Well waddya know! 'She was headed to a locked psych ward. Then an ER doctor made a startling discovery.
A physician’s gut instinct about a young woman led to a diagnosis that had been overlooked for years.
The 23-year-old patient arrived in the back of a police car and was in four point restraints — hands and feet strapped to a gurney — when emergency physician Elizabeth Mitchell saw her at a Los Angeles hospital early on March 17.
Chloe R. Kral was being held on a 5150, shorthand in California for an emergency psychiatric order that allows people deemed dangerous to themselves or others to be involuntarily confined for 72 hours.
She had spent the previous six months at a private treatment center receiving care for bipolar disorder and depression. Chloe had improved and was set to move to transitional housing when she suddenly became combative and threatened to harm staff and kill herself. Police had taken her to the emergency room at Cedars-Sinai Marina del Rey Hospital before a planned transfer to a mental hospital. . .
But something indefinable — Mitchell characterized it as “maybe gut instinct” honed by nearly two decades of practice — prompted her to order a CT scan of Chloe’s head to better assess her mental status.
When she pulled up the image, Mitchell gasped. “I had never seen anything like it,” she said. She rounded up her colleagues and “made everyone in the whole ER come look.”
“I was speechless,” she said. “All I could think was ‘How did no one figure this out?’ ”
It was then that Mitchell learned about the stunning oversight that had resulted in years of needless anguish for Chloe and her family.. .
Her mother, who practices yoga, thought it might boost her daughter’s mood. But she noticed that Chloe seemed wobbly, even in basic positions with her hands and knees flat on the floor. Her unsteadiness was the latest of physical changes that had begun in early adolescence. She tended to veer to one side when she walked, bumping into whoever was beside her. Sometimes she tripped climbing stairs. Although Chloe had been a good skier, around age 13 she fell more frequently and ultimately gave up the sport.
“Throughout high school I did have issues of not being able to walk in a straight line,” Chloe recalled. “It became sort of a joke.”
She also fainted periodically. In early 2018 she was taken by ambulance to an ER after fainting; no cause was found. When Alison followed up with the pediatrician, she said the doctor’s response was “Some people faint a lot.” . .
Beginning in the summer of 2020, Alison noticed that Chloe sometimes dragged her right foot when the pair took walks.
By fall, Chloe was spending her days on the living room sofa, inert. She forgot to bathe or brush her teeth. Once she urinated on herself while riding in her mother’s car. Her parents consulted a second psychiatrist who told them she needed to be hospitalized. In September she was admitted to a facility that provided intensive psychotherapy.
Stunning omission
Mitchell’s first call to Alison from the ER was brief. Her daughter was being evaluated, the doctor said, before her transfer to a psychiatric hospital an hour away.
Less than two hours later she phoned again with bombshell news. Chloe had a life-threatening condition that Mitchell characterized as “the most severe case of hydrocephalus I’ve ever seen.” She needed brain surgery as soon as it could be scheduled and was being sent to the neuro-ICU at Cedars-Sinai.
Hydrocephalus, popularly known as “water on the brain,” is caused by the accumulation of cerebrospinal fluid in cavities known as ventricles. Spinal fluid, which cushions the brain, is critically important to a wide variety of brain functions. Excess fluid was compressing the brain’s frontal lobes — responsible for memory, decision-making and emotion — against the inside of Chloe’s skull because it could not be reabsorbed. Without treatment, hydrocephalus, which can be present at birth or occur later in life, can cause brain damage, coma or death.
Alison had never heard of hydrocephalus. And Chloe, she told Mitchell, had never undergone brain imaging.'>>>
https://www.washingtonpost.com/health/2022/02/12/medical-mystery-mental-facility-ct-scan/
WOW! How awful for her! How lucky for ME! Another C.T. scan next week, so Doc can determine if rate of drain into my shunt is good, and Physical Therapy will follow.
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