Bringing back Leo
Jess Himes didn’t believe what she was hearing. Her son, Leo Hernandez, was going to come back to her no matter what anyone said. She knew it.
Early Christmas morning, two Emergency Room residents and a chaplain at Penn State Health Milton S. Hershey Medical Center told Jess she might have heard Leo’s voice for the last time. If he did regain consciousness, the residents explained, no one was sure what he’d be like when he returned.
“Take me to see my kid now,” she snapped.
Jess’s anger chased a numb shock that was beginning to ebb in the hours since Leo collapsed. Today, Jess credits Leo’s doctors, nurses and therapists at Milton S. Hershey Medical Center and Penn State Health Rehabilitation Hospital with saving Leo’s life and helping him through a recovery that was nothing short of a miracle.
But at that moment all Jess had was her belief.
The good pain
That night, the family had just returned home to Lebanon, Pennsylvania, after a holiday party at Jess’s parents’ place. Leo had a headache but Jess wasn’t surprised; the whole family was battling the sniffles that week. But when the pain turned excruciating, Leo screamed. The healthy 19-year-old clutched his head and started to vomit. Wracked by seizures, he collapsed to the floor and stopped responding.
Jess, a Veteran’s Affairs Hospital nurse, sat and held him as the seizures struck like electrical storms. Brain bleed was her first thought. Paramedics intubated him and rushed him to Hershey.
Still, any thought that Leo might not wake up didn’t cross Jess’s mind until the doctor said it. She’d been right, Leo had had a massive brain bleed, the doctor explained, from an arteriovenous malformation, or AVM. A knot of blood vessels in his brain had pinched closed. A bubble had formed in one of the vessels and burst, choking the inside of his skull with blood. The doctor installed a drain to remove some of the pressure, and two days later performed emergency surgery.
He lay unresponsive until around 5:30 Christmas morning, when a doctor in the intensive care unit noticed Leo had a slight reaction to pain. For Jess, it was as topsy-turvy as everything else that day – when her baby felt pain, she felt relief. It was the first glimmer of hope. Somewhere, deep inside his coma, Leo was fighting for his life.
‘You’ve got to drive carefully, mom’
Days piled up. Jess and her family put their Christmas gifts aside. She’d gotten him an Eagles jersey – he never missed a game. She also bought a big Dolly Parton sign for his room. He was musical, loved Taylor Swift, jazz and show tunes. He loved the spotlight, performing in school plays, sometimes as the lead. They’d have Christmas when Leo came home.
Jess and her family spent 14 to 16 hours a day at the hospital, but returned home in the evenings. Early one morning, Jess’s phone rang, and she was shocked to hear Leo’s voice. He had awakened restless and demanded to speak with her, according to the nurses. His voice sounded fine, and she told him she was coming to see him. It was snowing. “You’ve got to drive carefully, mom,” Leo told her.
By the time she arrived, he couldn’t speak any more. The coma hadn’t returned. His eyes were open, but it was still like he wasn’t there.
She’d lost him, again.
Up again
During the next few days, Leo improved but only slightly. He stared, grunted and managed the occasional word. Even sitting up required specialized equipment. Still, the family was relieved. Leo was reacting, rolling his eyes and even smiling on occasion.
To get to the next step, Leo’s family turned to Penn State Health Rehabilitation Hospital, where a physician-led team of nurses, physical, occupational and speech therapists could help him find his way back.
Just before his arrival, the nurses allowed Jess and the family to decorate his room with photos and familiar objects. When Jess arrived Sunday morning, Leo was waiting, dressed in one of his Eagles jerseys. It was the first time she’d seen him in weeks in something other than a hospital gown.
Already, on his first full day, she felt like Leo was coming back. “Oh, I like this,” Jess thought.
Within minutes, two therapists arrived, hoisted Leo from his bed and carried him into the hallway. As they held him upright, Leo began taking steps. He needed all the help he could get, his head lolled and his face was blank. But on Morning 1 in rehab, Leo was dressed in regular clothes and taking actual steps – 15 in all. “It was huge for us,” Jess said.
