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Stories of Hope: Chrissy

By Currents Editor posted 12-14-2020 10:31

Kate Meurer
Clinical Research Associate in Neurocritical Care and Vascular Neurology Yale School of Medicine, Yale New Haven Hospital
Ilayda Top
Clinical Research Associate in Neurocritical Care and Vascular Neurology Yale School of Medicine, Yale New Haven Hospital
Dan Doherty
Clinical Research Associate in Neurocritical Care and Vascular Neurology Yale School of Medicine, Yale New Haven Hospital
Firas Kaddouh
Assistant Professor of Clinical Neurology, Yale School of Medicine

Her Last Ride for A While

November 18, 2018: Chrissy mounted her horse as she had done many times before. The 27-year-old, revered for her exquisite equestrian skills, had been asked to break in the new horse at the stable for another rider. The horse’s name was Honor.

Chrissy’s passion for horseback riding was matched only by her love for teaching. She was in the early stages of her career as a high school English teacher, splitting her time between mentoring her bright-eyed students and galloping across the sprawling fields of Connecticut atop her horses.

Honor was a challenge that day. Chrissy was bucked off twice, both times leaving her falling to the ground, and yet she persisted – she continued to ride with Honor, unintimidated, for the remainder of her lesson. Afterwards, she untacked the horse, brushed her, and put her away, walking and talking all the while.

On her drive home, Chrissy started to develop a headache. Concerned that she had suffered a concussion, she called her mother, Diane, and sister, Taryn, while driving to the nearby urgent care facility. There, she was redirected to the hospital for a CT scan. Chrissy’s warm, outgoing personality immediately caught the attention of the nursing staff. Conversation flowed back and forth until Chrissy suddenly lost the ability to speak and move the right side of her body.

Preparing for the Worst

The clinical team rushed Chrissy to the CT scanner but found no sign of trauma. Taryn ran to the car to check the helmet her sister had been wearing and found it perfectly intact. There had been no trauma. Rather, when Chrissy was bucked off her horse, hyperextension of her neck caused a dissection (a tear in the inside wall of a blood vessel) in her left carotid artery. A Brain MRI showed that she had suffered a large stroke affecting most of the left hemisphere of her brain. She was transferred to Yale New Haven Hospital for a higher level of care in the neurosciences intensive care unit (Neuro-ICU). Swelling of the affected area of her brain ensued, and Chrissy required a decompressive hemicraniectomy, the surgical removal of part of her skull to relieve pressure that would build in her head if swelling were not controlled.

Diane flew up from Florida to be with her daughters. She and Taryn were in shock but had no misconceptions of how serious Chrissy’s injury was. Working in the medical field herself, Taryn was keenly aware of the challenges that her family would now be facing. “I remember the imaging was very bad. So, I knew, I said, ‘I don’t think this is going to get better,’ but I didn’t have the heart to tell her, and I didn’t want Chrissy to lose hope with her recovery. So, I just kept it to myself, but I knew it was severe.” Diane didn’t remember much from the devastating experience but couldn’t shake the prognosis from her mind. “What I do remember was that they only gave her a 30% chance to pull through, and they told me that she would probably never eat, walk, or talk again.”

Chrissy walks the hospital hallway with the help of Dawn and Geoff.

Though it was a blur for Chrissy and her family, what came next was a display of the meticulous and extraordinary care and attention given every day by the nurses, physicians, therapists, and other staff who work in the Neuro-ICU. After her surgery on November 19th, Chrissy stayed under their expert care for ten days. The clinical team’s attention extended to Chrissy’s family as well, through engaging them in her care and providing frequent updates regarding her condition. Chrissy was slowly improving, but it was difficult to be hopeful in the face of such a dire prognosis. “It was a very difficult time, trying to prepare for what might be our new life,” Taryn recalls. “I didn’t think you’d ever come out of most of that at all, Chris. I thought you’d be in a wheelchair.”

Hope, Love, and First Steps

That prognosis, however, did not limit Chrissy’s resilience or her family’s support. They stayed with her throughout the Neuro-ICU stay, listening to the medical team on rounds and engaging in decisions being made for her care. In just a few days, Chrissy began to communicate again – not verbally, but still enough to express some of her thoughts to her mom. She returned to a regular diet after just one week. These small things, the little improvements, gave glimpses of hope when it all looked grim and overwhelming.

Sammy keeps Chrissy company as she completes her PT exercises

As Chrissy’s condition stabilized, she was transferred out of the Neuro-ICU to the stroke unit. Through it all, her family continued to find reasons to be hopeful that she would beat the odds they had been given. “I remember, ten days after the surgery, [her physical therapists] Dawn and Geoff… I have it on video, them holding her up and Dawn behind her right leg, lifting it and moving it forward. They walked behind her with a chair and I was just amazed. You know, she’s got youth on her side and we pushed her and pushed her and pushed her, told her, ‘Come on, that’s right. You can do this.’ There were many, many mornings she did not want to get up. She would be like, ‘No, I’m tired.’ We realized how exhausting it was for the brain to do the smallest task, and we respected that, but we also all pushed her, and it paid off. She’s our little miracle for sure.”

