She Was Nicknamed Miracle Morgan Because She Shouldn’t Have Made it
At 13 years old, Morgan Johnson had a consistent sore throat and lack of energy.
Her mother, Kris Johnson, took her to a doctor but Morgan tested negative for strep throat.
Over the following weeks, Morgan’s health continued to deteriorate. The family got an unexpected diagnosis when a CT scan revealed Morgan’s symptoms — headaches, loss of appetite and numbness in her limbs — were due to bleeding in the brain.
When we left the hospital she was nicknamed ‘Miracle Morgan’ because she shouldn’t have made it," Kris said.
“When we left the hospital she was nicknamed ‘Miracle Morgan’ because she shouldn’t have made it,” Kris said.
Bleeding in the Brain
Morgan was diagnosed in the Emergency Department at Avera McKennan Hospital & University Health Center. She had lost so much energy that she could barely walk and she was having numbness in her left side.
The doctor saw her sunken eyes and ordered a CT scan. Bleeding in the brain was detected and the emergency team quickly started assembling a team of doctors to help Morgan, including Michael Puumala, MD, a Neurosurgeon with Avera Medical Group Neurosurgery Sioux Falls.
She was taken to the Pediatrics Intensive Care Unit where the team began administering medications with the expectation that Morgan would begin improving by the morning. But later that night Morgan health’s faltered and she was given a breathing tube to help her breathe.
“Around 11:30 that morning I was with our pastor and Dr. Puumala wanted to talk to me,” Kris said. “I remember him saying, ‘The only thing I know to do is go in and take a piece of her skull out. I’ve already called the OR.’”
That’s exactly what Dr. Puumala did.
“The brain is basically in a box – a confined space. As the brain swells there’s more and more pressure, and it’s hard for the blood to get pumped up to the brain, and the result can be a stroke,” Dr. Puumala said. “If you do an operation and take a piece of skull out, it’s not a closed box anymore and it relieves the pressure.”
Because she had a blood clot, the surgical team also removed a small portion of her temporal lobe, an area of the brain that Dr. Puumala knew would not cause harm. It was sent to the University of Iowa for testing.
An Uncommon Reaction
Morgan had herpes encephalitis, a rare reaction to herpes simplex — a common virus that is in the same family as chickenpox and the virus that gives some people cold sores.
“Most of us get exposed to it as kids,” Dr. Puumala said. “Pediatrics will see little kids come in, and they have a really sore throat and are crabby and fussy. It’s their first herpes infection.
“It’s always there, and then for reasons that we don’t understand, it can cause infections elsewhere – like at the base of the brain.”
Dr. Puumala said it’s uncommon to see such a case but not unheard of — he sees maybe one patient a year with such a reaction, and Morgan’s case was uncommonly serious.
"You just hope the treatment is going to be enough. We did the surgery and she just bounced back so well."
“When you see somebody in her condition, if you don’t do something, that person is going to die fairly quickly. It’s an emergency,” he said. “You just hope the treatment is going to be enough. We did the surgery and she just bounced back so well.”
Of that time in the hospital, Kris remembers the pediatric nurses and how caring they were to her and her family and is grateful for Dr. Puumala’s quick reaction. “I bless Dr. Puumala for going in and taking that piece out.”
The day after her surgery, Morgan started feeling better and recognizing people around her. She started therapy to rebuild strength and wore a helmet to protect her head for two months, at which time the removed skull piece was put back in place.
While the family was only in the Emergency Department a short time before being taken to the ICU, Kris said the care was seamless between the two departments.
In cases where time matters, Dr. Puumala said the Avera McKennan emergency team is instrumental in assembling the right team to offer the best care.
Today, Morgan has some peripheral vision problems. She also suffers from mood swings, which Dr. Puumala said is likely a long-term effect of the infection in her brain, not from removing part of her temporal lobe.
A junior in high school, Morgan has resumed her regular activities, including fast-pitch softball.
But she knows that the outcome could have been worse. When Morgan gets down, her mother relies on the family’s faith.
“I tell her, ‘Listen, there’s a reason you’re here, because you shouldn’t have made it.’ So, you have to think about it that way.”