There might be one fully functional brain between Chris Russo and Kara Ellsworth, as the Sacramento couple like to joke.
In brief encounters, few would guess that Russo, the 28-year-old owner of Russo's Shoe Repair in downtown Sacramento, and Ellsworth, a 36-year-old nurse at a local hospital, had suffered tremendous brain injuries several years ago.
Their injuries aren't visible no more wheelchairs or walkers. But pieces of their brains are forever missing.
Russo mysteriously contracted meningitis and encephalitis two potentially fatal infections involving brain inflammation and drifted in and out of a coma for a month at the age of 20. Ellsworth had vasculitis inflammation of blood vessels and then a stroke at age 27.
"You're thinking that you're in your 20s, starting to work full time and everything's looking good," Ellsworth said. "Then you're hit with an illness and everything's changed."
Physical therapy sessions turned out to be more than just helpful for their recoveries. Russo and Ellsworth met in a speech therapy group in 2006 and fell in love almost instantly.
"I saw sparks," Russo said. "We locked eyes for a split second, and I thought, 'I'm going to marry her.' "
The two exchanged contact information, and emails turned into text messages, which turned into long phone calls lasting until the wee hours of the morning. They bonded over similar effects from their different injuries food tasted weird and for some reason they couldn't stop counting things.
They learned each other's limits. And perhaps against their better judgment, Ellsworth decided to test herself in a swimming pool one night she used to swim competitively but the motion made her sick. Cleaning up her vomit, Russo proposed.
Russo and Ellsworth married in 2008. Russo, a third-generation cobbler, opened up his popular shop in fall 2010 and Ellsworth recently bumped up her working hours to full time.
They spend their evenings together quietly, walking their dogs and going on drives. Common activities they once enjoyed like swimming for Ellsworth or bar hopping for Russo are no more. They avoid crowds and excessive noise such as live concerts, blockbusters at the movie theater and busy restaurants.
But now these lifestyle changes feel normal.
"We've been doing it for so many years it just seems like part of us," Ellsworth said. "We used to both go out and have a good time, but now we have to watch the brain."
Ellsworth is missing more than half of her cerebellum, the portion of the brain that controls movement and balance. Encephalitis took scattered spots of Russo's brain.
This brain damage is permanent, said Dr. Piero Verro, a UC Davis Health System neurology specialist.
"The brain doesn't regenerate itself," he said. "Once you kill the brain, it's dead."
Ellsworth and Russo both have trouble multitasking too much going on and they get dizzy and Russo experiences occasional memory problems. Ellsworth's balance and spatial perception are sometimes off.
There is no such thing as a full recovery, but their brains have adapted.
"The brain kind of rewires itself we call it plasticity where other parts of the brain function in ways they normally wouldn't," Verro said.
What made them so sick, anyway?
No one really knows. Verro affirmed that ages 20 and 27 are young for brain injuries and infections, especially such unusual ones. And Ellsworth and Russo tell nightmarish tales of their initial misdiagnoses.
With headaches, throat aches and low energy levels, Russo thought he had mononucleosis "the kissing disease" and was prescribed four rounds of amoxicillin. Then he got into a motorcycle accident without a helmet.
"I woke up one day and didn't know who my mom was, what year it was, anything at all," Russo said.
For Ellsworth, doctors thought her months of headaches and vision loss might be linked to vasculitis. To test for the disease, a cerebral angiogram was necessary. The procedure had less than 1 percent chance of a stroke, but ultimately, Ellsworth fell into that 1 percent.
Her test came back negative for vasculitis, despite persisting symptoms. Years later, a different doctor made the correct diagnosis.
Ellsworth was often told she would never walk again. Russo's parents were told to prepare for their son's death.
"One doctor told me he didn't believe in miracles, but that there was no other excuse for me getting better," Russo said.
After her experience, Ellsworth feels she's become a better, more empathetic nurse. In the future, Ellsworth said, she would like to work with people who have suffered brain trauma.
"I don't even care about the little things I used to worry about," she said. "You always have to remain positive no matter what."
Call The Bee's Janelle Bitker, (916) 321-1027. Follow her in Twitter @JanelleBitker.