In November 2021, Isabel Cardoso underwent cosmetic surgery on one of her breasts.
The procedure -performed in Brazil- occurred after a benign tumor was removed, for which they had to remove a small part of her breast, something that bothered her.
After the operation, Isabel suffered from oxygen deprivation, something her husband, Luciano Bueno, says he’s not sure how it happened.
Lack of oxygen to the brain, also known as cerebral hypoxia, can cause severe and irreversible damage to cells in a matter of minutes, as the brain is a highly sensitive organ and depends on a constant supply of oxygen and nutrients to function.
Loss of oxygen flow can cause neurological problems such as loss of memory and motor coordination, difficulty concentrating, seizures, and even coma, which is exactly what happened to Isabel.
“Over the next few days, she had several seizures and had to be put into an induced coma for the medications to control the seizures,” her husband says.
“But when those medications were withdrawn, which is the time to see how the patient reacts, nothing happened. She was totally asleep. She would sometimes open her eyes, but it was what doctors call a non-contact eye opening. We didn’t even know if she could see,” she adds.
At that time, Isabel was 45 years old and Luciano was 43. They had been married for almost 15 years and were waiting on the adoption list for the opportunity to have a son or a daughter.
“We had a planned life, dreams of doing many things together. The first moment was a shock, but my expectation was that she would wake up from the induced coma and that we would go home, resuming life little by little”, says Luciano.
Little by little, the doctors explained Isabel’s difficult prognosis: the more time passed, the lesser the chances that she would return to her old self.
The chances of recovery for a person who has been in a coma for more than a year are relatively low.
According to a study published in the scientific journal Neurology in 2019, the recovery rate after a year in a coma is around 4%.
The neurologist Amauri Araújo Godinho, who did not follow Isabel’s case, explains that the low expectation is due precisely to the severity of the brain lesions caused by the lack of oxygen to the brain.
“There are very sensitive brain areas, especially the autonomous functions, which, when damaged, leave permanent sequelae,” says the doctor, who works at the Santa Lucía Hospital in Brasilia.
“A situation where the patient opens their eyes without contact is a vegetative state and we normally don’t see improvement in these patients. I would never tell a family otherwise so as not to create expectations, ”he adds.
According to the neurologist, in children recovery is somewhat more common due to neuroplasticity, the ability of a child’s brain to change its structure and function in response to stimuli and experiences during the process of brain development, although it is not guaranteed.
“In these cases, other areas of the brain can take over the function of those that were damaged,” he says.
“They told me the condition was irreversible”
The medical team informed Luciano that he would have to take his wife home, adapting the spaces so that she could do “home care”, with the help that Isabel needed.
“It was a blow, because I thought he would stay there in the hospital until he got better,” he says.
“At first I couldn’t understand the benefits it could have at home, but after a lot of research, I realized that the hospital is inhospitable for someone in Isa’s position.”
By working at his own company with his brother, Luciano was able to take time off to care for his wife.
Despite the fact that Isabel was being well cared for, a patient in bed, in general, is in more fragile health. This made her need recurring hospitalizations.
“The flu, for us, is not the same as for a patient in your condition. Isa was hospitalized to treat her for respiratory conditions, thrombosis… It always took 15 or 20 days to solve each specific problem”, recalls her husband.
“The doctor told me that the condition was definitive, that it was irreversible. He said that the chances of Isa waking up were 2%. I embraced that number.”
Luciano explains that he began to “actively look for that 2%”.
“I did extensive research on patients who had woken up from comas. I searched the scientific literature, but no case was similar to my wife’s.”
The “miracle of ICU 4”
In March of this year, Isabel had to be hospitalized for treatment of tracheobronchitis.
During the period in the hospital, she began to have seizures and had to be taken back to the ICU.
Back in the recovery room, one of the nurses, who used to make frequent visits to Isabel’s room, wished her the usual “good morning”.
“When we saw her, Isa was moving her mouth. Since she had a tracheotomy (the presence of a tube in the throat region), for the sound to come out, that little hole must be covered. We did that, and she was able to respond, with a lot of difficulty, saying her name and nodding that she knew she was in the hospital,” says Luciano.
“It was too emotional. I remembered at that moment that the doctor gave us only a 2% chance, but my wife woke up.
The team of doctors and nurses who had been involved in Isabel’s treatment for the past year and a half were called into the room.
Gustavo Tarre, coordinator of the ICU of the Marcelino Champagnat Hospital, in Curitiba, where Isabel was, says that the “awakening” of the patient was a surprise for everyone.
“I had never seen a case like hers. Some patients show progressive improvement after an induced coma, but hers was really amazing, because one day she was one way and the next day she woke up completely different,” she says.
The doctor explains that it is not known what caused Isabel to interact again.
According to him, he was not administered any drug or therapy other than the one he had already used in other hospitalizations.
At the hospital, the case came to be dubbed the “ICU 4 miracle,” referring to the number of the treatment unit where Isabel stayed most of the time.
The recuperation
The improbable evolution maintains Luciano’s hope in the recovery of his wife, even if the road is difficult.
Her husband says she has signs that at least part of her memory remains intact, despite the neurological damage.
She remembers her name, gets excited when she sees family members, but seems to have no recollection of the couple’s dog, adopted shortly before the episode that led to her coma.
“Despite the surprising improvement, it still cannot be said that it has recovered because it still has many sequelae,” says Tarre.
The treatment carried out at home consists of speech therapy and physiotherapy sessions, as well as follow-up with a psychiatrist.
As Isabel continues on the road to recovery, Luciano says he keeps her as comfortable as possible, even with herself.
“I schedule sessions with a podiatrist, which is something she has always needed, as well as professionals who do her hair, I moisturize her skin… I think maintaining her self-esteem is important to her,” she says.
“It is a step every day. But now I know that she is here, that she listens to me and, even with limitations, she manages to interact. It is something that fills me with hope, ”she concludes.
Keep reading:
* “After 7 months in an induced coma, my husband woke up and didn’t recognize me, he thought I was an impostor”
* Arkansas man dies after miraculously awakening from 19-year-old coma after 1984 accident
* Munira Abdulla: the woman who woke up from a coma 27 years after suffering an accident
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