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Episode 107: PERSPECTIVES - Dr Pravin George & Sidney Landis

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Episode 107: PERSPECTIVES - Dr Pravin George & Sidney Landis

Contributors

  • Lauren Koffman DO, MS

    Assistant Professor, Clinical Neurology, Lewis Katz School of Medicine at Temple University

  1. Hi and welcome back to the Ansi Us
  2. Podcast perspective Series, This is
  3. Lauren Kaufman and I'm a neuro
  4. intensivist at Temple University in
  5. Philadelphia today. I'd like to welcome
  6. onto the podcast authors from her
  7. current story of hope that was published
  8. in July twenty twenty three, as a bit
  9. of background, Ncs, current features
  10. the stories quarterly, and share
  11. stories of people that have a challenge.
  12. He stays in the array. See you today.
  13. I would like to welcome Dr. Pravin
  14. George and her attentive listener Nova
  15. in Fairfax, Virginia, and Sydney land
  16. us so welcome both of you to the podcast.
  17. Thanks for joining the for evidence,
  18. Though Sydney. Why don't I start with
  19. you before we kind of talk about how you
  20. ended up in the hospital and tell us
  21. what your life was like up until that
  22. moment. I think you twenty years old.
  23. You're a college student. Like Tell us
  24. how how life was before all this started
  25. before it all started. I was a typical
  26. college student. I was a sophomore in
  27. college, majoring in hospitality
  28. management and just. One to classes
  29. hanging out in my room mates. You don't
  30. make friends at a job. I was involved
  31. in different extracurriculars. I was in
  32. a sorority. I was in a sport management
  33. club Like different things like that. I
  34. was living basically a typical college
  35. life like lack of sleep. Lots of
  36. homework. Like just having fun and
  37. getting an education, and when you
  38. started having symptoms, What was it
  39. like? I think you are you a story?
  40. Talk about going to a clinic to get
  41. checked out Because you didn't think
  42. much of it is that. Right, Yeah, so I
  43. was everything was normal for a while.
  44. Then I started getting some really bad
  45. headaches, but I kind of just like like
  46. put off to stress dehydration. And lack
  47. of sleep things like that cause I was
  48. getting close to the end of us the
  49. spring term, so it was kind of like
  50. everything was piling up and stuff like
  51. that, so I didn't think anything of the
  52. headaches outside of anything crazily
  53. and then I had a couple headaches in a
  54. row for a couple of days, and then I
  55. had a good day where I felt nothing. I
  56. was great back to normal One about my
  57. life is all had been, and then the next
  58. day I woke up and I had thrown up that
  59. morning. So I called my mom, even
  60. though as a culture and I still call my
  61. mom and I asked her I was like. Hey.
  62. Like what do you think I should do like?
  63. I know I'm supposed to come home like
  64. tomorrow, But like do you think I
  65. should do anything and she recommended
  66. that I go to the health center at school.
  67. Just like to give it something like
  68. maybe the flu is going around or
  69. something like that, and so I went to
  70. the center the health center and they
  71. said like it's by a flu or some other
  72. viral infection of swords, so they sent
  73. me home with like an anti, nausea and a
  74. headache medicine, and nothing crazy,
  75. just thought it was something normal
  76. like a normal college sickness, so and
  77. then after that point what do you
  78. remember? I mean, I assume you don't
  79. remember ending up like. Do you
  80. remember the seizure? That is what kind
  81. of let up to everything or is it just
  82. kind of nothing, So my mom that day I
  83. took a nap after to the health center
  84. and I call my mom was like I don't
  85. really feel comfortable driving home
  86. Because it's right before Easter break,
  87. so I was. I called her. I said. Hey.
  88. Will you come get me and she said sure
  89. I'll come get you, so it's only an hour
  90. from my parents' house where I was going
  91. to school. You came and picked me up
  92. and took me home, and then that night I
  93. had started throwing up again, so had
  94. thrown up all night long, and I
  95. remember that like but some parts of
  96. that and like falling asleep on the
  97. bathroom floor and the next day my
  98. parents had to go to work because they
  99. weren't off that day and then my sister
  100. went to school because she was still in
  101. high school, so they will check them
  102. before they left for their day, and I
  103. remember them coming in and saying like
  104. hey, like call you anything. We're
  105. just minutes away from home. Low
  106. -income Get you or whatever into two.
