Neuro Patient Stories
Dean Lafleur - 100th Aneurysm Patient
Dean Lafleur had been tired and battling a severe headache for several days. Normally a much more energetic eighty-seven year old, Dean knew something was wrong and decided to see her primary care physician. In the doctor’s office, the nurse practitioner took Dean’s blood pressure – twice – just be sure.
“She took my blood pressure and said it was extremely high,” said Dean. “We waited a few minutes and she took it again – it was 244 over 135. They sent me straight to Tallahassee Memorial.”
As soon as she arrived at the hospital, Dean underwent tests to determine the cause of her symptoms, including imaging of her head. The images discovered an unruptured aneurysm in her brain. Caused by weakened blood vessel walls, aneurysms occur often and can go unnoticed and cause no symptoms. However, Dean’s aneurysm was different.
“Dean’s aneurysm had an irregular shape,” said T. Adam Oliver, MD, endovascular neurosurgeon at Tallahassee Memorial HealthCare. “Coupled with the larger size of her aneurysm, there was reason to be concerned that it would rupture. Ruptured aneurysms are significant medical emergencies – something we want to avoid at all costs.”
In the past, and still sometimes today, patients like Dean would need a craniotomy, or open brain surgery, to repair an aneurysm. But here at Tallahassee Memorial HealthCare, new technology and specially trained surgeons can repair aneurysms without opening the skull. Called endovascular neurosurgery, these procedures are minimally invasive and offered nowhere else in the region besides TMH.
“Endovascular neurosurgery is becoming a very popular option because it requires only a small incision rather than the larger incisions used in traditional brain surgery, has a faster recovery time and lessens the chance for infection,” said Dr. Oliver.
Endovascular neurosurgery works by reconstructing the blood vessel wall using small platinum coils to plug the aneurysm and it’s opening from the blood vessel in the brain. Dean’s operation utilized these platinum coils inserted via a microcatheter into her aneurysm to seal it off. After the operation, the body’s own immune system heals the inside of the blood vessel wall. Dean was the 100th aneurysm patient to be treated with endovascular neurosurgery at Tallahassee Memorial.
“Everything just went beautifully,” said Dean. “Dr. Oliver was able to show me before and after pictures which showed the aneurysm. After they had done the surgery and put the coils in it was gone!”
Since her surgery, Dean has returned to her normal self. Her blood pressure is down to regular levels and she has had no additional issues.
“It’s just mind blowing that they can do something like this. Dr. Oliver and the people that work in surgery were the most compassionate folks ever. They just made you feel like you were in really good hands,” said Dean. “Life is good.”
All at once human life can be both delicate and indestructible. The human body is an almost unbelievable network of tiny valves, strong bones and electrical impulses that can literally heal itself, yet potentially succumb so easily.
This vulnerability and strength is what makes life so precious – constant risk tempered with the sheer willingness to persevere. This juxtaposition shows itself throughout life – physically, mentally and emotionally – for us all. But for Clary Bateman, the last four years of her life have been a constant reminder of how far we can be pushed and the strength we’re capable of. She was 14, an 8th grader at W.R. Tolar K-8 School in Bristol, Fla. An athlete competing in track, softball and basketball. A straight A student. But on February 28, 2011, out riding 4-wheelers with a friend, Clary came face-to-face with the thin line between life and death. Caught in a dust cloud, she didn’t see a stop sign and inadvertently pulled out onto a highway – she was hit by a truck going 60 miles per hour.
Arriving at Tallahassee Memorial HealthCare (TMH) via life flight with a severe open skull traumatic brain injury, Clary’s prognosis was bleak. Her body was broken – arm, legs, pelvis, jaw, skull – and she had physically lost part of her brain.
“She arrived neurologically devastated,” said Christopher Rumana, MD, neurosurgeon at Tallahassee Memorial. “Her skull was open and she suffered a stroke in the left hemisphere of her brain. The damage was significant, but we remained positive and worked to incorporate her family into her care, keeping them informed and involved.”
Clary also had emergency orthopedic surgery to, quite literally, put her back together.
“Clary had left femoral and tibial shaft fractures and they both required surgical stabilization with titanium rods,” said Hank Hutchinson, MD, orthopedic trauma surgeon at Tallahassee Memorial. “The tibia fracture had several associated wounds that were repaired with multiple surgeries and skin grafts.”
After 20 or more surgeries, Clary was alive, but in a coma. She stayed at Tallahassee Memorial for three-and-a-half months, fighting to stay alive and slowly healing.
