Defying the odds
By JOSH ZIMMER, Times Staff Writer
LUTZ -- Even getting out of bed is a miracle.
Stirred by a morning wake-up call, Kim Fernandez rubs her eyes with the back of a shaky hand and slowly swings her legs toward the side of the bed. Her mom, Ginger Rodriguez, has removed the guardrails.
Rodriguez, loving but not shy, admonishes her 30-year-old daughter for taking off her hand splints. After her near-fatal car accident two years ago, Fernandez's hands naturally clench up. If she allows them to stay that way, Fernandez won't be able to use them as a healthy person does. As with everything else, that's something Rodriguez, 53, refuses to let happen.
Having already defied the odds, Fernandez faces a future that is a mystery.
She almost died two years ago in an early morning car accident at Florida and Hillsborough avenues. Everyone else, including her now-estranged husband, walked away with scratches and minor injuries. For weeks Fernandez barely clung to life in a coma at St. Joseph's Hospital.
Doctors, seeing the extensive brain damage and internal injuries, gave her a 20 percent chance of living, according to Rodriguez. The odds of exiting the coma were even worse: 1 percent.
Now Fernandez talks and feeds herself. She is riding horses and, with the help of an athletic trainer who sees her four times a week, is beginning to walk again. She puts on most of her clothes.
She amazed Rodriguez the other day by tying her shoes.
The former high school dancer climbs a mountain every day. Nothing comes easily, except the motivation.
"I want to be normal," she says.
Prognosis was gloomy at best
The collision left Fernandez with severe traumatic brain injury, which is distinct from strokes and other types of neurological damage. The accident also caused a violent crash in her head, between the brain and skull, upsetting the ultrasensitive nerve connections that orchestrate how we walk, talk, eat and see.
"She knows she had an accident," said Rodriguez, a retired dental technician who herself struggles with the details of that night. "She doesn't remember it."
Two weeks after the accident, the prognosis was gloomy at best. In a report, one of Fernandez's doctors described a frightening amount of brain injury, along with broken ribs, broken pelvis, and extensive cuts to her liver and spleen. Doctors performed a tracheotomy to open a passage to her windpipe and get her off the ventilator.
At 28, Fernandez was helpless and close to death. Her neurologist, Dr. Arthur Pedregal, didn't hide his reservations.
"I tend to be the ultimate optimist," said Pedregal, who admits being amazed by Fernandez's recovery. But "I was trying to be fair to the family up front. Basically, people with the degree of head injury she had, 95 percent will die. About 2 to 3 percent will go to a persistent vegetative state."
The accident added Fernandez's name to other daunting statistics.
According to the Brain Injury Association of America, an estimated 1-million people are treated every year for traumatic brain injuries. About 50,000 of them die. Traffic accidents are the leading cause.
The situation is a costly national issue, as an estimated 5-million people suffer from physical and emotional issues linked to traumatic brain injuries.
Treatment is expensive, especially because many victims require long-term care. Recognizing the distinctness of traumatic brain injury -- October is National Brain Injury Awareness Month -- has sharpened the focus of doctors, researchers, therapists and social service workers, said Tom DeLilla, chief of the Florida Brain and Spinal Cord Injury Program, a division of the state Department of Health.
The spinal cord injury program concentrates on hooking patients up with treatment and financial resources, such as the Social Security disability program, DeLilla said. But it will give people money as a last resort, as it did when Fernandez's work insurance ran out and she was in therapy at Tampa General Hospital.
Michael Fernandez, Kim's father, said her bills have topped $1-million. He already is searching for a new policy because Fernandez's federal COBRA coverage with the Robert Half International employment firm, her last employer, is due to end in March. The change could double her insurance rates to $500 a month, he said.
"These are life-changing events," said DeLilla, who broke his neck 30 years ago in a swimming accident at Hillsborough State Park and gets around in a wheelchair. "But that's not to say people with disabilities can't learn to cope, adjust or lead meaningful lives."
For families and friends involved in traumatic brain injuries, old relationships can change forever. Adults who take an active role essentially become parents of boys and girls again.
