Hernando: The long, slow road to health

Second in a four-part series

On her last day of outpatient physical therapy at Tampa General Hospital in August, Wendy gets help from therapists in using exercise putty to test and strengthen her hand and fingers.

Her daughter, who nearly had been killed in a horse-riding accident five days earlier, was alive and awake. Doctors had warned Mrs. Cisek that 13-year-old Wendy would not come out of her coma any time soon, if at all, and yet here she was, sitting up in her hospital bed.

"Wendy, honey, it's me," her mother cried, rushing over to the side of Wendy's bed.

Wendy looked like a zombie. She was hunched over, and her head hung low. Intravenous tubes draped down from her arms. But she was breathing on her own, and her eyes held recognition. She nodded, unable to speak, drained of energy.

"We were ecstatic," said Mrs. Cisek, who had feared the worst for her daughter. "But I felt like if we put our guard down, it would just make it harder. I just told myself, I can deal with anything, as long as she's awake."

In truth, Wendy's struggle was only beginning.

Every 15 seconds, someone sustains a brain injury in the United States. Every five minutes, one of those people will die and another will become permanently disabled. Wendy Cisek had survived, but doctors warned her parents about the other possibilities. They had no idea how much permanent brain damage the girl had sustained. Wendy might be alive, but she might never be the same again.

"The functioning of the brain is a very complex thing," said Dr. Richard Weibley, Wendy's critical care physician. "There are people who have brain injuries just like hers who remain in a coma for months. There are people who wake up and look fine, seem absolutely normal, until you ask them to do higher reasoning. And then it becomes obvious. They aren't."

Five days earlier, on May 20, the 13-year-old had been a normal teenager. A spitfire of a girl, she loved her independence, hanging out with friends and riding wild with her horse.

Her independence also bred a temper. On the day of the accident, she had gotten into a screaming match with her entire family. Later that evening, while riding her horse at a Brooksville rodeo, her horse spooked and rolled over her, fracturing her skull.

When she awoke from her coma, Wendy couldn't talk. She couldn't walk. She couldn't even remember how to swallow.

And so the long process of recovery began.

Challenges and optimism

With gentle spoonfuls of applesauce, Mrs. Cisek and occupational therapists coached Wendy through tiny movements that once had been automatic.

"We take it for granted. Swallowing is easy, right?" Mrs. Cisek said. "No. It's a complicated process."

As soon as Wendy's vocal chords were strong enough for her to speak, it became clear something else was wrong. Although the Ciseks had lived in Brooksville for two years, Wendy thought their house was still in Tarpon Springs. It was as if the last chunk of her life had never happened.

She also couldn't retain new memories. She didn't remember why she was in the hospital, although she had been there for several days and doctors had explained it over and over. Each time she saw her parents, she asked them where they had been -- why they had left her alone.

"We've been here the whole time," her mother would reply with a tired sigh. "We love you, Wendy."

Wendy's memory problems stemmed from the type of brain injury she suffered, a diffuse axonal injury. What that means, said Dr. Weibley, is that when Wendy fell and her skull was fractured, her brain flew into the skull and became bruised. The neurons, or wires, of Wendy's brain, which send electrical impulses, had been stretched, and in some cases broken.

The effect was that Wendy had trouble retrieving some information, even if the knowledge itself was intact. She would need time to heal before doctors could know what, if any, knowledge was lost permanently.

"Wendy had the attention span of a flea after the accident," Weibley said. "She was so easily distracted. You could hold her attention only for a few seconds."

The uncertainity of her condition was the hardest thing for her father.

"As a parent, it's awful, not knowing if this is how it would be for the rest of our lives," said her father, Dennis, a mechanic. "But the nurses were encouraging. They said she'd improve."

In the meantime, everyone tried to stay positive. They knew how lucky Wendy was. Down the hall, there was a 23-year-old patient who had been in a car accident. She had both brain and spinal cord injuries.

"She was paralyzed from the shoulders down," Fran Cisek said soberly.

Wendy, on the other hand, was relearning how to walk within several days of emerging from her coma, to the delight of her family.

At first, she used a walker to go up and down the hospital hallways. Later, she was transferred to Tampa General Hospital's rehab unit, where she would spend the last two weeks of her monthlong period of hospitalization.

There, she went through physical therapy for a few hours each day. Therapists would fasten a thick belt around her waist, and two of them would hold on to each side of her, helping her move forward and keep her balance. She also lifted weights.

Slowly, the weak, left side of Wendy's body regained movement and strength.

"I'm buff!" she joked with the nurses and therapists as she worked out, happy just to be out of her hospital bed.

Mrs. Cisek laughed along with her daughter. Humor helped, but Mrs. Cisek lived each day somewhere between relief and dread, juggling emotions along with the rest of her life.

Both parents had taken time off from work and moved into the hospital with Wendy. They packed clothes in a suitcase and slept in her room for all 30 days she was hospitalized. One night Mom would get the extra bed and Dad would take the floor. Then they'd switch.

Exhaustion threatened.

The only time the couple spent the night at home, southeast of Brooksville, was the day their eldest son, Dennis, graduated from high school. As they proudly watched him take his diploma, a day of celebration was tinged with regret.

"I was real sad," Mrs. Cisek recalled, "because Wendy wasn't there to see her big brother."

By mid-June, money had become an issue. Both of the Ciseks went back to work, although they continued to sleep at the hospital.

The problem was, once her parents had left for work, Wendy would forget where they had gone. She would call her grandmother in Tarpon Springs and ask in a desperate voice whether they even knew she was in the hospital.

So Mr. Cisek devised a plan. Each morning before he left for work, he would leave his cowboy hat on top of a protective netting that was suspended over Wendy's bed. When she woke up, it was the first thing she would see.

