"Let me tell you, people, that these nurses are angels on Earth. They are always beside him, watching him, talking to him, encouraging him. They have the patience of Job and the knowledge and wisdom to help Andrew succeed. I have seen few people who are as dedicated as these nurses. There are numerous other patients in the ICU with Andrew, and the nurses and doctors are tirelessly working on each of them."
Patients with brain injuries are closely
monitored using sophisticated equipment
in the NSICU.
The scrapbook begins with the words, "Andrew's Adventure: December 23, 2005." It was not the kind of adventure that any family would choose to take. But in the end, it had a happy ending for Andrew and his parents.
On the evening of December 23, a Friday, Andrew and several friends went skiing and snowboarding at a slope near Cincinnati. On one of his runs, Andrew fell and banged his head on the compacted snow. Andrew, not realizing that he had sustained a serious injury, went for one last run. Wobbly, he fell again and slid down the hill. An emergency medical technician from a local fire department saw Andrew fall and sensed something was wrong. The EMT, whom Andrew's family regards as their guardian angel, stayed with Andrew and summoned help.
As Andrew's condition deteriorated, University Air Care was called, and Andrew was flown to Cincinnati's University Hospital. He then went from the emergency room directly into surgery for treatment of a subdural hematoma, a blood clot that formed under the skull and its outer covering (the dura) but outside the brain. The blood clot formed after a blood vessel between the surface of the brain and the outer covering stretched and tore.
Mario Zuccarello, MD, a neurosurgeon with the Mayfield Clinic, removed a portion of Andrew's skull on the left side of his head and sealed the bleeding blood vessel. Dr. Zuccarello did not replace the portion of skull immediately; rather, he attached a protective synthetic membrane so that Andrew's brain had room to swell naturally. Andrew's skull would be replaced several weeks later.
During the next several days, 24 hours a day, highly trained nurses and physicians watched over Andrew in the Neuroscience Intensive Care Unit(NSICU), monitoring his intracranial pressure, brain temperature, and oxygen levels at all times and striving to keep them in optimal ranges. Andrew came through the first 72 hours, which are critical for patients with brain injuries, and then survived Days 4 and 5 without any dangerous brain swelling.
Slowly but steadily, Andrew regained consciousness and began communicating with medical staff and members of his family. Like the vast majority of people who suffer neurotrauma, he battled infection and fever spikes.
On January 2, ten days after his falls, Andrew gave a thumbs-up to Lori Shutter, MD, a neurointensivist with the Mayfield Clinic and Director of the Neurocritical Care Program at the UC Neuroscience Institute. Dr. Shutter then announced that it was time to get Andrew off the respirator that had been helping him breathe while his brain function stabilized. Later that day, in more signs of his comeback, Andrew sat on the edge of his bed, stood up, and took a step. His family attributed his remarkable recovery to the optimal conditions for healing provided by University Hospital's NSICU and it staff, Andrew's youth and fitness, and the support and prayers and dozens of friends and family members.
Andrew was transferred to Drake Center, Cincinnati's long-term rehabilitation center, on January 4. Prior to the transfer, his family said a "thankful, yet teary-eyed, good-bye" to a neuroscience nurse, Sarah, who spent more hours caring for Andrew than any other.
At Drake, the expert team of physical and occupational therapists guided Andrew's rehabilitation. Physical exercises helped him regain his coordination, balance, and strength, while cognitive exercises helped him regain his memory and speech.
Each day, a little more of his world came back to him. As Andrew prepared to go home, three weeks after his accident, his stepfather noted that the challenge now would be to keep 18-year-old Andrew from becoming "too rambunctious." With his skull still exposed and his bone flap not yet reattached Andrew was required to wear a helmet any time he was not lying down in bed.
Dr. Zuccarello waited until Andrew's surgical scars had completely healed before replacing the bone flap in a procedure called a cranioplasty. The delay is necessary because there is an increased risk of infection if the wound has not completely healed. On February 14, to the relief of Andrew and his family, Dr. Zuccarello replaced the bone flap, and Andrew's skull was once again whole.
By March – nearly three months from the time of his accident -- Andrew was a full-time student, readying for high school graduation, and driving. Even better, Dr. Zuccarello had awarded him a complete bill of health: Andrew could resume all activities, including sports.
Today, more than four years later, Andrew lives a completely normal life, just like any other college student. He is a college senior, majoring in international business and marketing and planning a career in consulting. Nevertheless, the injury has left an indelible, though invisible, mark. Andrew has a memory gap of two years, preventing him from remembering what happened a year before the fall and a year after.
More importantly, the ordeal has left him wiser, more careful, and keenly aware of how quickly a life-changing accident can occur. He wouldn't think of sending a text message to a friend he knows is driving, for example. To someone who's late for work or class, he has two words of advice. "Don't rush."
If he's feeling down himself, Andrew turns to a scrapbook filled with dozens of e-mails that his stepfather sent out to family and friends during his hospitalization and pores over the hopeful, caring reports of nearly three months of incremental progress from unconsciousness to thumbs-up to going home.
"That puts me in my place," Andrew says. "It makes me realize that I could have been paralyzed. Looking back now, it really shows me how much I've grown and how much I faced. I know I can overcome any obstacle. I can overcome life."
Hope Story Disclaimer - "Andrew's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.