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Story of Hope: William

By Currents Editor posted 28 days ago

Angie Murkins Written by: Kimberly Nokes Wilson
William’s Daughter
HOney Beddingfield Written by: Hana Nobleza, MD, MSCI
Medical Director,
Neurocritical Care Service Baptist Memorial Hospital
Associate Professor, Department of Neurology,
University of Tennessee Health Science Center
Section Editor
Lauren Koffman, DO, MS
Assistant Professor of Neurology, Lewis Katz School of Medicine, Temple University
Philadelphia, PA

It Started With Pain

On the morning of April 19, William woke up with some pain in his arm, along with other symptoms he had previously experienced when having a massive heart attack many years ago. After speaking with his cardiologist they decided he would need to come to the office for an evaluation. William was in the bathroom about to brush his hair when he suddenly realized he was not able to pick up the brush with his left hand. He quickly called out to his wife to come to help him. She noticed right away that the left side of his face was drooping slightly and his speech seemed different. His wife Pat was on the phone with their daughter and as she was explaining the situation she realized this could be a stroke. William was convinced they could just go to the cardiologist’s office but reluctantly agreed to call an ambulance. After William was assessed, he was taken to Baptist Memorial Hospital-DeSoto in Southaven, Mississippi to evaluate him for stroke. Their suspicions were confirmed, and because there was a high concern for stroke, he was given a clot-busting medicine called tPA and then transferred to Baptist Memorial Hospital-Memphis for close monitoring.

Hanging On by a Thread

While in the ambulance, William’s head began to hurt severely, and a follow-up CT scan that was performed upon his arrival in Memphis discovered a brain bleed. He was one of the unfortunate few people to bleed after receiving the clot busting medication. His healthcare providers gave him medications to help stop the bleeding and the rest of the night was a waiting game. William was watched closely in the Neurocritical care unit (NCCU), where staff performed frequent neurologic checks on him.

“We were desperately hoping and praying the bleeding would stop throughout the night and that he would not have to have surgery. We were told that if it continued to bleed and declined, he would need life-saving surgery. We were completely devastated and very scared when it was apparent he had to have surgery. We held on tight to the thread of hope the neurosurgeon gave us due to knowing my dad—the competitor and fighter he has always been. Our entire family was on a roller-coaster of emotions: scared, sad, confused, and mad about the clot buster wondering what his prognosis would be if he had not had it. Despite this we were hopeful and thankful due to the wonderful medical staff working at Baptist Memorial Hospital-Memphis. My mother was burdened with feelings of guilt from consenting to the clot-busting medication. Everyone reassured her it was not her fault at all.”

By the early morning hours, it was becoming obvious that his condition was worsening and that the bleeding had increased, meaning surgery was becoming more and more likely. William’s family was advised by the medical staff that the surgery could save his life, but that he would most likely be permanently weak in his left arm and leg. His close-knit family was all very thankful that the hospital allowed them to gather on April 20, as the odds did not seem to be in their favor. “Hanging on by a thread” were the words that played over and over in their minds after having discussions with the neurosurgical team. Dr. Kenan Arnautovic, of Semmes-Murphey Clinic in Memphis, was the one to offer the surgery, and William’s family was appreciative of him for taking on this challenge.

The Pepsi Fight

After the surgery, William had a series of battles ahead of him. He would have to fight to wake from the sedation, fight to breathe on his own, and fight to be able to move his left side. The road to overcoming these challenges was long, and who knew if there would be new obstacles along the way. But as William would say, when a person is surrounded by loved ones, wonderful medical staff, and a great therapist, there is hope that the battle can be won.

As William was breathing on his own and showing signs of improvement, the doctors decided to remove his breathing tube. His family was rejoicing in what seemed to be a step in the right direction, but it turned out to be premature. There was initial excitement when William became awake enough to ask for a Pepsi, but soon afterward his daughter noticed fluttering eye movements and called his nurse. Ernest Almeria came to assess William and immediately became worried this could be a seizure. The staff responded quickly and connected him to an EEG machine to monitor his brain wave activity; as suspected, he was suffering from seizures.

As part of the treatment for his seizures, William had to be heavily sedated, which meant that a breathing tube had to be replaced so that the ICU could treat the seizures safely. What seemed to be a step forward now led two steps back. But that glimpse of William asking for a Pepsi was enough for his family to continue the fight. Nobody was ready to give up, and thankfully William wasn’t either. The seizures proved difficult to control and many medications and sedatives had to be added. When the ICU team ultimately decided it was safe to reduce the sedation, William did not wake up immediately, and after some time had passed without a return to wakefulness, he underwent a tracheostomy and feeding tube placement. It was very scary for his family not knowing if he would ever open his eyes again and talk, but he eventually started waking up and following some simple commands on his right side.

Time to Transition

One of the hardest decisions William’s family had to make would be moving him to another facility. The Baptist Memphis NCCU staff had become their friends and family away from home. They helped and supported the whole family through so many low points, and spent lots of time explaining everything in a way that the family could understand. While William’s family had grown comfortable in the ICU, it was time for him to transition to a long-term acute care facility that specialized in taking care of patients with brain injuries after they were safe to leave the hospital.

As time went on, William became stronger each day. Eventually, he reached a point where the tracheostomy could be removed, though his continued difficulty with swallowing meant he still needed a feeding tube. As his therapy continued, it seemed like things were looking up, and he was starting to regain some function in his left arm and leg as well. Despite his progress, he was not yet ready to go home, so he was relocated to a skilled nursing facility. But his family knew he needed intensive inpatient rehabilitation, even if it was hard to convince others how much of a fighter he was. And there was still so much fight left in him!

William would get another chance to show his determination. On May 26, he developed problems with his breathing and had to be readmitted to Baptist Memphis, where he was diagnosed with a blood clot in his lungs. But while many would see this as a setback, he used it as an opportunity to show how much he had improved. When he was reassessed by physical therapists at the hospital, they decided that he now qualified for admission to Baptist Memorial Rehabilitation Hospital. He then proceeded to gain so much strength and movement from his therapies at Baptist Rehab Hospital that everyone was amazed at his progress. He was even able to start eating again and was finally able to enjoy that Pepsi he had been longing for. William’s entire family participated in his rehab and learned ways to help him so that he could regain his independence and be ready to go home.

Going Back Home

June 30 was a great day for William. He was finally going home to sleep in his own bed. His home may have needed some modifications like handrails and other safety devices, and he needed to use a walker to get around, but he had made it home.

William is now in outpatient therapy three times a week and continues to make strides in his recovery. He credits his wife Pat with his tremendous progress. Since returning home, his feeding tube has been removed and he is spending as much time as he can doing what he loves most—spending time with his family, especially with his grandchildren. He even surprised his sister by attending her 90th birthday party, which made the day even more special for everyone.

William, his family, and the Baptist Memphis team have all learned a great deal from his experience, and they want others to remember to keep fighting, even when faced with tragedy and the odds seem to be against you. If they can find hope, then so too can others.



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