Vim & Vigor - Summer 2020 - UVA - 55

55

Alex Fear walked a tightrope between life and
death but survived a traumatic brain injury
with tenacity and steadfast, superior care
BY HOLLY COOPER FORD

ILLUSTRATION BY GETTY IMAGES

PHOTO BY JACKSON SMITH PHOTOGRAPHY

A

lex Fear has no memory of
the accident. One minute he
was at a party, sitting on a
window ledge, enjoying the company
of friends. The next minute, he was
waking from a coma, unable to
speak. Fortunately, in those many
minutes in between-more than
50,000 of them-Alex had people
close by who were determined to
save his life.
Nineteen-year-old Alex fell from
that second-story window, landing
on the concrete below, fracturing
his skull and losing consciousness.
Alex's condition was so severe that
paramedics quickly transferred
him from a nearby Harrisonburg
hospital to the UVA Nerancy
Neuroscience Intensive Care Unit.
The unit is specially equipped and
staffed 24/7 to care for patients
like Alex with serious neurological injury.
"When Alex arrived at UVA, he
had a severe brain injury," says UVA
Health neurosurgeon Mark Shaffrey,
MD. "The percentage of people who
make a full recovery from an injury
like that is small, probably 1 to 2 percent. Considerable deficits or death
were real possibilities at that point."
Alex's parents, Chris and Brian,
of Broadway, Virginia, got the call
from a police officer notifying them
about the accident after midnight
on March 17, 2019. "When we saw
Alex, he was unconscious," Chris
says. "He had on a neck brace. There
was a bolt in his head. We were
stunned. Scared and stunned."

Alex was in a medically induced
coma to limit the demands on
his brain. As the Fears quickly
discovered, the greatest risk of a
traumatic brain injury is not necessarily the injury itself. It's the
effects that follow.
"The initial damage that occurs
at the time of the fall is the primary
brain injury," says clinical nurse
specialist Dea Mahanes, RN, DNP,
a doctor of nursing practice. "But
then there is a risk of secondary
brain injury, a complex cascade of
changes that happen in the brain-
including swelling and bleeding-
that can cause increasing damage."
To minimize this risk, the UVA
neurocritical care team focused
first on managing the pressure
inside Alex's skull. They gave him
medications to reduce brain swelling and kept a close watch on his
oxygen levels.

FIGHT OF HIS LIFE

But just days after arriving at UVA,
it became clear to Alex's care team
that brain injury was no longer
the only concern. Alex developed
acute respiratory distress syndrome,
a severe and dreaded lung
condition that causes fluid
buildup in the lungs and
compromised respiratory function.
"When the lungs don't
work, carbon dioxide levels go up, and that causes
increased pressure in the
brain," Mahanes says.
VIM & VIGOR SUMMER 2020

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4/1/20 9:28 PM



Vim & Vigor - Summer 2020 - UVA

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