Woman Survives Killer Blood Clots; Recovery Baffles Doctors

Sept. 15, 2008— -- Late last year, Marianne Cook, a 32-year-old single mother of two from Arnett, W.Va., wasn't feeling well and decided to take a hot bath. As she climbed into the tub, she suddenly felt dizzy and fell. The water continued to run as Marianne blacked out. She could hear her 2-year-old crying and calling for her, but she couldn't move.

Twenty hours later, a maintenance man received a complaint that water was leaking from an upstairs apartment, Marianne's apartment. He opened the door and found the bathroom flooded, Marianne unconscious on the floor and her 2-year-old son sitting in the water crying next to his mother. And so began the heroic efforts to save Marianne's life.

Still unconscious, she was taken to a nearby hospital and placed on life support. Emergency physicians repeatedly asked Marianne's parents to sign a "Do Not Resuscitate" order.

"She is brain dead," doctors told Marianne's mother, Wilma. Her brain is "like cottage cheese and if she ever does awake she will be a vegetable," Wilma Cook remembers them saying.

Within a few hours, Marianne was airlifted to a teaching hospital in Huntington, W.Va. Tests revealed the source of the problem: A tumor inside her heart had broken apart, causing clots throughout her body and triggering a massive stroke. Doctors knew the extent of the problem but also knew they were not equipped to fix it.

Marianne's parents did not give up. Ten other hospitals were contacted, and each refused to take the case, saying it was too risky. But on Dec. 1, three days after the collapse, with Marianne still unconscious and deteriorating, a medical center agreed to take her.

Marianne was airlifted to the Cleveland Clinic, where some of the country's leading cardiologists now admit they believed her chances were slim at best.

Emergency cardiothoracic surgeons were called in to remove the tumor in her heart in a three-hour operation. That was a start. Now they had to contend with the blood clots.

Cleveland Clinic heart surgeon Dr. Mark Gillinov recalled, "Pieces of the tumor had broken off and were speeding down her arteries like race cars, lodging in her brain, her legs, her feet and probably other organs."

The damage to her legs from the lack of blood was obvious. "It was pretty much as bad as I have ever seen, " said Dr. Sean Lyden, a vascular surgeon at the Cleveland Clinic. "Her legs looked mottled and purplish, and it really looked like she was going to lose her legs." But again, the physicians would try their best to help her.

There were just so many clots to remove. And they were long, some as long as pencils. Surgeons kept pulling them out one after another.

A scheduled one-hour operation ended up taking eight hours. The clots in her brain were too numerous and difficult to remove safely. Doctors could only hope that her brain was "plastic" or "adaptable" enough that functions from the damaged areas would be picked up by the remaining healthy parts.

The doctors had now done all they could. Marianne was in intensive care. The strain on her family was overwhelming. In the midst of it all, her 64-year-old father, Stanley Cook, died of a heart attack in his sleep. Doctors urged the family to delay telling Marianne for fear it would trigger more complications.

Marianne's whole right side was paralyzed. The family waited by her bedside and prayed. "We believe in the power of prayer," her mother said. And there was a lot of it. Her mother called the "prayer team" at her church. From there one person called another. Word, and prayers, were relayed from church to church, state to state. Within days "we had people across the country praying for her," said Wilma.

For a week, there was no change. Then, eight days later, Marianne started to move a toe. A few days later, a foot. The paralysis was slowly fading. The recovery had begun.

Just after Christmas, Marianne was released to a nursing home. Therapists predicted it would take a year before she was ready to go home. They, too, had underestimated Marianne. Less than three months after her collapse, Marianne arrived home -- walking and talking, and ever so grateful.

Marianne lost vision in one eye and part of one toe from the lack of circulation. But her prognosis is good. She and her family say they don't know much about miracles. But this, they say, certainly comes close. Her doctors approach it much the same way.

"I cannot remember ever seeing someone with so many strokes and so many problems before surgery walking out of the hospital," said Dr. Gillinov.

"Luck? Divine intervention? Some of both."

For more Medicine on the Cutting Edge stories by John McKenzie, click here.