And then, two months after returning home and without any notice, Clary woke up.
“It was the middle of the night, around 1 a.m.,” remembers Edie Ethridge, Clary’s mom. “She’d been in a coma for five-and-a-half months and then, all of a sudden, she was awake and making noise. She fought her way back.”
With Clary now awake, against the odds, the path to rehabilitation started to come into focus.
“We started some rehabilitation while Clary was still in her coma,” said Edie. “We were vigilant about moving her body and working to engage her however we could, but now that she was awake she worked in earnest to make positive steps towards recovery.”
In December 2011, almost ten months after her accident, Clary began working with therapists at the Neurological Rehabilitation Outpatient Unit at the Tallahassee Memorial Rehabilitation Center (TMRC).
“For me, meeting patients with traumatic brain injuries and their families is a magical moment,” said Sheree Porter, MS, CCC-SLP, TMRC’s Rehabilitation Program Manager. “Clary’s family did’t realize it at the time, but I knew that we are forming a very close bond that would transcend Clary’s situation. We become united, a type of family, with a laser focus on making positive steps towards her recovery.”
Clary’s therapy care team, Rebecca Greenhill, a TMH speech language pathologist, Patricia Quinsey, a TMH physical therapist and Helene Bennitt, a TMH occupational therapist, have seen Clary make drastic progress since her first days in therapy.
“At first, Clary only communicated with gestures and facial expressions,” said Rebecca. “Our therapy began with making sounds, just creating noise. Clary’s brain damage effected her temporal lobe, the area of the brain that is responsible for language and speech, so she lost the building blocks of communication – she’s not only relearning everything, she’s having to find new ways to learn it.”
After almost 4 years in weekly therapy, Clary has moved far beyond simple noises and gestures. She now has a vocabulary of words that is growing with each therapy session. Her mobility is also improving through her work with Patricia and Helene, as well as the help of a baclofen pump that was implanted in her stomach by Dr. Rumana. The constant flow of baclofen helps improve her mobility by creating the right balance of flexibility and rigidness in her musculoskeletal system.
“Clary’s having to learn new ways to tell her body to move,” said Helene. “Particularly in her right arm, she has very limited movement. We’ve come a long way in increasing the function of her arm, but also in creating new ways of completing activities for daily living despite her reduced mobility.”
Maybe most importantly, Clary’s spunky personality is shining through again. Thanks in part to her relationship with a very special part of her therapy team, Bogey. A Boykin Spaniel from Tallahassee Memorial’s Animal Therapy program, Bogey has a special relationship with Clary that has helped her progress in her rehabilitation. Rebecca, Patricia and Helene incorporate Bogey into every facet of Clary’s therapy, having her give voice commands and use a leash to walk Bogey with assistance. This unique approach interconnects her therapies and helps to facilitate memory and communication.
“Clary’s a miracle,” said Richard Gardner, Bogey’s handler and a volunteer in the Tallahassee Memorial Animal Therapy program. “One of the biggest moments we’ve had was around Thanksgiving 2014, we watched as Clary stroked Bogey from head to tail with her right hand. It was a huge achievement for Clary – we were all thrilled!”
While Clary has made amazing strides, and is sassier than ever, she’s still fighting every day to take another step forward.
“In every aspect of her care, TMH has taken Clary’s injury and recovery personally,” said Edie. “They truly want Clary to get better. As much as they’ve helped Clary, they’ve helped us, her family, equally.”
In May of 2015, Clary graduated from Blountstown High School, receiving two standing ovations. She accepted her diploma and celebrated with family and friends – including her TMH therapists and, of course, Bogey.
“I feel lucky to have had access to a place like TMH, but even more lucky to have a daughter who is as strong as Clary,” said Edie. “We call her ‘Clary strong’ – she’s living proof of something most of us never see, how strong a person can really be.”
We’ve all had a headache. But for Robin Prinzel, the headache she experienced on Tuesday, November 25, 2014 wasn’t normal.
“It was more than a headache,” recounts Robin. “I could hear the blood rushing in my ears, my heart was pounding. I knew something wasn’t right.”
Robin was right. She was suffering from a hemorrhage in her brain due to an aneurysm.
Aneurysms, weaknesses in the walls of a blood vessel that fill with blood, are common – it is estimated that 5% of the population has an intracranial aneurysm – but when they become large and/or hemorrhage, they can cause a stroke. Ruptured aneurysms and stroke are critical medical emergencies. Once an aneurysm has ruptured, there is a 40% chance of death. For those who do survive, more than half, almost 66%, are left with some permanent neurological deficit.
