Archives for 2006

And as they say “that was just the beginning…”

With my hand amputated I at least felt that I was on a road to recovery; but it was far from over. My arm was still open, likewise my leg, with many more surgeries still required.

The next two weeks fell into a fairly regular routine of three wound dressing changes a day and four hours of hyperbaric treatment, interspersed with a surgery or two during the week as they continued to bebride my arm and leg. It seemed strange to have my leg and arm remain open so long as they waited to see what was viable tissue. I was lucky to not get any major infection or complication throughout my recovery.

As word spread of my accident flowers started to arrive from friends and family. My mum flew in from Spain for a week, my brother from the UK and my very good friend from California. Being so far from anywhere I’d call home it was great to see familiar faces.

After the two weeks of surgeries they finally felt they would be able to close my wounds. This was to involve taking a free flap from the thigh of my left leg for my arm and a skin graft from the top of my right leg for my right thigh. The flap was a delicate operation, including connecting an artery and nerve that they took with the flap from my leg. The entire surgery took a total of twelve hours and at the end my arm had swollen to twice its normal size.

The first 24 hours after the operation were critical , the nurses checked blood flow and temperature ever hour or so to see if the flap was viable. This was an incredibly stressful time as we waited to see if everything would be successful. As the first 24 hours passed I recommenced hyperbaric treatments to assist with the healing and now I had wound care not just for my arm and right leg but also my left leg where they’d taken the flap from. Dr. Gonzalez-Hernandez was hoping to stretch the skin on my leg to avoid a further skin graft…this involved twisting wires in my leg every few days to try to close the gap!

The one consolation was the great view from my hospital room window and the weather, couldn’t have been much better if I was staying at a 5 star hotel. As I started to gain strength both physically and mentally I could venture outside in a wheel chair with my wife behind mem, I could enjoy the sun while California was being drenched in rain.

Even though the closure surgery was a success I was to still undergo several more surgeries as there was concern over the viability of my bicep and brachioradialis muscles. They kept a hole open at the bottom of the flap so they could continue to bebride the muscles, this wouldn’t finally be closed until I reached St. Francis hospital in San Francisco.

As the weeks rolled by both Kerry and I felt the desire to return home. We could have probably stayed another month or more in hospital in Miami recovering, but, with Kerry living out of a hotel and the hotel bills rising and after being away from home for nearly two months it was time to head home and so we worked with Kaiser Permanente and our doctors to get medically evacuated again back to California.

My finally surgery in Miami was to close my left leg, unfortunately my skin hadn’t stretched enough to cover where the flap was taken and so they did another skin graft to close the remaining area…not pretty but it did the job.

And so after a 10 hour flight involving stops in Alabama and Denver our medevac jet arrived at SFO and I was transported to St. Francis Hospital in San Francisco.

We meet some amazingly caring people at Mercy Hospital who helped both
myself and my wife get through such a traumatic time, I’m sure we will
continue to stay in touch and thanks to all of you for your kindness.

The ambulance arrived at Mercy hospital in Miami and I was admitted to intensive care on the 4th floor of 4 Carroll. Once I was hooked up, Dr. Eduardo Gonzalez-Hernandez from Miami Hand Center arrived along with Dr. Scott McDonald. Thankfully my doctor in Colombia knew Dr. Gonzalez-Hernandez, a hand specialist, and had contacted him to ask if he would take on my case…for this I am forever grateful. Doctor Gonzalez-Hernandez enlisted the help of Dr. McDonald, a plastic surgeon, to help in my leg and arm reconstruction.

At this time my hand was intact but not in great shape. My first surgery was there and then in my room as both doctors set about the debridement (removal of foreign material and dead tissue) of my arm, strange to feel them cutting away the dead tissue…no pain, just a sensation of tugging & pulling.

It was still unclear as to the extent of my injuries and to ensure the best chance of survival for the remaining tissue in my arm and leg I began hyperbaric treatment at the Hyperbaric and Problem Wound Center in the hospital. If you’re a scuba diver (as I am) then you’ll be familiar with Hyperbaric treatment for divers suffering from decompression sickness or “the bends”. It is now also used to treat wounds, allowing patients to breath 100% oxygen at a depth of 10m which saturates tissues with oxygen and speeds the healing process. My initial treatments were in the Sechrist, a single person chamber pressurized with 100% oxygen…no smoking allowed!

I got to meet some really caring people during these treatments, who truly helped me get through my 6 week stay in Miami, I was to continue hyperbaric treatment throughout my 6 week stay.

Within the first week it became clear that the prognosis for my hand was not looking good, despite the continued debridements and hyperbaric treatments. It was time to face the tough decision. My doctor explained he could continue trying to save my hand, but given the extent of the damage it was pretty uncertain how functional it would be and the process would likely be long and arduous as he attempted to reconstruct what he could and risky as necrosis set in, leaving me prone to infections that could kill.

After having prayed and hoped that my hand would be OK the time had come. It was probably harder for my wife than me, she’d been through so much, pushed so hard, and kept hope alive for the both of us…thinking back on how strong she’d been causes my eyes to mist even now. I believe that at some level I’d already accepted the outcome…I remember thinking before the second surgery in Colombia that my hand would probably be amputated, quite matter of fact.

My wife fought so hard to save my hand, but in the end I remember saying to her that we had to let it go. I wanted to get better, I wanted the uncertainty to be over, I wanted the never-ending surgeries to end. There really was a sense of relief for me, I didn’t look beyond the amputation or think about the consequences, this was just the next stage in getting back to a normal life…a mindset that stayed with me throughout my recovery – to think too far ahead was to be overwhelmed. I can’t imagine how this must have been for my wife, no friends for support and nothing but an empty hotel room to go back to, since we live in California!

