ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, November 12, 1996 TAG: 9611120072
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: Health Notes
SOURCE: SANDRA BROWN KELLY
What you read here today may be disturbing because it's about death and the clinical search for what causes it. It's also about a former co-worker and friend, Roanoke Valley writer Kathleen Wilson, who died in August at age 38 following a hysterectomy.
She wrote the Mingling column for The Roanoke Times from 1991 to mid-1995.
If you read all the way through this column, I hope you will understand better the phrase "died from unexplained causes." I also hope any woman needing a hysterectomy won't be scared away from the surgery by what happened to Kathy. Likewise, I would wish that any women suffering from endometriosis or considering a hysterectomy for any cause will take the time to research her condition just as Kathy did.
Kathy was being the guinea pig for a new book on hysterectomy. She read the book before the surgery and afterward I was going to interview her on its contents.
I still have an electronic message in my computer mailbox from Kathy about our plans.
A hysterectomy is the surgical removal of a woman's uterus and sometimes her ovaries. It leaves a woman unable to conceive. If the ovaries are removed, it also will plunge a young woman, like Kathy, into sudden menopause. It is major surgery and not to be decided upon lightly. Kathy didn't decide to have the surgery until after a long period of research and agonizing pain.
Kathy had endometriosis where the tissue that lines the uterus migrates outside the uterus and grows on other reproductive organs. It can be mild or severe. Kathy's endometriosis was severe; the pain controlled the last year of her life.
An average of more than a half million hysterectomies are done each year, and many of them are considered unnecessary, but that was not the case with Kathy. She had researched and/or tried the alternative treatments for endometriosis. They didn't work for her.
And that is how, in August, she came to be in a room at Carilion Roanoke Memorial Hospital, recovering nicely, it seemed, from successful surgery. Kathy chatted with Harry Wilson, her former husband who also was her best friend. Harry then went off to run some errands. When he returned to her room a couple hours later, Kathy appeared to be sleeping.
But, she wasn't. She was dead. And, in her death, Kathy, the gregarious redhead whose energy could exhaust others, became a case at the Western Virginia medical examiner's office.
Everyone wanted answers. Harry Wilson wanted to know what killed a person he loved. Was it something that happened during the surgery? Something that Kathy had done, like maybe taking some medication she shouldn't have?
Kathy's doctor also wanted answers. Did anything to do with the surgery kill Kathy?
Kathy Wilson was "a case that didn't follow the normal course," said Lucas Snipes, director of daily operations at Carilion Roanoke Memorial.
"A patient died a few hours post-operative. It was not expected. There was nothing to explain it," Snipes said. "It wasn't supposed to happen."
"We rarely see people after surgery," said Dr. David Oxley, deputy chief medical examiner for Western Virginia.
Oxley's office always gets for examination and determination of cause of death:
Anyone who died by violence, whether it be a gunshot wound or a fall from a roof; any child where death is suspected to be related to drugs; anyone who died while in custody of police; any body so decomposed that identification is a problem; any sudden or unexplained death where there could be a public health issue; and any other case the local medical examiner decides needs a closer look.
Kathy was one of the cases everyone "felt should be investigated," Oxley said.
His office serves 35 counties and 15 towns and cities and does 600 to 700 autopsies a year. Some take an hour to an hour and a half; others much longer for actual physical examination of the body, interviews and follow-up toxicology studies on body fluids.
The medical examiner wants to know the position of the body when it is found, whether there is the presence or absence of rigor mortis (stiffness) or discoloration; Harry Wilson was interviewed by a medical examiner because he was the first person to see Kathy dead.
Information about the circumstances of death help in the final determination. A heart attack can't necessarily be seen by looking at a heart, Oxley said. But, clogged coronary arteries or a clot in an artery are clues to an attack.
During an autopsy, the victim's body is examined externally and internally. Blood, eye fluid, bile, urine and tissue specimens are taken for toxicology studies. Analysts look for drug levels or drug interaction. In a surgery case, the medical examiner looks for any bleeding.
Sometimes there is no "anatomic footprint, and the diagnosis is largely by exclusion," Oxley said. "We rule out everything else."
That was the case with Kathy Wilson. Oxley's office did not find any clue to why she died, only what killed her - acute congestive heart failure.
Fluid in Kathy's lungs indicated there had been a change in her heart rate or rhythm that caused her breathing to slow and her heart to stop.
The "etiology," causes of death, were "undetermined," according to Oxley.
In the words of her friend and ex-husband, Harry Wilson:
"This is just one of the tragic things that happens. I'd like to have a more definitive answer, but I'm satisfied that everyone has looked into it."
I think Kathy would be also.
You can contact Sandra Brown Kelly at 1-800-346-1234, x393, or 981-3393 or at biznews@roanoke.infi.net.
LENGTH: Long : 104 lines ILLUSTRATION: PHOTO: File/1994. Former Roanoke Times columnist Kathleenby CNBWilson: After a year ruled by the pain of endometriosis - and after
trying alternatives - her surgery was necessary. color.