UPDATES
April 2004 Update
April, along with the typical roller-coaster of Rocky Mountain springtime weather, delivered some pivotal developments in Marla’s recovery process. The most important of these was her right elbow replacement surgery, which took place on the afternoon of Thursday April 22, 2004 at Swedish Medical Center in Englewood. Mary, Leo, and Marla packed their bags Wednesday night, and arrived at the hospital Thursday before noon for pre-operative preparations.
Mary stayed with Marla during the hour of surgical pre-op procedures. Leo and Mary arranged to be with her step-by-step each and every minute of the entire pre-surgery prep and post-surgery hospital recovery process. This helped Marla feel more comfortable and secure, as Mary and Leo are adept at communicating with Marla and helping her interact with her medical care providers, which is a vital process during such a sensitive surgical and recovery procedure.
Immediately before surgery, the family, including godmother Marge Cooper, visited Marla in the surgical staging area. They prayed together for a successful outcome and for guidance for Marla’s surgeons during this delicate operation. Each was astonished at her strength, calm resolve, faith and serenity. Marla practiced her relaxing deep breathing, and whispered the words “cool and collected”. Her determination and inner peace affirmed the family’s confidence in her. Friends Liz Beerman and Julie Andersen waited with Mary and Leo during the surgery, easing their minds with comforting conversation and support.
Dr. Sachar, Marla’s orthopedic surgeon, is a partner of Dr. McNair, who performed the original trauma re-construction at St. Anthony’s hospital, following Marla’s accident in December 2002. Both Dr. Sachar and Dr. McNair consulted with experts around the country in preparation for this uncommon procedure.
Dr. Sachar operated on Marla’s right arm for 5 1⁄2 hours. The surgery lasted so long due to the incredible amount of excess bone growth that had occurred in the tissue surrounding the shattered joint. Due to a process known heterotopic ossification, the body lays down excessive bone growth in areas surrounding severely injured joints, particularly in individuals who have suffered severe head trauma. The excess bone had surrounded the plates and screws that secured the bones of Marla’s arm, and extended both upward from the elbow into the bicep area, and also down into the forearm. Removal of the bone was an intricate and difficult process. At last, Dr. Sachar emplaced an artificial elbow joint to offer Marla’s arm increased mobility.
After the surgery and recovery room, Marla arrived in the recovery room around 8:30 at night. She was still quite groggy, but upon awakening, exhibited her humor, saying, “OK, speech therapy…. NOT!!” Leo stayed a restless night with her in the room, while Mary slept at a room they had rented in Craig Hospital family housing, 1 block from Swedish hospital, which allowed them to be close at hand and not have to travel to and from Northglenn each morning and night. All in all, Marla had the support of a family member in her room 24⁄7.
Friday, the first day post-op, was a tough one. Marla was in a lot of pain, despite an epidural block of the brachial nerve at the shoulder and a self- administered pain medication dispensing device. She spent 2-3 hours in the radiologic medicine department, where they prepped and delivered a 15 minute dosage of radiation to her elbow. This preventative treatment is designed to minimize the formation of additional excess bone around the elbow joint.
She also began immediate treatment with a CPM (Continuous Passive Motion) device. The CPM device moves the affected joint (e.g., flexion/extension) continuously for extended periods of time (up to 8 hours/day), without patient effort. Continuous passive motion improves recovery by stimulating the healing of tissues and drainage of fluid and by reducing local swelling.
Unfortunately, none of the nursing staff had experience in working with these systems. Mary and Leo were grateful that Celeste, Marla’s physical therapist at Craig, visited her and assisted them as best she could in optimizing the positioning of Marla’s arm in the CPM and in working through its setup and configuration.
On Saturday, Marla began to experience less pain, helped by the self-administered pain medication system. She had to strike a balance between pain-relief and itching caused as a side effect of her pain relief medication, which we were told is not unusual. She continued to amaze the family with her sense of humor, positive attitude, and willful determination in the face of difficult and uncomfortable circumstances. She got to watch a DVD movie or two to help pass the time.
Dr. Sachar visited Marla on Sunday morning, and after reviewing the incision, the x-rays, and the joint flexibility, indicated that Marla had achieved the best results that could be expected from the surgery! He was pleased that she could move her fingers and thumb already. He asked her to extend the arm, and she obliged! Upon trying to flex the joint however, Marla, despite a valiant effort, could not–her muscles require re-training after 18 months of not being able to bend! Nonetheless, Dr. Sachar was very pleased.
Monday morning, the last of the IV’s were removed, and Marla was discharged to go home. She surprised everyone by flexing her right arm, un-aided. What an amazingly strong young lady! She was teary-eyed at reaching this new stage in her recovery process. Although there is much physical therapy to come, she is very excited at how far she has come. Marla, and an exhausted Mary and Leo, returned to Marla’s townhome in Northglenn, embarking on the next stage of recovery together.
The hospital stay ended with an incredible (one might say cosmic) coincidence. Marla’s nurse on Saturday and Sunday during the day was a kind and caring young woman named Andrea. On Sunday afternoon, Marla asked Andrea to pause as she left the room. She communicated to Leo that she thought Andrea resembled someone Marla knows. After some guessing, Marla let Leo know that this person was someone she had known for a long time, and she wrote the letters “T…i..” on a piece of paper. Leo guessed a few names, and then something clicked when he saw Andrea’s face again, and he asked Marla: “Does Andrea remind you of Tiffany?” Andrea froze in her tracks. Andrea has a sister named Tiffany. In a rush of recognition, it was revealed that Andrea’s last name is McFarland, and her older sister Tiffany McFarland (now Van der Schaaf), was a good friend of Marla’s growing up in Glenwood Springs. Tiffany came to visit Marla several times during her in-patient stays last year at St. Anthony’s and Craig Hospital. During her visits to Craig, she’d mention that she enjoyed the opportunity to see both Marla and her sister, who worked close-by at Swedish Hospital. The connection didn’t click until now. What an amazing intersection of friends helping friends!
We’d like to thank each and every one for his or her prayers and healing energy on Marla’s behalf, as well as the supportive friends and family who visited and supported us with comforting conversation and care packages during the surgery and recovery process. We continue to be amazed at the power of this support in Marla’s healing process, and we see it reflected in her strength of spirit.