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Bill Harsey
04-07-2011, 21:31
general question for a specific case.


Short version, a young friend of mine (who's father was one of the legends of the airshow business and a very good friend) is also a performing airshow pilot.

During a recent airshow he had an engine problem, lost power and got the plane leveled out long enough for his wing walker wife to get into the front seat.

In resulting controlled crash landing she sustained third degree burns on 65% of her body and various serious bone fractures.

She had all digits amputated on her right hand.

First question is this, is there anything being done now to replace fingers?

I think the correct term is prosthesis and expect this would be non-functioning.

Edited to add; I think some of the best Docs in the business of serious injury are around here and is why I'm asking.
Also if any details of injuries are wrong, I will correct.

Bill Harsey
04-07-2011, 21:43
Here is some video news about the crash, http://www.youtube.com/watch?v=0a7TM65jAXE&NR=1

I'm not pretending to know sh*t about this case, and am staying out of the families way.
The news report said Amanda is in Brooke Army Medical Center in Ft. Sam Houston.

Tatonka316
04-07-2011, 22:37
If there is anywhere in the country that can and WILL give her the best care, it is Brooke Army Medical Center! The advances in prosthetics, burn care and rehab are occuring daily there!!! I know you have the knife show this weekend, but I will give you a call next week to see how things are going.

molon labe:lifter

perdurabo
04-07-2011, 22:44
Bill,

I heard about this when it happened. I didn't know her injuries were so extensive and I will keep her in my prayers & hope there's something that can be done.

Makes me miss the guy who crashed near Hobby Field awhile back who used to tow all the gliders. I used to love watching them toll around on a warm, sunny day.

PSM
04-07-2011, 22:51
Damn, Bill, I saw that video on TV a couple of nights ago. I didn't know it was that bad. I believe I met Kyle's dad, Jim, a couple of times when flying through New Mexico in the '70s. I didn't make the connection.

Prayers out!

Pat

DDD
04-08-2011, 08:16
Brooke is the best, I did a rotation thru there while in 300F1. There is a special place in Heaven for the staff of the burn ward at Brooke, they were by far the most upbeat, professional people I have ever worked with. I believe that my 5 days on the ward affected me more profoundly than anything else I have ever done.
Your friend is being well cared for, as for the specific question about her fingers: as far as I know, yes they have the ability to attach something cosmetic, but most people choose not to use them.

swatsurgeon
04-08-2011, 10:22
difficult to answer for a few reasons. Toe transfers can be done as can biomechanical and static prosthesis be fitted. A lot depends on the injuries to tendons (and nerves) which control these. If the burns were deeper than skin and affected the tendons and /or nerves, no benefit to mechanical since it can't be 'driven' by her ability to move via tendons.
If all is intact at that level, then the possibility is there to have a movable prosthesis. They ususally wait until the healed skin and structures can support a biomechanical or tissue transfer ....sometimes waiting up to a year.

Hope that helped

ss

Kyobanim
04-08-2011, 10:26
Have a look at this. http://health.howstuffworks.com/human-body/cells-tissues/extracellular-matrix.htm

This particular hobbyist happened to have a brother in the tissue-regeneration business, who told him to forego the skin graft and instead apply a powdered extract taken from pig's bladder to the raw finger tip. The extract, called extracellular matrix, lays the framework that cells use to generate any given body part. It's like a cellular scaffolding, and all animals have it. It holds the signals that direct cells to divide, differentiate and build themselves into a specific form.

Extracellular matrix is a component of body tissue that functions outside of the body's cells (thus the "extracellular" designation). It's made up mostly of collagen, a type of protein. So extracellular matrix extracted from the bladder of a pig does not actually have any of the pig's cells in it.



I saw the special on discovery. there's a lot of documentation out there on it but I don't know if it's gone anywhere. Didnt see anything about burns on it though.

CPTAUSRET
04-08-2011, 11:15
Bill:

Early in her career Nancy spent three years as the neuropsychiatric caregiver for seriously burned individuals...Patients with terribly deforming injuries, one individual, an electrical lineman lost his right arm and leg. She asked him if his home was on one level, he replied "No, it was a two story". She asked him how he planned to traverse the stairs. He stated that "I'll just slither up and down". She used this type of injury as the basis for writing the definition of PTSD for DSM lll.

I just ran this by her and she stated Brooke AMC, would be her choice of health care facility.

Red Flag 1
04-08-2011, 12:38
Bill,

Can only echo what others have said about BAMC; she is in the right place. IIRC, Walter Reed's Forest Glen annex is the center for prosthetics. How closely they work with BAMC I do not know, but worth a look.

Prayers out for Amanda and her family.

