Coming Back from the Brink of Death

On Wednesday, November 22, 2017, I had to have an urgent, simple, outpatient surgery.  I was discharged that afternoon and cleared by the surgeon to travel up to my parents' house as originally planned for our Thanksgiving holiday.  Little did I know that our holiday plans would drastically change within a matter of hours.  As we began our 2.5 hour journey by car, I was in pain and nauseated--something my doctor said would be a possibility and had instructed me to take Toradol for pain and Zofran for nausea.  Because I wanted to make the car ride as comfortable as possible and given my current symptoms, I chose to take 1 Toradol and 1 Zofran.  Instead of getting better as the journey continued, I got worse.  By the time I arrived to my parents' house, I was feeling terrible.  It was all I could do to sit on the couch and be still.  As the night wore on, I began to feel like my head was in a fog.  I knew something was wrong but didn't have enough cognition left to figure it out.  Twice, I asked my husband what was wrong with me which befuddled him, and he just reminded me I was tired from having surgery that day.  Shortly after that, I lost all conscious awareness and memory.  My husband claims I mumbled responses to a few more of his questions to communicate basic needs, but I have no recollection of any of these discussions.

Tim carried me downstairs to our awaiting bedroom and put me to bed.  At 1 a.m. on Thanksgiving Day, Thursday, November 23, I screamed a "bone-chilling, blood-curdling cry" that will forever be etched into Tim's memory and made him jump out of bed and turn on the light.  He found me in a full Grand mal seizure.  Tim managed to lower me to the floor to prevent me from falling out of bed and put me on my side as I foamed at the mouth with blood running out the side of my mouth thanks to my biting my tongue.  The seizure lasted about 90 seconds according to Tim.  Because I am the one who makes the medical decisions in the house, Tim decided to wait for me to wake up to ask me what we should do.  I never woke up.  By 3:00 a.m., I had vomited all over myself.  After the second vomiting episode, Tim was really starting to get concerned, but was too afraid to leave me to go up 2 floors to awake the rest of the household.  Just before 6, David awoke, and sensing something wasn't right went downstairs to find Tim and me.  Tim hurried David to wake up my parents to let them know we needed to go to the hospital.  That started a flurry of activity as preparations were made for my dad to drive Tim and me to the hospital 20 minutes away in Scranton.  After another vomiting episode in the car, we arrived at the hospital where the real urgency quickly became evident to all.

I was whisked off to Trauma 1 and pounced on by many specialists.  I was unconscious and unresponsive.  However, I had a lot of meaningless movements that showed agitation and inhibited medical care making medical intervention difficult.  I was injected with Versed, a sedative, to assist the staff in getting blood drawn and an IV line in.  I was given a rating of a 7 in the Glasgow Coma Scale which falls in the severe brain damage category.  My pupils were not dilating or responding, I had no signs of cognition, and I had severely abnormal flexion of extremities to give you a small glimpse of how bad it looked.

Due to my depressed mental status and agitation, the decision was made to intubate me and put me on a ventilator.  I was also further sedated in order for a CT scan of my brain to be done to check for a brain bleed (thankfully, the CT scan showed no brain bleed).  My preliminary blood tests came back with the most alarming result showing my Sodium level to be 121 which is dangerously low!  My EKG also showed some issues going on with my heart which isn't a surprise with low sodium, and I was placed on a heart monitor.  At that point, the doctors were thinking it was too late and that I wasn't going to make it, but they made every effort to get me as stable as possible.  The parish nurse was called in to say a final prayer over me.  The doctors began to treat some other electrolytes out of whack and get me hydrated.  Tim said at one point, I had 4 usable IV sites in my arms and had 3 IV sites being used at the same time to get meds and IV solutions into me.  I also had an Nasogastric tube (NGT) down which they were using to get electrolyte tablets into my stomach.  Once I was stable, they transferred me to the ICU (Intensive Care Unit).

My ventilator

I had a foley catheter inserted into my bladder to keep my bladder draining, and thankfully, the thermometer gage on it alerted the staff to a quickly elevating body temperature.  They discovered I had aspiration pneumonia from aspirating on my vomit, so they quickly responded with IV antibiotics.  Tylenol was given via NGT and a fan was brought in to get my temperature down.

As the hours went by, and I remained alive, and my sodium levels started to increase, the thinking turned to maybe I will survive, but will I be permanently brain damaged or will I ever wake up or will I remain in this vegetative state?  I also continued to be very agitated and was allegedly pretty persistent in trying to pull out all of the many tubes and wires going into me.  While I was intubated and breathing on a ventilator, I had to be restrained in order to keep me from pulling the breathing tube out.  Tim claims that didn't stop me from trying to slide my body down so that I could try to reach the tube with my tied up hands anyway.  Who knew I could be such a fighter when unresponsive??? As the day wore on, I passed a spontaneous breathing trial and was maintaining proper oxygen levels, so I was weaned from the vent and extubated and placed on an oxygen mask.

