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Mending hearts: Nurse assumes dual roles in mother’s recovery

By Erika Pedroza | Published Saturday, February 9, 2013

Cindy Woods adores her resilient cat, Tigger.

The small feline has boldly recovered from three close calls – dangling from a chair after becoming caught between its back panel and seat, choking on chicken and being rolled over on in bed.

But even if he started with the fabled nine lives, Woods’ family members are pretty sure he has fewer than six left.

“I think Cindy may have used a couple of those,” Cindy’s husband, Rick, said. “I don’t know how you transfer lives, but … That cat has had about as much trouble living as Cindy has.”

The 48-year-old from Boyd barely dodged a heart aneurysm and survived open-heart surgery, just five years before suffering a dysrhythmia that caused her to go into sudden cardiac arrest – and a 30-day coma – last summer.

Now the vigorous mother of two is 90 percent recovered.

“A miracle, God, the treatment she’s received – I think it’s all played a factor,” said her daughter, Courtney Etter. “She is a miracle. ”

ON HER SECOND

Courtney Woods. Messenger photo by Joe Duty

Courtney Woods. Messenger photo by Joe Duty

In 2007, Cindy underwent open-heart surgery to prevent an aneurysm rupture.

“The emergency room in Azle barely caught it from an x-ray,” Rick said. “She was sent to (Harris) Downtown (in Fort Worth) from Azle with only a 10 percent chance of her making it and the doctor being able to operate on her and save her … It was rainy and nasty and cold, and the wind was blowing. They couldn’t use CareFlite so they had to take her by ambulance. That’s why they said she probably wouldn’t make it.

“But she did,” he continued. “They cut her and took her heart out and fixed it; put a tire patch on it; put it back. And she was fine until the 25th of May of 2012.”

That summer day, Cindy suddenly collapsed at Jackets’ Nest, the Boyd tanning salon she had owned and operated since 2005.

A woman from a neighboring business administered CPR until medics arrived.

“They worked on her quite a bit in the parking lot in front of her salon, I would say about 15 minutes,” Rick recalled. “They couldn’t get her heart started again. They worked on her all the way to Decatur to the hospital, which no matter how fast you’re going it’s about 15 minutes or so. So there’s 30 minutes right there with no heartbeat. I don’t know how long she was at the hospital before they did get a heartbeat again. But they did.”

The emergency staff at Wise Regional Health System then initiated the next steps of hypothermia – a relatively successfully treatment they’ve been using for two-and-a-half years. The treatment preserves brain function by cooling the body to reverse the effects of a lack of oxygen to the brain.

“Otherwise we wouldn’t be here,” Rick said. “Or if she did live, she would have so much brain damage she couldn’t function at all.”

Once a patient reaches a goal temperature of about 92 degrees, the body is gradually warmed to the normal, 98.6 degrees.

“It’s usually a three-day process between cooling and warming,” said Courtney, who is also a registered nurse at Wise Regional. “You cool for 24 hours and warm up over the span of 48 hours. It takes longer because if you warm up too fast, that could lead to electrolyte disturbances and a whole bunch of issues. But for cooling, the quicker they are cooled, the better the outcome.”

Following protocol, medics inititated the treatment on Cindy at the tanning salon, and her body temperature was regulated at the hospital roughly within the typical three-day frame. But that’s where Cindy stopped following the standard.

“The patients we’ve seen (at Wise Regional) have been pretty textbook,” Courtney said. “Once they’re warm, they start coming around within days, maybe a couple weeks. They walk out of the hospital just fine, or it doesn’t work because they weren’t a candidate. But the ones that come around are pretty well functional.

“My mom was not our typical patient.”

Cindy did meet the criteria for hypothermia treatment, but after it was induced, she remained in a coma for 30 days. Once stabilized, even though she hadn’t yet awakened, she was moved to the cardiac care unit, the very unit where Courtney works.

IT’S PERSONAL

Rick and Cindy Woods. Messenger photo by Joe Duty

Rick and Cindy Woods. Messenger photo by Joe Duty

Courtney was headed from her home in Boyd to Decatur with her six-year-old daughter when her sister, Danielle, called to tell her their mother was being transported to the hospital.