Fernandez, who was a caseworker at Robert Half and pursuing a business degree at Eckerd College, now lives with Rodriguez in the Heritage Harbor home she shares with her second husband, Mario Rodriguez. She is Rodriguez's only child.
Rodriguez and Michael Fernandez, a mortgage banker who lives in Lakeland, describe Kim as a vivacious, active child who danced for the Chamberlain High School Chieftans and ran for the track team. She always kept in good shape.
The contrast between Fernandez today and her old self is hard to swallow, they said, although she remains sharp-witted and positive.
"It's a life-changing experience -- seven days, 24 hours," Rodriguez said while watching Fernandez undergo balance therapy at the Quantum Leap Farm horse riding complex in Odessa.
"Everything's a struggle. I stay awake at night sometimes thinking . . . 'What can we do next? What can we do better?' Thank God she's been a joy. I feel it's there from the time she gets up to the time she goes to bed."
'One thing after the other'
Fernandez spent a month at St. Joseph's before her condition stabilized enough so she could be moved to Tampa General, the local trauma center in the Brain and Spinal Cord Injury program's network. She spent four encouraging months there before entering the outpatient program, where she remained until February.
At that point, taking advice from doctors, Rodriguez took Fernandez's care upon herself.
"We've driven through storms," Rodriguez said. "It just wasn't acceptable to miss therapy."
Fernandez, whose head droops but whose eyes and ears capture everything around her, started horseback therapy at Quantum Leap in the spring. In the past six months, Rodriguez and the trainers have seen improvement. Riding forces her to sit up straight and balance herself. It also helps her focus on different tasks, boosting the short-term memory she lost in the accident.
"It's a lot to think about," trainer Kimm Schmidt said after one recent session. "We go through warmups and decide it's what we both want to do."
"It's one thing after the other," said Fernandez, who drew laughter with her mock complaint.
At first she hated going.
"I like it now," she said.
Every second is somehow devoted to Fernandez's recovery. Rodriguez, who adapts with new tactics as Fernandez gets stronger and gains coordination, said her daughter does not seem distracted by the absence of her husband, Rodney Maggiacomo. Maggiacomo could not be reached for comment. Rodriguez says he dropped out of her daughter's life several months after the accident. Fernandez says she doesn't miss him.
Fernandez can brush her own teeth now, so Rodriguez puts the toothpaste on the brush, laying it out on the breakfast table so her daughter won't forget. Although Fernandez complains, Rodriguez has her folding clothes. At night, she sits Fernandez before the computer where she works on memory skills, typing personal information into Microsoft Word, then playing solitaire and Wheel of Fortune.
Fernandez is well known at the Bob Sierra YMCA, where she has eliminated aquatics from her routine to spend more time with an athletic trainer. The trainer, Ryan Goodwin, puts her through a grueling series of movement exercises, from walking along a guardrail while he holds her by a waist strap to stretching while she sits on a floor mat.
About a month ago she started walking on the treadmill without any help, more encouragement that she may some day walk on her own.
No one can say how far Fernandez will progress. She already has defied the percentages, offering inspiration to all around her.
"They were basically preparing us that she'd have to be institutionalized," Michael Fernandez said while recalling the early days after the accident. "We just would not give up." Instead, they sought "to give her the opportunity to make progress. It's a miracle. God decided it wasn't her turn."
Pedregal, an integral part of her treatment from day one, is equally impressed.
"I think it ranks up as one of the best successes I've seen," he said. "I think one of the things that accounts the most for it is her relatives, particularly her mother, who have just been exceedingly supportive. Never missed a day, never an hour of visiting time.
"Every time she comes to me she's doing better," he said. "I can't tell what the final outcome will be."
The improvements in Fernandez give Rodriguez a little bit more time to herself, if only to rest. She's not lifting Fernandez into the recliner at night anymore, only making sure she doesn't fall. Rodriguez, who thanks her husband Mario, a salesman, for his patience, said she recently went to the movies with him for the first time in two years.
She welcomed the rest. But Fernandez says she never gets tired.
"I'm a fighter," she said.
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