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It's a tribute to her spirit that she can laugh at her problems and look forward to helping others

Sunday, June 09, 2002

Text and photos by Matt Freed, Post-Gazette Photographer

Just ask Karen Herman what happened to her, and be prepared.

	Karen Herman holds a studio photograph of herself taken a week before she became ill with bacterial meningitis in May 1998. Within days, three of her limbs and the fingers on her remaining hand had to be amputated. "I still automatically think, 'OK, I've got to paint my nails, my toenails. It still bugs me when I shop. I still look at shoes." (Matt Freed, Post-Gazette photos)

Like the time an older woman walked up to her in a hospital waiting room. With little feeling, the woman blurted out "Oh, honey, what happened to you?"

Herman thought to herself, "You've got a lot of nerve to say that." Then, "I told her 'Well, I was in Vietnam, and I stepped on a land mine,'" Herman says, breaking into laughter.

She has several explanations saved up:

"Sometimes I'll say I was washing clothes down in my basement when the house caught on fire. I was kind of lightheaded, and I passed out. [Then] the house fell on top of me."

And her latest?

"I was crocodile hunting. That's my new one."

A good sense of humor is partly how Herman, 48, of South Fayette copes with her new life. A life minus both legs, a right arm and the fingers of her left hand, the result of bacterial meningitis.

More than just a cold

It began on the morning of May 11, 1998, when Herman felt a cold coming on shortly after arriving at her job as a loan collector in the US Airways Federal Credit Union.

"I started feeling cold -- like ridiculously cold. I went to my boss, and she said I'd better go home."

Herman, who is divorced, heeded that advice and returned to the Carnegie home she shared with her children, Lindsay, now 18, and Marty, 20. She went right to bed, but awoke the next day even sicker.

"My left leg was dragging. I went to grab my ankles, and they had black spots all over them and on my arm. I got pretty scared, and I couldn't even walk. So I called the ambulance."

"I was scared," she repeated.

Herman was taken to St. Clair Hospital that morning, then transferred to Mercy Hospital, where the trauma team took over. She slipped into a coma shortly after arriving, and her fever spiked to 109.5 degrees.

Herman was diagnosed with meningococcal meningitis, a rare disease that can prove deadly within a few hours.

Spread by the Neisseria meningitidis bacteria, the disease is transmitted by carriers -- who often do not get ill -- through direct contact with nose or throat secretions.

There have been seven reported cases in Allegheny County through mid-May this year, said Dave Zazac of the Allegheny County Health Department, with victims ranging from a 4-month-old to a 91-year-old. And while there have been no fatalities this year, approximately 10 percent of cases result in death.

Knowing she had never shared eating utensils or even a cigarette with anyone, Herman and her doctors believe she came in contact with the disease from turning to say "Bless you" to a young man in line at a shopping center. Since she was suffering from a sinus infection at the time, her doctors believe her immune system was low, and as she turned to the young man, she may have come in contact with airborne matter.

As Herman lay in a coma with a dangerously high fever, doctors told the family the only way to save her life was to amputate her legs. And even with amputation, she had only a 30 percent chance of surviving.

"I was traveling" for work, said Herman's brother, Denny Marchetti of Nevillewood. "I was in New Jersey and got a call from the doctor. He said if we don't amputate, gangrene will set in, and she's going to die."

Within a few hours, Marchetti had made countless phone calls between family members about his sister's condition. Marchetti, the older of Herman's two brothers, had power-of-attorney and knew the final decision rested on his shoulders.

Marchetti made the decision for doctors to amputate his sister's legs. Less than a week later, doctors had to amputate her right arm and the fingers on her left hand.

"That was traumatic. I thought, 'She's not going to have anything left,'" said Marchetti.

He especially remembers the first time he visited his sister at the burn unit at Mercy.

"I saw this woman who looked like an elderly black woman. It was my sister. All of her limbs were black and swollen. I almost fell down."

The family soon decided to make funeral plans.