RF 1

Sacamuelas
04-11-2011, 08:25
Recently, I sat through a fairly detailed CE course by an Oral/max surgeon from Brooke. The staff at brooke are the BEST in the world at what they do. They have a team approach with all the necessary components on site to thoroughly treat and followup on the care of injuries like this lady's. They are constantly refining, updating, and innovating. They are literally on the cutting edge of burn/reconstruction. Unfortunately, this is because they have so much experience with our guys and gals coming home from IED attacks. Practice makes perfect... and these guys are utterly amazing.

Bill.... she is in the right place. I wouldn't make that statement for all treatment needs at a military/government healthcare facility. However, for burn/reconstruction injuries...... I think brooke is prob one of the best in the world.

frostfire
04-11-2011, 09:06
just echoing what others have said. I recently went through the burn ward and the Intrepid center at BAMC. Jaw-dropping is an understatement. There are latest advancements borderline scifi.

Having said that, the patients show me the ultimate price to be paid, especially in SF. Bilateral amputees , over 95% burn, total care.... :( There are no mirrors on the burn ward.

Bill Harsey
04-14-2011, 10:19
Thanks all for the kind words and votes of strong confidence in Brook Army Medical Center.

I spoke with Amanda's husband Kyle last night. Kyle gave me permission to re-post from his face book page to here, this is from 11 April 2011:

Amanda's surgery went well today for the most part. The doctors graphed skin from her scalp to most of her face today. They did not do her forehead because of a possible infection concern. They will try to finish her face next time. But, from what I hear she looks great. They are also going to wait on graphing her "grown skin" or "epy cells" as they call it till later next week, (was planned for later this week). Apparently Amanda has some significant infections in areas they wanted to graph, nothing life threatening they a sure me. It's just the "epy cells" are VERY fragile and an infection could destroy them. It takes almost six weeks to grow them and to lose them to an infection would set Amanda back considerably. Otherwise when I saw her today, she was resting and had just gotten back from surgery. I talked to her some and started disc 2 of her "Two and a half men". I'm hoping to try to talk with her later this week. Something I forgot to mention is that she has been off the ventilator for over a week now.....like I said, "I love my strong beautiful girl."



As for me, I went to lovely Physical Therapy today, every Monday, Wednesday and Friday. It's not that bad and I'm not complaining, trust me I'm not. I'm just ready for my fingers to stop being one giant blister factory!



Thank you all again for all your kind words and thoughts, goodnight and God bless,



Kyle

Bill Harsey
04-14-2011, 10:26
And this looks like a tough case, again in Kyles words from his Face Book page, "Franklin's Flying Circus", 14 April 2011:

Amazing how things can change in 24 hours. Talked with Amanda's main doctor this morning and they've changed their plans for her. Amanda's infections are not doing as well as we had thought and have become a much bigger concern. Her doctor told me before that with burns it's a "two steps forward, one step back" game but today he told me "we're just taking steps back now". So to try to get her infections under control they are taking her into surgery today, tomorrow, and Saturday. They will be, "Bleaching" (lack of a better term) her wounds out for the next three days to try to stop the infections. I'm not sure when they're going to take her in today.

To our friend Gary, thank you for sharing your story and pictures of your "Hyperbaric Treatment" success. I asked Amanda's doctor about it and he said "it was a great question." He has used Hyperbaric chambers before, however in Amanda's case he feels it is to early to use them. One, Amanda is still in critical condition and there are almost no monitoring capabilities in a chamber. Two, in her currant condition there hasn't been much proven that it would help her right now. Three, there is a problem with her bandages and any petroleum based ointments they have on her could spontaneously combust in the pure oxygen environment. That being said, Hyperbaric Treatment may be something they use later down the road to speed up her healing among other things. Like I said he has used them before and is open to using them, just not at this point. He even knows where the nearest one is, about 45 mins away.

Amanda's doctors seam very smart and very open to ideas. So if you know of some treatment they might not know about or just know of something that works, like Gary did, please tell me about it. I will do anything to help my beautiful girl.

Thank you Gary, thank you all. I will let you know how things went, later tonight.

God bless,

Kyle

P.S. I do know about the "Skin Gun" and it will not work in Amanda's case. Thank you though.

Gypsy
04-15-2011, 18:41
My prayers are with Amanda and Kyle.

Bill Harsey
04-20-2011, 08:36
Gypsy, Thank you.

Amanda still has a tough go as the Docs are trying to keep her alive.
In tracking Kyles posts I'm learning how tricky serious burns can be.

In her husband Kyles words:

Amanda 4-19-11
by Franklin's Flying Circus on Tuesday, April 19, 2011 at 10:40pm

Better news today still not great but better. They said her wounds looked okay today. Infections are going down for the moment, the biopsies on the spots on her arm came back as not a big deal. So some good news. However they will be taking her in again tomorrow to clean her again and the "battle" over the rest of her scalp skin goes mostly to her "Body" doctor. Amanda's "Facial" and "Body" doctors have been fighting over what was left of her scalp skin. Her "Facial" doctor had used half of it to graph to her face but isn't finished with her face. (The first graph from the scalp is the best for the face.) Her "Body" doctor wants whats left to graph to her body's open wounds. Being Amanda has very little good skin to graph this has been a problem. Her "Body" doctor did make the point if she doesn't survive her wounds it doesn't matter what her face looks like. Which is hard to argue with. We will see exactly how all this turns out. As we all have found things can change very quickly.

