Harper's Miracle: Overcoming AVM Brain Surgery

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Harper's Miracle: Overcoming AVM Brain Surgery

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As some have heard back on July 29th. We took Harper to our local ER, thinking she had a migraine. The ER doctor wanted to send us home because he felt she was refusing to do what was asked of her and was faking the amount of pain she was in. He told me that he was 99% sure she didn't have meningitis, and after I told him I wasn't worried about meningitis but more worried about her confused mental status. She couldn't tell me what my name was, what she liked in her happy meal, couldn't count to 10, or say her ABC. She was also saying the wrong words when trying to talk to us and tell us how she felt.
After being admitted around 1am and getting some rest, the hospitalist came to see us around noon and asked us questions, including Harper. She told me that she would like to do a CT scan, and I told her we weren't going home without one. I'm so thankful that we did that scan. Within 6 minutes of being back in the room, she came running in and said she had a 3x3 brain bleed and would be sent via helicopter to St. Louis Children’s for emergency brain surgery. She told me she would return after the phone calls to talk more.
I called everyone I needed to, and then our whole world changed. Our once normal 7-year-old would have had her entire world change forever. When the doctor returned to the room, she said there was a storm in St. Louis, so they sent their ambulance to get her. She also told us that she needed another CT scan, this time with contrast, so her neurosurgeon would be able to see better what was going on.
After that CT scan, we were told that she more than likely had an AVM rupture. This is very rare for children to have happened. Around 4pm on July 30th, Nick and the three amazing men took off to take her to St. Louis to save her life.
Once they arrived, everything changed from what we thought would be an emergency surgery that night or the next day. Turned into a hurry up and wait. We were told it would be best to allow her brain to heal before they go in and mess with her brain, because she could lose even more speech and language functions.
From July 30 to August 14th. That's what we did: allow her to heal as much as possible. In that time, she had another CT scan and a functional MRI to see if she was stable, and went home for a week so we could all heal from everything before we stepped into the scariest two days of our lives. Thankfully, she was healed enough to go home just in time for her brother's 10th birthday.
From Aug 15th to Aug 24th, we tried to be as typical a family as possible without risking her getting sick. So the three of us stayed home, watched movies, and relaxed while her dad worked. We spent 4 nights in the PICU. With night one being awful, she had an adverse reaction to the migraine cocktail that she was given at our local hospital and had to be lightly sedated for her safety.
On August 25th, we said goodbye to Abel and gave all the hugs, so we could take Harper back to St. Louis Children’s for as relaxing a night in the hotel as possible. The next morning, Aug 26th, we had to do all the surgery protocol, gearing up for her angiogram that afternoon. We left the hotel and went to Forest Park to allow her some sunshine and relaxation before we took her back to the hospital for an unknown amount of time. While there, Harper met two men riding cop horses, and it made her whole day to see and pet a horse.
We left the park at noon to get checked in for her angiogram. She got her IV, and we left the Children’s Hospital to go over to Branes-Jewish Hospital, where we met her neurovascular surgeon, after a few hours of waiting and making more insurance phone calls. He told us the best news that could come from this procedure, that her AVM was small enough that they didn't have to do the extra procedure of embolization to try and make the next day's surgery easier. After a run back to the Children’s hospital, and I mean a run, we were admitted to the PICU for the night. This is where both surgeons came in to meet with us to let us know that she would need one more MRI before her surgery to get one last picture of what they would be doing. They also told us that she now has an arterial line IV as well as her IV to keep a constant eye on her blood pressure through the night and through surgery, and for the coming days. That MRI happened around 11:30 that night, and unfortunately, it did not allow her to eat anything.
Once we returned from the MRI, we all just tried to sleep before her AVM surgery to save her life forever. That night, we didn't sleep very much at all. I prayed over her, I prayed over the room, and the next day I prayed over her surgical room.
Aug 27th, the day that never ended, yet also went speeding by. The day that saved our beautiful 7-year-old princess from having another rupture that would make her lose her speech forever. From everything we were told the day before surgery, she is a fighter and will punch, kick, bite, and scream to make sure the medication to calm her does not work. When we told everyone on her anesthesia team this, they said that it is perfectly OK and means she is going to fight through everything and will make her so strong as she gets bigger. They told her that options and a strong personality are everything they want from a child. When her surgeon came to visit us before the surgery, he said his goal for after the surgery was for her to make some growing sounds and move her arms and legs. He also told us that she would come back with two more IVs in her ankles and a central port put in during surgery to help with medication and any blood that is needed during surgery. After 13 hours of surgery and phone calls every couple of hours to let us know what was going on. We finally got to see our girl and see what her next hairstyle looked like, and I had prepared myself for something so much worse than what I saw. Her surgeons shaved just enough hair to do her procedure safely and not a quarter to half her head like he initially thought he’d have to. I also wasn't ready for everything, for the cords and IVs that I saw. It was so scary to see her this way, and it took everything I had not to start crying. Then we heard her beginning to make noises. Then she heard my voice and said Mommy, I need. I needed to listen to this because we were told not to be surprised if she returned to what she was when she first came to St. Louis. She couldn't say my name, she didn't remember who I was. Then Dr. McEvoy, her surgeon, came in and said she did amazing and that it was the perfect AVM surgery. There were no big surprises, and she didn't need as much blood as he had thought she would. He said this AVM was not as nasty as some can be to remove. Then he got to her scream at him to get out of her room and that they were no longer friends, and he just smiled and said Well, that's more than I expected and I'm very pleased with everything I hear and see. And on that note, I'm going to leave her alone, and we will become friends again later. We thanked him one last time for saving her, and we all just relaxed for the next 8 hours as she had to lie flat because she had a second angiogram during surgery.
We spent the next 2.5 days in the PICU, and then we were moved back to the 12th floor (Neuro care floor) to our favorite nurses and doctors. They were so amazing to all of us as a family. We stayed on this floor for 3 days. Before her surgery, we were told it would be at least 10-14 days post-surgery before we went home, but this miracle girl got sent home on day 6.
From the time we got home, her recovery has been a true miracle. On September 12th, she went for her two-week follow-up with her surgeon, who gave her the best news. He told her she is the poster child for AVM surgery because she is. This was the best possible outcome anyone could ask for. He also told her she could start returning to school and dancing on October 1st. Then we went on Oct 3rd for her neuropsych evaluation to help with her school 504 plan. Then we met with her neurology team to see how she was neurologically. They told us she was doing great considering everything she has gone through.
She had to return to school starting October 7th and dance on October 13th. She said this was the best birthday gift she could have ever gotten from Dr. McEvoy. She is doing half days for October and maybe starting full days in November, but we will see how she feels after Halloween.
We have three appointments in December. For now, we also go to Speech and OT weekly. She will also be starting these therapies at school. So her journey isn't over, but she is stronger than I ever knew. This girl is a blessing and a true miracle.

Organizer

April Prather-smith
Organizer
Mattoon, IL
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