Monica, the mother, works as a hairdresser at Buzz Cuts in Hoboken. Patrizio, her husband, is a waiter in North Bergen.
All three of the kids sat atop their respective classes in the Union City school system (the family recently moved to North Bergen). They were a close-knit group, willing to do anything and everything together.
In July, 2001, the Altamirano family traveled to Walt Disney World in Florida for a family vacation to celebrate the 15th birthday of the family's eldest daughter, Patrizia, also known as Patty, who had just finished her sophomore year at Emerson High.
Younger daughter Monica Andrea, known as Andy, was set to enroll at Emerson High School after finishing among the top students at Robert Waters School. Younger son Luigi also enjoyed the trip.
"Patty and Andy went on all the rides," Monica Altamirano explained. "They had a great time together and went on the rides over and over."
But a month later, tragedy began to strike the loving family. Andy Altamirano suffered a seizure at home.
"We called the ambulance and took her to the hospital," Monica Altamirano recalled. "But after the seizure, she woke up fine."
But doctors wanted to know what had caused the seizure. So young Andy went to New York Presbyterian Hospital for a CAT scan. An angiogram found that there was a malformation on Andy's brain.
"She was the healthiest of our children," Monica Altamirano said. "I mean, the other two always had colds and were sick. Andy never even had a headache."
'Abnormal collection of blood vessels'
Doctors at New York Presbyterian told Monica that the malformation looked like "little balloons or bubbles of air...like the size of grapes on her brain."
In medical terms, the prognosis was an Arterio-Venous Malformation, or AVM, which the American Medical Association defines as "an abnormal collection of blood vessels."
According to the AMA website, AVMs are very rare and affect about 250,000 people in the United States. There is still much to be known about the disease.
Arterial-Venous Malformations are areas that lack the tiny capillaries that most people have, which enable blood to flow normally from the heart to the brain, and vice versa.
"We don't know what causes most AVMs," the AMA website reads. "People are born with AVMs, although they do not appear to be hereditary. AVMs occur about equally in both sexes and in different races. An estimation of 3 million people in the United States are born with vascular malformation, 10 percent of which are AVMs. Most patients do not know that they have an AVM."
The site notes: "A number of the patients with AVMs have seizures or persistent headaches. An AVM can put additional strain on the blood vessels and the surrounding tissues."
The brain specialists said that they could not simply operate on Andy to take the malformation out.
"It was too difficult to get there, and they were in too deep," Monica Altamirano said.
The brain specialists told the Altamiranos that they had to try a special procedure on Andy called an embolization.
Embolization is a method of plugging the blood vessels of an AVM. Under X-ray guidance, a small tube called a catheter is guided from an artery in the leg up into the area to be treated. Once the area is reached, glue or sometimes even a wire coil is placed to block off the area.
Better, than worse
During the embolization, the patient is awake but is made comfortable with the help of an anesthesia team.
"They told us that there was a slight risk," Monica Altamirano said. "They said the risk was perhaps one in 3,000."
According to the AMA, the embolization method is usually not a problem for the young (under the age of 20). But the increased flow of blood caused by the shunt weakens the blood vessels. These weakened blood vessels can rupture. This is known as a hemorrhage or a bleed.
If an AVM bleeds, the patient experiences an extremely severe headache. The bleed may cause a stroke and even death. About 4 percent of people with AVMs experience some sort of a bleed.
Andy Altamirano went through a series of embolizations to stabilize her AVMs. The first two went fine, but the third did not.
Told she would never wake up
The first procedure took place in October of 2001.
"They closed four of the holes, but couldn't do more, saying it was too risky," Altamirano said. "But after that, she was fine."
In February of 2002, Andy had another embolization.
"Nothing happened," Monica said.
"I was awesome," Andy replied. "I was going to school."
In April of 2002, Andy Altamirano went back to New York Presbyterian for what was believed to be the last of her embolizations for her condition.
"She started screaming, 'My head hurts, my head hurts,'" Monica Altamirano said. "I said, 'Please do something for her.' After the third time she screamed, 'My head hurts,' she just went limp."
Doctors later found out through a CAT scan that they didn't close one of the veins and it had burst and bled, sending an overflow of blood to Andy's brain and causing a massive stroke.
"The doctors told my husband and me that it was very bad, especially where the bleed was located," Monica Altamirano said. "They told me that she was never going to wake up, that she was going to remain in a vegetative state, that the entire central nervous system was damaged and that there was nothing they could do."
Respirator and feeding tube
Andy Altamirano was placed in a clinical coma. She had open skull surgery to relieve some of the pressure on her brain, but prospects were not good. She was being kept alive by a respirator and other machines. She was placed on a feeding tube.
"They called it artificial life," Monica Altamirano said.
Since the specialists at New York Presbyterian decided there was nothing more they could do, Andy Altamirano was transported to the Children's Specialized Hospital in Mountainside, N.J., where she remained for three months, showing no sign of recovery. When doctors ruled out recovery, the Altamiranos' insurance company stopped footing the bill for specialized treatment.
"No one gave us any hope," Monica Altamirano said. "She really looked like a dead body, just lying there. She didn't even look like she was in this world."
