The first days were very touch and go, minute by minute. Ryan was breathing with the assistance of a ventilator and was sedated while the medical team chilled his body to 94 degrees for 24 hours. Cooler body temperatures have been shown to improve neurologic outcomes following an event like this, where the brain was deprived of oxygen. In these first days he had a CAT scan, ECGs, a chest x-ray, and had a pacer (temporary pacemaker) inserted.
Ryan was able to open his eyes the day after his cardiac event, however his body and brain had taken a lot of strain. His eyes were open, but he didn’t make eye contact and we were not certain how aware he was of what was happening around him. He squeezed his nurse’s hand on command once, but was unable to follow any additional commands. The neurologist prepared us for the worst following a non-responsive physical exam on Friday, May 26th. The medical team suggested an MRI (once the pacer was removed), an EEG, and another CAT scan so we could have better picture of what was going inside his brain. We, his family, thought we’d seen small signs of response/awareness from Ryan, but the doctors remained unconvinced that it was “meaningful.”
But we knew that Ryan was with us. We knew the actions were meaningful. The neurologist saw “some improvement” on Saturday, May 27th, and even more improvement on Sunday, May 28th. This was all very encouraging since we were told that much of Ryan’s recovery would be in the first days, weeks, and months following his brain’s injury. Improvements every day were such a positive sign for his recovery.
The MRI showed that Ryan had a few areas of the brain that had been damaged when he was deprived of oxygen—before he woke Bek up, before the CPR, before the ambulance, before the hospital. The doctors described it as a “global stroke,” affecting his entire brain. It was uncertain if these areas of damage would be permanent or not. Only time would tell. This gave the family mixed feelings. We were disheartened to hear Ryan’s brain had been damaged, but held out hope that a few small areas of damaged were better than one big area. We had faith that his brain would heal or learn to work around those affected areas. The EEG showed that Ryan’s entire brain was still firing, but slower (about half speed) than to be expected in a healthy person. As with the MRI, there was no telling if his brain would speed up or not given time to heal. Only time would tell.
We started making plans for the long-haul. Ryan had a PICC line inserted in his arm on Tuesday, May 30th. The PICC line allows for easier administration of medications and fluids. It also made Ryan a lot more comfortable. The medical team started talking about transferring Ryan to an intensive, long-term care hospital on the West-End where he could receive the same sort of specialized care found in the ICU, but with much more emphasis on rehabilitation work. (Ryan would later derail/postpone these transfer plans by exceeding everyone’s expectations.)
On Wednesday, May 31st—one week in to the ordeal—Ryan confirmed for everyone, doctors included, that he was aware and responsive. He nodded his head to a couple direct questions. He raised two fingers on command—apparently this is an easier and more clear indicator of responsiveness. (Hands can squeeze involuntarily and it requires the coordination of many muscles. Raising a couple fingers is more unusual and thus more deliberate. It requires less muscle coordination, too, making it easier for Ryan to do.) The therapist said, “I’m excited.” And so were we! All day his eye contact was fantastic. All his friends and family said so. It was pretty amazing. Every day we were seeing more and more of that Ryan-Light in his eyes. He would move his eyes from one face to the next, taking us all in. It was a happy day for us.
Ryan’s breathing tube was removed on the morning of Thursday, June 1st. He’d done very well overnight and was following commands from the doctors to follow their finger with his eyes and to squeeze their hands. They didn’t even think a trach tube was required—another piece that had been proposed for the long-term plan. It was the best day yet. Ryan was so responsive we didn’t know if we should just cry tears of joy or do cartwheels around the room! He nodded and shook his head a lot. “Are you cold? Are you in pain? Are you okay?” He could communicate quite well with his eyes, movements, and even some small whispers. “Bek. My mom. I’m fine.” Unfortunately it was just too much work for him to keep his lungs clear and the doctors decided to re-insert the ventilator that same afternoon. Ryan needs to rest, get stronger, and they’ll try it again in a day or two. Hopefully, by that time, he will be strong enough to cough more effectively and the tube will be gone for good.
While we were all disappointed by this step back, Ryan most especially, we’re sure (that tube is no fun), we know there will be lots of ups and downs along the way. We have faith that the lowest low is behind us now. Ryan is making great improvements every single day. May the trend continue until he is back pulling pranks at work and tapping kegs of homebrew.
Ryan, Bek, and the Schatzke family are on a roller coaster, but we’re hopeful that things are, overall, on the way up. The entire family appreciates all the support, love, and generosity that has held us up—and continues to do so—while we travel this road together.