“I was at the hospital before they got there,” Courtney recalled. “When I saw her come in on the ambulance, I knew it wasn’t good.”

Courtney was allowed back into the treatment wards and attempted to set aside the personal attachment and help as a nurse.

“She still had no pulse, and she wasn’t breathing on her own. They were still doing CPR, trying to get her back,” Courtney recalled. “It was upsetting because I knew it was my mom. But I tried to not think about that. The things they were doing were things we do every day. I went into nurse mode and followed protocol.

“It wasn’t until they were rolling her away for an x-ray and I saw her face that it brought me back to reality. I’m not an emotional person, but I realized then, ‘I don’t know if I could go in and work very rationally – this is my mom.'”

Policies prohibit nurses from tending directly to family members, but Courtney was close by. She watched as her mother was treated for thyroid issues – which, along with high blood pressure, are believed to be factors in her heart ailment.

“They don’t really know, though,” Courtney said. “She had open-heart surgery at Harris Downtown in 2007. But doctors think that if that were to have caused it, it would’ve happened then. It would not come on now.”

She also saw the staff’s efforts to control her mother’s unexplained repetitive kicking and arm-tossing, which required a special enclosed bed to avoid bruising and prevent her from falling to the floor.

“The days I worked, I was there and could make sure everything was going OK, could talk to doctors,” Courtney said. “I didn’t want my daughter to see my mom like that so on my days off, I could stay home with her and not be worried. I knew the people taking care of her, and they were good about keeping me informed. That made it a lot easier.”

In addition, doctors were receptive to the suggestions she made based on her extensive research.

“I probably drove everybody crazy, but my coping mechanism was through research. I like to research anyway. But during this time, I was constantly Googling information, wanting to know all there is to know about whatever treatments were available,” Courtney said. “Sometimes my research would make it worse because I would not find any hope. But then I would try to look for positive stuff that could help me.

“I think at a certain point my co-workers wanted to take my phone away,” she recalled with a laugh. “But If I had a suggestion, the doctors and CCU director would listen to me and either say, ‘OK we can try that’ or ‘No, I don’t think that would work.'”

While the exposure of working near her mother had its benefits, there were also drawbacks.

“Combining both what I read in researching and what I’ve learned on the job, I knew that cases of full recovery after being out for so long were very rare,” Courtney said. “If the person wasn’t awake two weeks after their bodies had been rewarmed, the chances were really slim of their recovery afterward. After about two weeks, I thought, ‘Well this isn’t good. We should be seeing something.'”

Thereafter, Courtney admits, the nursing hat got harder to wear as the daughter hat took its place.

“I was not rationally thinking. I was way too emotionally involved,” she recalled. “You can try to prepare for something like this all day long, try to focus on the medical side. But you’re not going to be emotionally ready, especially when it comes down to your own mother.”

On the flip side, the professional detachment gave Courtney an entirely new perspective through the reversal of roles.

“Now I see how emotionally draining and exhausting things like this are on the family,” she said. “I hated waiting in the waiting room. I also saw a disconnect between the staff and patients as far as understanding. Family members would try to convey to other loved ones the medical explanation the doctor gave them, but it wasn’t at all accurate. You realize people are really not understanding a word you said. It gave me a completely different perspective.”

Regardless, Ricky praises the perspective, insight and knowledge of his stepdaughter.

“Very possibly, if Courtney had not pushed what she pushed… we might not be here today,” he said.

When doctors hesitantly mentioned using Adderall to stimulate the brain, a technique that had been recently introduced at a conference in Chicago, Courtney disregarded their apprehension and encouraged them to proceed.

“Given some other health factors, they didn’t really want to do it for fear that it could worsen her condition,” Courtney recalled. “I finally spoke up and said, ‘I understand why y’all don’t want to give it to her. But if this was me and I was in this situation – it just doesn’t seem like it could get any worse.’

“After they went back and forth, they decided, ‘What’s it going to hurt? She is in our unit already, being monitored. If we need to do something, we can.'”

Not one to follow the norm, Cindy had an idea of her own.

Next installment: Turning point

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