  107. So what do all my life? I felt fine. I
  108. felt like asleep, and then the next
  109. thing I remember, I don't remember
  110. seizing, but the next that's the last
  111. thing I remember is throwing up and then
  112. my parents checking on me the next
  113. morning before they went to work, and
  114. before my sister went to school, and
  115. that's the last thing I remember until
  116. the end of the story. Okay, Wow, so I
  117. guess we will have hadn't come in, so
  118. this has gotten twenty seventeen year
  119. working at Cleveland Clinic. You're
  120. part of an array your team, So like
  121. what role did you play and taking care
  122. of Sydney the the night regarding City's
  123. care, I mean. It was actually from one
  124. of our residents who was that seeing the
  125. case unfold and he said You know. I
  126. think she may really benefit from being
  127. taken over to the Cleveland Clinic arm.
  128. I think her eyes if he is high, and I
  129. think that she actually has a treatable
  130. condition. It looks like she has a
  131. sinus venous thrombosis. I didn't have
  132. access to the images or anything, but
  133. give him the story that he gave in. We
  134. brought her over right away and we
  135. brought a writer away overlay, and by
  136. the morning it'll be noticed that she
  137. was in her shoes and a complete comatose
  138. state or Paris read the bedside, and
  139. you know they were. They were kind of
  140. devastated that momentum in seeing her
  141. breathing tube in, and just you know
  142. not looking so good, and I remember
  143. that night, calling R and a vascular
  144. team in and and the The evaluated the
  145. cave, and then. As early as I believe,
  146. eight and the next morning, and you
  147. know, they took her down for the
  148. endovascular procedure, trying to
  149. figure out all all of what was blocked
  150. off in her brain and they found does
  151. some very important veins that were just
  152. have obliterated by this clot, so they
  153. went to work right that morning, and
  154. and I, you know they, they were able
  155. to actually form a pathway through all
  156. of the veins, and they opened up the
  157. entire Ah sinus area that was clouded
  158. off, and at that point it was just
  159. giving her time, and she spent a lotta
  160. time in her eyes. You retain you lazing
  161. a lot of those vessels, getting a lot
  162. of our blood thinner medication, and
  163. I'm just having her parents and her her
  164. sister at bedside, and you know we got
  165. to know each other a lot just cramp or
  166. outright. With the underlying causes
  167. for this, Yeah, so we we did. We did
  168. a hypercar get work up, and you know
  169. has, as city knows that it seems like
  170. she has a a genetic factor that
  171. predisposed her to causing a clot a
  172. little bit there, so home we ended up
  173. having to start crying the long -term of
  174. blood thinning regimen, but you know
  175. she, she seemed to
  176. hold up to that side of the treatment
  177. plan.
  178. Her Her mind. Do you remember any of
  179. that current, or is it different than
  180. not? I don't. It's very weird. I
  181. don't remember much of it, but there
  182. are certain things that are strange that
  183. come to me like I remember certain songs
  184. playing like they trigger something like
  185. I remember a certain Harry another song
  186. after I left the like after I was
  187. healing about it. I was more like in
  188. tune with what's happening in the world.
  189. I remember hearing songs I'd like I'd
  190. asked the number. Was the song playing
  191. when I was in the? I see you are like?
  192. Why is the song giving like this weird
  193. like memory to me like that was
  194. happening, and then one of the nurses
  195. that I think was in the step down unit,
  196. Not the C you and I remember her and I
  197. asked her about her. I was like hey,
  198. Because she's actually from my hometown.
  199. I was like Hey was so and so's daughter
  200. my nurse, and she was like. Why do you
  201. remember that portion of the whole
  202. tenure? You're there use remove certain
  203. little random things, but I truly don't
  204. remember much else from that trip from
  205. that. Stay in the icy you stream. To
  206. be honest. It's probably your time.
  207. Your looks good. You don't remember
  208. that, and I guess I'm interested
  209. program. You know she isn't super long
  210. time. I think you guys ended up
  211. recommending a moving forward with a
  212. tray and peg placement Art. You know
  213. these difficult cases. Sometimes the
  214. team thinks you know what are we doing.
  215. Do We need to reconsider what we're
  216. doing. I know Sydney, Super young.
  217. Did you guys ever lose hope or was it
  218. always just you know, Push forward.