Following her discharge from Yale New Haven Hospital, Chrissy continued to make strides in her recovery at her rehabilitation facility, Gaylord Specialty Healthcare. After about two months, Chrissy visited Dr. Charles Matouk, her neurosurgeon, to schedule a cranioplasty (a procedure to replace the part of her skull that had been removed initially). He was amazed at her condition: “Carissa has made a remarkable clinical recovery in a short period of time,” Dr. Matouk noted. She later underwent the cranioplasty and, after a brief post-operative stay in the hospital, returned to Gaylord to resume rehabilitation.

Unfortunately, Chrissy was readmitted to the hospital due to seizures and severe headaches. Her imaging showed encephalomalacia, a condition caused by a loss of brain tissue after an injury, along with new fluid collection in that same area. The seizures, which were likely provoked by the fluid collection, suggested that Chrissy may be at increased risk for post-stroke epilepsy. This is a complication that is the subject of much ongoing research, in which 3-10% of stroke patients develop epilepsy due to stroke-related brain damage. While the seizures were ameliorated by medication, Chrissy still required removal of her prosthetic bone flap to drain the underlying fluid. Four days later, she was back at Gaylord, where she remained through her second cranioplasty in June – this time with no complications.

January 2019: Chrissy smiles after a visit with current and former NFL and college football players at Gaylord.

Chrissy had persevered through numerous hospitalizations and was ready to continue her path to recovery. She was defying the odds and doing better than anyone could’ve expected on that fateful November day. However, she and her family were far from finished. Many goals and milestones remained to be reached, some of which they couldn’t even imagine at this point. “Horses were banned from the family. We said, ‘Never again.’”

Once safely back at Gaylord, Chrissy moved rapidly along her inspirational road to recovery. Her time there largely consisted of physical therapy, occupational therapy, speech therapy, sleeping, and family visits. Even Chrissy’s cocker spaniel, Sammy, made an appearance at the facility after Diane noticed his depression in Chrissy’s absence at home. His wagging tail and wet kisses were just the motivation she needed; in the months that ensued, she went from being unable to get out of bed and into a chair to putting on makeup in the morning, walking with a walker or cane, preparing her own meals, and dressing herself.

Other Important Milestones

November 2020: Chrissy returns to Gaylord after eight months of telehealth appointments

One of the most devastating aspects of brain injury is that it can impact the very core of a patient’s ability to communicate with the world. For Chrissy, a friendly, outgoing English teacher, this was her language. Though she could communicate basic ideas, she was far from regaining her mastery of speech and self-expression. However, hope was born in the early days of her recovery, when one of her doctors asked a simple question: “Has anyone started singing with you yet?” Her clinical team began to sing Happy Birthday, and Chrissy joined in with the fluency that had been so evasive, planting a little seed in everyone’s heart that she could (and would) regain her speech. At Gaylord, Chrissy and her nurses sang songs from The Beatles’ Hey Jude, to Queen’s Bohemian Rhapsody, and even Shaggy’s It Wasn’t Me to entertain themselves, improve fluency, and distract her from the pain of heparin shots. The singing helped Chrissy to eventually articulate that she was feeling “perfect” and ask, “Mom, can you take me home please?” Through laughter, Diane assured her that she would take her home as soon as they got the green light from her clinical team.

Chrissy’s family battled unimaginably difficult events, becoming stronger with each new challenge faced and fight won. Their faith evolved with every prayer. Chrissy found comfort in her new connection to God, and her family grew closer than ever. “When you come so close to losing someone and then they pull through, you realize how lucky you are,” Taryn notes. The most frequently shared words between Chrissy and her family: “Taryn and mom, I love you.”

Holding the Reins Again

Throughout her journey, Chrissy had always kept one goal in mind: returning to the stables. When she first expressed the idea in April, her family was justifiably apprehensive. “She kept asking me, and of course I didn’t want to hear anything to do with horses,” Diane recalls. “But I spoke with a psychologist, who said, ‘Oh no, absolutely let her get back on a horse. It’s the best thing you can do for her.’”

Taryn’s sunglasses hid her tears as she watched her sister grab the reins again. “These were tears of moving forward, Chrissy getting better and doing what she loves and is passionate about,” Taryn said. Following an epic two-year battle through the Neuro-ICU, operating room, and rehabilitation centers, Chrissy is accomplishing the unimaginable: living independently and returning to the stables once a week to reclaim her passion. She comes home to her very own apartment, where she and Sammy eagerly host family and friends whenever they can. Re-dying her hair a platinum blonde is next on the to-do list.

September 2020: Chrissy and Taryn enjoy a bite at The Hopkins Inn & Restaurant in Warren, CT.

Chrissy showed that she is the epitome of resilience, unyielding determination, hope, and hard work. Despite the severity of her accident, her family never lost hope in Chrissy or in her recovery. Such a remarkable recovery was only made possible by the dedicated teams of providers who supported her all the way. Her story demonstrates that even though the road to recovery from brain injury can be long, challenging, and discouraging, it is possible to overcome your fears and resume your passions, especially with loved ones by your side to support you every step of the way.

#LeadingInsights #StoriesofHope

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