"I said 'Mom, you've got to prepare yourself that Karen's going to die.' We talked about it at length. We talked about having her casket closed. We wanted to remember Karen how she was," said Marchetti.

Adding to his worries was how his sister would react if she survived. Would she be angry about the decisions he made? Doctors also warned that she might be left deaf, or possibly mentally unstable.

The deciding factor, Marchetti says, was that "I kind of knew in my heart she'd want to live."

Herman was brought back to life twice on the operating table. She lost partial hearing in her right ear from the high temperature, but her other functions were stable.

It took nearly six weeks before she woke up. Her first memory is of family members, wearing hospital garb, gathered around her bed.

"My brother [Denny] recalls me looking at him and looking down [at my body]. He said, 'I know, Karen. Just don't worry about it. Let's just get you better first.'"

At that point, she knew her limbs had been amputated, but she was too sick to care. It was only after coming off morphine that reality hit.

"Oh my God," Herman thought to herself. "What happened to me?"

Marchetti's worries were put to rest, however, once doctors removed the ventilator six weeks later.

"She said she was so happy I did it. I started to cry."

Recovery

By September 1998, Herman was healthy enough to be transferred to Healthsouth Harmarville Rehabilitation Hospital. She had to relearn everything. The staff made an adapter for her right arm so she could brush her teeth.

"It was so hard. I was crying," she recalls.

	Herman stands on prosthetic legs for the first time with help from physical therapist assistant Bob Brunn and prosthetist Judy Wagner. "I felt tall. I felt real tall," Herman said when reminded of the moment. "It just felt real good to be standing again. I took six steps for the first time. It was hard, but I did it." (Matt Freed, Post-Gazette)

Rehabilitation was a slow process. She learned to eat using a prosthetic arm. She learned to apply makeup again. Staff members agreed to help her smoke -- something she has steadfastly refused to give up.

Herman's children had moved in with their father during this time, but they visited their mother often. Months later, fueled by constant visits from her family, especially Lindsay and Marty, Herman was ready to move on.

In March 1999, she moved to Sunrise Assisted Living in Green Tree. By October of the following year, she was ready for the next stage of her recovery: a set of artificial legs.

Doctors had advised against using prosthetic legs because the stumps that remained after her amputation were so small. Herman didn't like the idea of being told what she could or couldn't do.

"It made me feel good that I made the judgment call. At least I tried. If I couldn't do it -- fine."

After such a long time lying in a bed, most amputee patients feel dizzy and lightheaded when they stand for the first time.

Not Herman.

She spent most of her rehabilitation time in a gym walking back and forth. When Lindsay and Marty weren't there, "I just visualized my kids being at the other end of the mat. It gave me more incentive to walk."

Herman will never be able to walk more than a few feet without being tired from the weight of the legs.

"But, if I want to get up now and stand for a while, I can do that."

Rough days

Herman, always upbeat before her illness, had a rough time adjusting to her life, especially when she first arrived at Harmarville.

"It was scary because I was away from home. It was hard being away for the holidays. ... I was down. But I'd ride the hall and realize these people hadn't been home either, and I'd make the best of it."

It wasn't until a 30-year-old woman came in who had been in an automobile accident that her attitude really turned around.

"You see other people worse off than me. I'm a bad-case scenario. But she was a vegetable, and she ended up dying. That killed me. I looked at her and thought, 'She can't even say 'Hi' to her kids -- to tell them 'I love you.' When she died, I really took that to heart. It could be a lot worse."

Herman found herself in other wings of the hospital, cheering up other recent amputees. "I would always go down to the spinal cord unit. Paraplegics. Quadriplegics. I always talked to them. We had laughs. We cried together. I would hang out with the 18- and 19-year-olds. They probably missed home, and I was like their big mom. It made me feel good to be with them."