Championship run
Therapists honed in on Leo’s strength. His right side was weaker. To rejuvenate his leg muscles, physical therapists had him use a functional electrical stimulation bike. Electrodes were attached to Leo’s legs and sent low level impulses that stimulated his muscles allowing them to contract more effectively and pump the pedals. Leo also used a specialized table equipped with a lift that gradually raised him to a stand where he supported his own weight.
Among other therapeutic purposes, the lift allowed him to stand upright and add weight to his legs to reduce tone and increase strength.
Leo’s occupational therapist had him sit at the edge of a table and balance sitting upright to strengthen his core. He also wore specialized goggles to focus his eyes – he was having trouble seeing his right side. The strength training and vision work dovetailed into daily life strategies. Those strategies included sitting up, getting dressed, using the bathroom and moving from one place to another. Leo had to try getting dressed while standing up – an activity he could have done sitting down, but it helped him with his balance.
Speech therapists conducted a swallow study with Leo to determine his tolerance for various food and drink. They started him on broth followed by thicker liquids, pureed then soft and gradually solid food. He also worked with pencil-and-paper games and puzzles geared to stimulate his cognitive ability.
As Leo grew stronger his beloved Eagles seemed to hitch a ride. He’d collapsed just before the next to last game of the regular season. The team won a playoff game three weeks later, a nail-biter against the Los Angeles Rams. “I come from a loud football family,” Jess said. They all watched the games at Leo’s side in the rehab hospital, careful to follow instructions -- keep their volume, and that of the TV, low.
As Leo grew stronger his beloved Eagles seemed to hitch a ride.
Meanwhile, Leo kept piling up wins. They came painstakingly. His first steps were made clinging to the arms of therapists or parallel bars and later with a single point cane. He moved on to stairs. He grew strong enough to move from his bed to a chair without any help, and his memory began to click.
Then one day, he just started speaking. Nobody recalls what he said but suddenly Leo was back. The love of music, art museums and bass guitar, all there. He’s an animal lover who also considers himself a great carpenter and fix it guy (“He isn’t,” Jess laughed). When he collapsed, he was on a break from Penn State Harrisburg, where he was studying forensic sciences, and working a job as a floral arranger for Royer’s Flowers & Gifts in Harrisburg.
Leo’s biggest day arrived when he could eat again on his own. Like any good Philly fan, he asked for a cheesesteak. With his care team’s approval, Jess bought him one drizzled in Cheese Whiz.
Two weeks before he went home, the Eagles beat the Washington Commanders in the NFC championship for a shot at the Super Bowl. Within days, Leo was walking more than 300 feet sometimes with a cane – sometimes, on a level surface, entirely on his own. He could climb and walk down 12 steps while holding a hand rail.
The day of his homecoming was announced – Friday, Feb. 7, two days before the Eagles faced the Kansas City Chiefs at Caesars Superdome in New Orleans in Super Bowl LVII. “I don’t know,” his mom joked. “They won all those games while you were here. I wouldn’t want you to jinx the team...”
“Shut up,” Leo said.
Belief
The family celebrated the Eagles’ first Lombardi trophy since 2017 and another victory too big to measure. The family joked about performing what has become a Philadelphia sports tradition for a championship – heading outdoors and climbing a telephone pole. Leo laughed - he wasn’t quite ready for that. He nicknamed his cane “Kane-drick Lamar” for Kendrick Lamar, star of the half time show
But he has been improving every day. Jess bought him a thick book of puzzles specially designed to help stroke victims improve their cognitive faculties. He breezed through it in a weekend. In May he ditched Kane-drick Lamar, anxious to get back to work. He wants to go back to school.
Leo’s short-term memory is still patchy. He can’t remember little things from day to day. He has almost no memory of his hospital stay or his time in rehab. When he could speak again, Jess says he told her remembers distinctly his family being in the room with him. He was separated from them by glass, and no matter how much he yelled, they couldn’t hear him. He can’t remember even saying that.
How far Leo’s abilities can take him isn’t quite sure. Will he eventually reach a wall he can’t scale? They’ll learn in time, but in March, they received a miraculous sign -- the best news since Leo opened his eyes for the first time weeks ago. Leo’s latest scans showed no trace of his aneurysm. He would not require radiation to remove remaining remnants.
No matter what the future holds, Jess says, the old Leo is back.
She never really believed he’d gone away, she said.