Monday 16 December 2019

Persistence pays for man who went out on a limb to save his leg

An accident led to my husband fighting for his life and against the amputation of his leg, writes Breda McIntyre

Breda McIntyre

IN 2000, on a cold January night in New York, my husband Fintan was struck by a speeding car while crossing the street. He was thrown up on to the vehicle, broke the windscreen and rolled on to the snowy ground.

It was midnight, a Fire Department ambulance was quickly on the scene and within minutes Fintan was in the emergency room at Elmhurst Hospital in Queens.

My husband was treated for a broken pelvis, an open fracture of his left tibia and fibula (long bones below knee) and multiple rib fractures. He was critical on his way to the operating room at 1am.

All this happened while I lay sleeping. I am a nurse and had worked that day in Manhattan. When I awoke at 1am I sensed something terrible had happened. I dressed and went up the street where I passed an area sectioned with police tape, marking the spot where my husband had been knocked down. But I did not know this yet. I checked bars and diners, but to no avail.

By now terrified, I called the police at 3am. They told me I needed to get to the hospital immediately. Fintan was heavily sedated and on life support when I arrived at the intensive care unit (ICU) at 4am. I took his right hand in mine, remembered my mother and whispered the prayers she taught me as a child.

As a critical care nurse I knew that my husband was now in God's hands as much as in the hands of dedicated professionals.

Even in the low light I could see that his face was black and blue.

His left leg was encased in an Ilizarov frame (a long, metal circular frame to support a broken limb bone). Fintan's chest injury had caused a bilateral hemopneumothorax (blood seeping into the pleural cavities of both lungs). By 5am his nurse was hanging the fifth unit of blood to keep pace with his blood loss from the trauma.

As daylight flooded into the room I stared in shock as Fintan lay on the bed, almost unrecognisable. Bruised and bloated with a breathing tube protruding from his mouth, all was quiet except for the rhythmic purring of the ventilator beside him. Over the next 72 hours Fintan's condition was very unstable. He was suffering from acute respiratory distress syndrome, a potentially fatal condition. Management of his care now included the prevention of other organ failures. Two weeks later Fintan had a tracheotomy performed (a breathing tube inserted into his neck) in order to continue safe ventilation. This was an extremely distressing time for him. Now less sedated, he could not talk while on the ventilator but he wrote notes to me constantly which eased his anxiety. As the weeks passed I stayed vigilantly at the bedside while the staff allowed me to do almost everything for him now. My friend Nancy Cunningham, also a nurse, came every other day to help me.

On week six Fintan's lungs started improving and the doctors began weaning him from the ventilator.

The general body swelling was coming down. It was a difficult three days, but he got off the ventilator. He had lost 30kg in six weeks. A week later Fintan's leg was red and swollen at the wound. Osteomyelitis was suspected (a serious bone infection). I did not think he would survive another operation at this time.

The doctors allowed me to make the decision. I flew Fintan home to Ireland on March 31 to be near his family. It paid off.

Four days later amid the surrounds of Cork's street- scape and lilting accents Fintan broke out of his depression, hopped on his good leg and with the help of a Zimmer frame manoeuvred himself around his bed. He started eating and gained weight. I finally brought him home to Tipperary in May 2000, four months after his accident.

The doctors felt that osteomyelitis had, indeed, set in in Fintan's leg. Despite their best efforts, his leg remained unhealed and still oozed pus two years later. They wanted to amputate his leg. Fintan declined.

I brought Fintan back to America. We constantly researched new treatments in osteomyelitis around the US. One night Fintan found Dr George Cierny III's website, an orthopaedic surgeon at the Resurgens Orthopaedics clinic at St Joseph's Hospital in Atlanta, Georgia, and it looked promising.

In 1996 Dr Cierny set himself the task of confronting the 'black sheep' in orthopaedic medicine, none other than osteomyelitis.

After looking at X-rays and examining his leg, he said to Fintan: "Stay a year here and I will have you walking -- no amputation." In November 2002, Dr Cierny carried out a radical debridement (surgical cleaning) of Fintan's left infected tibia bone.

He implanted antibiotic beads into the area and his whole leg was encased in an Ilizarov frame.

He also had to break the tibia bone further down his leg in order to tease the bone to grow. Several weeks later Dr Cierny carried out a bone graft from Fintan's right tibia to his left tibia which closed the remaining bone gap.

The Ilizarov frame was to stay in place for eight months. In May 2003 Dr Cierny took the huge frame off Fintan's leg, and my husband walked unaided out of the hospital.

Ten years after that terrible January night in New York and Fintan is out and about around the fields here in Bansha, Co Tipperary. At the age of 60 he has no trouble managing a herd of 30 Connemara ponies. Free of pain and with not even the hint of a limp, he is climbing over gates and walls and I can't keep up.

My thanks go to Elmhurst Hospital for Fintan's life and Dr Cierny for his limb.

Sunday Independent

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