Team Koral Reef Amoeba Awareness
In memory of Koral Reef Meister Pier, we are committed to bringing knowledge of brain eating amoebas to the public.

Mission Statement

The Goal of Koral Reef Amoeba Awareness team is to raise awareness in communities of the dangers presented by this brain amoeba, Balamuthia Mandrillaris, and other free-living amoebas. Lobby for the medical community to be properly trained to recognize this brain-eating amoeba in the early stages, proper diagnostic tools be readily available to medical personnel, updated training for medical staff, in order to secure early diagnosis and treatment. Make every effort to have the amoeba placed on the national register of infectious disease listing. Work with the center for disease control to assist in areas needed. Work towards securing funding by appearances on media programs, and appearances at local eventsInter act with health departments and water districts nationwide in order to share information and gather information on cases nation and worldwide.

Her Story

On September 29, Koral Reef Pier was a bubbly, energetic twenty year-old who entered her local emergency department for increasing weakness on her right side and changes in her vision. During the previous year this healthy and athletic young woman experienced seemingly nonspecific symptoms, such as fatigue, nausea, headaches, neck pain and tingling sensations in her ear, casually noting the onset of each to those closest to her. Koral sought attention for her increasingly debilitating pain and discomfort through traditional pharmaceutical means, as well as through massage and complementary interventions. As anyone who knew her would agree, she was not inclined to linger in a demonstrably negative state but rather took opportunities to celebrate life in the birth of her goddaughter, milestone transitions in her family, the promise of entry into culinary school and her own newlywed bliss after a beautiful summer 2014 wedding to the love of her life, Corey, all the while coping with appreciable changes in her health. Much to the shock and disbelief of all who come into contact with her story, that day in September would begin the final three weeks of her life.

Something about her initial neurological exam drew the attention of the emergency medical staff at Temecula Valley Hospital, for an MRI was ordered swiftly and with devastating results: several lesions (or “tumors”) were noted by the radiologist. Findings such as these call for immediate action and expert consultation, thus Koral was transferred to the Intensive Care Unit (ICU) at another hospital for close observation, started on anti-seizure medication and steroids due to expected swelling in the affected areas, and referred to the Neurology and Neurosurgery doctors for the next steps in diagnosis. On October 1, Koral was taken into the first of what would become three total neurosurgical interventions in 3 weeks, this first allowing for tissue specimens to be collected and sent to a specialist laboratory at a major university in Southern California. Despite being withheld pain medication (for fear that it would interfere with her ability to participate in medical exams) and often food (in preparation for diagnostic testing), Koral sunnily hosted her many friends and extended family members, kept up with the well wishes from those out of the local area via text and phone, and enjoyed preparing for her Super Sunday football watching ritual with her mother and husband by her side… all the while with sustained swelling in her brain, its accompanying discomfort, and blurry and double vision. The potential gravity of her condition hadn’t dashed her spirit, as Koral presented with new demands that friends and family rally their resources and deliver the New England Patriots’ Tom Brady to her bedside for moral support. That sense of humor carried her through a long first weekend of October as she awaited biopsy results, the diagnostic differential shifting from suspected oncology causes to infectious disease.

At the beginning of the next week, Koral’s condition began to decline as increased numbness, loss of mobility, headaches, changes in memory, rapid heart rate and, ultimately, vomiting and nonresponsiveness became part of her clinical picture. Her neurological status went from being stable on medications to precarious enough that expert physicians decided on an emergency surgical intervention to reduce the pressure on her brain by removing a piece of her skull for relief. Forever the headstrong spirit, Koral awakened from her surgery to the faces of her husband, mother and extended family and friends, now-christened “Team Koral Reef” for the purposes of providing her 24-hour physical and spiritual support. This community would take on a new identity after the identification of what made Koral’s already-abnormal brain biopsy tissue appear ‘atypical’ to neurosurgeons: Balamuthia mandrillaris, an amoeba that is known to inhabit soil and water in warmer weather environments along the southern border of the U.S. (i.e. California, Arizona, Texas, Florida, etc.) At this point the motto of those loving, caring and praying for Koral becomes “not losing to a parasite”. Medical care is transferred to another hospital with a strong infectious disease team and to experts at the Centers for Disease Control (CDC, based in Atlanta, Georgia), the administrators of an experimental protocol for treating this infection. The date is October 10.

Upon arrival to the ICU at the new hospital, Koral’s health status takes a turn: she is rapidly placed on a ventilator for assistance with her breathing and rushed into another emergency neurosurgery. A radical resection of eight centimeters of the right frontal lobe was indicated once surgeons visualized the increased swelling in and infected areas of her brain, an intervention that requires prolonged hospitalization and critical medical watchfulness. Koral remained on respiratory support; however, once awakened from sedation post-surgery, was able to move parts of her face (e.g. opening one eye, raising her left eyebrow) and hands in response to her doctors and family. The risk for bleeding in the brain and resulting stroke activity becomes a new concern at this point in the course of treatment, and the healthcare team monitors her closely for signs of change. The antimicrobial medications are being given around-the-clock to kill the amoeba per the recommendations from the CDC. Prayers and love are flooding in from around the country. Koral’s family maintains a 24-hour vigil at her bedside. The date is now October 15.

The next four days are touch-and-go: expectations from the medical team change, priority goals for treatment shift, and Koral moves into a state of unresponsiveness for the final time in her life. The fear of blood clot formation becomes a reality- blood thinning medications are started in anticipation that bleeding will not alter her neurological capabilities irreparably. Nurses and physicians are diligently monitoring the smallest details in her intensive care status. Repeat CT studies are completed. Fluid is externally drained from her head. Incisions are cleaned and cared for. Baths are given, sheets and clothing are changed. Sleep and self-care come at a premium to her family and friends, as the delicate nature of her health status is stressed from moment to moment. Today is October 19.

This third weekend of October proves to be nightmarish for the loved ones of this beautiful woman- frequent diagnostic testing reveals that Koral no longer has brain function. Consequently, a decision about withdrawing respiratory support has to be made by the pillars of Team Koral Reef, her devoted mother and beloved husband. From 48-hours of potential successful interventions to twenty-four hours to determine a time for Koral to take her last breath, those watching- familiar and unfamiliar, medical team members and old friends- remain humbled by the fragility of life on this planet. Team Koral Reef gathers nearby and from remote locations to support Koral in her transition. At 8pm on Monday, October 20, 2014, the person known as Christian Koral Reef Meister Pier passes away with both hands held.

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