Eden Carlson was a bouncy 23-month-old chatterbox who loved music, dancing and make-believe when a near-drowning in her family's pool in Fayetteville, Arkansas, had doctors telling her parents, Kristal and Chris Carlson, that their daughter would never walk, talk, eat or play again.
Today, less than a year and a half later, Eden has defied that grim prognosis.
"She's doing everything, all of it," her mother said last week. "All the things that the doctors said she would never do again."
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Eden's severe brain damage was apparently reversed by a treatment called hyperbaric oxygen therapy, a technique designed to enhance the body's own healing processes by placing patients in a chamber where they breathe 100 percent oxygen under increased atmospheric pressure.
During a two-month course of treatment in New Orleans, she spent 45 minutes per day, five days a week, cuddling with her mom in a hyperbaric chamber while the two watched Disney movies.
To her parents, it's a miracle. But Eden's case is also drawing attention in the medical world as the first time such a reversal of brain shrinkage has been seen.
Her treatment was overseen by Dr. Paul Harch of the LSU Health Sciences Center New Orleans School of Medicine, who is a clinical professor and director of hyperbaric medicine at LSU. His published report on Eden's treatment, written with Dr. Edward Fogarty of the University of North Dakota School of Medicine, appeared recently in the journal Medical Gas Research.
Eden's brain was severely injured, with damage to both the gray matter and the white matter. "The whole brain had shrunk," Harch said. But an MRI taken 27 days after her course of 40 treatments showed nearly complete reversal of the atrophy. What's more, her neurological function has recovered.
Nothing in medical literature showed tissue regrowth from what Harch called a "whole brain perspective," including both the gray matter — the neurons of the brain— and the connective white matter.
While Eden's case is a first, however, Harch said it is not a fluke. He had another near-drowning patient, a 15-year-old boy in 1998, who was put in a hyperbaric chamber within an hour and a half of the incident. The boy went from being medically paralyzed to awake in two days, and he returned to school a few days later, Harch said.
That case showed that a single treatment within the first hours to first day can have a dramatic effect, Harch said. There have been 42 other children with near-drownings whose hyperbaric oxygen therapy was done further out in time from their injury, but they still showed cognitive improvement and a decrease in seizures, he said.
Hyperbaric oxygen therapy was first used in the Netherlands to treat patients suffering from flesh-eating bacteria, gas gangrene and carbon monoxide poisoning, Harch said. But he said it can be used to treat wounds in any part of the body and of any duration, including the brain. He's treated dementia patients, veterans suffering from PTSD and concussion victims.
The increased pressure and oxygen turn on genes for growth and repair hormones and inhibit those that cause inflammatory response and cell death, he said.
The treatment still remains controversial, Harch said, which he blames on a misunderstanding in the medical community. He hopes that Eden's story will help provide a forum for looking at hyperbaric oxygen treatment without bias. He'll be speaking about her case and introducing his young patient next month at the International Hyperbaric Medicine Conference, to be held in New Orleans Aug. 18-20.
Harch attributes the "startling regrowth of tissue" in Eden to the fact that doctors were able to intervene early in a growing child. She was also very close to the date of her injury when treatment began, and her near-drowning was in cold water, also a factor weighing in her favor.
Initially, however, her very survival was in question.
The little girl was discovered on Feb. 29, 2016, in the backyard pool where she had been submerged for 10 to 15 minutes. Her mother immediately began CPR, which continued at Washington Regional Medical Center in Fayetteville, where emergency room doctors and nurses worked for two hours before they were able to restore a heartbeat. Eden was then airlifted to Arkansas Children's Hospital.
"That day is a blur," Kristal Carlson said. She and her husband stood in the doorway of the emergency room watching two young men take turns administering CPR. Their little girl was given 17 epinephrine shots to restart her heart. "We knew any minute they could call it, and she'd be gone," Kristal Carlson said.
But there were glimmers of hope. Eden's heart would flutter a bit, and the ER doctor who led the team told Kristal there was not a single woman in the room who didn't have a child near Eden's age.
Harch called their efforts heroic.
"We were just so grateful she survived, but very, very scared," her mother said.
No hyperbaric chamber was available where Eden lived, but Harch, who was consulted, prescribed a bridging treatment: oxygen administered through her nose for 45 minutes twice a day until she could get to New Orleans.
The Carlsons saw an immediate improvement. Eden had not been responsive to commands and was constantly squirming and shaking her head. She became more alert, stopped squirming and actually began smiling, laughing and saying words, although with a smaller vocabulary than before the accident.
Her treatment in New Orleans began 78 days after her accident, and after just 10 sessions, her mother told doctors that she was near normal except for her gross motor function. After 39 sessions, she was walking with help and had a larger vocabulary than before the accident.
Eden, who turned 3 at the end of March, has been back to New Orleans twice for a booster treatment of 10 sessions, something that her mother said they will continue to do. Every time, she has better focus and improved fine motor skills.
Eden has some residual core muscle weakness from the 13 weeks when she was in a vegetative state, her mother said, and she does physical and occupational therapy with horses and in a clinical setting.
But the youngest of their five children is back to her old self, "singing all day long," with speech and cognition that are on target for her age.
"Her old personality is completely back at this point," her mother said, noting that her daughter "was very sassy and spunky, a little wild and into everything."
She remembers her accident, her mother said: "She tells us about once a day, even now. She says, 'I fell in the pool. I was in the hospital. I'm all better now.' "
This story was altered on July 25 to reflect that a 15-year-old near-drowning victim was treated by hyperbaric oxygen therapy within and hour and a half of the incident.