Cardinal Hill program helps victim of car wreck come out of coma, work toward recovery

mmeehan1@herald-leader.comSeptember 3, 2013 


    Some common causes of brain injury for patients in the Disorders of Consciousness program: Motor vehicle accidents, motor cycle accidents, ATV accidents, falls, aneurysm, stroke.

Louetta Hetrick learned that her daughter Naomi had been seriously injured in a car accident after images of the mangled car appeared on the local news.

Naomi had been pulling out of the parking lot of Bluegrass Technical and Community College — where she was studying to be a social worker — when her car was broadsided.

Louetta Hetrick, who was near their Richmond home, rushed to her daughter's side. She found Naomi in a coma. So she and her husband Mike waited and waited and waited for a sign that their daughter was still lingering inside a body frozen in trauma.

A few days after the accident on Halloween 2012, as Naomi was in intensive care at University of Kentucky Medical Center, Louetta asked the doctor to perform a test to determine her daughter's brain function. She didn't want her baby suffering through any more operations if she was never coming back.

"He refused the test," she said, "but he told me, 'She's still in there.'"

"I told him, 'I am listening to you but I don't believe a word you are saying,'" she said.

But slowly there were signs. Naomi would wiggle her foot. She would seem more aware.

By February, Naomi's physical condition had improved enough for her to enter Cardinal Hill Rehabilitation Hospital. She was admitted under a new program that Louetta credits, along with the family's strong faith, for bringing her daughter back to her.

In the program, patients with minimal brain functioning receive therapy to help them reform the damaged neurological connections even before they can respond to their environment.

Since the program started in August 2011, 45 patients have been referred to the Disorders of Consciousness Program from 15 hospitals in five states, said Samantha Richardson, Cardinal Hill's marketing coordinator. Many patients have emerged from their comas and have gone on through Cardinal Hill traditional brain injury treatment and from there worked with outpatient therapists to gain further function and independence.

Under the program, Naomi received help while she was still unresponsive. A team of therapists provided mental and physical stimulation to help her brain heal and help the families learn ways to assist in therapy. All this took place before she was fully conscious.

"They were consistent in doing things over and over again," said Louetta. "They showed us what to do.

"If we had 20 million questions, they were gracious enough to answer," she said.

Part of the process for patients, including Naomi, was to receive physical therapy before she could fully respond to what was going on around here.

She was a screamer, said therapist Deana Brashear, an occupational therapist and certified brain injury specialist. As Brashear tried to extend Naomi's constricted arm she would scream nonstop for the hour-long therapy session.

"We called it 'fun Fridays,'" said Louetta, able to laugh at the memory now that everything has changed for the better.

Naomi doesn't remember the treatment, but she told her mom that she has a vague recollection of feeling hurt and panic and thinking she was having a bad dream. Brain injuries are like that, said Brashear.

Sometimes the body and the brain need to go through some violent transitions on the way to be re-ordered and healed, said Richardson. Flailing and vocalizing in brain injury patients can be an indication progress is being made, she said.

That was the case with Naomi, Brashear said. The extra therapy, she said, "gave her a chance."

Before the program began in 2011, patients like Naomi with minimal brain functioning would have simply been discharged from a hospital in a vegetative state and left to the care of their family, she said.

"She wouldn't have even had home health," she said.

"We usually keep people in that program for four weeks to get them to emerge," said Brashear. Naomi "went right up to the wire," she said, adding that at the four-week mark "she wasn't completely aware of her surroundings or what was going on in therapy."

But Naomi's team thought they were so close, they saw glimmers that the young woman was coming back.

"We saw it, we hoped, we had our fingers crossed."

And then, it happened. After four months, Naomi's parents had the sign they had waited on and prayed for so long. Therapists call it functional use of an object. It is one of two signs that the patient knows what is going on. The other is functional communication.

In Naomi's case she picked up a phone and put it to her ear.

Once she emerged from her coma, Naomi embraced therapy. She set her own ambitious goal of walking in the center's 5K Run for the Hill in March. She didn't quite make it, but she did walk across the finish line.

Brashear was there to see it and could barely believe it.

"It was just like whoooaaaa," she said.

Naomi, 23, now walks with a cane and a nearly imperceptible wobble. Her speech is slow but clear and purposeful. Her brown eyes are lively and her smile engaging.

She will walk again without aid, she said. She has a long life to lead. Naomi, who has traveled to Africa to do mission work, has talked with her mom about how she still dreams of adopting a child when she gets stronger.

She knows lots of people took special care with her when she wasn't fully in this world, and she knows she's lucky.

"I want to say thank you. Everybody was so nice and I really appreciate that," she said following her weekly session with her speech therapist. "I'm very glad I'm not still in my wheelchair."

Did you know?

Some common causes of brain injury for patients in the Disorders of Consciousness program: Motor vehicle accidents, motor cycle accidents, ATV accidents, falls, aneurysm, stroke.

Mary Meehan: (859) 231-3261. Twitter: @bgmoms. Blog:

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