APEX — Austin Harrell went caroling with the youth group from Colonial Baptist Church in Cary on Dec. 20, and the tradition served as a kind of speech therapy for the teenager whose brain now struggles to find common words.
Austin didn’t miss a lyric as those around him sang songs such as “O Little Town of Bethlehem” and “Angels We Have Heard on High.”
“Music is something that gets kind of ingrained into your brain,” his father, Chris Harrell, said. “That was great for him.”
Austin, 18, has spent the past five months recovering from an ischemic stroke, which is sometimes called a “brain attack” because blood stops flowing to the brain.
It’s not how he planned to spend his first year out of high school.
Austin graduated from Apex High last spring with soccer on his mind. He was set to attend Liberty University, where he hoped to walk on to the men’s soccer team.
Austin was working out in his family’s backyard on July 22 when he suffered the sudden stroke.
Doctors removed the left side of Harrell’s skull in an emergency surgery. The stroke disrupted certain motor and language skills.
It may not be the Christmas any of the Harrells planned, but Austin’s improvement and modest wish list shines a positive light on all of it. He asked for sweaters and puzzles this year.
“His may seem like a simple answer, given the events of this past year,” said his mother, Susan Harrell. “But Austin knows that the true gift of Christmas has already been given to us. God gave his Son to us and he is with us all year long, not just on one special day.”
The Harrells are a Christian family. The four of them, including Margo, a freshman at Apex High, have been going to Colonial Baptist for years.
Instead of focusing on why something bad would happen to Austin, they have accepted that there are some things they’ll never know.
“(God) has a plan,” Susan Harrell said, “even though we feel like everything is in chaos, (and) we want to understand why things are the way they are.”
‘Worst day of my life’
The day of the stroke, Austin began holding his head to ease the pain. Something was clearly wrong – the teen never had migraines.
He couldn’t speak, and his right arm went limp. Those symptoms are signs of a stroke, but even now the whole thing seems unreal. Less than 1 percent of stroke victims are under the age of 20.
In a matter of about 12 hours, Austin was transported from WakeMed’s Cary campus to Raleigh and then flown to Duke University Medical Center, where he was minutes away from dying.
Austin’s brain swelled dangerously, pushing down on his brain stem.
“It was a whirlwind day,” Chris Harrell said. “It was the worst day of my life. Without a doubt.”
The doctors said they will never will know for sure what caused Austin’s stroke.
Doctors will put an artificial plate on the left side of his skull on Friday.
Austin knows what happened, said Susan Harrell. But he wasn’t clear on how much time had passed. He didn’t realize he had missed the start of college.
“Time disappeared on him,” Susan Harrell said. “It was hard to tell him that time had passed and it was now late August.”
Austin spent about four months at Atlanta’s Shepherd Center, one of the nation’s top spinal cord and brain injury rehabilitation facilities.
He was released to come home in time for Thanksgiving and a Nov. 23 wellness walk in his name that raised money for the family’s hospital expenses. Though many of the bills haven’t come in yet, the family says their two-hour stay at WakeMed in Cary fetched a pharmaceutical bill of about $17,000.
Most stroke patients who see near-full recoveries do so after 16 to 18 months.
Austin has been wearing a helmet to protect the vulnerable skull-free part where his light blonde hair has grown back over the scars.
He also needed a gait belt around his waist so someone could walk behind him and hold on in case he lost his balance.
But now his left leg works fine. Because the stroke was in the left side of his brain, the right leg is improved, but not completely healed. His right arm is also taking longer to respond to the brain’s commands.
Austin’s stroke was like a reset button for his brain’s most basic communication with the rest of his body.
He has aphasia, an interruption of how the brain processes language, and apraxia, in which a person has trouble saying words correctly and consistently.
Doctors explained it to Susan Harrell as the brain’s files that hold words and language have been scattered on the floor. They’re there, but not in the right order.
One time in the hospital, a doctor asked Austin if he was in pain. He shook his head yes, but his parents could tell he meant the opposite. When the question “pain?” was written down, he shook his head “no.”
“It’s not a matter of will to make it work or practicing, it’s really about getting the communication back,” Susan Harrell said.
The next few months are crucial.
After Austin recovers from the surgery he will undergo on Friday, he will focus on rehabilitating his right leg and right arm while still working on his speech.
Then he’ll likely go to an intensive speech therapy facility for a few months.
Little by little, Austin is coming back.
Perhaps he’s even fortunate. Many other side effects of a stroke – memory loss, personality shift, intellectual impairment – never happened.
No one is guaranteeing he will play soccer again, but there’s a chance.
“We’ve found that no one will promise you anything because they can’t really tell you,” Susan Harrell said. “Your story is so different from anyone else’s.”
The story of Austin will include that summer day when normal life functions turned into hard work. But it will also include those Christmas carols.
Things changed suddenly for the Harrells, but Christmastime feels restoring. The kid who needs an artificial skull only asked for sweaters and puzzles.
Blake: 919-460-2606; Twitter: @JMBpreps