Critical Difference Stories:
Neurosciences/Stroke Care
Read More Neurosciences/Stroke Care Stories: ---------------------- View all Neurosciences/Stroke Care Stories Justin Shields: My Stroke Care Story Man of Mystery: The Chris Bounds Story Christmas Gift: The Ashley Rivers Story Awareness: The Julia Shoemaker Story Karen Bell: Only a Headache Sarah Hitch: Stroke Survivor Tom Jones: Life Interrupted Miracle from Down-Under

Karen Bell—Only a Headache

It was early May and late at night. Karen stood at the bathroom sink, then turned and headed for the door. But as she turned she lost her balance and fell to the floor, slamming her head on the floor. The fall gave her a headache that would linger for the next two weeks. She didn’t seek medical treatment for the head pain as she didn’t believe it was serious. She couldn’t have been more wrong.

Falling was not unheard of for Karen. As someone diagnosed with Multiple Sclerosis (MS), losing the sense of balance is fairly common, though this was the worst fall ever. She typically used a cane or wheel chair to move around, but not inside the home. She blamed the fall that night on her MS. It also seemed logical to blame MS for the falls that happened later – logical, but inaccurate.

One weekend in June, Karen was home alone. She was outside in her yard when she fell; this time she couldn’t get up. After 45 frustrating minutes, she managed to drag herself back inside the house. She pulled herself into bed and stayed there until her husband, Gary, got home. Soon afterward, her entire left side became paralyzed. Karen and her doctor believed the paralysis was caused by a major MS exacerbation; and was treated accordingly.

Karen was now wheelchair bound. Her headaches returned with a vengeance and occasionally she would become incoherent and rambling.

ALTERNATIVES
Karen’s neurologist Dr. Allen Han sent her to have an MRI scan of her brain. Her doctor was so concerned by what he saw in the MRI images, he asked a neurosurgeon to also review the images, Dr. Timothy Johans.

After the surgeon saw the images, he agreed to see Karen at once. He showed her the pictures of her brain and explained what she was seeing. Karen had a blood clot on the surface of her brain, about the size of a banana. The doctor told Karen that the massive subdural hemorrhage should have put Karen in a coma, or worse. She had no alternatives; it had to be removed as soon as possible. Karen was sent directly to Saint Alphonsus.

But there was another potential problem; Karen’s religious beliefs prevented her from accepting blood transfusions, often required in this type of surgery. Not long ago, such a problem may have precluded the surgeon from accepting the case, or may have lead to a court order forcing the transfusion upon the patient. But in 2001, Saint Alphonsus became the first formal transfusion-free medical program in Idaho. The doctor explained the hospital’s alternative solution to Karen and the surgery was set for the following day.

A NUMBERS GAME
The surgery went well. The blood clots were removed from Karen’s brain; only time would tell if she would regain any of her lost functions. Dr. Johans tried to remove the membrane which surrounded the clots, but it was so firmly attached removing it would have caused brain damage. Within 24 hours Karen was transferred from the ICU to a patient care unit.

Everything appeared to be going well when her nurse, Becky, became concerned. Karen was displaying signs of paralysis and she was answering word questions with numbers.

Becky called Dr. Johans and told him of Karen’s odd behavior. He ordered an immediate CT scan. The CT image revealed that her brain was still shifting and she was developing signs of hydrocephalus – fluid on the brain. Karen’s condition was becoming critical.

Karen’s sister, Emily and daughter Kari, found Karen’s new number language amusing. A more serious mood fell over the room when the doctor arrived and explained the results of the CT scan. Another surgery was needed – immediately. Karen was not capable of giving permission and her husband, Gary was 25 minutes away; Karen did not have that kind of time. Gary granted permission over the phone and raced back to the hospital hoping to get there in time to say good-bye.

Back in the OR, the surgeon faced a difficult scenario. In order to drain the excess fluid a tube was necessary. A normally easy procedure was now risky and complex because of the extreme brain shift.

With very little help from the CT images, the surgeon took his best shot. When the drain was inserted, the trapped fluid emerged. A relieved surgical team applauded, but all the danger had not passed. Dr. Johans reopened Karen’s skull and was now able to remove the remaining membrane. Odds of surviving the next 24 hours: 50/50 at best. Surviving without brain damage: nearly impossible.

MEMORIES
Karen did survive and after three weeks Gary took her home. Remarkably, Karen not only survived the traumatic ordeal without further neurological damage, but she also regained the use of her left side. Rehab and three weeks of in-home therapy helped Karen learn to walk again.

Reflecting on the incredible events, Karen remarked, “It’s one thing for friends and family to think my survival was miraculous and quite another thing when a neurosurgeon of Dr. Johans’ caliber maintains God ‘was in on it’. It gives me goose bumps.”

“I am so impressed by the skilled and compassionate doctors and nurses who kept me alive, and the therapists who have contributed to my quality of life.” Her gratitude was extended to the many friends who maintained the vigil with her family and prayed for her recovery. She wants everyone to know, “I will never ever forget”.

Karen faced another major event in her life, her daughter’s wedding. At one point, the notion of Karen being around for that was almost unthinkable. But in January her daughter was married and Karen was there. “I’m blessed to be in the picture,” Karen said. Against all odds, Karen is still in the picture.