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Brain Surgery, C-Section, Teamwork Save Mom, Baby

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The O’Donnell family – husband Joe, wife Kara and 5-year-old son C.J. – planned a relaxing vacation at a Pocono-area resort. Early in the day, they lounged by an indoor pool. But as the day went on, Kara – who was in her third trimester of pregnancy – felt tired. Then, in the middle of the night, she vomited. “That’s when I knew we had to see a doctor,” Joe says.

At Pocono Medical Center’s Level III trauma center in East Stroudsburg, colleagues immediately took Kara’s blood pressure. Joe, an emergency medical technician, gasped. “209 – that’s a bad number,” Joe says. “I know high blood pressure in a pregnant female is not good. She was deteriorating.” A CT scan revealed substantial bleeding in the brain due to preeclampsia (high blood pressure during pregnancy).

Colleagues at Pocono knew she needed care at a higher level trauma center with a maternal fetal medicine (high-risk pregnancy) program. Joe first suggested a hospital near their Lake Hopatcong, N.J., home, but Pocono recommended Lehigh Valley Hospital (LVH)–Cedar Crest in Allentown. “They said they have the facilities, their team is waiting, and time is of the essence,” Joe says. A Lehigh Valley Health Network (LVHN) MedEvac helicopter flew Kara to Allentown while Joe and C.J. traveled by car.

In Allentown, once MedEvac landed, a team of neuroscience and maternal fetal medicine specialists leaped into action. Kara was unresponsive and needed a breathing tube. To help her, neurosurgeon Mei Wong, MD, with LVPG Neurosurgery, first performed a craniectomy, removing a portion of Kara’s skull to relieve pressure on her brain and evacuating the blood clot in the brain.

All the while, obstetrician/gynecologist William Scorza, MD, with LVPG Maternal Fetal Medicine, monitored Kara’s baby. “The baby’s vital signs became unstable and showed signs of distress,” Scorza says.

What happened next was extraordinary: Teams coordinated to deliver Kara’s baby – her second son, Miles – via C-section as she lay on her side undergoing her craniectomy. “You occasionally talk about special cases in medicine,” says neuroscience intensive care unit nurse Patrick Keane, RN. “She’s someone everyone in our unit remembers.”

Keane had just ended his shift when Kara came through. But he stayed to meet the arriving Joe and C.J. “I couldn’t imagine what he was going through while also caring for a 5-year-old,” Keane says.

Following a whirlwind of explanations and forms, Keane took Joe and C.J. for a cafeteria breakfast. “Patrick asked if we had any questions and told us what great people were caring for Kara,” Joe says.

Noticing Keane’s backpack, Joe realized the nurse was off-duty and asked why he was still there. “Patrick told me, ‘If I were in your situation, I wouldn’t want to be alone,’” Joe says. “His caring really had an impact on me.”

The newborn was sent to the hospital’s neonatal ICU while Kara was put into a medically induced coma as her brain swelling subsided. “I was torn,” Joe says. “In one place was one of the greatest joys of my life – in another was one of the biggest horrors.”

Because the O’Donnells live outside the area, Joe and C.J. stayed at the Hackerman-Patz House at LVH–Cedar Crest, which provides affordable accommodations for loved ones. “That was a true blessing,” Joe says. “You run into other families with their own stories and situations. A lot of prayers are shared.”

As mother and baby recovered, caregivers brought Miles to Kara in a portable incubator. Laying Miles on his comatose mother seemed calming – her intracranial pressure and pulse dropped. “There are so many factors in medicine beyond what’s in textbooks,” Wong says. “Though I don’t have scientific evidence, I’m sure bonding helped her heal.”

After spending several weeks in intensive care and emerging from her coma, Kara transferred to a rehabilitation facility, returning to LVHN in July to have her skull repaired. Baby Miles left the hospital and is thriving. “Kara is not fully recovered but has made progress in a short time,” Joe says. “As far as I’m concerned, she and Miles are two miracles.”

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