When Terin Graham has one of her episodes, it looks like she’s asleep. She’s not. She passes out for about three seconds.
When Terin Graham has one of her episodes, it looks like she’s asleep. She’s not. She passes out for about three seconds.
Then, Graham’s body starts shaking.
She can hear people around her, but she can’t talk or open her eyes. She can nod.
Eventually, the Tompkins senior defender/forward opens her eyes, lays still for a minute, sits up slowly and returns to the soccer field. An episode can be as short as five minutes or as long as 20 minutes.
“It’s a lot better now than it was at the beginning,” Graham said.
In late October, Graham, 18, was told she had dysautonomia, a group of conditions caused by a malfunction of the autonomic nervous system (ANS), which regulates all unconscious functions in the body. Graham has a severe case of the disorder, causing her to pass out randomly.
The family thinks Graham was exposed to it when she was put under anesthesia while getting her wisdom teeth removed on Aug. 29.
“They think people with dysautonomia have probably had it their whole lives, but there’s a trigger that makes it like a volcano that just erupts,” said Graham’s mother, Teri. “That’s what they see, especially with athletes. Because we know the day it started, they say the anesthesia must have dropped her blood pressure so low, because it was already so low, that it completely knocked her balance off.”
For the past five months, Graham has dealt with dysautonomia. She can’t eat hot foods because all the heat and blood will go to her stomach. She can’t eat large portions. She can’t be in a room that’s too hot or too cold. She can’t be on her feet for too long, but she can’t sit for too long, either.
“Everything has to be balanced,” Graham said.
She can drive to and from school, but not anywhere that’s farther than 15 minutes and not alone. In fact, she can’t be left alone at all.
Graham sleeps most nights on a couch downstairs because she has trouble sleeping upstairs. She thinks it’s because higher elevations make her condition worse sometimes.
She has a cardiologist, neurologist and a primary care physician.
“It is such a mental struggle for her every day to just get herself up,” Teri said. “Her brain says, ‘Get up and get going,’ and her body says, ‘No way.’ That’s what’s so unique about her story … just the struggle I see in her, every day, trying to do it.
“I just think, ‘You know, I would’ve given up by now.’ Most people would just say forget it. It’s just constant. Every minute of every day, she’s aware that she could pass out.”
‘THEY’RE TOLD THEY’RE CRAZY’
The Grahams went to an oral surgeon and had two emergency room visits when Graham first started passing out. Doctors gave Graham IVs and sent her home, citing anxiety. Dysautonomia is often confused with anxiety, and patients are put on Xanax and sent to a psychiatrist.
One morning, however, Graham passed out for 30 minutes. She was again taken to the ER. Doctors said it was because of dehydration, likely from anxiety. But Teri was not convinced.
“She is a (then)-17-year-old, perfectly healthy kid one day, and now she can’t walk to the mailbox,” Teri said. “Because she was otherwise completely mentally healthy, as far as knowing where she was going to college, confident in her senior year, and so many things she was looking forward to, we knew stress wasn’t the underlying factor. We weren’t going to leave until they told us what it was, and that it wasn’t a brain aneurysm or not a seizure or not something wrong with her heart or not something wrong with her blood. That’s when they sent us downtown.”
Graham spent five days at Children’s Memorial Hermann Hospital, where a team of doctors, anywhere from two to 10, would come into her room, brainstorm about her condition, and solicit information from the Grahams about what was happening. They put together Graham’s history, which included really bad calf cramps and slow recovery from injuries.
“All of those are symptoms, but you would never think to piece them altogether,” Graham said.
She passed out in front of doctors while hooked up to electrocardiograms measuring her heartbeat. Within four days, doctors came to a solution.
“That’s when they were like, ‘OK, there’s a thing called dysautonomia that not a lot of people have heard of, and even most doctors hadn’t heard of,’” Teri said. “In the medical world, it’s still a fairly new diagnosis. Most doctors don’t know, and most patients go years without being diagnosed. They’re told they’re crazy, and they’re put on medications and nothing helps.”
Tompkins soccer coach Jarrett Shipman remembers when Graham first had an episode not long after her wisdom teeth removal. The team was on the soccer field during an athletics period.
“She had lost a bunch of weight and we were trying to figure things out, because she’d say things like, ‘I’m just not feeling like myself,’” Shipman said. “And then, the first time she had an episode we were out on the field playing and she kind of just sat down and has a whole episode. It was the first time I’d experienced it, and I was like, ‘Oh my gosh, this is so much more than soccer right now.’ I’ve been through 10-15 of them now.”
Graham’s father, Gusty, praises Shipman, his coaching staff and the school’s athletic training staff for their work with his daughter.
“It’s a lot of effort, and I feel bad, and I know Terin feels bad, that all these people have to do what they’re doing because of her, but they do it willingly,” Gusty said. “It’s been a blessing. Coach lets her play as long as she can play and leaves her in, whereas a lot of coaches would be like, ‘This is too much. I’ve got more things to worry about.’”
When introduced to Graham’s condition, Shipman spent hours researching dysautonomia.
“More (hours) than I want to admit,” Shipman said, laughing. “It’s a lot of responsibility for me with her, and I wanted to know what I was dealing with. I wanted to know what was going on with Terin, and I wanted to do everything I could.”
Assistant athletic trainer Claire Mifsud works closely with Graham. Graham has a “pass-kit” for games, which consists of Gatorades, pre-made ice packs that go on her chest and back, and salt pills. The kit itself is used to prop her feet up so that her lower body is elevated higher than her upper body.