"Now, babe, I'll be back," he'd whisper, kissing her goodbye, "because you know your Daddy would never leave anywhere without his cowboy hat."

One month later: freedom

Wendy returned home from the hospital on June 20, exactly one month after her accident. She was talking, walking, even joking about her brush with the beyond. Her bruises had faded to yellow-green and would soon disappear for good.

After being cooped up for so long, Wendy's tiny country home -- which sits outside of Brooksville amid acres of pasture populated mainly by cows, horses and oak trees -- might as well have been heaven.

"I love it here," said Wendy, who grew up in Tarpon Springs until a little more than two years ago, when her family gave up a big house in exchange for 10 acres of grass and sunshine. The Cisek children have flourished here, as have the dogs and the chickens.

In celebration of Wendy's release from the hospital, and to help raise money for her medical bills, the woman who originally found Wendy unconscious at the rodeo organized a horse-riding benefit for her.

Marie Rape, who raised nine children and didn't have a reliable car of her own to get to the event, said she knew the true meaning of hard times and wanted to help out.

"My heart went out to that girl," Rape said. "Those medical bills, I know, they're outrageous. I just wanted to do more."

Decked in boots and blue jeans, most of those who came to the fundraiser, on the same rodeo grounds where Wendy had been injured, paid an entry fee and then rode for prizes. Others spent the day relaxing in the shade, listening to country music that poured from the speakers of a truck. Alan Jackson sang the virtues of being a "little bitty," and the Ciseks fervently agreed.

"We love it up here. We love the country," Mrs. Cisek said. "It may be a small town, but these people have big hearts."

Lunch was a feast of hot dogs, hamburgers and baked beans. Fresh watermelon awaited in the bed of a Ford pickup. In all, about $800 was raised.

"You didn't have to do this," Wendy repeated over and over, blushing as friends and strangers wished her the best.

Throughout the morning and afternoon, Wendy never strayed far from the watchful eyes of her mother. Even when the two would separate -- which wasn't often -- Mrs. Cisek would search for her in a crowd, as if to assure herself that Wendy was really there.

Physicians had warned Mrs. Cisek that when Wendy returned home, she would still require 24-hour care. At a time when most girls her age would be fighting for their independence, going out at night with friends and looking forward to getting a driver's license, Wendy would be as dependent on her mother as she had been when she was a young child. She might look healthy, but Wendy was still at risk.

"Because of her short-term memory, she could be cooking and go to answer the phone and totally forget about the stove," Mrs. Cisek said. "The house could burn down. So I have to be there."

And yet, things began to progress at what doctors called an "amazing" pace.

After a month at home, during which time she went through outpatient therapy at Tampa General, Wendy was back in almost prime physical condition. And mentally, she was healing by leaps and bounds. So much so that her therapist felt she would be ready to start classes as a freshman at Hernando High School in mid-August.

The prospect was both encouraging and daunting for the Ciseks.

On one hand, Wendy's long-term memory had returned completely, and she could remember old names, dates and phone numbers. She grumbled about how her eldest brother had always gotten all of the attention in the family; she recalled things she had learned in school the previous year and was itching to see her friends.

But new memories remained a problem. She still sometimes forgot what month it was. And tasks with several steps were confusing. She would stop and forget what she was supposed to do next, as well as what she had already done.

"It's the little things," Wendy explained. "Like, I'll be wetting down my horse for a bath. And suddenly I won't know whether I need to wash her with soap or if I'm rinsing her because I've already done that."

The reason Wendy still was having problems with her short-term memory and not her long-term memory, doctors say, has to do with the way people learn and store information. For a piece of information to become part of a person's long-term memory, new neural connections have to be laid down. But Wendy's brain, still recovering from the accident, was not able to do that with the same ease as someone without a brain injury. Old memories, on the other hand, had already been consolidated and were therefore more readily accessed.

"The transference of short-term memory to long-term memory is damaged," said Dr. Weibley. "Now, how long it will take for her to get back to 100 percent, you just don't know. What you do know is the faster her rate of recovery (early on), the better chances she will recover fully."

After having Wendy with her almost non-stop during the summer, Mrs. Cisek knew it was going to be difficult to leave her at school. The two had grown close during these last weeks. In a way, Mrs. Cisek had gotten her baby back. Now, she was nervous about letting go.

Mrs. Cisek recalled one day over the summer when she had taken Wendy to work with her in Tampa, where she is an office manager at a small business that sells counter tops. The office doesn't have its own restroom, so Wendy had to walk down to the other end of the shopping plaza to use the restroom. Minutes ticked by as Mrs. Cisek answered the phones.

When Wendy didn't come back, Mrs. Cisek jogged outside -- just in time to see Wendy walking in the wrong direction, away from the office and toward a street of busy traffic.

"Wendy!" Mrs. Cisek had cried, more than a bit frightened, motioning her child back toward her.

Mrs. Cisek knew she wouldn't be able to help Wendy like that at school. And it remained to be seen how such difficulties would affect Wendy's interaction with other students and her studies.

"It's hard to know until you really get back into that school setting," cautioned Nikki Ryckeley, Wendy's occupational therapist on the teen's last day of outpatient therapy.

"You have to listen to the teacher, tune out the background noise, and then switch your attention down to a paper. It's a lot to ask."

Wendy felt she was ready for the challenge. Her parents hoped so.

-- COMING THURSDAY: Wendy returns to school

PREVIOUS COVERAGE: Horse accident leaves girl in coma

Back to Hernando County news

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright

From today's
Hernando Times

The long, slow road to health

12 more teachers obtain honor

County delivers on vow to aid private agencies

O'Sullivan is following in footsteps of sisters

Caldwell zeros in on goal