Time is the most important factor in treatment. Robin’s sense not to ignore her headache and other symptoms saved her life.
“While aneurysms are common, an aneurysmal rupture is rare but often devastating,” said Adam Oliver, MD, the Tallahassee Memorial HealthCare Endovascular Neurosurgeon who treated Robin.
After talking to her husband, David, on the phone about her symptoms they decided to seek help immediately, notifying a neighbor who worked as an EMT and calling an ambulance.
Robin arrived at her local hospital, but as a resident of Navarre, Fla., she didn’t have local access to the type of medical procedure that she needed to treat her aneurysm. In a race against time, Robin, along with her husband, were airlifted by Life Flight to Tallahassee Memorial, the only hospital in the region that provides endovascular neurosurgery.
An endovascular neurosurgery procedure is an innovative new way to reconstruct the weakened blood vessel wall using platinum coils. These coils are inserted into the aneurysm, and its opening from the blood vessel into the brain, by a microcatheter that enters the body through a small incision in the groin. This operation doesn’t require open-skull surgery and provides a quicker recovery and reduced chance of infection.
“Robin was a good candidate for an endovascular neurosurgery procedure because of the size and location of her aneurysm,” said Dr. Oliver. “The surgery went extremely well.”
After her successful procedure, Robin was monitored in the Vogter Neuro Intensive Care Unit (VNICU) for two weeks to ensure she healed properly and to monitor for any neurological changes.
“Everyone in the VNICU was wonderful,” said David, Robin’s husband. “Robin was doing so well, we couldn’t believe how lucky we were. You hear all the time about people who didn’t make it, or people who have to live with lasting effects that significantly change their lives. This experience has been life changing, but not in a negative way, we don’t sweat the small stuff anymore.”
One month after her discharge from TMH, Robin was able to return to work and is fully recovering from her aneurysm.
“I call Robin a ‘lucky duck,’” said Dr. Oliver. “She came to us early. Neurologically, she looked excellent and was fortunate enough to be alive in an era when this technology was available. Postoperatively, she did well. She is very lucky and I’m very happy.”
Robin now travels to Tallahassee for regular check ups to ensure she’s healing well and that there are no new signs for concern.
“I can’t say enough good things about Dr. Oliver,” said Robin. “Throughout this whole ordeal, he made me feel very comfortable, explaining everything in a way I could understand and providing meticulous care. Everyone at Tallahassee Memorial has been wonderful – from the nurses to the dietary staff – they’ve all gone above and beyond. I’m so happy to share my story, it’s my way of making sure that everyone at TMH knows how thankful I am for their care.”
Until last year, Doug had rarely been to the hospital but was a familiar face at Tallahassee Memorial’s Premier Heath & Fitness Center, where he had been a member for 16 years. Despite an active lifestyle and excellent health, he suffered a stroke one day after his routine workout, suddenly collapsing beside an elliptical machine.
Len Harvey, Director of Premier Health & Fitness Center rushed to his side, and staff members immediately contacted emergency services.
“I am very fortunate I was at Premier, surrounded by people who are trained to recognize when someone is in distress,” says Doug.
First directed to the Bixler Emergency Center, when medications to break up the clot were ineffective, Doug was immediately transferred to Tallahassee Memorial’s brand new neurovascular suite for a state of the art procedure.
“Time is critical for stroke patients, which is why bringing advanced neurovascular treatments to the region was such an important undertaking for Tallahassee Memorial,” says endovascular neurosurgeon, Matthew Lawson, MD. “With care immediately available in our community, stroke patients can get the care they need quickly, which is key to better outcomes longterm.”
Doug was the first in the region to undergo a thrombectomy to treat stoke. The minimally invasive procedure allows for the removal of blood clots in the brain without an incision to the skull.
Following his procedure and two weeks in rehabilitation, Doug was eager to return to the gym. “I am convinced there is now way I would have recovered as well if I hadn’t been in as good of health before the stroke. As soon as I finished with rehab, I wanted to be back at Premier,” he says.
Doug quickly discovered he was not quite ready for this step but found support through another new offering at Tallahassee Memorial, the Cardiopulmonary Rehabilitation Center. Here, Doug spent three-and-half months working out under the guidance of expert trainers. Today, he is back at Premier Health & Fitness Center, working out on a regular basis. He has regained almost full muscle strength and control, returned to work, and is looking forward to vacationing with his grandchildren.
