THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Wednesday, December 6, 1995 TAG: 9512060438
SECTION: FRONT PAGE: A1 EDITION: FINAL
SERIES: BRAIN SURGERY
THE RECOVERY
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Long : 131 lines
The day after Jack H. Pearce Jr.'s surgery, Nurse Linda Vaughn breezed into Room 224 of the neurological intensive care unit at Sentara Norfolk General Hospital. She reached for Jack's chart and scanned it. His temperature had been up and down. Not unusual after brain surgery.
Then she glanced at the bed.
He was on a respirator.
Tears flooded her eyes.
Jack's wife, Laurie, and his parents, Jack Sr. and Ruth, arrived at 6 a.m, after the doctor called to tell them Jack had suffered massive seizures during the night.
Dr. Jonathan P. Partington, Jack's surgeon, told them the seizures likely were a fluke, a passing reaction to the trauma of surgery. The day before, Partington removed about 6 ounces of Jack's brain in an effort to cure his epilepsy.
The brain doesn't like to be tinkered with, and there probably was a small air pocket left under the skull. It would eventually dissipate, but while there, it irritated the brain.
Jack's post-operative seizures involved all areas of the brain. They were very different from his usual episodes, which were limited to one side of the brain.
That's a good sign, because if the surgery succeeds, he should never get one of his typical seizures again. And once the immediate trauma of the surgery is over, he shouldn't get any more - ever.
Out in the waiting room, Jack's family staked a claim to the alcove near the television. They spent the day there, munching on pretzels and trying half-heartedly to finish a jigsaw puzzle.
``Today's been longer than yesterday,'' said Sheri Clark, Jack's daughter.
At 8:30 p.m., the last visiting period, Jack was still sedated, his face wide and swollen. The machine that breathed for him wheezed every time his chest fell.
Before surgery, he had told Linda Vaughn that he dreaded waking up with that respirator tube in his throat, wanted it out before he regained consciousness. Now, cuffs pinned his arms to the bed so he couldn't pull it out. Once, during a brief waking moment, Linda asked, ``Are you mad at me?'' He shook his head no.
Jack woke up the next day. He couldn't talk, because of the tube in his throat, but he could write.
``Son,'' asked his father - Jack knows his dad is serious when he starts a question that way - ``is it worth it?''
Jack nodded his head, yes. Then he wrote ``but it was rough.''
Then he wrote, ``Where's Linda?'' Everyone knew what he meant. He was mad about the breathing tube.
Jack made a fist and waved it in the air, joking.
They knew he was OK.
It wasn't an easy recovery, even after he got out of intensive care. In the hospital, he suffered such excruciating headaches that all he could do for the next few days was moan in agony.
Then it was a few weeks recuperating, spending the days dozing at his parents' house while Laurie worked.
One evening in October, almost two months after the surgery, Jack was smiling, buoyant, sitting in the family room of his Virginia Beach home with Laurie and his parents. His hair was growing back. Eventually it will cover a bit of his scar that peeks out on his forehead.
A tiny sliver of peripheral vision, out of the left side, seems to be all Jack lost from surgery. It was expected, since the operation swept close to fibers that connect the eyes to the vision center of the brain. The change is so small it won't interfere with reading or driving.
Total recovery, though, will be slow. These days, it takes Jack a little longer to remember something than it did before, said his father. A patient's memory usually worsens right after the surgery, but eventually it is usually better than before the operation.
``They said within a year he might be back to normal,'' says his dad. ``Of course, in Jackie's case it may take three years.''
``Get out of here, Dad,'' says Jack.
And he tires a little more quickly. But he went back to work sooner than his family wanted. ``I'm really proud he's done that good,'' says his dad.
After a year, a psychiatrist will test Jack, looking for subtle changes in his judgment, his emotional reactions, his perception of time, his ability to order tasks properly.
Jack apparently hasn't suffered any of what those in the profession call deficits as a result of the surgery. In fact, he doesn't seem any different, except happier.
There's no guarantee yet that the surgery has worked. Even before the operation, Jack could go months without a seizure. The operation fails for one of every six people.
But his doctor and his surgeon believe Jack will be one of the successful ones. The signs are very good - the chances of a seizure are greatest early after the surgery, but the episode he had in the hospital didn't seem to be related to his epilepsy. As time passes without another seizure, his odds improve.
Generally, anyone who goes for two years without a seizure is considered cured.
``The only way to know for sure who's right is two years from now,'' said Joseph Hogan, his neurologist. ``If he doesn't have any seizures, we'll know we did the right thing.''
Jack probably will always use some anti-seizure medication just to stay on the safe side. Over time, his doctor will steadily reduce the dosage.
He'll be able to get his license back in February, if he doesn't have another seizure. That'll be a time for celebrating.
A bottle of chardonnay sits in the fridge, a gift from Jack's boss when Jack and Laurie bought their house. For years, the high levels of medication have kept him from touching alcohol.
Laurie has plans for that wine, after Jack gets his license back, after his medication levels drop way down.
She pulls it out and holds the bottle, cold in her hands, vapor coalescing on the glass. She glances at the big brick fireplace in their family room.
``We'll sit by the fire and pour it. . . ''
Not for this year's wedding anniversary, but maybe next year's. ILLUSTRATION: Color photo
MARTIN SMITH-RODDEN/The Virginian-Pilot
Jack Pearce jokes during Thanksgiving dinner at his sister-in-law's
house. Since his operation, he has not had any sign of epilepsy,
though he has had some seizures that are common after brain
surgery.
Photo
MARTIN SMITH-RODDEN/The Virginian-Pilot
Counting their blessings at Thanksgiving dinner in Virginia Beach:
from left, Jack's mother, Ruth, his wife, Laurie, Jack and his
father, Jack Pearce Sr.
by CNB