On Thursday, September 19th, Alex was skateboarding in front of his house when he fell. Unfortunately, he landed on the back right side of his head ( where he had received an injury and surgery when he was an infant). Even more unfortunate, he was not wearing a helmet. The impact knocked him unconscious, and was followed by a seizure; this caused him to repeatedly bang his head onto the asphalt. His mom came to his side and held his head; he remained unconscious.
A few minutes later, the paramedics arrived, and he was put on a stretcher and the ambulance left for Rady's Children's Hospital. While in the ambulance, and after arrival in the hospital, he had more seizures. The ER crew performed a CT scan that showed he had a fractured skull, and brain damage.
He was taken to the pediatric intensive care unit (PICU) with his parents in tow. Upon arriving at the PICU, his parents noticed the Neurosurgeon, who was reviewing Alex's CT scan, was the same Doctor that had performed Alex's surgery 13 years ago when he was an infant. Even more surprising, the doctor remembered the details of Alex's surgery from over 13 years earlier. The surgeon performed a procedure to monitor the intra-cranial pressure (ICP) that his brain was exerting on his skull. This pressure is in response to the brain swelling due to the injury.
It is extremely important to control the brain swelling since this can cause further damage to brain cells that were not damaged during the fall. So, keeping the ICP low is really important for the first 5 to 7 days which can be the period of maximum swelling. To keep the brain from swelling, they heavily sedated Alex to the point of putting him into a medically induced coma. This basically reduces the brain function such that its demand for Oxygen is low, and thus the requirement for blood flow is reduced. This keeps the brain from swelling and reduces the ICP. Since Alex is in a coma his natural breathing function does not work so they had to install a breathing tube into his throat that is connected to a ventilator; the "breathing machine" provides Alex's air and can be programmed to adjust exactly how much and how often he breaths. They also had to install a tube into Alex's stomach to provide him food.
They use many different drugs to control Alex's brain activity, heart rate, blood pressure, blood Oxygen level, CO2 emission level, and the all important ICP. They also cool Alex's body temperature to 95 deg F (instead of the normal 98.6 deg F) to minimize swelling.
The first night Alex's condition was stable but still critical. The doctors and nurses estimate that Alex will remain in this state for one to two weeks before he wakes up. We are told that the affect of the brain damage will not really be known until Alex wakes up.
We hope that when everyone hears Alex's story that they will learn the importance of always wearing a helmet when skateboarding, scootering, and biking.
Day 71, 11-28 Thanksgiving
Nov 28, 2013 1:45pm
On this annual day of giving thanks, we are thankful for many things.
We are thankful we have our Alex back. We are thankful for his smile, his laugh (a little higher pitch than it used to be), his crazy sense of humor, his spirit, his outgoing personality, his great friends; who have showed such great support for him since the day of the injury. His friends rallied around Alex by making incredible wrist bracelets, stickers, posters, Instagram posts, text messages, Caringbridge posts, and personal cards.
We are thankful for his extended family/friends/community who offered such encouragement and prayer support, who provided us snacks, daily healthy smoothies, lunch, dinner and company everyday we were in the Hospital. They held a prayer vigil for Alex that brought all of his friends together to send prayers and positive energy his way. The extraordinary messages contained in the Caringbridge posts, cards, texts, and emails.
We are thankful for the wonderful nurses that we got to know really well and that took care of Alex like he was their own child, and provided daily motivation and positive reinforcement for him and his parents. Many of them signed up to be Alex's primary nurse which allowed him to develop relationships (even when he was in his coma) with them and provided continuity for his care. The nurses provided excellent advice to Alex's parents including taking it one day at a time, don't set expectations too high or low based on what doctors say, eat healthy, and getting enough sleep,
We are thankful for the remarkable rehabilitation nurse practitioner who had a special connection with Alex and was able to mix her positive attitude with her sense of humor to keep Alex positive, and to provide the spark for him to start talking and walking again. They seemed to be kindred spirits (see photo of Alex with her); both of them have the "magic smile."
We are thankful for the amazing physical, occupational, and speech/school therapists at Rady's who all had awesome personalities that resonated with Alex's spirit. They worked with him everyday and helped get his brain and body working again. They allowed Alex to push as hard as he wanted; which was hard! His miraculous recovery was an amazing experience for us all.
We are thankful for the great Doctors who had the right recipe of medicines to preserve Alex's brain from being injured further. The compassionate Doctors who spoke with us everyday about Alex and always made sure we understood what Alex's status was, goals for the day, and next steps.
We are thankful that the Rady's Children's Hospital ICU traumatic brain injury guru was the attending physician the night of Alex's accident, that his intracranial brain pressure stayed low, that the IV medicine that leaked in his chest magically leaked back out onto the bed, that his lung recovered rapidly after being punctured, that his lungs recovered after they started to falter due to being in bed for three weeks, that he was able to wean off the ventilator before waking up, that he did not have any more seizures, that his first coherent interaction showed his humor and smile, that his first coherent words were 'I Love You" and "Thank You", that he never went through the inappropriate, agitated phase that is common when coming out of a coma, that the Director of the Rehabilitation program at Rady's is a traumatic brain injury expert, that Alex was highly motivated to get better and used his humor and smile to push through the hard times, and to develop relationships with all that came in contact with him, that he remembered his life and all his friends and family, that he can talk, walk, jog and beat his Dad at thumb wrestling.
We are thankful that Alex's sister made her way to college and was able to join a sorority, do well in her tough classes, and even make the A team on the Womens Lacrosse Club Team. She was able to FaceTime Alex everyday, often with her college friends. She came home from college and Alex was able to meet her at the airport. When she saw him, she embraced him with a big hug, and started crying and would not let go. The whole way home in the car she held his hand. Alex and his sister now have a new bond that will last a lifetime.
We are thankful that so many friends are sharing stories with us about kids in the community wearing their helmets. Our greatest hope, is that Alex's ordeal will help many kids not have to go through what Alex and his family have gone through. Once he is able, Alex will do his best to share his story and be an advocate for helmet safety.
We are thankful that God has answered our prayers.
From David, Paige, Lauren, Alex, and Lola. Have a Great Thanksgiving. Be thankful for family and friends.
As always, thanks for all of the prayers and positive energy for Alex and his family.
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