SHAKE, RATTLE, AND ROLL!: The Initial CT Scans of My Brain After Injury
MAY 10. 2011: SHAKE, RATTLE, AND ROLL!
The morning started with My mom’s phone alarm shaking her from her terrifying dream. For a few seconds a false relief peeped into her head. “It’s just a dream,” she thought. This brief moment of calm before the storm of anxiety and fear was the only moment of peace that she would have for the rest of the day. Her reality was just as scary as her nightmare had been. Her heart raced and the cortisol pumped through her veins as she got dressed and made her way to the hospital to spend the day with her son’s comatose brain and body.
Kris took my hand as her overflowing emotions poured in the form of snot and tears that rushed from her face like a waterfall. “Good morning, my sweet boy.” the words squeaked from her face. “You’re in the hospital.” She explained. “You had an accident and your mom is here.” Her voice cracked as she told me that I was safe. “You’re going to get better, ok?” She took a long pause while she visualized her son in a white healing light and set her intentions on my resurrection. “You need to know that you’re not alone, Cavin. I’m here, and I will walk through this with you.”
After a few minutes Kris regained her composure, and soon a doctor stepped into the room wearing a white lab coat over a pair of teal scrubs. ”Hello. My name is Dr. Weingardt. Are you the mother?” He approached and Kris nodded.
As a trauma doctor, Dr. Weingardt had to move quickly between several patients. He went down the list of injuries with my mother again. “We took him off of sedation last night, and he’s agitated and not following commands yet.”
“The main concern at this point is your son’s inability to breathe on his own. We have him on a ventilator and are keeping him sedated for now to allow him to regain some strength. The problem is made worse because he also has fluids in his lungs from aspiration.“
“Is there anything I can do?” Kris asked helplessly.
“We are working to save your son’s life. And we will do the best we can.” The doctor paused for a moment to look at my chart. “Ya know…” he said “Your son is very agitated unless he’s highly sedated with fentanyl and propofol, and the only time I really see this is when someone is going through withdrawals from alcohol. We could give him a ringer with some different B vitamins to ease his symptoms if you think he could use it. Do you know how much alcohol he drank?”
“Give it to him!” Kris said with urgency. “I don’t know how much he drank, but he was a bartender, so I would imagine that he had at least a few drinks every day.”
Soon after the doctor left, Kris’s phone rang. Stina had just arrived and was on her way to the hospital. After dragging her bags from train to train and from station to station, Stina arrived to stand by Kris’s side.
As soon as she saw me laying there with tubes down my throat and a neck brace, she burst into tears. “Oh my god, Cavin,” she said as she stroked my head. “You really hurt yourself, honey.” Cavin and Stina were very close friends throughout middle and high school, before Cavin moved to New York. Their relationship had certainly drifted since they no longer were in close proximity, but the familial love that they had for each other was undying.
After spending an hour or so with my unresponsive body, Stina and Kris left the hospital to drop Stina’s things at the hotel and to grab a bite to eat together. “How are you holding up, Kris” Stina asked.
“I don’t even know how I’m holding up, Stina… I’m kind of numb, which I guess is better than falling apart.” Kris said as the stress continued to pump through her veins. Stina nodded, surprised at Kris’ ability to contain the intensity of the situation.
“I… I…” Stina stuttered as she searched for the words that she wanted to express. “I know how incredibly strong you are, but I can imagine how hard this is for you. I don’t even understand how you are keeping it all together.” Stina reached across the table to take Kris’ hand.
After finishing lunch and leaving the restaurant, Stina and Kris stepped onto the bustling bodega and restaurant lined urban habitat underneath the elevated train above and Stina lit a cigarette. “Can I have a drag of that?” Kris asked, and Stina obliged as they walked towards the hospital. As the nicotine filled her lungs Kris felt the first soothing sensation she was able to register since she got the news.
Passing by a bodega, Kris held up one finger as she slipped in. “I need a pack of Virginia Slim 100s and a lighter.” The clerk put the items on the counter and charged her $15. Kris looked at Stina with surprise. “Fifteen dollars!?! Wow! When I used to smoke, this would be $5 max!” She paid the clerk and opened the pack. “I can get through this without drinking,” She said, “but I am not going to even try to do this without smoking.”
“I’d say you deserve that vice right now.” Stina smiled.
While Stina and Kris were out, several of Cavin’s friends had arrived, filling the room where he laid. Returning to Cavin’s room, they watched as several nurses came and went, weaving between my company and monitoring my vitals. Wearing a lab coat and holding a clipboard, an Indian doctor entered the room.
“Are you the mother?” He asked in a thick Indian accent, rolling his Rs. Kris nodded. “My name is Dr. Bhat. I have been called for a neurological consult. I have looked at the CT scans and I see nothing that should prevent him from waking, so I suggest that we try to arouse him to consciousness.” A forceful tap echoed in Cavin’s hollow chest as the doctor began to aggressively tap on my sternum. “Hey!” Lindsay reacted in disbelief. “You can’t do that! He has broken ribs!” With a distasteful look, the doctor lifted his hands above his shoulders. “Ok… You wake him up.” As the neurologist walked out of the door, Lyndsay and the others carefully came to my side, gently shaking my unresponsive body in an attempt to rouse me.
Time slowed for Kris as she observed the surreal scene before her eyes. She thought of the worst and best case scenarios simultaneously. What if Cavin woke up now? What if the hospital staff became fed up with the crowd that Cavin had visiting him? What if the doctors and nurses were simply annoyed by her son’s friends? What then? Dr. Bhatt was in charge, and he seemed to be annoyed with the crowd in Cavin’s room. My mother had recently spent months caring for her hospitalized father, and she knew the importance of a good rapport with the people who were taking care of a loved one. Later that night, she and Stina approached the front office to limit Cavin’s visitors.
After 24 hours had passed since my injury, another cranial CT scan (CT of my head) was done. This CT scan now showed bruising of the left frontal cortex and some bleeding that created pressure on my brain. MRI studies have shown that the frontal area is the most common region of injury following mild to moderate traumatic brain injury , and an injury to the frontal cortex would likely mean personality changes as well as the possibility of a loss of motivation, initiation, and drive.
If the pressure from my internal brain bleed was above a certain amount, a piece of the skull would have been temporarily removed to relieve pressure, but this was not a necessary procedure for me. Despite these apparent injuries to my brain, the damage shown should not have prevented me from waking. Because I would not wake, Dr. Bhat suggested that they up the ante by reducing the amount of oxygen that was being pumped in and out of my incapable lungs. This could at least encourage me to breathe on my own rather than to rely on the respirator to keep me alive. Getting me to breathe on my own would bring me to a higher Glasgow Coma Scale (GCS) score, signifying that I was becoming more conscious, so an attempt to reduce the oxygen was scheduled for the next morning.
In my experience working with the families of patients who are comatose, friends who are not very close to the patient tend to burn out on visiting or have trouble handling the scenario of a comatose patient. Limiting visitors during this stage of recovery gives friends, who are not especially close, the space to digest the scenario so that when the patient comes to consciousness and could really benefit from the community support, those friends are more likely to be there.
It is especially powerful to incorporate high-dose DHA and EPA rich omega-3s when a patient is comatose. Learn more about this therapy on my other website: Feed a Brain.