Yearning for independence

Herman knew Sunrise Assisted Living was just a steppingstone to the next phase of her life. She lived on the Alzheimer's unit for eight months before moving to another section. She was the youngest resident. It was there she met Stew Rood, a 55-year-old man with multiple sclerosis.

	Herman learned to apply makeup with a prosthetic hand , a skill she used while living at Sunrise Assisted Living in Green Tree in March 1999. (Matt Freed, Post-Gazette)

The two became close friends, and both yearned to live independently. They are just good friends, Herman stresses, even though when they're in public, it's assumed they're married.

"We'll be out shopping and hear an older couple say, 'Oh, look at that couple, what a shame. They must have been in a car accident,'" Herman leans in. "Yeah, one hell of a car wreck," she says, laughing.

The two realized their dream by November 2000 in a five-bedroom, three-story Victorian home in South Fayette. With the help of five caretakers, friends and family, the two live comfortably in their new home. Except for the handicapped ramp in the front entrance and an elevator in the living room, it looks like any normal household.

When they first moved in, there was live-in help for both Herman and Rood, who has no control over his limbs. Today, helpers come and go as needed.

In addition to Social Security disability, her former co-workers at US Airways Federal Credit Union have held several benefits on her behalf to help defray their expenses. In addition, Rood is able to help support them with his own disability and pension.

"I was just so happy to be in a house," Herman says. "I thought 'OK now, this is another chapter in my life, and I'm just going to go forward from here on.' It felt good. I felt reborn."

Out and about

Herman still worried about how people would react to her appearance. She remembers the first time she ventured out, for her daughter's high school dance recital.

"My kid's friends came up to me and gave me a hug and kiss. That meant everything to me," she says.

Before the accident, Herman liked to dress nicely when she went out, wearing high heels, "my nylons, nice dresses, skirts and blazers. ... It still bugs me when I shop. I still look at shoes."

In October 1999, when the Post-Gazette first chronicled Herman's ordeal in the Health section, she expressed concerns about requiring help from others for the rest of her life. At the time, she already had become skilled at using her power wheelchair, but she was afraid of being left alone in some places. Having Rood along has eased that fear.

The pair are regular customers at the Shop 'n Save in South Fayette, where many employees know them by name.

"We go monthly," says Herman, explaining the large amount of food they try to buy during each visit. "It's too much work."

On a visit to the store last month, the two seem to be oblivious to looks from other shoppers. Herman and Rood cruise up and down the isles in their motorized wheelchairs. They move toward the vegetable aisle, and a customer watches as they speed by. Once eye contact is made, he pretends to be looking at the watermelon.

And while in the aisles, several customers move to get out of the way, saying "Sorry" instead of "Excuse me," notes Herman.

She doesn't mind someone asking what happened to her, as long as it's sincere.

"If I meet someone new, I tell them the reason I look this way is because I had bacterial meningitis. You talk about it, then they forget about it."

Herman understand the stares. "I would look, too," she says. "But if they keep staring, and I see them whisper to their spouse or boyfriend, 'Look at that,' I'll go by them and go 'Boo!' I shouldn't do that, I know. But it makes me feel better. I've been with my brother and he'll say, 'Oh, Karen, I can't believe you did that!' "

Looking ahead

Herman is content with this stage of her life while still dealing with lingering effects of her illness. She still has what are called "phantom pains" -- pains she can vividly feel where she used to have arms and legs. She sees a pain management doctor and practices meditation.

And she considers what's next.

"What I really want to do is talk to burn victims, like kids -- if their face is disfigured or they lost their arms or hands. I'd like to talk about how to overcome that. You never forget. It's just something you overcome. You just have to overcome it and keep going."

Herman firmly believes things happen for a reason.

"I was so stressed out working, raising kids, being a single parent. I think this was to slow me up because I would have had a heart attack. This was meant to be. I wish it didn't have to be this dramatic, but there is a reason why. That's history, what happened to me. Now I have to go forward.

"My whole life is completely different now, and it's a whole new life, and it's a good life. I'm glad to be alive."