- Associated Press - Sunday, December 6, 2015

GALVESTON, Texas (AP) - On the morning her life forever changed, Sarah Hrachovina Coreas said goodbye to her husband and left for work.

She was headed along 61st Street toward the Interstate 45 overpass at about 7 a.m. when the driver of a Range Rover plowed into her car. The driver was drunk and fled from the police before being found hiding nearby. The impact mangled the young mother’s car, leaving her severely injured.

Five years on, at 24, she’s one of the youngest - if not the youngest - residents at The Meridian, a nursing home and assisted living center on Seawall Boulevard in Galveston.

From the confines of intensive care units, hospital rooms and a brightly painted room in The Meridian, her family has watched her ward off pneumonia, kidney stones and blazing fevers.

They spend hours each week trying to re-establish normalcy by preserving the sense of humor that helped create their earliest family memories.

And despite a bleak prognosis from her doctor, her parents, Aaron and Teresa Hrachovina, are optimistic that a miracle is on the horizon.

“It’s not that I don’t believe medically what the doctors say is true, but I think at some point God steps in,” Aaron Hrachovina told the Galveston County Daily News (https://bit.ly/1IpRgfR).

Coreas can’t walk or sit up on her own. She has a feeding tube and a tracheostomy to help her breath. She weighs 92 pounds. Perhaps the most devastating part is she can’t talk, her mother said.

She spends most of her time in her room at The Meridian. But on holidays like today she joins her family at its home on Crockett Boulevard.

Traumatic brain injury is a complex condition and researchers said it’s nearly impossible to predict whether the wires that dictate speech and motor functions will re-connect in the right way.

It’s also difficult to know how much a person in a semiconscious state is taking in or their ability to understand what’s happening around them, researchers said.

About 2.5 million people sustained traumatic brain injuries in 2010, according to the U.S. Centers for Disease Control and Prevention. Injuries ranged from mild to severe, and added up to nearly $77 billion in medical costs.

The most common causes for brain injuries were car accidents, firearms and falls, the agency reported. Most of those traumas are considered mild, but of those that resulted in hospital stays or a coma nearly half of the people had a related disability a year later, according to the agency.

While brain injuries open a world of uncertainty, one thing is clear: The emotional toll of such injuries extends to all aspects of this family’s life, her parents said.

Coreas’ situation is perhaps less common than most. Being so young, the injury pushed her parents into a role that children typically fill as their parents age.

But anyone who’s watched advanced Alzheimer’s disease steal a husband’s personality or had a bedside view to an ailing mother so fragile a simple cold could become a death sentence understands the emotional roller coaster disease and trauma create.

“I never know when I’m going to get a call that she’s in the hospital again - it’s constant anxiety,” Teresa Hrachovina said.

“People will tell me at least you still have her; at least she’s above ground. Above ground is definitely better . but I want her back.”

On Oct. 18, 2010, emergency responders rushed Coreas to the University of Texas Medical Branch emergency room. She’d died for several minutes at the site of the car crash, Aaron Hrachovina said.

She stayed in an induced coma for nearly five weeks and in the intensive care unit for three months. She lived in a couple of different nursing homes before settling into The Meridian three years ago.

Periodically, urgent medical problems - issues with her breathing tube or fevers - thrust her back to the hospital’s intensive care unit.

After the accident, the driver, Omar Santana Ortiz, was sentenced to 10 years community service and more than $800,000 restitution to defray Coreas’ medical costs and help her husband support their daughter.

But when Ortiz failed to pay on the restitution, he wound up back in court and in April was sentenced to 10 years in prison.

The Hrachovinas said they’ve forgiven Ortiz, as their Christian faith teaches them. Although they admit that forgiveness can be difficult at times.

It’s unknown the full extent of Coreas’ sentence.

Her doctor told the family that if Coreas hadn’t made more recovery within three years, she would likely remain in a vegetative, nonverbal state.

Her family sees hope in the kind of things people unacquainted with brain injury might take for granted.

When she smiles at a funny video or after her father tells a story, for example. When her face lights up because her husband or daughter arrive for a visit. She recently made noises - what might have been the start of a laugh.

“That was a huge sign of improvement,” Aaron Hrachovina said.

Because Coreas can’t speak, the family looks for nonverbal cues such as emotion and movement of her big, brown eyes to guess what she’s thinking, her father said.

Dr. Brent Masel, a neurologist and National Medical Director for the Brain Injury Association of America, said the brain is such a complex organ that drawing any kind of timeline for potential recovery is nearly impossible.

“The old expression is: ‘If you’ve seen one brain injury, you’ve seen one brain injury,’” Masel, who is also the president and medical director of the Transitional Learning Center in Galveston, said.

Masel has not seen Coreas as a patient.

Axons carry messages back and forth throughout the brain and allow people to control their motions, he said. Recovery is largely about reconnecting those axons.

Researchers once believed there was a specific part of a brain that controlled our thought processes, he said. But of late, scientists have learned that the “wiring process” is more complex, he said.

He compared it to airline flights: Instead of a one-way direct flight from Los Angeles to New York to repair cognitive and motor abilities, it’s more like a series of connections and layovers.

“They can rewire, but not always the way we want them to,” he said.

The unanswered question is what causes those axons to re-connect, he said.

Regardless, the most tragic part of brain injury is that it’s nearly impossible for the brain to recover back to its pre-injury state, he said.

“Life is never the same,” Masel said. “It’s defined by the date of that accident for the person, the family members, spouses, everyone involved.”

The nursing home stay costs about $3,000 a month, not including any hospital visits or doctor appointments, which social security helps to pay for, Teresa Hrachovina said.

The crash and Coreas’ injury plunged the family on an emotional roller coaster, Teresa Hrachovina said.

“It’s been a long five years,” she said.

As the youngest of four kids, Coreas has plenty of people to watch over her.

Her family makes several trips a week to her home, where they watch their favorite television shows together and try to break up what they assume are many hours of boredom and monotony.

Teresa Hrachovina even left her job at Ball High School to dedicate more time to her daughter.

“Sarah is my main priority now,” she said. “I miss the check, but she’s far more important.”

Coreas’ husband, Edwin Coreas, also visits the nursing home several times a week, Teresa Hrachovina said. Edwin Coreas chose not to speak with The Daily News. The two met in junior high at Odyssey Academy and started dating while at Ball High School. They wed in 2009.

“It’s hard for him to talk about it,” Teresa Hrachovina said.

On a recent November afternoon in the Hrachovina’s home on Crockett Boulevard, Coreas’ daughter, Naomi, now 6 years old, was bursting with energy.

As many kids her age would respond, Naomi sometimes rebels at the notion of making a trip to the nursing home. Other days, she pleads to see her mom.

Coreas, described by her family as deeply driven, graduated from Ball High School a semester early in order to enroll at Galveston College to get a pharmacy technician certificate.

She planned to attend school to become a certified public accountant like two of her older siblings.

Arica Angelo, Sarah’s eldest sister who lives in California, stayed with her parents in Galveston for several months earlier this year to help around the house and spend time with her youngest sister and Naomi.

While in town, Angelo and her mother went to a Cinco de Mayo celebration at Naomi’s school.

Teresa Hrachovina recalled something Angelo told her: “She said, ‘We’re getting to enjoy (watching Naomi grow up), but Sarah is missing everything.’”


Information from: The Galveston County Daily News, https://www.galvnews.com

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