Fast, skilled response allows patient to survive

A few days before Thanksgiving 2016, Joy Cartwright, 38, develop a “horrendous” headache

By MultiCare Health System

A few days before Thanksgiving 2016, Joy Cartwright, 38, was recovering from a run-of-the-mill cold when she began to develop what she calls a “horrendous” headache. Because she isn’t prone to migraines, she assumed it was due to her cold.

But even with several days of rest, Cartwright’s headache still hadn’t gone away and she was developing other unusual symptoms. After coming in to check on her, her boyfriend found her sitting up and staring blankly at the wall, unable to speak or walk properly.

At that point, Cartwright’s boyfriend called 911. When the firefighters arrived, they diagnosed Cartwright’s condition as dehydration related to a cold or the flu — but her boyfriend suspected there was something more serious going on.

“At that point, he picked me up, put me in his truck and took me to MultiCare Covington,” Cartwright says. “If he hadn’t responded so quickly, I wouldn’t be here today.”

Minutes at stake

Right away, doctors at MultiCare Covington Emergency Department (ED) performed a CT scan and discovered that Cartwright had massive bleeding in her brain that was severely compressing her brain tissue.

“The patient’s pupils were dilated and her body was becoming totally nonresponsive,” says Braden Andersen, RN, nurse manager at Covington ED. “This was extremely concerning and indicated she was in the emergent window.”

Brain bleeds are rare in people as young as Cartwright, and also very dangerous.

“The brain is a soft tissue enclosed in a hard, fixed environment of bone, so excess fluid and pressure within the fixed space is extremely dangerous,” says Andersen. “There are only minutes to intervene in a situation like that because the pressure starts to collapse and kill off healthy areas of the brain, which can be irreversible if not treated immediately.”

The staff at Covington ED rushed Cartwright to MultiCare Tacoma General Hospital, where Ryan Brennan, MD, the on-call neurosurgeon, began emergency surgery. He opened Cartwright’s skull to reveal the problematic artery bleeding just at the surface of her brain.

Faced with two options — clamping the artery and hoping it stopped bleeding, or cutting and cauterizing it — Dr. Brennan chose to carefully cut the artery. He then drained the excess fluid from Cartwright’s brain and completed the surgery.

On the way to a full recovery

Cartwright’s surgery was so successful that she was able to return home for Thanksgiving only several days afterwards.

Not all patients survive brain bleeds, and those who do often suffer brain damage, speech impediments or paralysis. But Cartwright is doing well, with no major repercussions from her experience other than some fatigue as her body continues to heal.

This good outcome is due not only to the skill of the doctors who treated Cartwright but the speed at which she entered surgery. A delay of just half an hour could have resulted in brain damage or even death.

“Half my head is shaved and I have to wear a crocheted beanie, but I don’t mind,” Cartwright says with a smile. “Dr. Brennan is my hero. And I can’t praise enough the immediate services I received at Covington and Tacoma General.”

Cartwright says that when she was recovering from surgery in the ICU, the nurses at Tacoma General were also proficient and caring.

“The kindest people took care of me there,” she says. “The doctors and nurses that came to my aid are my little angels.”

“I’m not religious, but I do feel like I was given a gift of grace,” she continues. “Throughout the whole experience I felt very well taken care of by everybody. It was because of those caring hands that I got where I am right now. And I’m so grateful for it.”