Amanda was not real responsive when I went to see her today. She's been through a lot this past week and I can see it's taking it's toll on her. Hopefully things will go well the next few days and she doesn't have to go through this cleaning crap again.

Sorry for the really late post. A good friend came down and got me out of here for awhile.

Let you all know how things go tomorrow.

Goodnight, God bless,

Kyle

Barbarian
04-20-2011, 10:15
Wow. That's a really sad situation. I'll be praying for Amanda and Kyle, Mr. Harsey.

alright4u
04-20-2011, 17:09
difficult to answer for a few reasons. Toe transfers can be done as can biomechanical and static prosthesis be fitted. A lot depends on the injuries to tendons (and nerves) which control these. If the burns were deeper than skin and affected the tendons and /or nerves, no benefit to mechanical since it can't be 'driven' by her ability to move via tendons.
If all is intact at that level, then the possibility is there to have a movable prosthesis. They ususally wait until the healed skin and structures can support a biomechanical or tissue transfer ....sometimes waiting up to a year.

Hope that helped

ss

Few know that the man who led the first BDA into COSVN HQ west of the fishhook in early 69 was shot through his WP grenade. That WP fire burned and kept burning. He took several morphine syrettes. Bill retired from the CIA. I am proud to call him the best officer 10 I ever knew. He was burned beyond my imagination from what one medic said. No, he received not one valor award.

Red Flag 1
04-21-2011, 08:33
And this looks like a tough case, again in Kyles words from his Face Book page, "Franklin's Flying Circus", 14 April 2011:

Amazing how things can change in 24 hours. Talked with Amanda's main doctor this morning and they've changed their plans for her. Amanda's infections are not doing as well as we had thought and have become a much bigger concern. Her doctor told me before that with burns it's a "two steps forward, one step back" game but today he told me "we're just taking steps back now". So to try to get her infections under control they are taking her into surgery today, tomorrow, and Saturday. They will be, "Bleaching" (lack of a better term) her wounds out for the next three days to try to stop the infections. I'm not sure when they're going to take her in today.

To our friend Gary, thank you for sharing your story and pictures of your "Hyperbaric Treatment" success. I asked Amanda's doctor about it and he said "it was a great question." He has used Hyperbaric chambers before, however in Amanda's case he feels it is to early to use them. One, Amanda is still in critical condition and there are almost no monitoring capabilities in a chamber. Two, in her currant condition there hasn't been much proven that it would help her right now. Three, there is a problem with her bandages and any petroleum based ointments they have on her could spontaneously combust in the pure oxygen environment. That being said, Hyperbaric Treatment may be something they use later down the road to speed up her healing among other things. Like I said he has used them before and is open to using them, just not at this point. He even knows where the nearest one is, about 45 mins away.

Amanda's doctors seam very smart and very open to ideas. So if you know of some treatment they might not know about or just know of something that works, like Gary did, please tell me about it. I will do anything to help my beautiful girl.

Thank you Gary, thank you all. I will let you know how things went, later tonight.

God bless,

Kyle

P.S. I do know about the "Skin Gun" and it will not work in Amanda's case. Thank you though.

Sorry to learn of the infection complications. That is one of the big fears in dealing with burns. Prayers out.

Re: Hyperbaeric chamber. My residency @ Wilford Hall included an elective in Hyperbaeric Medicine. We trained @ Brooks AFB at the southern end of the loop, probably the chamber they use also. Not the place for Amanda right now.

RF 1

orion5
04-21-2011, 22:45
Few know that the man who led the first BDA into COSVN HQ west of the fishhook in early 69 was shot through his WP grenade. That WP fire burned and kept burning. He took several morphine syrettes. Bill retired from the CIA. I am proud to call him the best officer 10 I ever knew. He was burned beyond my imagination from what one medic said. No, he received not one valor award.

a4u, thanks for sharing that.

Bill, I was pissy over a couple of stitches I had removed this week...incomparable to what Amanda is going through. Perspective is good.

greenberetTFS
04-22-2011, 08:35
Few know that the man who led the first BDA into COSVN HQ west of the fishhook in early 69 was shot through his WP grenade. That WP fire burned and kept burning. He took several morphine syrettes. Bill retired from the CIA. I am proud to call him the best officer 10 I ever knew. He was burned beyond my imagination from what one medic said. No, he received not one valor award.

a4u,

Great post.........:( Prayers out for both of them............:(

Big Teddy :munchin