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Mom brought back from coma after hearing newborn’s cries

A nurse's view: Family-centered care is a priority

Carolinas HealthCare System 

When new mother Shelly Cawley slipped into a coma after giving birth to her daughter, nurse Ashley Manus’s quick thinking was key in saving her life. Manus, along with Shelly, her husband Jeremy and their daughter Rylan, will be on Dr. Oz sharing their story on Wednesday.

(Dr. Oz airs on WJZY at 11 a.m. and 4 p.m.)

Manus shared her story about the unusual delivery. The Cawleys just celebrated the one-year birthday of Rylan.

Q: How was Shelly Cawley’s delivery unusual for you?

A: It was just a regular night working on a mother and baby. The labor delivery department called to say they had a delivery for us and the mother would not be coming, she’d be going to the ICU. That’s not normal. Usually we get the mom and baby together. If we get just one, it’s typically the mom. It’s very rare that we get just the baby.

Q: Did that immediately concern you?

A: We didn’t know a whole lot in terms of what was going on with Shelly, just that she would not be coming to us. We were waiting on the ICU to give us the go ahead. We called back and forth, and they finally got clearance from the doctors that it was OK to bring Jeremy and the baby and Shelly’s mom to see Shelly. They said, if y’all are going to come, you need to come now.

Q: How did you feel, walking into that room to see Shelly with Rylan and Jeremy?

A: I honestly thought I was going to be accompanying them to say goodbye. I could sense the urgency in the nurse’s voice in the ICU when she gave us the go-ahead to come, and I know Jeremy and Shelly’s mom could sense the urgency in my voice. When I walked into the room, I teared up.

Q: You thought to put Rylan on Shelly’s chest, which ultimately awoke Shelly. What made you think to do that?

A: Family-centered care is a priority at NorthEast. To us in the mother-baby unit, family-centered care for mother and baby means we do pretty much everything we can at the bedside. From labor to delivery, when the mother and baby come up to us, we start the baby with skin-to-skin contact, and that’s where the baby stays (on the mom). Not just that, but the baby stays in the mother’s room for the majority of the time – and that’s during the entire stay, not just at day and night. We allow people to come, and for family members to stay with the mom and with the baby. We try to keep everybody together as unit as much as we can.

Q: Why is that so important?

A: It’s what we believe. Mother-baby is typically a happy time. New mothers need support and babies need support, and not just from the mom, but the entire family. Seeing siblings is very important, grandparents, the whole family.

We would do this for anybody. We weren’t just thinking that this particular scenario. I had my one little patient, little Ms. Rylan, and I thought it was important to get them together. When most mothers deliver, they have that bonding time, that baby on the chest, and Shelly didn’t get that. Worst case scenario, they would’ve had that time together.

Q: How does that speak to the emphasis on quality healthcare at NorthEast?

A: We put the patient first, always. Doing what’s easy for me as a nurse and what’s easiest for the unit is not always the best thing. It’s what is best for the patient. If it puts more hardship on the staff, that’s OK, because we’re not first. The patient comes first.

Q: Has the Cawley family story stuck with you?

A: It’s a situation I’ll never forget. Even though it’s been a year out, I pretty much think about the family every day in my thoughts and in my prayers. And I’m not the only one. There are a lot of us that were involved in Shelly’s story, from the time they got there to the time they left. They’re in our thoughts constantly.

Carolinas HealthCare System 

Even though none of the doctors said it, Jeremy Cawley knew that they had brought him into his wife’s hospital room to give him a chance to say goodbye. Shelly was not doing well and there was only one more thing to try.

“The doctor said, ‘Let’s get the baby undressed and put her on her mother,’” said Jeremy. “We had to work hard to get Rylan to cry, but she did.” Shortly after, Shelly’s vitals improved enough to prepare her for transport to Carolinas Medical Center.

Establishing skin-to-skin contact is often done to help struggling premature babies. In this case, it was done to help a new mother struggling to live.

On Sept. 5, Shelly Cawley, 23, a nursing student at Cabarrus College, went to Carolinas HealthCare System NorthEast to deliver her first child. Shelly had a blood clot in her leg, which had been treated throughout her pregnancy and the soon-to-be parents did not expect it to interfere with a normal labor and delivery. During the course of her labor, though, she developed life-threatening complications, including preeclampsia and HELLP Syndrome, which required an emergency c-section.

After the c-section, Shelly’s lungs rapidly filled with fluid, and her health went downhill fast. She ended up on an oscillator, a special ventilator only used when regular ventilators are not sufficient. But even that was not working.

“We needed her vitals to be stronger so that she could survive being switched to the portable ECMO lung transplant system that we were bringing up from CMC,” said Dr. Dana Bush, the obstetrician involved in Shelly’s care. “The mother-child bond is incredibly strong. I thought it might make a difference if Shelly’s subconscious could hear and feel her daughter.”

When it worked, Jeremy knew that his daughter had saved her mother’s life. He also credits the coordinated care provided by Carolinas HealthCare System.

Shelly was transferred to CMC and placed on Extracorporeal Membrane Oxygenation — ECMO — until her lungs recovered enough that she could breathe on her own. ECMO is a procedure that uses a machine to take over the work of the lungs and sometimes the heart. It is only used with patients that have not responded to other treatments.

“I never really understood how important that connection (between CMC-NorthEast and CMC) was until now,” Jeremy said. “The fact that the hospitals are even connected now gave us options we wouldn’t have had otherwise.”

After Shelly was breathing on her own again, she returned to Concord for rehabilitation at Carolinas Rehabilitation-Northeast, a 40-bed inpatient rehabilitation hospital that opened in 2013.

Because she was so close to home, her family could bring her baby daughter to visit throughout the day. Shelly’s friends came to visit, play games with her and help with her rehabilitation.

“Support from friends and family is so important in the recovery of our patients,” said Todd Bennett, director of Carolinas Rehabilitation–NorthEast. “Just a year ago, Shelly would have been in rehab in Charlotte, and her friends and family would have had a harder time visiting her. Providing care close to home makes a real difference for our patients.”

Just two days before her daughter’s one-month birthday, Shelly went home.

“The medical teams at CMC-NorthEast and Carolinas Medical Center saved Shelly’s life,” Jeremy said. “One of our goals as we continue our recovery process is to draw attention to the amazing medical system that we have in our community.”

 

 

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