Steve Mellon, Post-Gazette
Jim Lowers holds grandson Jayden Matthew Antill in a waiting room at the intensive care unit at Allegheny General Hospital on Wednesday. Jayden's mother -- Jim Lowers' daughter, Jenet -- died Thursday night after being in a coma caused by a December car crash.
As 17-day-old Jayden Matthew Antill grows up, his grandparents will tell him about his mother's life.
Jenet Lowers, 19, died Thursday night at Allegheny General Hospital. The cause of death was listed as "anoxic brain injury and cardiopulmonary arrest," meaning her brain had been deprived of oxygen and her heart and lungs stopped functioning.
The stark terminology doesn't reveal the glimmers of hope and the grim setbacks her family experienced in the six months after she was severely injured in a car accident.
Her dad, James Lowers, gave her the unusual name of Jenet by replacing the "a" in his sister's name with an "e." When she was born in St. Petersburg, Fla., on July 27, 1987, she weighed 4 pounds, 3 ounces. He will always be amazed by how small she was.
Since that day, he has been wrapped tightly around Jenet's finger. When Mr. Lowers and his daughter's birth mother split up, he took custody of the 2-year-old. A year later, he married Tina Lowers, who became mom to the little girl, her "sidekick."
Jenet was a good kid who loved school and stayed out of trouble, her parents said. She was in ninth grade before she came close to sassing them. She played softball (mostly right field, sometimes catcher) from fourth to 12th grade, ran track and was a cheerleader.
The pretty, dark-haired young woman with the bright smile was voted prom queen and dubbed "Most Gullible" in the yearbook. She graduated from high school in 2005 with 63 other students in Cameron, W.Va., where the Lowers family had lived for the past decade. The town, with a population of about 1,200, is in the northern panhandle.
Jenet always was on the go, talked a mile a minute, loved the phone and country music. Last fall, she began attending West Virginia Northern Community College in Wheeling, with the intention of following in an aunt's footsteps to become a pediatric nurse.
"She always did very well with children," her dad said. "She loved kids."
So Jenet was ecstatic when she became pregnant. Jeremy Antill, with whom she lived in Cameron, gave her an engagement ring around Thanksgiving and they planned to get married in the spring, a couple of months before their baby's due date of July 16. Jenet soon had a wedding dress and chose her bridesmaids.
Her fiance took pictures of her holding up her shirt to show off her pregnant belly.
"It was just a wee little pouch," Mrs. Lowers said, laughing. "But she's got that big old smile and she's glowing. They were really happy."
All that changed on a sunny, warm Saturday morning two days before Christmas.
Jenet, more than 10 weeks pregnant, had driven about a third of the way to her job at Starbucks when her 1998 Chevy Malibu, a four-door sedan, went off the road as she rounded a curve. Nobody knows for certain what happened.
"A deer could have jumped out in front of her, she could have been talking on the phone, or playing with her radio dial," Mr. Lowers said. "A million things could have gone wrong."
The Chevy landed below the road in a field and, perhaps during her attempt to drive out again, the car slid into a tree. The roadway had a speed limit of 50 mph, and investigators estimated that Jenet was going between 45 and 70 mph.
A few minutes later, Jenet's friends spotted her car as they drove past, and they called for help. Within a half-hour, she was flown by medical helicopter to a Wheeling hospital.
Mrs. Lowers had just had her hair done and was driving home when her mother called to tell her that Jenet was in a bad car accident.
"And I flipped," she said. "I was crying when I called him. I think I was screaming."
"Calm down, I can't understand you," Mr. Lowers said again and again when his wife tried to tell him the news. The contractor was in Akron, finishing a job that he'd expected would take another month. He grabbed some clothes and drove to Wheeling.
"When we got there, she was still in surgery," he said. Among other injuries, "she broke five ribs, her collarbone, pulled the muscles on her jaw, cracked her cheekbone up around her eyeball and her eye socket, [and] severed her spleen."
Severe brain injury
The Wheeling doctors stabilized Jenet, but her brain injury was so severe the Lowerses were told to find her a nursing home. Instead, at the end of January, they moved their daughter to Allegheny General Hospital's intensive care unit.
According to neurologist Dr. James Valeriano, director of the hospital's comprehensive epilepsy service, the young woman sustained what's called diffuse axonal injury.
"It's a shearing type injury," he explained. "Your head gets rocked back and forth quickly [and] you actually tear nerve fibers in the brain. It's a very common head trauma injury and it can be very devastating."
Without proper signals within the brain and from the brain to the body, cognition and movement are significantly impaired. All of Jenet's limbs were spastic, or stiff. Her legs stayed extended, and her arms pulled against her chest. She occasionally opened her eyes.
After a few weeks, she was moved to the Children's Institute for rehabilitation. But a few days later, she vomited and had to return to Allegheny General to be checked for aspiration. Another transfer to the rehab center was cut short when she developed pneumonia.
The inconsistency was at times frustrating, her father said, "just like we're taking one step forward and five steps backward." And even when she could stay at the institute for longer periods, her rehabilitation was limited by her pregnancy, which was progressing without a hitch.
When she was about six months along, Jenet went back to Allegheny General so that specialists from many disciplines, including obstetrics, nutrition and neonatology, could keep a close eye on her and her baby. They held weekly 90-minute meetings to share information and concerns.
It was the end of March, and "she was in a persistent vegetative state, not responsive," said perinatologist Dr. Steven Golde.