“Her doctors say it’s really good for her to exercise and it will help with the condition,” Shipman said. “If she can go out there and play, I want her out there, because she’s nothing but a positive energy. She’s a fighter, she cares, and it’s impossible for a head coach to see someone like that and consider her too much of a distraction. In whatever capacity she can be a part of this program, we’re going to embrace that.”
Graham can feel when an episode is about to strike.
“The No. 1 side effect is I’ll start to get really dizzy,” she said. “I’ll be in-and-out of it, things won’t be making sense, and then I’ll get really hot or my toes go numb. I’ll be confused at first and not know what’s going on, and then I’ll start to understand, ‘Oh, I’m about to pass out.’”
Every year, Katy ISD has its coaches participate in medical emergency trainings. They are taught who contacts the athletic director, who contacts the cops, who goes for the ambulance.
Shipman set up a similar system for Graham.
“Everyone knows their role in the situation,” he said.
At first, it was scary. Then, Graham felt embarrassed. Now it’s not as scary anymore.
Initially, teammates thought she was having seizures because of how her body shook. Now it’s so normal that they take pictures of Graham whenever she passes out in funny positions.
“The coaches and I have a little tell, and I’ll say, ‘Don’t feel good!’ and they’ll hurry and pull me out,” said Graham, who often has two episodes in the same game. “I’ll have an episode for 5-6 minutes, and then I’ll stand back up, get on my feet and go back in.”
Not long after Thanksgiving, Graham expressed to Shipman her desire to be a team captain. It was a goal of hers all throughout high school—the most important, in fact. There was little question she had leadership qualities.
“She’s always there for other people, and she doesn’t do a lot of things for herself,” Shipman said. “As a leader, she’s always embodying what we want as far as someone who is always doing the right thing, always on time, always pushing people to be their best.”
But the dilemma was Graham had missed most of the preseason with her condition, and there was no telling who players would pick. Players choose two captains, explain why, and then coaches make the final decision.
“About a year and a half ago, I gave Terin a book on leadership and she read through the whole thing,” Shipman said. “To be honest, she’s been a leader since day one, as far as always doing the right thing. She’s someone who’s backed by the players in our program. But she hadn’t been here. I know how much she cares and how important it is, but we had to have everybody on board. She came to me with things she had done, things she had noticed, in a very mature way. We let it play out, and whatever happened, happened.”
This season, for the first time, the picks for captains were unanimous: Graham and fellow senior defender Valeria Gomez.
‘I LOVE MY TEAM’
After competing in the prestigious The Woodlands tournament in early January, the Falcons played Bridgeland High just three days later. They were out of sorts, grinding through a relatively meaningless non-district contest after wrapping up an exhausting three-day slate against elite competition just 72 hours before.
It was Graham’s goal late in the second half that lifted Tompkins to a 1-0 win.
“We looked dead, and she scored in the last four minutes to give us the lead in that game,” Shipman said. “There’s that Terin magic. We didn’t even know if we’d have her, and she goes out there and puts the team on her back and finishes it off for us.”
In the first 11 games for Tompkins this season, all of which the Falcons won, Graham has eight points—three goals and two assists.
“We’ve gone off her cues of what she can do and what she wants to do,” Teri said. “There are some days it’s too hard, but there’s also days she realizes it makes her feel better. Her structured soccer and school routine makes her feel better. She has really good days with bad days, but it’s more to where there are even-keel days in between.”
As fast as it struck, Teri said, dysautonomia can taper off just as quickly. Teri said girls in their late teenage years typically grow out of it in their early 20s, especially the more active they are.
There are victories. For instance, during Tompkins’ district opener against Taylor on Jan. 24, Graham did not pass out once.
“It was a really big accomplishment for me, because I hadn’t even made it a full game without passing out at least once,” she said.
Graham verbally committed to play college soccer at Utah Valley in the eighth grade. But about a year ago, she started voicing concerns about whether that was the right place for her.
Her club coaches started talking to other schools, and Houston Baptist showed interest. About six weeks before Graham started having episodes, the program offered her a full scholarship.
She signed her letter of intent in the fall.
Interestingly, the hospital where Graham’s doctors are is located on the grounds of the HBU campus.
“We’ve learned a lot about faith and letting things happen as they need to,” Teri said.
Graham has a “Tilt-Table” test scheduled for March. She will be placed on a table, hooked up to a lot of different nodes that examine temperature, heart rate and blood pressure. The table will be tilted in different directions until she passes out. Doctors will take her readings so they can see what her body did and if she might need to adjust to or try different medicines.
For now, Graham has her mind on other things, like her team and a state championship. The Falcons have been to the state championship game two of the last three years, but fallen short each time. This season, Tompkins is 11-0-0 and ranked No. 1 in the nation by topdrawersoccer.com.
It’s why the four-year letterman was so adamant about playing her senior year despite dysautonomia. Nothing was going to keep her away from the field.
“Times when I pass out, I feel 10 times better than when before I passed out,” Graham said. “The coaches joke with me, ‘Just have an episode before the game so you’ll play better.’ Because I will play better. ‘Do you just want to have an episode now, so you’ll play better?’ It’s funny.
“I love my team. I love my coaches. I consider these girls my sisters. We want to go to state again, and this was my senior year and I wanted to make it the best.”