Hand restraints to keep me from pulling out all of my tubes

Breathing on my own but with an oxygen mask

In the evening, my parents brought David to see me.  He sweetly sat by my bed and held my limp, unresponsive hand while I continued to lie there with oxygen going in via nasal cannula by that point.  As the sun went down, I got more and more agitated, so David couldn't stay at my side any longer.  He was such a trooper through the whole, scary ordeal.  [He won't talk about how he is feeling after going through all of that which concerns us.  We pray he will open up when he is ready.]

Overnight Thursday into Friday, I was taken off of oxygen completely
Note: David wanted to help calm me down while he was with me and did my hair.  Do you like my hair dew?

Holding steady

I finally had to be sedated again to keep me calm, and Tim entered another sleepless night waiting at my bedside praying that I would wake up.  Sometime early Friday morning, I woke up for the first time.  I was very groggy and pretty confused.  I was shocked to learn that I was in the hospital then succumbed to sleep once more.  Later that morning, I woke up again to relearn I was in the hospital, discover that I was in a hospital in Scranton (for a while, I couldn't figure out how I had even got up there since I didn't remember the drive up to my parents' house Wednesday night at first), and then I felt panicked when I learned I was in the ICU!  I was also disheartened to learn that I had completely missed Thanksgiving!  It took a few more periods of sleep and being awake before I learned the whole story of how I got there.

Sleeping peacefully after having become responsive once again

By the afternoon, I was allowed to get out of bed for the first time.  It set off the heart alarm making staff come running, but it felt so good to get up.  A physical therapist and occupational therapist later came by to help me walk a little bit for the first time.  I learned a new meaning of baby steps!  I had a visit from one of my aunts and then my parents and sister and David.  I am sure David was so happy to see me awake, and it was so good to give him a hug and truly hold his hand.

Working with the PT and OT to walk for the first time

My second walk was with my handsome date as my escort

I was so much better come late that evening, the doctor decided to move me from the ICU to the main floor.  Ironically, I ended up being moved to their pediatric unit.  It was very weird for me, a pediatric nurse, to be a patient in a pediatric unit!  I continued to set off the heart alarm each time I got up, but at least then, only one person came running.

Saturday morning in the pediatric unit

Enjoying our visit with David

On Saturday, I was feeling stronger and enjoyed a visit from David, my parents, sister, and brother.  We were then given the good news that I could go home that evening if my last blood test results came back fine and after I had a brain MRI to follow up on the findings of the CT Scan.  [Back in 2011, I was diagnosed with a brain lesion.  Cancer, Multiple Sclerosis, Lupus, and a parasite were all ruled out, but the four neurologists I did see couldn't figure out what it was.  The decision was made to repeat the MRI yearly and follow up with the neurologist I chose to be my treating neurologist.  After two subsequent yearly MRIs showed no changes, the decision was made to repeat the MRI every few years.  My last MRI was in 2013.  The CT scan revealed another lesion and changes to the previous lesion, and the MRI in the hospital that day ended up showing definitive changes.  I follow up with my neurologist this coming Wednesday to find out her thoughts on the changes and to discuss any long term damage to my brain that may have occurred from the dangerously low sodium levels.]

At 9:30 on Saturday evening, I was discharged following the completion of the MRI.  I arrived back at my parents' house by 10:00 to get settled into bed for the night.  The next morning, we woke up, packed up the car, and left to head back home swinging by the Lancaster area to pick up Josh for a home visit from his residential center he had been at for the month.  Once we were home, I got settled on the couch so I could enjoy seeing my family together and be able to interact with them as I was able.  It was a happy day despite the fact that I was tired and weak.

Settled at home and happy to spend time with Josh

So many people have asked what happened since all of this had been so sudden and unexpected, so I thought blogging about it would be helpful to give a thorough recounting and perhaps save me or Tim from having to rehash it several times a day.  There is still so much more to the continuing story, but perhaps that will be for more blog posts to come.  We are very much still trying to process all that has happened and figure out what God is trying to teach us.  We remain confident that God will work all of this out for our good and His glory and are praising Him for the miracles He worked in my life the two days when I walked on the brink of death unknown to me in my unresponsive state.  One other thing we are confident of is that God's not finished with me on earth yet!  I still have work to do!