Courtney Jean Nash

Courtney's Story

Courtney was a sixteen year old girl who was a beautiful social butterfly. She made friends of all ages from babies to senior citizens.  I would like to share a few things about her that made her who she was.  In elementary school she would help the handicap children with horse therapy, and when she was not doing that she would paint the young girls fingernails or brush their hair or just hang out and talk with them. (Some of the kids were paralyzed from the neck down).  She did this for two years.  When my husband’s father was dying from cancer the last weeks of his life, she would stay home from school to help care for him.  She was only 13 then.  Her fun nights on the week-end were playing board games with her friends and their families.  When we would go to the mall she would tap me on the shoulder and say look mom, see how cute he is.  It would be this elderly man just walking.  She was just an ordinary 16 year old girl, with just everyday growing up problems.  But she didn’t think of only herself.   She was kind, giving, always wanting to lend a hand, giving you the biggest hugs and she had the most precious smile. It made her happy to see others happy.  This special girl was not ashamed to post her info on face book the 3 most important things in her life.  That God was #1 in her life followed by her family and friends. Courtney was ahead of her time.  She already at 16 knew she wanted to be an OB/GYN Physician.  She even had her children’s names picked out.

Here is the medical history that took place.

On August 3rd and 4th Courtney went swimming in the St Johns River with her brother and 3 other friends.  On Friday August 5th she received her driver’s license.  While doing this she reconfirmed the organ donor status she had established when she was 14 years old. On Monday August 8 she registered for school.  Also, on Monday she went online to confirm her donor status was up to date. Late Monday night she started to have a headache.  Tuesday when I arrived home from work, I notice that she was not doing any better, and the headaches were unbearable. Courtney told me that she vomited 20 times so I decided to take her to the ER.  The ER did some blood work, gave her something for the pain, 500 ml’s of saline IV and Rocephine.  The doctor did mention the idea of doing a spinal tap and CT scan but felt it would be a terrible expense since the family didn’t have insurance.  He also advised me that he had seen 6-7 patients that week with the same symptoms as Courtney and they were all negative and he felt she had just a bad case of the flu.  Courtney was then sent home.  The doctor advised me that if she was not better by the next afternoon to bring her back into the ER.

During the night I fought to control Courtney’s temperature.  In just a few hours it had now spiked up to 104.00.  At this time I knew something was terribly wrong. I called my mom Judy, to come and look at Courtney.  Judy wore a mask because we had been concerned about Meningitis. 

I called my brother-in-law Tom (District Fire Chief /Paramedic) around 08:30 AM concerned about an intermittent rash that Courtney had developed.   I told him that Courtney’s fever had increased to 103.5.  He advised me that he would immediately drive over to the house and look at her.

When Tom arrived at the house Courtney was lying in my bed.  She had a fever, a rash on her back and a severe headache.  She was responding to verbal stimuli appropriately.  We immediately loaded her into Tom’s truck and rushed her to Arnold Palmer Hospital in Orlando, Fl.

Upon arrival at Arnold Palmer Hospital I informed them that I thought she might have meningitis.  They immediately took Courtney back placing a mask on her fearing Meningitis.  Within 2 hours the doctors were performing a spinal tap.  When the spinal fluid came out it was cloudy meaning that there was some kind of infection.  A short time later the ER doctor brought us into a conference room.  The doctor advised us that the lab came back with a report that she was infected with amoebas.

Dr. Laham the infectious disease specialist came to talk to us.  He advised us that he had been in the lab when the sample of spinal fluid came in.  He confirmed, through the microscope himself, that it was an amoeba.  He told us that he had already been in contact with the CDC (Center for Disease Control) and several experts around the nation.  They were formulating a plan of attack and still contacting more experts.  Courtney was then transferred to the Pediatric Intensive Care Unit.

Upon arrival in the PICU we were counseled by the ICU staff and the intensivist specialty doctor.  They advised us they were going to concentrate primarily on Courtney’s airway and temperature.  The staff was also going to start the medication regiment that the infectious disease doctor had ordered.

During the night she started to develop some airway problems and Courtney was intubated with a breathing tube.  This wasn’t completely unexpected as the intensivist had warned us that if she developed gag reflex problems she would probably develop airway management issues. 

On Thursday the infectious disease doctor continued to continuously research sources for advice on how to treat this ailment.  Courtney’s fever still was a problem and it was obvious that she was developing a problem with intracranial pressure.  Into the evening it was obvious that her intracranial pressure was increasing.  During the night a neurosurgeon placed a drain in Courtney’s head because of intracranial pressure.

On Friday the infectious disease doctor advised us that they had exhausted the CDC’s knowledge base and that he was now trying experimental treatments. The Doctors at Arnold Palmer were not going to give up on Courtney.  When their shifts were done and they were supposed to go home, the Specialists took their own personal time to go to the library and the computers to research and find a way to help Courtney. One of the medications was a fungicide and the last ditch was a medication that might cause damage to the regular human tissue also.

On Saturday I was advised by the doctors that they didn’t see any brain activity.  They had already scheduled an EEG and brain perfusion study to confirm this finding.  At 16:30 brain death was declared. 

During the day Trans-life organ transplant team had been in contact with me.  The final outcome of the organ donation was that 4 people’s lives were saved.  One person received both lungs.  Another person received the right kidney. The third received the liver. The final patient received the left kidney and pancreas.  Because of Courtney‘s generosity these people have a second chance at life.  Unfortunately due to the medications that she was given her heart couldn’t be used.

We also would like to thank the Doctors, nurses and staff for the exhausted efforts they took to try and save Courtney. Arnold Palmer Hospital is a teaching hospital. I can say that everyone involved with her case was truly touched and went beyond just a Dr. - Patient relationship. The Doctors also are putting together a task force to try and combat this horrible type of meningitis caused by an innocent day of swimming.

 After searching the internet about amoeba’s I had read a case about a nine year old boy in Virginia where he was first diagnosis with meningitis.  After seeing Courtney’s story on the news/internet an autopsy was performed and it was discover he too had the Naegleria Fowleri Amoeba Parasites.

It is our hope that through  telling  Courtney’s story that people realize

 1).Any body of water fresh or brackish that reaches a temperature of 80 degrees Fahrenheit or more is a potential hazard. 

2). Funds are needed for additional research to try to find a cure and create awareness to prevent this from happening to anyone else.

 3).Physicians will be more aware to accurately and rapidly diagnosis’ this killing parasite.

 4). Also so other lives might be saved through organ donation.

Amoeba Awareness and related stories:
http://www.courtneynashamoebaawarenessfoundation.com/
 https://www.facebook.com/#!/RespectOutdoorsTV
http://www.translife.org
http://www.brevardtimes.com
http://www.gofundme.com
http://www.swimabovewater.org

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