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Turning Up the Heat on CancerSTORY BY

Meredith Raine

CRASH

Devin's motorcyle was hit by a car.
Then, she was run over.
A last-resort long shot
took her from coma to cure.

Leslie “Devin” Olive was riding a motorcycle when her life took a sudden turn.

It was late at night, and the driver of a car made an illegal U-turn, causing a collision with the motorcycle.

It almost killed her. Her head hit the side of the car, and then she hit the pavement. The driver kept going, and Devin was left in the dark near Beechnut Street. Another car ran over one her legs before anyone realized there had been an accident.

Devin, 19, calls the highway horror a blessing in disguise. And while she has no memory of it, she describes what happened in the next month as nothing short of a miracle.

When Devin arrived at Memorial Hermann Hospital in the Texas Medical Center, the pressure inside her skull was four times higher than the normal range. Traditional therapies for traumatic brain injury failed to bring down the pressure.

The prognosis was bleak. If Devin survived, in all likelihood, she would be severely disabled, unable to communicate or care for herself.

Aaron Mohanty, M.D., an assistant professor in the Department of Neurosurgery at The University of Texas Medical School at Houston, initially removed a portion of her skull in an attempt to relieve pressure caused by swollen brain tissue. Even then, the pressure remained dangerously high.

He then medically induced a coma in an attempt to reduce the intracranial pressure. Still, there were no signs of a favorable response.

It was time for Mohanty and Devin’s parents to make some tough decisions.

Mohanty told Devin’s parents about a procedure he thought may help. He could perform a lumbar puncture by inserting a needle through the lower back into the spinal canal and draining a small amount of spinal fluid through a catheter. In his previous experience at a Phoenix hospital, this helped to bring down and stabilize intracranial pressure in children with similar head injuries. If it worked, Devin wouldn’t need additional surgery to relieve pressure.

Mohanty tempered the information with harsh facts.

“He told us it was unconventional and isn’t normally done on adults,” Devin’s mother, LaDona Kincade, said. “It would make an immediate difference. She would either live or she would continue to deteriorate.”

Because the pressure in Devin’s brain was so high, Kincade was worried that another surgery would be too risky. “It was the hardest decision we ever had to make, but we felt the lumbar drain was the right thing to do.”

Mohanty and physician’s assistant Lee Bonner rolled Devin into a fetal position. Mohanty performed the lumbar puncture, inserted a small tube into the spinal canal and controlled the drainage of a small amount of fluid. Meanwhile, Bonner watched Devin’s pupils to make sure they didn’t dilate – a sign of further brain injury and bad prognosis.

This was Devin’s turning point – when she stopped slipping away and started recovering. The pressure immediately began to drop and the brain swelling subsided.

“Patients don’t usually survive intracranial pressure as high as Devin’s,” Mohanty said. “When all other measures failed, we tried this as a last resort.”

Almost one month after the accident, Devin began to talk and her memory returned. Mohanty had been concerned that the area of her brain where language is stored had been damaged during the accident, but Devin had no problems. An aspiring language translator, Devin awoke from her coma with her English, Spanish, Chinese and American Sign Language skills intact.

“She has no deficit at all. She came back 100 percent,” Kincade said. “She is amazing. She truly is a miracle.”

Devin said she not only has her life back, but she also has a new outlook on life.

Before the accident, Devin said, she was heading down the wrong path. She had a strained relationship with her family and had sabotaged her grades by skipping college classes. She also was depressed.

“I seriously feel like a whole new person now,” Devin said. “I’m loving it.” She is finishing up TIRR (The Institute for Rehabilitation and Research) Challenge Program, an outpatient program for patients with brain injury. She plans to re-enroll in college in 2006 and wants to pursue a career in language translation.

“I love being able to speak other languages,” she said. “It opens up your world to so many more possibilities. You can meet so many more people if you can understand and speak their language.”

Mohanty said Devin’s outcome demonstrates a need to conduct clinical trials to determine whether draining cerebrospinal fluid is safe and yields better outcomes than currently accepted therapies for patients with brain injury.

“This is an area of interested that I would like to explore,” Mohanty said. “We have much to learn about this procedure.”

Kincade said her family felt blessed to have a choice when it came to Devin’s medical care.

“We were so impressed with the skill and level of care she received,” Kincade said. “God has blessed us in so many ways.”

UPDATED: 04-27-2006