On a severity scale of 1 to 6, David Ayello’s ruptured aneurysm was a 5.
“He had less than a 10 percent chance of surviving,” says his father, Jesse Ayello.
After surgery at Alexian Brothers Medical Center (ABMC) stopped the bleeding in the college student’s brain, his intracranial pressure (ICP) soared far past the danger point, despite attempts to control it through multiple therapies.
“We almost lost him several times,” Jesse Ayello says.
To save his son’s life, doctors tried an innovative therapy, cooling and gradually re-warming his body over 10 days. Known as induced hypothermia, the therapy improved his condition and helped him emerge from a coma that lasted about 23 days.
Today, David, 23, again is pursuing his dream of attending medical school and is thinking about becoming a neurologist. “Now, I’m not just doing it for me, but for everyone who brought me back,” he says.
ABMC started using induced hypothermia a few years ago in cases involving ventricular fibrillation, a lethal arrhythmia that can cause cardiac arrest and sudden cardiac death. ABMC since has expanded its use of induced hypothermia to include a variety of other cases, including David’s.
Induced hypothermia involves covering 30 percent to 40 percent of a patient’s body with pads through which cool water flows, and controlling the water temperature mechanically to lower the patient’s body temperature.
In cardiac arrest cases, doctors usually wait 12 hours before gradually returning the patient’s body temperature to 98.6°F over eight hours. In David’s case, doctors had to wait 10 days before they could return his body temperature to normal without an increase in ICP.
“They tried to wean him three times, but his (ICP) numbers kept going up,” says Jesse Ayello. “Finally, they raised his temperature extremely slowly….Then the brain pressure finally held (at a low level). That’s when we were all jumping for joy.”
David remembers emerging from his coma and hearing his father asking, “David can you hear me?” Jesse Ayello recalls: “He couldn’t talk but was conscious….He squeezed my hand and gave me a thumbs-up.”
Four days after doctors returned David’s body temperature to normal, he no longer needed life support. Soon after, he decided to get out of his hospital bed and to take a few steps. Nurses stopped him, explaining what had happened to him and telling him he wasn’t ready to walk yet. He had no memory of the day he was hospitalized, except for complaining to his mother about a headache that morning.
“It was pretty intense when I found out,” he says. “My parents told me I was in a coma for basically a month. I was thinking, `How can I have been out that long?’ The entire summer was over already. I was processing the shock.”
He remained at ABMC for a couple of more weeks before transferring to Alexian Rehabilitation Hospital in Elk Grove Village, Ill., where he stayed for a month. Several months of additional rehabilitation followed, initially in the hospital’s day program and later in its outpatient program.
Alexian Rehabilitation Hospital is a partnership with the Rehabilitation Institute of Chicago, designated by U.S. News & World Report as the nation’s No. 1 rehabilitation hospital for 20 consecutive years. “You find out you are going to one of the best rehab centers, and it makes you feel like, `What a coincidence that they are right here,’ ’’ David says.
He also appreciates the fact that he lives just minutes from ABMC, where he had worked as a summer volunteer a year before he was hospitalized. “It’s just amazing what they can do now – the new devices they use to keep patients alive,” he says. “Alexian Brothers definitely deserves to be mentioned in the top hospitals.”
More than a year has passed since he was rushed to ABMC, and David, a former cross-country runner, is looking to the future with optimism. He says he has learned “not to take life for granted and to always appreciate each moment you have.”
Although his physical stamina has not returned to the high level he enjoyed before he was hospitalized, he worked part-time at a fast-food restaurant during the summer and has returned to running short distances.
He also is learning to compensate for impaired vision in his left eye, another side effect of the ruptured aneurysm. He regularly does special eye exercises and activities to improve his vision. “They say as long as I keep doing those, I have a pretty good chance of getting my vision better,” he says.
“He’s doing really, really well,” Jesse Ayello says. “He has made a remarkable comeback. It’s just amazing he survived. We’re indebted to these doctors who helped our son. They never gave up hope.”
David’s experience has made him more determined than ever to go to medical school, but instead of becoming a child psychiatrist, he’s now intrigued by the idea of becoming a neurologist. He was inspired, he says, by the way his doctors worked together and by their intelligence and expertise.
“The doctors, the nurses who put all that work in and definitely the therapists in rehab, with everything they gave, I don’t want to disappoint them,” he says. “I just want to keep pushing forward to the highest point I can.”