Watching a loved one die, a cautionary tale
 

Two weeks ago my beloved wife (of 49 years) began leaning to the right. Shortly after, she began to have severe back pain which increased to the point that she could not get up without help. She also mild trouble walking. We went the the ER. MRI of back was normal and diagnosis was muscle spasm. Advised to take muscle relaxants and Motrin. These helped the back pain, but her trouble walking increased. We had just been to Vermont, so I started her on doxycycline thinking probably Lyme's disease (I'm a doc). But the right tilt, and trouble walking were getting worse. She was also beginning to ignore her left side, dropping things. She went to her internist who thought she had a left sided weakness on physical exam ? stroke and started her on a statin and baby aspirin and recommended a head MRI/MR angio, again thinking maybe a stoke. Her symptoms were getting worse now by the day and I knew I was losing her. The earliest MRI we could get was a week away and I was sure by that time she would not be with us. She refused to go back to the ER.

One thing I have not disclosed so far, is that 3 months ago, she had fallen off of a ladder. It was a significant fall of about 5 feet but she did not remember hitting her head, there was no loss of consciousness, no bruising and she got up and felt fine. We talked about going to the ER but decided against it since there really was not problem.
We did relay this to all of the medical encounters above. After the fall there were no obvious sequelae.

After all of the events described in the first paragraph, I came to the conclusion that my wife, dying in front of my eyes, might be suffering from a chronic subdural hematoma (expending blood clot on the brain) as a result of that fall. I called every radiology center I could to try to get the MRI moved up, but to no avail. I called and pleaded with a neurologist to see my wife who agreed to see her in a few days at the earliest. When I told him my concern, he suggested a CT scan could be done probably faster than the MRI and that it would not hurt given my concern. We did get a CT scan two hours after that phone conversation. The radiologist told us to go the emergency room at the local hospital immediately and he would arrange for a neurosurgeon to admit my wife for an emergency craniotomy to drain the blood from a large subdural hematoma. My wife had the surgery tonight is now recovering in the intensive care unit. Barring any complications she is expected to fully recover. Another 24 hrs and she probably would not have survived.

In a severe head injury with a large sudden hematoma, if the blood is not evacuated immediately, the patient will die as the pressure inside the brain increases and pushes the brain away from the blood and down. The downward pressure is called herniation and destroys the brain stem with the loss of breathing and death. But subdural hematomas can also be insidious("chronic"). Even a subtle head injury can cause a small subdural. Sometimes these just resolve on their own, but other times they begin to swell, gradually enlarging to push the brain sideways and down, months after the injury. This is what happened to my wife. Hopefully, after the surgery, we will have happy ending.

Charles

My wife of 42 years left a note taped to the step ladder in the garage for me the other day.
No Ladders when alone.
I think it goes both ways now.

Sounds like you were very lucky Charles, and being persistent about getting that CT done was what saved your wife. Congrats. I hope all ends well.

What Scott said. Best wishes for a speedy full recovery for your wife. Please keep us posted.

Charles.....please keep a close eye on her aftercare and in particular her catheter, if applicable.

Making sure it is draining well - check this as often as possible.

I know you are a doctor but I have a reason to mention this to you.

Thanks and good luck!

Scary stuff... Thanks for sharing that Charles. All the best to you and your wife.

Strength and healing!

Thank you for the warning.

Wow....had no idea a hematoma could develop that slowly. This forum is quite an educational tool.

Glad you were able to achieve what should be a positive outcome. Prayers and Karma sent your way.

A friend and his Wife took a trip to Egypt where they went on a camel ride. His Wife fell while getting off the camel and bumped her head. She went to an Egyptian Doctor and was cleared, it was towards the end of the trip and they flew home.

Not more than 24 hours later my friend found his Wife on the bathroom floor, she passed away at 32 from a subdural hematoma. Devastating loss to say the least. You can never be too careful.

Good thing you reacted quickly.
Best of luck and a speedy recovery!

Good luck Charles. And good thing you are a doctor and could make things happen.

That exact thing killed my mother.

What is note worthy is the run around that Charlie got which is SOP now. This is not an isolated incident..it is every where at every level.

Wow. Best wishes for a speedy and complete recovery.

Good luck with your wife's recovery . Take each day as a positive .

Best of luck for a full recovery.

Quite an experience. Hope the wife continues to improve.

The most dangerous tool I own and it is a step ladder. I'm old and have had vertigo issues. Loosing my balance scares me.

Charles, I hope for your wife a speedy recovery and kudos to your persistence.

the run around is scary..... can't be seen for a cough is one thing. showing life threatening symptoms so rapidly and they still didn't care to help is crazy.

good luck

I clicked on this thread with much trepidation.... all I can say is "whew!"

Best to you and your wife Charles .... thank you for sharing and teaching the flock.....

Please let us know how her recovery is going when you have time.

Thank you for sharing your story with us. I wish you and your wife all the best.

Great job advocating for your wife. Scary it got that close.
Your experience should remind all of us that doctors are people too, not omniscient.

Best
Les