And so my hand was amputated…

So there I was, in hospital, in Colombia, surrounded by doctors and nurses who didn’t speak English. With my Spanish being pretty much non-existent I could see we were in for an interesting time…looking back it’s quite amusing to think of my wife Kerry using her pocket English/Spanish dictionary to communicate about my medical needs and condition. I’m thankful that Richi was there some of the time to translate some of what was going on.

We spent 5 days in hospital in Colombia, during which time I underwent 3 surgeries on my arm.

The first was the day I arrived. They did an ultra-sound like scan on my arm to see the remaining blood flow, it didn’t look good from below my mid-forearm and so the doctor took a vein graft from my right leg to use as an artery in my arm to try to restore some flow.

Initially the surgery seemed successful but after a while the blood flow seemed to stop again. Through Richi’s translation the doctor explained he may have to amputate…you can imagine how that makes you feel…and a doctor, who knew some English, hand wrote a consent for me to sign for the amputation. As I went in for my second surgery the last thing I remember saying to the doctor was, “please try to save my hand”.

I awoke with hand still intact, but again as time passed things started to turn blue and so they rushed to get me into surgery for a 3rd time. I remember waiting on the trolley, staring at the ceiling, doctor by my side, wondering what we were waiting for, praying for the surgery to start so that I’d be asleep and not in pain. He explained, in his broken English, that at that time of night on the weekend they only had 2 operating rooms open, so we were waiting for one to become free. As we waited the lights went out twice due to what I assume were power outages…confidence building stuff.

So after 3 surgeries it wasn’t looking good and whilst amputation was looking likely we decided it was time to get back to the US. The doctor felt I was stable enough to fly and so we contacted DAN (Divers Alert Network) for emergency medical evacuation assistance. I cannot recommend their evacuation insurance enough, once my wife called their hot-line they put the wheels in motion to fly us out of Colombia to Miami and within 36 hours we were aboard a private jet bound for Mercy hospital in Miami. It is hard to put into words the sense of relief I felt to hear the English-speaking voice of the medical flight attendant from Air Ambulance Specialists as the ambulance arrived at the airport in Bucaramanga and they loaded me aboard the Lear Jet…it’s just indescribable!

I’d always fancied a ride in a private jet, never quite envisioned it would happen like this and after a quick 3 hour flight we arrived in Miami and an ambulance whisked me away to Mercy hospital and the next chapter in my recovery.

I was in Columbia on vacation, I’d joined Richi & Annie of Vuelo Libre for 10 days of paragliding in Bucaramanga, Richi’s home town. I arrived with my wife Kerry on Feb 11th 2006 and proceeded to enjoy some great paragliding. Russell Agnew was my flying buddy for the trip and he kept a great online journal documenting the flying sites and his experiences in Colombia. If you’re a paraglider pilot you really should consider joining Richi for a trip, Bucaramanga is a beautiful place to fly!

So, on to the fateful day. It was Feb 18th and this was the last day flying the mesa (see photo of launch) as we were then heading to the last flying site of the trip. We’d been flying every day so far…and as they say familiarity breeds contempt.

I launched straight into lift and circled over launch to see Kerry just getting out of the truck with her camera (she’d been trying to clean the lens). I suddenly realized I hadn’t given her our customary kiss before takeoff…strange (and perhaps portentous) that I thought “just my luck to kill myself today after not kissing her goodbye”…strike 1.

So I was flying XC (cross-county) with Russell, it had been a fun flight with both of us quickly getting to cloud base over launch and then deciding to head across the canyon to the far side. We easily got to the far side, arriving at what is called the “tram project” (where they’re currently building a tram, see photo). As we flew the ridge line heading to higher ground there wasn’t much lift and we both struggled to get any altitude. Russell headed back to the viewpoint (the house thermal) and got lift pretty much to cloud base while I struggled to find anything. Russell then headed back up the ridge. Not getting much altitude I headed back to the viewpoint also…it was at this time my GPS decided to run out of battery! Strike 2.

Russell landed while I was still climbing and I unfortunately didn’t see where. I headed in his direction but couldn’t spot him on the ground, I had good altitude so decided to push on (strike 3). I was now in unknown territory and as I pushed on I wasn’t finding much lift, rather than heading back to a safe landing I decided to push my luck and see if I could find something further along the ridge…

The rest is a bit sketchy, I remember heading to what seemed to be open ground to land. I remember pushing into a headwind as I headed over the top of the ridge-line, I still had good altitude at this time but I remember the alarm bells starting to ring. The next I remember I was low and coming in to land (can’t recall quite where or how I’d got there…very strange) when I spotted two power lines directly ahead…all I could do was bank my glider into a steep right hand turn to try to avoid them…not knowing what else I might hit.

I woke up on the ground in my harness with the sound of shouting as some locals came to my aid…I’d hit the power lines and from what I can gather my glider was still in the lines and I was on the ground in my harness.

I could see my left hand and arm was badly burnt…it was bent and I couldn’t straighten it. My left hand was gripping the brake handle and I had to pry my fingers apart to release it. My right leg was also badly burnt too. I had the presence of mind to call Richi on my cell phone and was lucky to have locals who where able to tell him where I was…he was 15 min away in the chase car with my wife Kerry. All I could say to the locals was “Ambulancia, hospitali”…as if that wasn’t obvious!

I got myself out of my harness and the locals helped my down an embankment, bundled me into their truck and drove me to the local clinic where they started to clean me up. I remember Richi and my Wife arriving at some point…I must have looked a mess.  From there they took me to the main hospital in Bucaramanga, Clinica Carlos Ardila Lulle, and, thankfully given Richi’s contacts (his farther was a well-known Doctor in the area), into the hands of the top hand surgeon, Dr. Monroy Gelman. I was in pretty bad shape but damn lucky to be alive!

Thus began my recovery…