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| When Katelyn signaled to her Dad (left) that she wanted her iPhone to text friends, he knew she was going to be ok. |
Katelynn Malone,13, was sprawled on her side about six feet from the motorcycle. She'd been a passenger on the bike—and was not wearing a helmet—when the motorcycle and a car collided at North 31st Street and Avenue G in Council Bluffs.
Her vital signs were normal but she was sleepy, with bouts of crying. Katelynn complained of pain, not knowing then that she had a broken tibia in her left leg and the ligaments in her left knee were torn.
But most concerning to the medics who rushed her to Creighton University Medical Center, the designated trauma center that Saturday in May—blood in her right ear, swelling in the back of her head and some decline of consciousness.
The trauma team was activated. A trauma surgeon, a neurosurgeon and an orthopaedic surgeon gathered. Doctors expected Katelynn to live but didn't know how well she would function again, given the traumatic brain injury she suffered when she was thrown from the motorcycle.
Charles Taylon, M.D., chief of neurosurgery at CUMC described the first days: "A computed tomography scan of her brain revealed she had a traumatic brain injury. We placed her on a breathing machine and gave her medicine to control her brain swelling. It also acted as a sedative. Katelynn was in an induced coma for two weeks while we monitored the oxygen and pressure levels in her brain. She went through some bad periods when we didn't know if the treatment was going to be successful."
Two weeks into her coma, Katelynn's dad Jeff left her side to go to home to Woodbine where friends and strangers were holding a community vigil. He knew her future was uncertain. Doctors told him he could be caring for her, even feeding her, the rest of her life. In their hometown, about 130 people held candles and prayed for Katie. Jeff remembers her best friend coming up and giving him a hug, then everyone else lining up behind her, giving him more hugs and encouragement.
On the hour drive back to CUMC, he had no idea that back in a fourth floor room,his daughter was coming back to him. The nurses were smiling and one of them couldn't wait to tell him him, "Things are changing!" As the pressure in Katelynn's brain stabilized, Dr. Taylon and his medical team had gradually weaned her off most of the medications so she could slowly wake up. Jeff described the first couple of days as "scary." She wasn't Katie. You couldn't have a conversation with her." But then she signaled him that she wanted her iPhone—and now! Katelynn wanted to text her friends. She didn't have the motor skills yet to punch words and numbers into her phone, but at that moment he knew she was going to be okay.
Like Jeff, doctors were surprised at the suddenness of her recovery. Justin Siebler, M.D., the orthopaedic surgeon at CUMC who stabilized her leg during her coma said: "When the orthopaedic nurse navigator called me and said Katelynn was sitting in bed reading a book, I didn't know how it could be true given the grim prognosis she had faced. One day she was in a coma. Two days later, she was able to speak with me. Obviously, a miracle had occurred."
Dr. Siebler repaired her left leg after she came out of her coma, using a plate and screws to fix her broken tibia. Last week, just in time for Thanksgiving, she returned to CUMC to have her knee checked. Thomas Connolly, M.D., repaired her damaged cartilage and continues to monitor her. She's likely to need a couple more surgeries on the knee. She's also had to spend two weeks at a rehabilitation hospital and has undergone extensive occupational, physical and speech therapy.
Jeff and Katelynn credit much of her recovery to the trauma team and the physicians who cared for her, as well as the nurses. Jeff says, "CUMC is a super place. The physicians and particularly the nurses in pediatric intensive care, got us through each day. I am so grateful to all of them." Katelynn remembers one nurse who washed her hair for her and combed out the knots. She says all of them smiled at her all the time and urged her on.
Dr. Taylon also praises the nursing staff: "Their nursing knowledge and experience in taking care of pediatric head injuries was the material and substantial cause of her recovery."
Patients who are in a coma for as long as she was can develop sores, pressure ulcers, pneumonia and other complications. Robbie Dumond, the trauma services manager, said Katelynn's recovery "was directly related to the nursing care that was provided." He says her case is a good example of how the trauma system works: EMS recognized her need for specialty trauma care. She was brought here directly and the doctors were all on standby. Her care was seamless and everyone functioned as a team to assist in her recovery: "We had no idea then that she would do the things she does today."
Dr. Taylon believes she'll be able to return to a "relatively normal life" while Dr. Siebler is "cautiously optimistic" about her being able to participate in sports again. Dr. Connolly tells the family she likely will need two more surgeries on her left knee. Katelynn was very involved in basketball, volleyball and track and field. After her accident, the teams made her "manager," so she could still be with them.
Jeff isn't ruling anything out. "We're taking things slowly but Katelynn has shocked everyone so far." He expects that she'll be active again in sports in high school. She's in eighth grade now.
Katelynn made the honor roll this semester and despite issues at first with her speech and her sense of smell, she continues to improve. At her checkups, she makes it a point to stop by and say hi to the people who helped her. Then she heads out the front door, cell phone in hand, texting her friends that she's on her way home.
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