The long road of an AVM

May 22, 2008

The morning of April 2 was far from any normal morning for senior Jessica Platt, my girlfriend, along with myself. It was a life changing morning, one that you could say came straight out of left field.

Waking up was a little different than usual. In­­-­­­­stead of being woken up by the beeping of alarm clock, I was awoken by the moans and restlessness of my girlfriend. I asked her what was wrong, but instead of the normal response of “nothing,” she replied, “I need a Tylenol.” I popped up out of bed, feeling the urgency that was in her voice, went to the vanity, and grabbed the brand new Tylenol bottle that sat there. After opening the bottle and getting two pills out, I turned around, and complete horror attacked my senses.

My girlfriend was having a seizure.

Not really knowing what was happening to her, I called Campus Safety, and waited for them to come. The seizure continued and Campus Safety finally arrived. Immediately the decision was made that she needed medical assistance and one of the Campus Safety officers made the call. Within minutes the Galesburg fire department responded. The second that the first paramedic came through the door, she awoke from the seizure.

The paramedics quickly strapped Jessica into a stair chair and wheeled her down to the first floor of Raub house. In a matter of minutes, Jessica was securely strapped into a transport bed and put into the ambulance.

After a quick ride in the ambulance, Jessica arrived at Cottage Hospital. She went through a slew of tests, and the Emergency Room doctor determined that there was something seriously wrong in her brain. Since Cottage Hospital does not have a trauma unit, it was decided that Jessica needed to be transferred to a level 1 trauma hospital.

Peoria OSF Saint Francis Medical Center answered the call, and after about an hour Jessica was loaded into the same ambulance and the paramedics were ordered to get her there as fast as possible. After about twenty minutes of high speed driving the ambulance arrived at OSF and Jessica was transferred into the neuroscience critical care unit, where her condition was finally stabilized.

Jessica’s parents arrived in the early afternoon.

More tests were conducted, and it was found that she had an arteriovenous malformation (AVM), or clump of malformed veins, in the left side of her brain, sitting near her brainstem. The doctors needed some time to figure what to do. That night, it was decided that an external drain or stint would be put into the ventricles of her brain to drain excess blood and fluid off of her brain.

The shock started to set in for both Jessica and I as we discussed the procedure. The severity of the situation started to hit.

After the procedure was over, Jessica seemed to be okay, and the stint they had just inserted was draining a blood-colored liquid that was not the consistency of blood.

Things started looking good as Jessica started feeling better, and began to start acting like her usual self.

After a couple days, we finally met the neurosurgeon who was working on Jessica’s case. He was very cordial, and believed that the AVM was inoperable. Luckily, medical science has come quite far and they could treat the AVM with a form of very precise gamma radiation, from a machine called the gamma knife.

The only thing they could do at that time was to permanently internalize the stint. After about nine days in the neuroscience critical care unit it was decided that she would go in for the very minor surgery and then be released a couple days later.

The surgery went very smoothly, and Jessica was up and moving within about four hours. The next day, she was downgraded into the general care unit, and was observed to make sure everything was going well.

On April 14, she was released from the hospital and told to go back home to St. Louis for a week to regain strength and then come back to school.

Things were looking very good. Jessica went home with her family and started regaining her strength, and started getting back to normal. Plans were made for her to come back to school the week of the 21, and get back into a modified schedule.

April 18 changed everything. At around 5:30 a.m. Jessica awoke once again in pain and had another seizure. Luckily her mother was already awake thanks to the earthquake that occurred that morning at 4:30 a.m. The paramedics once again rushed her to a non-trauma unit hospital and eventually she was transferred to St. Louis University Hospital.

After receiving the news of what happened at around 10:15 a.m., my mom and I rushed to the hospital. The three and a half hour trip seemed to take forever. I couldn’t wait to see how Jessica was doing.

Once we arrived at the hospital, we met her parents, who were visibly shaken and upset. The second seizure was not as bad as the one I had witnessed, but the internal stint (shunt) had done its job, draining blood and excess fluid out of the ventricles and into the lining of her stomach. The quick reaction time of her mother also helped make sure that Jessica was going to be ok.

After eight hours in the emergency room, Jessica finally got transferred into the 5-ICU. Yet again Jessica pulled through a seizure without any brain damage and things were looking pretty good.

