Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Saturday, September 05, 2015

One Lucky Little Girl

"She came up behind the boat and at first I thought, OK, she is going to be OK'. Then she started screaming, 'My leg is gone!'"
Leslie Baker Toews, Calgary

"It was very clear when we took off the bandages that the top and the bottom of the leg were practically disconnected."
"We thought, we can put this back together again."
Dr. Thomas Lindsay, vascular surgeon, Peter Munk Cardiac Centre

"When we told the family that this is experimental, but this is what we think we can do, they jumped on it."
"We were surprised, because it typically would take a year to get some movement back."
"Augusta has an indomitable spirit."
"The nerve was completely divided in half and because of the severity of it, we had to do what's called nerve grafting, where we take a piece of nerve from elsewhere in Augusta's own body and then graft the defect to bridge the gap."
Dr. Gregory Borschel, nerve specialist, Sick Children's Hospital, Toronto
Peter Munk Cardiac Centre
Peter Munk Cardiac Centre The wound to Augusta’s leg was clean, almost like a sabre cut. Had it been otherwise, surgeons would have amputated.

Augusta was seven, an active outdoorsy child who loved to hike and bike and ski and swim. She was at her family's cottage on Lake Rousseau in Ontario when her mother was operating a motorboat and her father was water-skiing. Their daughter, Augusta, was sitting at the front of the boat. Her father Eric fell and her mother Leslie cut the throttle, inadvertently causing their daughter to fall into the water, directly under the boat.

What began as a fun day out on the water in June of 2014, turned quickly into a nightmare of unforeseen proportions, causing Augusta's frantic parents to believe they were losing their active, fun-loving child. Her left leg was severed at mid-thigh, left hanging by virtual threads of skin and muscle, and bleeding horribly from a metal fin on the boat's hull that had sheared through the child's bone, blood vessels and sciatic nerve.

Eric Toews tied off his daughter's leg with the bow line of the boat, as hard as he could on a makeshift tourniquet to stop the blood loss. "We really believed that we were helping Augusta onto her death that day. I was trying to keep her awake", said her mother afterward, describing their terror and the dread emergency that had overtaken their life, as she held her daughter, and sang to her.

Airlifted to the Hospital for Sick Children in Toronto, she was seen by vascular surgeon Dr. Lindsay who just happened to be visiting Sick Kids when the child was wheeled into emergency. He swiftly ascertained that the wound was clean, not requiring an immediate amputation. Dr. Lindsay, along with an assortment of other doctors, felt Augusta could be saved, and so could her leg.

A six hour operation ensued one where veins and muscles, flesh and bone were knitted together again to re-create a whole little girl. And then loomed another operation, an experimental, never-before-hazarded one, to re-attach the longest, largest nerve in the human body. The sciatic nerve represents the command centre; without its intact condition muscle movement and sensation are not controlled. Limited motion and feeling and neuropathic pain ensue.

Dr. Borschel pioneered a new procedure; to activate the sciatic nerve with an electric current in 30-volt bursts. The theory was that the electrical charges would serve to activate the nerve's lost functions; to stimulate regeneration from the connection point at the base of the spine back down past the point of injury and on to the toes. The ten-hour surgery was conducted and then came the suspense to determine whether it might succeed.

Augusta left Toronto to return home to Calgary in a wheelchair.  Once home the chair was left at the front door and never again used as Augusta preferred to haul herself around, eschewing crutches and a walker as well. As she began to recover her strength and energy, she retraced her infancy by crawling, and then hopping. In October of 2014, she managed her first steps, and a month later an examination confirmed that the sciatic nerve was healing.

A year later, the family returned to their cottage north of Toronto on Lake Rousseau. In a race with her two older siblings down to the water's edge, she was first to leap into the water. "She was first off the dock. Nothing can stop Augusta", her mother said.

NA0904_Leg_Surgery_C_MFJoe O'Connor

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