Nick’s Story

Site created on February 26, 2019

Dear family and friends, 

As many of you know Nick suffered a heart attack on 2/17/19 while fixing our broken washing machine.  He called 911 and was transported to Baltimore Washington Medical Center.   He underwent a cardiac catheterization where two stents were placed to clear the blocked arteries.  Both arteries were 100% blocked.  This procedure saved his life.  He spent a few days in the cardiac ICU and further time in the hospital.  Towards the end of the week he developed pneumonia but was finally cleared to come home with instructions to rest, a list of medicine to take,  and much to his dismay strict orders for a low sodium, heart healthy diet.  This meant no Japanese takeout and no coffee of any kind.  Nick hadn't seen the girls all week so he was excited to get home.  N2 missed him too.


Nick spent a restful quiet weekend sleeping, watching movies and hanging out.  He was happy to be home and on the road to recovery.  My parents took the girls home with them to Pennsylvania to give Nick some quiet time to rest.  Sunday afternoon I went grocery shopping and checked in with Nick several times and he was fine.  I left Sunday around 4 to meet my parents halfway for dinner and to pick up the girls.  We had dinner and headed home.  I checked in with Nick again prior to leaving for home and he was fine.  We arrived home around 7:30 and Nora ran ahead and found Nick collapsed at the bathroom door.  He asked me to help him up, but I was unable to.  His left leg was shaking.  I immediately called 911.  Fire and EMT's arrived within 5 minutes and Nick advised he was having pain as he experienced during his heart and was transported again to Baltimore Washington Medical Center.  Upon arriving at the hospital several tests were administered (EKG, blood tests etc).  It was at this time that I started to notice that something else was going on.  Nick wasn't able to respond and clearly was in trouble.  His face started to droop on the left side.  Nick was evaluated immediately and the doctor advised she believed he was having a stroke.  He was taken  for a specialized CT scan.  She explained that a super blood thinner called TPA (Tissue Plasminogen Activator)  would be given asap.  She also advised that depending on the size of the clot Nick might be transferred to another hospital for a surgical procedure.  After the CT scan I was advised that as suspected Nick had suffered a massive stroke behind his right eye.  I was told that Nick would undergo an interventional radiology procedure called Catheter-directed thrombolytic therapy.  "Through a tiny incision in the skin to access the femoral artery and through the use of live, x-ray -guided imagery, the interventional radiologist directs a catheter (a thin plastic tube) through the body's blood vessels to the clot located in the brain. Once at the clot, the physician delivers the thrombolytic agent, in a targeted manner, directly at the clot to dissolve it, restoring the opening of the blood vessel."  (2019)  Nick was transferred to the University of Maryland Medical Center in Baltimore and immediately had the  interventional radiology treatment. Three hours later the doctor met with us and delivered the bad news that after three attempts they were unable to dissolve the clot.  She advised the stroke had done irreversible damage.  The stroke had caused Nick to have no feeling on his left side.  The right side of your brain controls the left side of your body.  It was honestly the most terrifying conversation I've ever had in my life.  We were told CT scans would be performed to monitor the clot.  We were also told that there was a high possibility of brain swelling between the third and fifth day.  Nick was monitored very closely through a variety of tests as well as neurological exams to make sure there were no significant changes in the wrong direction.  He was able to respond to us with a thumbs up or down, and even opened his eyes occasionally.  The doctors told us it was a waiting game.  We were also advised that Nick's condition was very complicated.  Since Nick had just had a heart attack and stents were placed to keep his arteries open he needed blood thinners to avoid blood clots.  If Nick had to have surgery to relieve pressure on his brain, the blood thinners would need to be held because there is a high chance of bleeding.  It's really risky and very scary.    On Tuesday, 2/26/19, Nick had an ok day.  By late afternoon I noticed he was growing more and more tired.  The doctors advised that was a sign of swelling.  He also had a bad headache.  The doctors advised another CT scan would be done early Wednesday morning.  On Wednesday, 2/27/19, we arrived to a rapidly declining situation.  At morning rounds we learned that NIck's brain had swelled significantly.  He wasn't responding well during his neurological exams either.  The neurology, ICU, and stroke teams unanimously decided that surgery was Nick's best option.  Nick was prepped for a Hemicraniectomy.  "This surgical procedure, which is performed in the operating room under anesthesia, consists of temporarily removing a portion of the skull (sometimes up to one-half or more) in order to allow the swollen brain to expand beyond the confines of the skull bone, without causing further elevations in brain pressure. The part of the skull bone that is removed is typically preserved until the edema resolves, at which point it can be sutured back onto its original position to protect the brain."  (2018)  This procedure if successful would be life saving.  Nick went into surgery on Wednesday morning and after four hours we were told that the surgery went exactly as planned.  Within hours Nick was able to respond to us and by late afternoon we were listening to Lionel Ritchie in his room.  Yes, Lionel Ritchie is the ONLY musician the two of us can agree on.  :)  They performed another CT overnight and Nick's doctors confirmed that there is no further damage to his brain.  Modern medicine is truly amazing.  This truly was the best news our family could receive.  Yesterday started out pretty dark, but it ended on a really high note.  