But throughout the ordeal, Monica Altamirano maintained her strength.
Saw it in her eyes
"I was always talking to Andy," Monica said. "I would say, 'Can you hear me, Andy? Can you hear Mommy?' "
Monica added, "I could see in her eyes that she was understanding me. The doctors told me that she couldn't, but I could tell. One day, I came into the room and her pulse rate went up, so that was a sign that she was excited. Another day, her brother and father went in and the same thing happened. So I had a feeling she was listening."
Monica Altamirano made the drastic move to spend night after night in the hospital room with her daughter, many nights crawling into the bed to sleep beside her.
"Doctors told me that I had to put her in a home, but I wasn't going to do it," Altamirano said. "I decided I was going to take care of my daughter. I was going to take her home."
The family had to move out of their Union City apartment, because Andy was not going to be able to move up and down stairs. They purchased a more handicapped-friendly residence in North Bergen.
Patrizio and Monica staggered their work shifts so they would each have time to spend with Andy.
Patrizio worked as a waiter at the Coach House in North Bergen during the days while Monica cared for Andy. Then, at 3 p.m., when Patrizio would come home, Monica would head to her job as a hairdresser at Hoboken Buzz Cuts.
Adjusting their lives
In between, the two other siblings chipped in. The attention of the entire family shifted to the care of Andy.
"God gave me this for something," Monica Altamirano said. "We all had to move forward. It was so hard for all of us, but we all realized our life had to continue for Andy. My husband has been unbelievable. We have our ups and downs, but we've always been very close, and thank God we've made it through this together. We always had a lot of faith and that definitely helped."
Monica constantly talked with Andy.
"I always believed she understood what I said," Monica Altamirano said.
Christmas Eve miracle
In December, 2002, the sign of recovery came, maybe with a little divine intervention.
"It was Christmas Eve and I said, 'Andy, all I want for Christmas is to see you smile,'" Monica Altamirano said. "That's all I wanted. She opened her eyes and smiled for me. I started to cry and said, 'Thank God.' She did the same thing for my husband and her brother. She wanted to make me happy for Christmas."
When Monica told doctors that Andy had smiled, they didn't believe her.
"Little by little, she started recovering," Monica said. "She would make contact with her eyes. She would look at pictures of people and smile. She just kept getting better, little by little."
Andy started to do little things that showed signs of life, like thumb wrestling with her brother, like trying to move her arms and legs.
"About a year and a half later, she started talking again," Monica said. "After a while, we were able to send her to school [at the Hudson County Regional School for the severely disabled in Secaucus]. They were angels. They treated my daughter like she was one of theirs. I was so focused on my daughter's recovery and she was finally getting better."
Therapy with dolphins
Two years ago, Andy was able to go to the Dolphin Human Therapy clinic in Key Largo, Fla., a facility that works with patients who suffered severe brain injuries. They believe that swimming with dolphins helps the patients recover some of their mental capacities.
A little more than three years after that near-fatal stroke, Andy Altamirano is making strides towards living a productive life. Now 18 years old, she attends school daily four days a week at the A. Harry Moore School for the handicapped in Jersey City.
On Mondays, she still goes to the Children's Specialized Hospital for therapy.
"She's almost walking by herself now," Monica Altamirano said. "She needs the help of a walker, but she's getting there. She's speaking better every day. She's a good student. She does messages on the computer and can type."
"I always wanted to be a fashion designer," Andy Altamirano said. "Maybe I can be a designer now."
Her older sister Patty is a student at the College of New Jersey, majoring in business administration, two years after graduating from Emerson as the valedictorian for the Class of 2004.
"I'm so proud of her," Andy says.
Luigi just graduated from North Bergen's Franklin elementary school and will head to High Tech High School in the fall.
Customer nominated her
A few months ago, Monica Altamirano was telling her story to a customer at the Hoboken hair salon. The customer then nominated the Altamiranos for an award, as Parents of the Year from the New Jersey Parents Foundation.
Last Sunday, July 23, was National Parents Day. Ever since 1994, the National Parents Foundation has honored dedicated parents for their service to their children.
This year, the New Jersey Parents of the Year are Patrizio and Monica Altamirano. They were slated to receive their award at St. Joseph and St. Michael Church, which they attend, and will also receive special proclamations from Gov. Jon Corzine and North Bergen Mayor Nicholas Sacco.
"I didn't know what this was all about," Monica Altamirano said. "Believe me, I'm shocked."
It's also a special week for the Altamiranos. Later this week, Patrizio and Monica will celebrate their 22nd wedding anniversary.
Andy Altamirano is living proof that there is always hope.
With hair and makeup intact and flashing a bright smile, Andy easily sings songs like Christina Aguilera's "Beautiful," and the Backstreet Boys' "Shape of My Heart," and dances to Spanish tunes with her mother.
She snapped her fingers when someone asked how she was doing.
"I'm the coolest," Andy said. "I'm so hot, honey."
"We're always together," Monica Altamirano said. "She's still my baby. When doctors told me that she wasn't going to wake up, I said, 'No.' I never believed it. Now, she's speaking and walking, and the doctors are the ones who don't believe it."
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