“I am so thankful Dr. Lawson was here, and the technology and programs were available so my treatment could take place. I cannot say enough about all the resources at TMH,” Doug says.
As a full-time accountant, a part-time graduate student and a leader in her church, Tracy Peppers keeps a packed schedule. When she began experiencing severe headaches, stress seemed to be the obvious explanation, even after the pain led to emergency room visits on two occasions.
In reality, the headaches were symptomatic of a latent health problem, which became frighteningly clear one evening in late August.
“I had sat down on the couch to watch TV and fell asleep—the next thing I knew, the dog was going crazy,” says Tracy.
Alarmed by the barking, Tracy’s son rushed into the room to find his mother experiencing a seizure. He ran for Tracy’s husband, James, and they called 9-1-1. An ambulance transported Tracy and James to the Tallahassee Memorial Bixler Trauma & Emergency Room, where tests revealed an intracranial aneurysm in the frontal lobe of the brain.
Fortunately, Adam Oliver, MD, one of the region’s only two neurosurgeons capable of providing endovascular treatment for anuersym and stroke, had just begun practicing in the Big Bend. Dr. Oliver scheduled Tracy for an endovascular surgery the following day. The minimally invasive procedure allows for the removal of aneursyms without an incision to the skull. Dr. Oliver and Matthew Lawson, MD, are the only physicians in the area offering this state-of-the-art procedure.
“Dr. Oliver was sent here for me, I think,” says Tracy.
After the operation, Tracy recovered in the Tallahassee Memorial Intensive Care Unit for three weeks. Dr. Oliver and the clinical staff monitored her recovery and vital signs. Persistent bleeding in the brain called for a second operation, but following two more weeks in the hospital, Tracy was able to begin rehabilitation to restrengthen her cognitive and physical abilities. Today, she has returned to all her normal activities and plans to graduate with her master’s degree in Health Administration in July 2014.
Tracy even recovered in time to enjoy a cruise through the Western Caribbean that she and her husband had been looking forward to for months before the emergency.
“I haven’t had a headache since the surgery!” she says.
“What Dr. Oliver did—performing the procedure, explaining it to where the family could understand it, the sensitivity he showed and for Tracy to come out the way she did—you can’t overstate that. And the fact that Tallahassee now has that capability is wonderful,” says James.
Looking back now, I recall nothing of the horrendous motorcycle accident that could have taken my life. What it temporarily took instead, was my memory, speech, and the ability to move one whole side of my body.
Though I was wearing a helmet, which prevented a potentially fatal head injury, the impact of the accident caused a serious traumatic brain injury, resulting in a coma, complete paralysis on one side of my body, and considerable neurological damage.
After being in the ICU for two weeks, I was transferred to inpatient rehab, where I had physical, occupational, and speech therapy every day for the next five weeks. Occupational Therapy helped me to relearn how to dress, bathe, and feed myself. Physical therapy was grueling. I had to relearn how to walk, and progressed from requiring two people to support me, to using a walker, to a cane, and finally to needing no assistance.
Little by little, over those five weeks, I grew stronger. Each daily victory was celebrated with my family, therapists, nurses, and so many other medical staff members at the Rehabilitation Center. I can definitely speak to the value of having the support of family and friends as an important factor in recovery. I realize that this injury did not just happen to me, but to my whole family.
I have not taken my recovery for granted. This life-changing experience has created a special perspective for me. I realize how much I took for granted before my accident. I understand better what people with permanent disabilities have to deal with, and I know things could have turned out so much worse for me.
In March of 2004, I was boating with some friends in a pond full of cypress logs. We hit something and I went airborne and landed on one of the logs. I was knocked out and floating face down in the water when the driver of the boat found me. When he pulled me out, I was barely breathing.
It ended up that I had a traumatic brain injury (TBI), a cracked hipbone, and my vertebra was cracked in my neck. I spent three weeks in ICU and another 2 months in the rehab center before I was able to come home. I had to re-learn to walk and talk again.
Thanks to A LOT of prayers and by the GRACE OF GOD I’m still here trying my best to be a normal walking, talking human being!! The staff of TMH has been there and helped me a whole bunch!! Also, my family and friends have been a MAJOR help too!!!
In the years since the accident, I have had physical, occupational, speech, and pool therapy. I have had it all as inpatient, outpatient, and twice in rehabilitation facilities. As of now my “therapy” is just getting on with life. I now am living on my own. I can take care of myself and my house. I also have a part-time office job two afternoons a week.
Traumatic brain injuries can happen to anyone but can be overcome.