If the baby had been born then, at 24 weeks gestation, survival chances were about 50-50, he noted. And, the risk of neurological damage in such a premature infant likely exceeds 80 percent. So unless Jenet got worse, her baby would be delivered by Caesarean section closer to full term, probably at 36 weeks.
Unused to treating such a critically ill patient, the obstetrical nurses learned from their intensive care peers how to manage Jenet's tracheostomy, feeding tube and other needs.
She was infected with two hard-to-treat bacteria, methicillin-resistant Staphylococcus aureus and Clostridium difficile, so isolation precautions were used to prevent spread to the rest of the ward. Sometimes, she had "autonomic storms," a complication of brain injury in which she'd sweat profusely and her blood pressure soared.
Despite all that, her father, who stayed at the hospital round-the-clock to help care for his daughter, and the medical staff began to see indications that Jenet was regaining some neurological function.
"You can ask a question and tell her to blink and she would," Mr. Lowers said. "She would hold your hand."
Said Dr. Golde in May, "I thought as late as two or three weeks ago that we were going to have her just persist in this vegetative state. Since that time ... she has responded to verbal commands, she makes eye contact, she seems to track individuals, and I think she's starting to wake up. I think Dad's observations were spot on."
Mr. Lowers' optimism ran high. He was determined to have Jenet in rehab after the baby was born, convinced that one day she would be able to walk and talk with him again.
"She's going to come out of this one way or another and I'm not going to give up until she does," he said. "Whatever I've got to do to get her out of it, that's what I'm going to do."
Not that Mr. Lowers didn't endure some bleak moments. Then he'd try to leave behind his frustration and fear by walking from Allegheny General to the waterfront near the North Shore stadiums and through Downtown.
His dedication to his daughter was apparent to all. He learned how to get her rigid limbs into splints for proper positioning. He'd take her outside in a wheelchair and talk to her for hours. When she was in intensive care, he snoozed in the waiting room. If she was in a regular room, he stayed on the pull-out couch.
Seventeen days ago, he was asleep in the bed next to Jenet's when a nurse came in at 11:30 p.m. to administer her medicines and found her in the throes of a seizure. Within an hour, the medical staff decided the baby, at a bit more than 34 weeks, would have to be delivered immediately.
Mr. Lowers described the scene: "They're taking all her IV bags and food bags, throwing them on the bed, kicking the brake off and running down the hallway. I'm like, 'Huh?' I wasn't even awake yet."
Jayden Matthew was born at 1:30 a.m. on June 7. He weighed 4 pounds, 13 ounces, and measured 18.5 inches long. "We knew it was a boy the week before the accident," Mrs. Lowers said. "Jenet already had the name picked out."
The baby was monitored in the neonatal intensive care unit, in part to help him recover from the narcotic medications his mother needed while she was pregnant. Because of the staph infection, he could not be taken to her room and then returned to the nursery. Instead, his grandfather taped photos of him to the sides of Jenet's bed.
"She'll stare at it when her eyes are open," Mr. Lowers said soon after Jayden was born. "Having this baby is going to help bring her out of this coma."
The final hours
Plans to have Jenet transferred to a rehab center from the hospital began to take shape. Fiance Jeremy, who was at her side whenever he wasn't working, got ready to take their son home to Cameron, with orders from Mr. Lowers to bring Jayden to see his mother every weekend. But, at around 4:30 a.m. this past Tuesday, a nurse discovered that Jenet had stopped breathing and had no pulse. Mr. Lowers woke up at the same time.
"I jumped out of the chair and looked at Jenet and she was solid white," he said. "They called the crash cart or whatever. Next thing I know, there's tons of people running in the room, and they kicked me out."
An hour earlier, when a blood sample was taken, she was fine. An hour later, Jenet had been resuscitated and was in the intensive care unit, where doctors struggled to control seizures that continued unabated despite multiple medications. They stopped on Wednesday.
Neither heart nor lung problems appeared to precipitate her cardiac arrest, but the abnormal brain activity could have, said critical care specialist Dr. Raj Adurty. "The type of seizures she had is very poor prognosis as far as any kind of neurological recovery," he said. "She will not be able to do any kind of movement or any kind of activity after this."
"It's the worst it could get," a devastated Mr. Lowers said that night. "I've accepted the fact that there is no hope."
On Wednesday, Jayden went home to Cameron. It was his father's birthday, made bittersweet by the gift of his newborn son and the loss of his fiancee.
Mr. Lowers, who hasn't worked since his daughter's accident, was making arrangements to have a service for Jenet in Cameron, followed by burial in Akron next to his parents. His mother died of cancer a month ago. For now, he will try to help Jayden's dad get comfortable with caring for a baby.
"Then I'm not exactly sure what I'm going to do," Mr. Lowers said. "I'm just kind of lost right now."
Jenet never got to hold Jayden before her death, but her father knows that she will be watching over him for the rest of his life.
"She would have been a great mother to him," he said. "She wanted to hang on long enough to make sure he was OK. She just didn't have no more fight left in her."Steve Mellon, Post-Gazette
Jeremy Antill, left, holds son Jayden Matthew Antill while the baby's grandfather, Jim Lowers, caresses his hand. Mr. Antill and Jenet Lowers had planned to get married this spring.
Click photo for larger image.
Anita Srikameswaran can be reached at firstname.lastname@example.org or 412-263-3858.