  219. Yeah, so certain points, you know. In
  220. a sitting there with her dad and her mom,
  221. it was it was you know a lot of those
  222. discussions, you know to be continued
  223. pressure. Because as we started getting
  224. to that three week point are a lot of
  225. people were saying you know, Should we
  226. consider the train and peg, I mean, at
  227. some point you know she's going to have
  228. to continue with from therapies and
  229. stuff like that, and that's when we
  230. didn't make the decision late, albeit
  231. to kind of go for a tracheostomy and I
  232. laugh at this because the day after she
  233. got the tracheostomy was the, she woke
  234. up, and you know she, she opened her
  235. eyes and then she was wide awake and
  236. she's like what's going on and and you
  237. know is so that it was a Quaker and go
  238. with the trick and I think she ended up
  239. going to the the acute rehab or the long
  240. -term acute care. And while she was
  241. there because she was so awake, I
  242. believe she pulled out her trick
  243. yesterday. Ah, but then she's like I
  244. don't need this anymore. Remember the
  245. last I remember not wholly, but like my
  246. dad. It's funny story because my dad
  247. was on duty that day because my parents
  248. would take chefs, because my sister was
  249. a senior in high school, so they also
  250. like to be a part of her life, too and
  251. not just worry about me, even though
  252. mine was a little more serious than hers
  253. at that point, but he was on duty that
  254. day and he turned around to grab a
  255. coloring book or something for me to do
  256. with him and I just turned back on. I
  257. had it in my hand and he was like. Oh
  258. God, this is not good, so we like
  259. scrambled to go get the nurse, and then
  260. she came in and tried to open the new
  261. trick and that's flew all over the place
  262. and it's just a story that my dad died
  263. laugh at to this day, but at that time
  264. it probably wasn't funny, but I still
  265. think it's funny, but
  266. I have some sense of humor about these
  267. things. Yeah, what do you think was
  268. the most challenging part of your
  269. recovery?
  270. That's a great question. I think, just
  271. the not being able to do everything I
  272. could do before I think it was like the
  273. mental adjustment like I could do
  274. everything on my own, and at that point
  275. I couldn't do everything on my own. So
  276. was the hardest part for me to be like I
  277. can't do this on my own, but it also
  278. haunt me realize like I have to dedicate
  279. my energies to therapy like physical
  280. speech. All of the things I had to do
  281. to get back to normal if I wanted to be
  282. back to normal again because it was such
  283. a challenge for me to be like I was a
  284. college kid. I was out on my own. I
  285. was out of my parents Also was living my
  286. life. Making my own decisions. Are my
  287. own thing on my own time, and at that
  288. point I couldn't like I couldn't
  289. physically do the things I was still
  290. doing, and mentally I was like still
  291. not one hundred percent there either,
  292. so it's kind of like I would say things
  293. I was like I dunno what you're saying
  294. and things like that so like frustrating,
  295. too for me, because I couldn't always
  296. articulate what I was trying to say Like
  297. On the first try, At least I would say
  298. something almost like. Do you mean this
  299. like Yeah. That's what I said Like No,
  300. you said this so just an adjustment
  301. period for me like physically and.
  302. Mentally to like dip pass that into a
  303. state where I could be on my own again
  304. and do things like I had been doing
  305. before, but it was a long journey, But
  306. for that journey, what is it that kept
  307. you motivated by country going, and you
  308. know kept pushing? Yeah, I think it
  309. was like the support system I had with
  310. like Dr. George and the nurses and the
  311. other doctors that were there, and then
  312. like my family being there all the way
  313. through and then all the other visitors
  314. I had from like my friends and other
  315. people in my life, just having them
  316. come in and like being so worried about
  317. me in a time that I don't remember any
  318. of it and then than just being like
  319. sober, leave to see me awake and like
  320. functioning and things like that that.
  321. It was like they went through this hard
  322. thing like I did to physically, but I
  323. don't remember any of it. They have to
  324. deal with all the memory of it, so I
  325. think for them I had to for myself, and
  326. for them I had to recover and get back
  327. to normal and let them see that I'm back
  328. to the Sydney I was before, and things
  329. like that, and what would you have any
  330. advice for other people that are kind of
  331. going through similar experiences,
  332. whether? If the people dealing with it
  333. or their family members and caregivers
  334. and the people dealing with it, I think
  335. it's as horrors of is to say to do after
  336. saying or what am I trying to say? It's
  337. easier to say than is her said than done,
  338. so I think you just have to find
  339. something whatever it is whether it be
  340. the people in your life. The career.
  341. You want to have the like you want to
  342. write a book like whatever you have to
  343. do to get you through. You have to
  344. target on something when you can narrow
  345. your focus that drives you to get up
  346. everyday and give therapy or give
  347. whatever your full one hundred per cent
  348. because I think that was what for me is
  349. like I am as a sophomore in college,
  350. Like I want to get a degree. I want to
  351. have a job. I went to a family. I want
  352. to live this life that I was always
  353. dreamed of my whole life. Like I have
  354. to get to that point. So I was like I'm
  355. not my life's an ending or stopping here.
