September 27, 2022 by Adrienne Sylver
Remarkable Recovery: He Beat 3-Month Coma, COVID-19, Multiple Strokes and a Craniotomy
Jose Morejon, 44, has beaten so many odds that one might need a spread sheet to keep track. He was in a coma for months, while suffering through sepsis, COVID-19 and several bilateral (both sides of the brain) strokes — one of which caused bleeding and brain swelling.
For a single individual to suffer bilateral strokes is very rare and life-threatening. Sepsis is a bacterial infection of the bloodstream which can lead to tissue damage, organ failure, and death.
“I was in a coma for three months,” recalls Mr. Morejon. “When I woke up, I couldn’t talk. This hand, I could not move at all.”
He has undergone extensive treatment and surgery at Miami Neuroscience Institute, part of Baptist Health, during which a portion of his skull was removed to relieve pressure from the swelling. An extremely grateful Mr. Morejon can now speak about his remarkable recovery, which started in September 2020, when he was comatose and was transported to the Institute at Baptist Hospital.
(Watch video: Hear from patient Jose Morejon, his wife Lorena Ulloa, and neurosurgeon Jobyna Whiting, M.D., the director of degenerative spine surgery at Miami Neuroscience Institute, as they recount Mr. Morejon’s remarkable recovery. Video by Carlos Barquin. )
“(Mr. Morejon) was comatose and was experiencing brain swelling from the strokes,” recalls Dr. Whiting. “We were just beginning to understand, at that time, that COVID made people more likely to have strokes. And we were seeing strokes in young people who were COVID-positive where we wouldn’t normally expect to see a stroke.”
And she adds: “Now, he had a blood clot inside this swelling area and it was starting to press on his brain, and we could see that in his blood pressure and his heart rate.”
A large stroke on the right side of Mr. Morejon’s brain caused “hemorrhagic transformation” — bleeding into the brain that results in a blood clot and swelling. This complication alone can significantly worsen a stroke victim’s prognosis.
The only possible solution to Mr. Morejon’s dire series of medical events was a hemicraniectomy, a risk-prone surgical procedure where a large flap of the skull is removed, allowing for enough space for the swollen brain to bulge and reduce the intracranial pressure. The procedure can have many serious complications.
Dr. Whiting is part of a multi-disciplinary team at the Institute that treats a small group of patients who have “suffered a completed stroke” — as in the case of Mr. Morejon. “We sometimes play a role in decompressing the skull to allow the area of the brain that has already been damaged by the stroke to swell without injuring the good brain that’s still there.”
During a hemicraniectomy, “sometimes we remove as much as nearly half of the skull because that allows that infarcted or dead tissue that has already suffered a stroke underneath to swell out as it’s going through its swelling phase, rather than to swell in and press on the remaining brain that is still good.”
Both Mr. Morejon and his wife, Lorena Ulloa, are extremely grateful for Dr. Whiting and her team. They realize how bleak his outlook appeared before the hemicraniectomy.
“Thank you, Dr. Whiting,” says the patients wife. “I really appreciate what you’ve done with Jose. I am grateful to you for what you have done for us and for our family.”
Dr. Whiting admits that some physicians may have felt that Mr. Morejon “was too far gone.” And that the couple’s gratitude is “really a very poignant thing for me to hear.”
“You don’t want to, as a surgeon, operate futilely, and you don’t want to put patients through something that you don’t think can help them,” she adds. “But looking at this, hearing that, it reminds me that we have to be very careful about making those decisions. And we have to remember that there are people who really have a life ahead of them that’s worth saving.”