If anyone has the courage and strength to fight through this it's Nick.  As you know he's a career Army veteran with 18 deployments behind him.  He's tough and he will get past this, but he has a long road ahead of him.  It could be several weeks before he leaves the ICU and will then spend several more weeks in 
rehab.  He has so much to live for and our family will be standing by his side every step of the way.  As you all know Nick is the VERY proud Daddy of Nina and Nora and I know he can't wait for the day when he's able to give them a huge hug.  He misses them so much.  


We've started this blog to keep you all updated on Nick's progress over the upcoming days, weeks, and months.  Please send prayers, notes of encouragement, jokes, chips and dip (kidding . . . sort of),  and most of all just lots of good thoughts for Nick and our family.  We could all use them and here's to team Nick!  Most of all as I say to Nina and Nora every night and as Nick said to me the night before his surgery after asking me if I was scared, "Be Brave and Be Kind Always."  


Love, 


Kelly





“Diseases and Conditions.” Society of Interventional Radiology- Deep Vein Thrombosis, 2019, www.sirweb.org/patients/stroke/.


Vega, Jose. “Hemicraniectomy After a Stroke.” Verywell Health, Verywellhealth, 18 Dec. 2018, www.verywellhealth.com/severe-brain-injury-stroke-and-hemicraniectomy-3145992.





Newest Update

Journal entry by Molly Grimmer

Hi everyone -

Nick's obituary has been posted on the funeral website and can be found here:

https://www.fairfaxmemorialfuneralhome.com/obituaries/Nicolas-Eduardo-Prabhavat?obId=4486038#/obituaryInfo

There will be a reception which will immediately follow the funeral on 6/27 at:

The Springfield Country Club 
8301 Old Keene Mill Rd.
Springfield, VA  22152

Directions for Arlington on 6/28

Nick will be buried at Arlington National Cemetery on 6/28 at 10 am.

Anyone attending Nick's burial at Arlington National Cemetery needs to be there by 9:30 am as services start promptly at 10am.   This means by 9:55 am they will depart the administration area for the gravesite.   
 
All attendees need to enter the cemetery via the Memorial Bridge entrance, this is the main entrance for the cemetery.      The guards will assume that you are a tourist.   First you will need to tell them your are here for the Prabhavat burial service.  The driver should have photo ID available should they request it.    If you are unfamiliar with the administration office, ask for directions.    Basically it is the first left and the second left is the parking area.     Parking is designated for each burial ceremony one are will be reserved for those attending the  Prabhavat  service.    Ask the parking attendant which building they are assembling.    (The main building is going under renovation and it is closed, temporary buildings are set up and used for guest )
 
As the time gets closer to depart for the grave, a representative from Arlington National will direct people at this point and give direction at the grave as well.   
 
Anyone attending the burial via the METRO should be warned that Arlington National does not provide transportation.


Thank you again for your continued support and prayers.  The girls and I are so thankful to have you in our lives and we're looking forward to seeing you next week.  

Love, 

Kelly


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