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
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
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.