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.