  356. Like I have to push through to see the
  357. end of it like to see it through and
  358. then for the people that are surrounding
  359. the supporters and the surrounding folks
  360. in those people's lives just be patient.
  361. But also be strong willed, and the fact
  362. that your strength helps more than they
  363. realize, like everyone says that, but
  364. truthfully having people strong people
  365. around you to support you and love you,
  366. and just to be there to help you do the
  367. things that you used to do on your own
  368. that they can help you do things like
  369. eating going to the bathroom like
  370. reading your name things like that like
  371. it's better to have the support system
  372. and the support system goes a long way.
  373. So be that support system in whatever
  374. way works for the individual. Whether
  375. it be going to see them talking to them,
  376. treat them like normal. Like whatever
  377. it is like for me, I didn't want to be
  378. like the patient, and like everyone was
  379. focused on me and things like that like
  380. I just wanna live a normal life, but
  381. like recover, so it was kind of hard
  382. for everyone involved myself included
  383. like I don't need your help. I don't
  384. need this, but I did, but then my
  385. mom's side to urban parents and
  386. everyone's support side of it too was
  387. like we just want to help you buy, like
  388. you not wanting your help is frustrating,
  389. so like you to find that safe space and
  390. that ground that you guys can find
  391. together that works well for. Moving
  392. forward and is there anything you wish
  393. like the the care team like her dining,
  394. and it's probably talk, Cause you don't
  395. remember much, but I guess for us as
  396. like people that take care of patients.
  397. Like what can we do to like Help people
  398. get through this. I think it's just
  399. staying positive and I know it's hard
  400. cause like medical professionals want to
  401. stay the truth and things like that,
  402. but I think at some point there has to
  403. be a point where you can read the people
  404. that you're telling the news, too, and
  405. how to tell it to lead us. I think my
  406. mom from her experience like someone in
  407. there was like well. We don't know
  408. what's going to happen. Where like Dr.
  409. George would come in and say we have
  410. confidence Alex. She is. It's gonna
  411. work out like we're going to figure
  412. everything we can do to help her get to
  413. wherever she can get like saying in a
  414. positive and encouraging way without
  415. saying like she's gonna wake up.
  416. Everything's gonna be fine. But like
  417. we're doing everything we can do to get
  418. her to wherever she can get, rather
  419. than mean. Like we don't know she could
  420. be normal again. She could be back to
  421. like it, just having that positivity in
  422. the the new sharing and the. Also, I
  423. think for my dad personally, it was
  424. like having all the information 'cause
  425. he's definitely like a knowledge-based
  426. person where he wanted to know
  427. everything. So he would stay late at
  428. night with Dr. George and ask him, I'm
  429. sure way too many questions. So I'm
  430. gonna apologize in advance to my father
  431. for that, Dr. George. But he always
  432. wants to know everything from A to Z
  433. about everything. So I'm sure for him,
  434. like it's about reading the people
  435. 'cause I nominated the positivity and my
  436. dad needed the questions answered. So
  437. it's kind of about finding that ground
  438. with the patient and the caregivers and
  439. the lovers and the family around them
  440. that you can kind of feel what works
  441. best for them and what's gonna help them
  442. along the journey. Yeah, I mean, that
  443. can be a hard balance to find where you,
  444. like, at least for me, I want to be
  445. honest and communicate what's going on,
  446. but you still do, you know, like you
  447. said, being positive, you know. Yeah.
  448. So I think it's something we all have
  449. room to work on. Yeah, and I think
  450. it's easier said than done too, 'cause
  451. like I'm not a medical professional, so
  452. I know sometimes you have to tell the
  453. hard truth and that's just how it is
  454. sometimes, so. Now, a more positive
  455. way to end the story is, I think you
  456. returned to college of less than a year
  457. after this all happened. Were you back
  458. to your normal self? Or like were you
  459. still kind of working on things?
  460. Both. So I went back to school, but I
  461. had signed through my outpatient therapy.
  462. We had talked about how I could go back
  463. to school and how things would work for
  464. me. So I had worked with the department
  465. at school that gave extended time and
  466. things like that. So I talked to them
  467. and I got extended time for the first
  468. semester back just to take tests and
  469. things like that 'cause we didn't know.
