What Silvia Buceta remembers about the morning of Sept. 13 comes only from what others have told her. It was the day an aneurysm burst deep within her brain and she nearly died.
Not a typical Monday
It was Monday and Silvia was upstairs in her Stroudsburg home. Her husband, Al Buceta, heard a thump, and a short time later – after Silvia crawled to the bedroom door – he heard her yell to him for help.
Al rushed to Silvia's side, and his first thought was that the migraines she ceased having a few years earlier had returned. Silvia was screaming; her back was drenched in sweat. This was no headache, he thought. Emergency medical crews arrived and quickly took her to Lehigh Valley Hospital (LVH)–Pocono, where a scan showed bleeding in her brain from a ruptured aneurysm.
Critical care
Silvia soon became unresponsive. Intubated and on life support, she was flown by LVHN–MedEvac helicopter to the neuroscience intensive care unit (NSICU) at Lehigh Valley Hospital (LVH)–Cedar Crest, where a critical care team was waiting.
Neurosurgeons began to drain the buildup of blood and fluid that was causing the tremendous, painful pressure that had caused her to become unresponsive. Next was interventional neuroradiology, where a coil embolization was performed on the aneurysm to prevent rerupture. The minimally invasive technique involves inserting a catheter through the groin and threading it into the blood vessels in the brain. Platinum coils, about the thickness of a human hair, are packed into the aneurysm to prevent rebleeding.
For several days, on a ventilator and feeding tube, Silvia was in pain, she later said. Al was fearing the worst. Would his wife be disabled or die? Then she started to wake up, and subsequent brain scans showed enough improvement that the drain in her brain and her breathing tube were able to be removed. Silvia was rapidly improving.
Up and walking in a week
About a week after arriving in intensive care, Silvia was walking. Two weeks later, she was doing so well she was discharged from the NSICU and able to go home.
“They could not believe I was walking,” said Silvia, who attributed her recovery in part to her active lifestyle that includes kayaking and biking. A nonsmoker and breast cancer survivor, she said she focused on getting better and on the target date for her potential release home. She was eager to get home and recuperate there.
“They were amazing – all the doctors and nurses,” she said. “My husband never saw anything like it. They were constantly there for me.”
“We have an amazing team of very dedicated individuals from the intensivists to the advanced practice clinicians and the nurses and therapists,” said neurointensivist Christopher Melinosky, MD, who helped treat Silvia. “These patients are truly a team effort, and we all play an important role.”
Beating the odds
Surviving a large brain hemorrhage isn't guaranteed. Melinosky said that about 20 percent of patients with a subarachnoid hemorrhage die before reaching the hospital. Overall, 30-day mortality is as high as 35 percent. Survivability is variable but better at a comprehensive stroke center, a high-volume center with a dedicated neurological intensive care unit such as the one at LVH–Cedar Crest.
“Based on Silvia's initial severity, she did remarkably well,” Melinosky said.
Although she is not a big believer in miracles, Silvia said the remarkable treatment she received shows there's hope for patients such as her.
Bleeding in the brain, like what Silvia experienced, is considered a stroke. About 15 percent are hemorrhagic, from bleeding in the brain, whereas 85 percent of strokes are caused by blockages in blood vessels.
“Not all patients with severe brain injury do well or even survive, so when we put an incredible amount of work and effort into saving our patients, it's wonderful to see them survive and do well,” Melinosky said. “We rarely have the opportunity to discharge a patient directly home, which makes this case so special. It really is the most rewarding part of this career – seeing a patient come in comatose and walk out of the NSICU with her family because of the efforts of my team.”
A hopeful future
Silvia says she's looking forward to getting back to work and driving. She and Al are avid travelers, which they plan to get back to as well. One of the biggest reasons she wanted to get well and go home was for her three granddaughters. Because of her health scare, she couldn't take them to the corn maze last fall, as she has in years past.
“I have hope that all of this is over and behind me,” she said. “I want to be there for my grandkids and be there when they get married.”
Lehigh Valley Health Network | lvhn.org
This post is a sponsored collaboration between Lehigh Valley Health Network and Lehigh Valley Style.
