept more than a few hours, for the first time. Thursday Mary got up and walked a few laps of the 7th floor. Friday afternoon, her Dr’s recommended discharge to home instead of ‘in house rehab.’ She is high level functioning: she can walk, climb stairs, brush her teeth, get dressed, feed herself…etc.
What she does need is out patient therapy for speech and cognitive skills. Her doctors want her to rest, sleep, nap and thrive in her own home.
In a recent post, we asked you to continue to pray for Mary to just have relief of her pain. Mary’s pain began to decrease once she was able to get some sleep. She can go several hours longer than before without a pain pill.
Friday July 2, (Also known as Day 14)
3:00pm~With 2 nurses at her sides, Brad and I asked Mary: ‘If you could go anywhere right now-anywhere you wish-where would that be?’ ‘Home.’ ‘Okay! Wish granted! We’re going home right now!’

With sincere thanks to all of you~Peggy and the Fam
*Mary will begin out patient therapy this coming week and meet with her Dr. 

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