  470. Like I hadn't been in a class. Like I
  471. did great with speech therapy and things
  472. like that, but I hadn't been back in a
  473. classroom since pre-stroke. So we're
  474. like, they were like, We don't know
  475. how you're gonna absorb information,
  476. how you're gonna take tests and things
  477. like that. So they wrote me notes and
  478. things like that. So I got extended
  479. time and all my faculty knew about the
  480. story and everything like that 'cause I
  481. went to a smaller university And then
  482. there was just helpful to me to have
  483. that opportunity, but I really only use
  484. it. I think the fall semester when I
  485. went back, I might have used in the
  486. spring, too, But I'm not positive.
  487. And then what are you up to now? I mean
  488. there were several years later which are
  489. lifelike. I now live in Buffalo, New
  490. York, So I moved away from Ohio. I'm
  491. working at the University of Buffalo
  492. here and doing something a little
  493. different than where I thought maker
  494. would go, but still some parts of it
  495. are still there, and during a small bit
  496. of events, but I'm also doing more and
  497. higher Ed things now I dunno what I'm
  498. trying to say, But yeah, I live here
  499. for hours my parents, so it's been an
  500. adjustment there too Cause my mom still
  501. worries about me every day, so they
  502. call her and she's like. Oh you have a
  503. sniffle. Are you okay and I'm like just
  504. a cold. So are you sure you want me to
  505. come up there and like nope, I'm good.
  506. I'll call you if I need you and everyone
  507. in my life knows that too like my mom is
  508. very worrisome and she's still. I don't
  509. think she's Really fully process the
  510. whole thing yet still to this day, I
  511. don't know if she ever well truthfully,
  512. but like I joke about it and it's fun.
  513. It's not funny to me, but like I had to
  514. make joke of it in light of it now
  515. Because of like I'm doing, I'm living a
  516. life I always thought I would and I'm
  517. healthy and everything's going well in
  518. my life currently, so I just like you
  519. can spend life and always in the
  520. seriousness and everything like it
  521. happened. We're moving past that were
  522. good, but already, and when I really
  523. want to hear, as you know, this
  524. happened five years ago, and you, an
  525. province were able to reconnect or I
  526. think he reached out to you, cause I,
  527. you know I'm always asking my friends
  528. for stories of hall, and he's like I
  529. got one and it. He put us together. Ah,
  530. But you know years had passed, so how
  531. did you guys stay in touch?
  532. I just think that Dr. George played
  533. such a big part in our family's lives
  534. that we just continue to like chicken
  535. and we're friends on Facebook, and like
  536. I will to this till the day I die will
  537. always. Poor daughter, Georgia,
  538. whatever he does and will stand by him,
  539. and whatever like he'll be invited my
  540. wedding one day like everything about
  541. him because he is just such a great part
  542. of art. I don't even say. Like as a
  543. healthcare professional. I say I was
  544. like upon number of our family like he
  545. truly helped my parents so much through
  546. it, and then later after meeting him
  547. help me through it and then we've done a
  548. couple of things like this before where
  549. he's I'm always willing to do lists for
  550. him because it's the least I can do to
  551. share my story for others because I am
  552. one of the lucky ones I can sit here
  553. today in Germany, three of the healthy
  554. individual after the craziness that
  555. happened to me and I don't think it's I
  556. don't think it's my duty to keep it to
  557. myself. I think it's worth sharing. It
  558. should be shared. So I mean thank you
  559. so much for sharing proud of what you
  560. have to say about that.
  561. It's It's been an honor to be artists or
  562. their family or their family discussions
  563. throughout the entire, or saline,
  564. leading them right in the beginning,
  565. you know you could tell that there was a
  566. lot of love there and. seeing, you
  567. know, her mom at the bedside
  568. and she was looking for hope and her dad,
  569. like she was saying, was looking for
  570. more on, you know, what caused this,
  571. how did it happen, you know, what are
  572. the outcomes usually with this, it was
  573. very, and
  574. yeah, you really have to kind of
  575. understand what each one is looking for
  576. and,
  577. you know, if you can provide that to
  578. them and you can give it to them with,
  579. you know, as much honesty as possible,
  580. I think that's the most important thing
  581. here, but, you know, one thing led
  582. into another and Sydney is where she's
  583. at now and, you know, she's a powerful
  584. individual.
  585. Well, thank you both so much for
  586. joining. I would like to ask any final
  587. words or anything else you'd like to
  588. share with our listeners
  589. I have a goal to write a book one day,
  590. so when that happens, hopefully you all
  591. will maybe read that book. Absolutely.
  592. I love that. Well, thank you for
  593. joining. We'll include a link to the
  594. article in the show notes, but to check
  595. out this or other currents content,
  596. please go to
  597. currentsneurocriticalcareorg. I'd love
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