Wednesday, March 16, 2005

It is Brain Surgery (Part II)

Here's what happened. Jessica, then 23, is the middle child. She was preparing for her first semester of Physical Therapy school finals. She was cramming too hard, sleeping too little, and getting incredible headaches.

The headaches got so bad that my dad wanted to drive up to check on her. "No, no," she said. There was a blizzard outside and he would have to drive all the way through Chicago. The trip might take hours, and her apartment was in no state for company anyway. She needed to study more. She'd call home tomorrow after her final.

Jessica was class president and pretty dependable. She didn't show up for her final. Her friends conferred - no one had heard from her. One friend, an amazing, wonderful, take-charge little person called Stephanie, decided to drop by Jessica's apartment to check on her.

Stephanie found Jessica still in her pajamas, wandering around the apartment and making little sense. Jess refused to go to the hospital and kept talking about needing to take her final. Steph managed to get her outside by suggesting that they stop by the doctor's office instead of the hospital. As soon as they were outside, Jess immediately stopped and put snow on her head.

"It's so cold," she said.

Jessica wouldn't tell Stephanie where her doctor's office was. She still wanted to take the final and was trying to give directions to the school. Stephanie drove to the hospital.

There's something you should know about Jessica. She's an amazing liar. When they got to the hospital, Jessica was examined by a resident. Jessica told him that her head hurt because she'd fallen down while rollerblading the week before.

"Look outside! There are 2 feet of snow on the ground. She was not rollerblading last week!" Stephanie said. The doctor ignored this. He believed his patient. "She's not herself. She's incoherent. She's not making any sense," Stephanie said.

"I was like that in medical school," the resident said. "You need to go home and get some good sleep," he told Jessica.

"No," Stephanie said, bless her little heart. "We're not leaving until she's had a CAT scan."

The CAT scan revealed a small mass blocking the base of the third ventricle. Cerebrospinal fluid was unable to drain properly and had been building up in Jessica's head. She was already in and out of consciousness. She blacked out very soon, and if the pressure wasn't relieved in the next couple of hours, she would have suffered permanent brain damage.

The race began. Doctors called my parents, who dropped everything to make that drive through Chicago in a blizzard. My mother just jumped into the car when my father picked her up at work. She didn't even take her purse. Jessica was transferred to a bigger hospital via slow, careful ambulance and the on-call surgery resident who was to do the emergency surgery raced through snow and ice to meet her there.

"As soon as I can put in a shunt to drain the excess fluid and relieve the pressure, she'll wake up and be herself again," the surgeon said.

As she was being transferred to the ambulance, she suddenly opened her eyes and said, "I'm outside. It's cold." That was the last time my parents saw her alert for a while. Hours before, she was sounding like herself, cramming for finals.

The emergency procedure to relieve the pressure in her brain was successful, though due to trauma from the built-up cerebrospinal fluid, Jessica didn't remember anything and had short term memory problems for weeks. Months. She still doesn't remember anything about the day she missed her final, or most of the two weeks in the hospital that followed.

Do you know how they relieve pressure in your head? They drill two holes in your skull and insert a shunt to drain the fluid out. For weeks my sister had tubes coming out of the top of her head. But those little holes were nothing compared to the incision site for the surgery.

The two weeks Jessica was in the hospital - a wonderful, wonderful place, I might add - felt like hell frozen over. It was unusually cold: -20, -30 F. When we didn't stay at the hospital all night, we left after dark and returned long before the sun came up, so it felt like it was always silent, bitterly cold, and perfectly dark outside. I had brought all the wrong clothes, like the worst jeans in the world, so I was physically uncomfortable. Everything felt surreal.

Several days after the onset of the crisis, Jessica survived the main event. Her brilliant surgeon - not a resident this time - managed to resect about 60% of the tumor. She steadily improved, and eventually the shunt came out. We all went home on Christmas Eve.

Jessica's professors were very understanding about the finals and her exhaustion over the next several months of recovery and radiation therapy. She graduated on time 2-1/2 years later with a Doctorate in Physical Therapy. She was married a year ago, to a guy she'd just started dating a few weeks before all hell broke loose. Her annual MRIs are showing no return of the tumor.

I used to believe in medicine the way I believe in math. You solve this equation, then it's done. Now I know that nothing is that easy. Jessica's tumor crisis is over - for now. My daughter's heart is repaired - for now.

Once we have any medical problem, it's never guaranteed to be over forever. These things have a way of popping up again and again when we least expect it. And that's just not fair.

Living through an experience like this should be a once in a lifetime event, don't you think?

5 comments:

Psycho Kitty said...

Oh, honey.

Jessica said...

Yes, living through Jessica's experience and then Ellie's heart procedure should be once in a lifetime events alone - not together.

trisha said...

Oh, no. How horrible. Man.

trisha said...

See? This is why I always feel like such a tool leaving you comments.

Sarahlynn said...

Thank you all so much for the sympathy.