Healing the Caregiver: Betty Cotton is a Survivor

At first glance, you would never know Betty Cotton had a sick day in her life. Cotton, a vivacious and giving personality, spends her days caring for people with developmental disabilities at her business, the World of Joy and Caring group home.

On August 22, 2018, when a ruptured brain aneurysm threatened her life, it was time for family, friends and the team at UF Health Jacksonville to take care of Cotton.

Fortunately for her, the multidisciplinary team at UF Health Jacksonville use a comprehensive approach to collaborate on every problem-solving angle. She was in good hands.

On the morning of the aneurysm, Cotton was at her brother’s house when she noticed her vision was getting dark and blurry.

“I told my niece to call 911,” Cotton said.

As one of seven siblings who grew up in the north Jacksonville neighborhood, many of Cotton’s family members still live on the same street. In a matter of minutes, everyone showed up to support her, along with the rescue unit and ambulance.

Cotton was rushed to the UF Health Jacksonville emergency room, where staff discovered she was suffering from a subarachnoid hemorrhage caused by a ruptured aneurysm.

All ruptured aneurysms are high-risk with 50% of patients not surviving the hemorrhage. Of those who do, only half may return to a normal life.

Before moving to the Interventional Radiology suite to perform surgery, the emergency room team completed a CT scan and an angiogram to map out the vessels in her brain using x-rays and dye.

“When the blood vessel wall is weak, it pushes out like a balloon,” explained UF Health neurosurgeon Grzegorz Brzezicki, MD. “This can cause it to rupture and spill blood around the brain. This was what Betty came to the hospital with.”

Dr. Brzezicki is highly regarded at the UF Health Skull Base Center as being one of the best in his field. He explained how the hemorrhage caused further complications, blocking and backing up spinal fluid in Cotton’s head.

Interventional Radiology staff worked quickly to perform a ventriculostomy, creating a hole in her skull and inserting a catheter to drain the bloody liquid before the condition, known as hydrocephalus, could cause brain damage.

They couldn’t celebrate yet. The road to recovery would be long.

“We got the aneurysm, but that was just the beginning,” said Brezezicki explaining that most of the bleeding from the hemorrhage happens outside of the brain where the normal blood vessels are.

The veins around the brain respond to that bleeding by spasming, which brings a risk of stroke. This can happen five to seven days later, which meant Cotton needed to be closely monitored in the Intensive Care Unit.

After two weeks, Cotton successfully made it out of the danger zone, but faced yet another challenge: taking the drain out.

“Many patients require a shunt to accommodate high pressure in the head,” Brzezicki said. “The problem was the pressure in her head was very low, so it required a special valve. It was a shunt, but we had to modify it.”

This was no easy task. It took a couple of tries to get right, but ultimately, they were successful in saving Cotton’s life.

Cotton was in the hospital for 11 weeks. Throughout all of the challenges, her faith never wavered. Multiple people visited Cotton every day, including family, friends and the residents from her group home. Brzezicki believes this support played a role in her recovery.

“She had a really nice recovery,” said Brzezicki. “Every time I saw her, she was always smiling. Despite facing challenges throughout the treatment, she kept a positive attitude.”

Cotton recalled that her room was filled with balloons from her daily visitors. She showed her generous spirit by sharing them with staff and other patients to brighten their day.

“I had so many balloons. They started calling me the balloon lady.” she laughed at the memory.

When asked if anything changed following the surgery, Cotton’s daughters joked that she now drives faster. But in truth, they are grateful things were not worse. The odds of her developing a mental or physical disability were high, but Cotton had a full and successful recovery.

Cotton is forever grateful to Dr. Brzezicki and the staff at UF Health Jacksonville for saving her life.

“The whole staff. Every shift of people.” Cotton said. “They were so good. I really want them to know that.”

The 63-year-old still has a youthful energy and passion to help others. Alongside her daughters, they continue to supervise and offer personal support around the clock for the adults who live in the home and provide assisted living services off campus for more independent residents. They are like family to Betty.

“That’s why God had to keep me here,” Cotton smiled. “I’ve got to take care of my people, honey.