One thing that Jessica had shown throughout all of this is strength. She was like a rock, not allowing any bad news to shake her.

After a new set of tests, the feelings that things were going to be okay slowly started changing. A darkness started enveloping all that were involved in the horrible situation, including Jessica.

The strength that she possessed was still there, but was different.

After a preliminary conversation with one of the doctors, the prognosis changed severely from what had been said in Peoria. Jessica was dealing with an AVM that was quite a bit more complex than had originally been thought. The doctors warned that any one thing could trigger a massive seizure that could take her life.

With news like that everyone started preparing for the worst. Jessica talked with each one of us privately and gave us a course of action if something terrible happened to her.

The doctors decided that Jessica’s condition necessitated action. They decided to start a procedure called embolization. The procedure would be conducted in multiple sessions. The doctor would systematically glue closed each part of the AVM, in hopes that it would divert the blood flow away from the AVM. It would also reduce the risk of her having future seizures.

On Tuesday, April 29, Jessica went in for the first embolization. The procedure was supposed to take four to six hours but took more than seven. The doctor believed that the surgery was a success and he glued over 50 percent of the AVM closed.

The second embolization occurred on Thursday, May 1, and went along right on schedule. The doctor believed that the procedure was successful and that there was only about five percent left of the AVM that needed to be closed.

After the second embolization, sometime between the time she woke up from the procedure and noon on Friday, Jessica suffered a minor stroke. It affected her eyesight, and some long term and short-term memory. The eyesight loss was more severe than the memory loss. Fifty percent of her right eye did not work.

The doctors were quite surprised to see the results of the stroke. They needed time to reconsider their course of action.

On Monday, May 5, they decided to go ahead with the third and final embolization, with the hopes that could get 100 percent. If they met their goal, Jessica would have been able to be transported back to OSF for the Gamma Knife.

Tuesday proved a hard day for everyone. Unfortunately, the vein structure proved to complex for the doctors, and they decided it was too risky to try for the extra vein.

On May 7 it was decided that surgery was the only option. The surgery was scheduled for Friday the ninth.

Jessica had one of the best days I had seen on Thursday. She was talking, happy, and having a good time. Underneath her happy demeanor though, you could tell she was scared to death. She was ready, though — ready to get rid of this burden that had caused her so much pain and grief through the past months.

Saying goodnight that evening was brutally hard on all of us. The thought that something bad might happen during surgery was overwhelming.

At ten minutes to six Friday morning, Jessica was taken from her room in the 5-ICU to the pre-operation waiting room. Her mom, dad, and I were the last ones to her before they rolled her away to go into surgery. Goodbye was not the last thing that any of us said to her. We all tried to be positive and send her into surgery with positive thoughts.

8:30 a.m. gave each of us some hope. Jessica’s professors, along with the deans, approved her graduation. Everyone celebrated for a couple of minutes, and then we started talking about her future, which was looking brighter and brighter as each hour passed.

The first incision was made at 11 a.m. and by 1 p.m. the doctor had made his way to the location of the AVM. The critical period was approaching and we all started getting nervous.

At around 5:20 p.m. the doctor called and said they were closing. It was odd that things went as fast as they did, since we were prepared for up to 18 hours of surgery. The doctor told us that he believed he had removed 100 percent of the AVM. Things were looking amazing.

Sometime before 8:00 p.m. we were allowed to go see her. She looked amazing. There was no need for her to go on a ventilator like is usual for brain surgery patients. We all slept a little bit more soundly that night.

We all made it through a massive brain surgery.

The road to recovery had finally started.

Currently Jessica is charging through her hospital recovery, and is physically very strong. Her brain is still in a state of trauma, and not allowing for much to happen. She is slowly trying to learn how to re-process things, and is working hard to re-learn how to speak.

Yesterday was a big day. They downgraded her out of the 5-ICU, and put her into general care. Today is going to be another wonderful day. She is getting transferred to an inpatient rehabilitation facility.

The road to recovery is long, but Jessica is surely going to make it through in a style that is all her own. Things are finally working themselves through.

In the upcoming weeks, the Knox women’s soccer team is going to be tabling in Seymour Union to help Jessica in any way they can. Please stop by and help her out!

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