Saturday, January 16, 2010

Mr. Miracle

It all started the Sunday morning after Christmas. I got a phone call from my mom, "Kass can't move his leg." "What?" I asked, "Why not?" Mom explained that he woke up with a horrible headache and couldn't move his right leg and that his right arm was weak. First red flag...Kassidy NEVER gets headaches. He said that when we tried to get out of bed he fell and that as he tried to walk he kept stumbling, "like Bambi" he explained it. Mom tried to get him to start drinking lots of water and described that when he was holding the bottle of water and talking to her and dad he was spilling the water and didn't even know it because his hand was so weak. I knew that him and his friends had been sledding behind the 4-wheeler until late the night before so I asked if he hit his head sledding or had fallen on the ice or anything. Mom said that she had already asked him those questions and he said no and that they had called his friends and all of them said no as well. I then asked if he was having any slurring of speech, facial drooping, or cognition problems, and mom said no that he was acting fine. I thought that he might have injured a nerve in his low back or slept wrong, as he had some epidural steroid injections in his back previously related to a minor low back problem, but the arm weakness too just didn't fit. I told her I would be over soon to check on him.
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In the mean time dad had him start doing exercises to try and "get his blood pumping" and try to "work it out" of his leg. Kassidy then began to use his leg slightly better but still described it as feeling heavy and "like jello." After being in the hot shower several minutes he yelled at mom and dad that suddenly his arm and leg were working somewhat normally again. His headache was now down to a 2-3 out of a 10 instead of a "15" as he had described when he first woke up. Mom called me back and said nevermind that she thought he was getting better and not to worry about it. Because he felt almost back to normal, Kassidy even went to a rock climbing birthday party that night and hung out again with all of his friends.
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The next day around lunch time I got a call from dad and Kassidy. He still had the dull headache that had never went away and his right arm and leg still felt a little heavy and weak, "just not quite right." Kassidy had started taken Accutane a few weeks prior for his acne and a rare side-effect is stroke which really worried dad. I called the nurse practitioner that I work with to consult with her and we ordered an MRI and MRI of the brain that day. As I'm at work later that after working on a chart in between patients Dr. Kemp comes over to my side of the clinic with an awful look on his face. He had no idea about Kassidy's recent episode, the arm and leg weakness, etc. "Did you send your brother for a MRI?" "Yes," I answered, knowing by the look on his face that bad news was coming next. "He's had a stroke." NO! I was thinking. How could this be? A healthy, active, intelligent 18 year old boy. NO! This couldn't be happening. He is the starting short-stop on Varsity baseball, he made a 34 on his ACT, he has a full ride to OU next year, Mr. Social, he's MY little brother...NO! "Radiology is on the phone, acute CVA." I burst into tears and Dr. Kemp rushed back over to his side to finish talking to radiology. Although I knew Kassidy was fine at the time, I mean, he went rockclimbing the evening after this happened, I still felt terrible. Maybe I should've taken it more seriously, we should have sent him to the ER, but he got better, he felt fine, he had no other stroke symptoms. A healthy 18 year-old having a stroke? Surely not the highest on my list of differential diagnoses.
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He was initially worked-up at Unity ER in Shawnee and then was transferred to OU Medical Trauma Center. You would have never known that he had had a serious embolic stoke unless you had read the MRI report. He was acting just fine and was almost 100% "normal." At OU Medical Center he passed his initial neurologic exam with flying colors except for a little bit of decreased sensation in his right forehead and chin. The neurologists were amazed at how well he was doing...our MR. MIRACLE!!! After initial testing and evaluation, he was started on heparin, a blood thinner to decrease the risk of more blood clots until the cause was discovered and transferre to the acute stroke unit. The neurology team on this unit was AMAZING and we felt as if Kassidy was receiving top notch care from some of the best neurologists and stroke specialists in the country.
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Mom and Dad never left his side! They were there for 11 days and made theirselves at home. Mom put a Scentsy in his room and there was no shortage of food or snacks...
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or GIRLS!
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This is Krissy, one of our really good family friends from Broken Arrow.
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Reid helped to keep him entertained!
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And I tried out his bed...it was actually really comfortable!
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Eating some beef jerky - his favorite hospital snack!
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Yes he was "hooked up!" - he even had his flat screen and Play Station 3
Blood work, testing, more blood work, more testing, eventually revealed that there were no clotting abnormalities and that the blood clot that caused the stroke had went to several parts of his brain. A transesophageal echocardiogram revealed that Kass had a congenital heart defect, a patent foramen ovale, that should've closed a birth that was most likely where the clot got through to go to his brain. Interestingly, the cardiologist told us that 27-30% of the population have a PFO but not all of them will have strokes because this only happens under certain circumstances. Although Kassidy has never had a heart murmur, the cardiologist said that this "flap" in between his right and left atrium of his heart was actually pretty large and that there was quite a bit of blood flow going back and forth. The reason for the clot in the first place? No one can say for sure. Neurologists and cardiologists say that it was just kind of like "the perfect storm." That everyone makes clots off and on but that our bodies usually dissolve them or they are very small clots and go to our lungs where they are absorbed (only the large ones cause pulmonary embolisms). Other things could have contributed such as dehydration or a clot could have broken loose from his leg that may have formed from one of his previous knee or finger surgeries several months ago.
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It got a little tiresome at times, but Kassidy was quite a trooper! He was in good spirits the entire time and ALWAYS stayed positive with a smile on his face, even when he had to be in the hospital at New Year's. I truly couldn't ask for a better little brother.
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It was decided that Kass would have a procedure where they would go up through both of his femoral veins in his groin and patch the patent foramen ovale. This would prevent any more clots from ever going to the left side of his heart and into his brain and would keep him from having to be on blood thinners for the rest of his life. We were all a little nervous about the surgery but knew that this was the right thing to have done. The procedure only took an hour and they only gave Kass a little bit of medicine to relax him because he told the cardiologist that he wanted to be awake the whole time and watch the procedure on the screen. Kassidy was really interested in all this and actually is thinking about going into interventional cardiology now. He recovered great from the surgery and was able to go home the next day. The neurology and cardiology team sent him home on Plavix, an antiplatelet medication, and aspirin daily for the next 6 months. Because these medications thin the blood, playing baseball is still in question but all we care about is that he recovered 100% from the stroke and is doing GREAT!!!
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We give all the glory to God and know that He has the perfect plan. Our family's trust in Jesus Christ is what carried us through this scary experience. The Lord blessed him with a miraculous recovery and we are all so thankful. He must have some pretty big plans for Kassidy Glenn Cook!
"For I know the plans I have for you, plans to prosper you and not to harm you, plans to give you hope and a future." - Jeremiah 29:11
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So glad to be leaving!

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