Montana Man Survives Aortic Tear Thanks to St. Vincent Trauma Team

March 28, 2015, started out like any other Saturday for Richard Simons and his wife, Susan. The couple had just wrapped up a trip to the grocery store and was on their way home, when the wind started to pick up.

Richard Simons

Trauma Patient: Richard Simons

“We were about three miles out of town and all of sudden we were engulfed in a black cloud of dust and debris. We couldn’t see a thing,” Simons recalled. “I don’t really remember what happened next, but we were involved in a terrible accident on Interstate-90. I remember slowing down, but I didn’t want to stop because we didn’t know who was in front of or behind us. I ended up colliding with a vehicle in front of us, which then caused our vehicle to spin and we were hit broadside by a truck. My wife did not survive the accident.”

Simons, 72, sustained numerous injuries during the traumatic crash and was transported to St. Vincent Healthcare by an area ambulance service.

“His life depended on everybody doing their part flawlessly, beginning with the EMS providers on the scene and continuing through the ED, OR and Cath Lab teams. It helped so much that we all knew each other and had a mutual trust and teamwork that have been honed every day for years,” said St. Vincent emergency physician, Dr. Douglas Parker. “While very focused and intent, we didn’t panic because we knew we could count on everyone to do their part.

Upon arrival to the St. Vincent Healthcare Emergency Department, it was determined that Simons was suffering from a pericardial tamponade. A pericardial tamponade occurs when blood fills the sac around the heart, causing pressure on the heart. Dr. Parker and St. Vincent trauma surgeon, Dr. Michael Wilcox, began using syringes to draw blood from the area around the patient’s heart. Simons temporarily improved each time they drew blood, but they needed assistance from the cardiac team.

While in the emergency department, St. Vincent cardiothoracic surgeon, Dr. Jason Fitzgerald, emergently opened the patient’s chest to control the pressure on the heart and promptly transported the patient to the operating room with the cardiovascular team.

trauma team & patient

Pictured Left to Right: Dr. Jason Fitzgerald, Dr. Michael Wilcox, Dr. Douglas Parker, Richard Simons

In the operating room, the patient was found to have a traumatic thoracic aortic tear. Dr. Fitzgerald and St. Vincent vascular surgeon, Dr. Kevin Bruen performed the aortic repair.

More than 80-percent of patients who sustain a traumatic thoracic aortic tear die on scene and the odds of survival are slim even if they do make it to a hospital.

“This was one of the most memorable and gratifying cases of my career. It demonstrated why we go to all the work and planning of a trauma system,” said Dr. Parker. “Because of it, our patient went on to survive an injury that has a 90-98% mortality rate among those who arrive to the ED unstable.”

“When I woke up in the ICU, I remember the doctor telling me that I was a very lucky man. They told me that no one ever comes through the emergency department in my condition, alive,” Simon said. “That was pretty impressive to hear. It’s absolutely fantastic what the doctors and nurses were able to do for me.”

Simon spent one week in St. Vincent Healthcare’s Intensive Care Unit and one week in recovery on the third floor of the hospital. He’s now back at home and on the mend.

“My lungs were pretty badly bruised, so I’m still a bit sore and have shortness of breath, but I’m healing up pretty well,” Simon explained. “I have my good days and bad days, but I’m trying to keep a positive outlook. I have a great support network both at St. Vincent Healthcare and at home.”

“I truly believe that the exceptional care delivered in the field and carried through the entire hospital stay, gave this gentleman an extraordinary second chance at life,” added St. Vincent Healthcare Trauma Coordinator, Samantha Kaufman. “It was a true team effort.”

Botox for Limb Pain?

It’s been nearly 20 years since Scott Petersen was involved in a vehicle accident that altered his life forever.

Botox - PLP Patient“It was January 14, 1998. I was driving across the Midwest in a whiteout blizzard, when I collided with another vehicle head on,” recalled Petersen. “I was ejected from my truck. It’s amazing that I survived.”

As a result of the accident, Petersen’s right leg needed to be amputated below his knee.

“For many years, I dealt with phantom limb pain,” explained Petersen.  “Your life just stops with phantom limb pain. It not only hurts physically, but it changes you mentally. It feels like someone stuck an ice pick in the bottom of my stump.”

At its worst, Petersen’s phantom limb pain would last for 24-36 hours. Approximately 80-percent of amputees experience phantom limb pain, according to St. Vincent Neurologist Dr. Arturo Echeverri.

Desperate for a solution, Petersen was referred to Dr. Echeverri. After meeting with Peterson, Dr. Echeverri suggested injecting Botox (botulinum toxin) into the base of Petersen’s amputated leg.

Botox - Phantom Limb Pain“Scott had failed to respond to any other treatments or medications,” explained Dr. Echeverri. “So I suggested we give them a try and Scott was on board.”

The toxin works by blocking neurotransmitters in the injection area. Larger doses can lead to a fatal illness called botulism, but Petersen receives only about 400 units per procedure. A toxic dose would consist of 2,700 units. The injections are extremely painful to receive, so Petersen is now placed under general anesthesia during the procedure.

Botox treatment for phantom limb pain has not been approved by the U.S. Food and Drug Administration, but Dr. Echeverri believes it will be approved in the future.

“It will take years before it’s FDA approved, but I do believe it will be approved,” said Dr. Echeverri. “Botox injections have been approved for a number of other conditions that cause head and neck spasms, excessive sweating and chronic migraines. So I think it’s just a matter of time before it’s approved for phantom limb pain.”

The results of the Botox injections have been very dramatic for Peterson.

“When a solution comes along that actually works, you just thank God that he put someone in your life who could help you,” Petersen said. “For me, that was Dr. Echeverri. He totally turned my life around.”

Petersen lives in Lewistown, so Dr. Echeverri travels to Lewistown every few months to perform the procedure on Petersen. This allows the patient to stay close to home, while still receiving specialized care that would not be routinely available.

After Six Concussions, Student Educates Others About Head Injuries

Lacing up her soccer cleats and hitting the field has been a way of life for 18-year-old Alexis Torbert, but her passion for contact sports has come at a price.

“I’ve had six concussions that have been medically treated; my first one was in sixth grade,” explained Senior High School Senior, Alexa Torbert. “If I get another one, I will be out of contact sports forever.”

Concussions among student athletes is an issue that Athletic Medicine and Performance (AMP) physician, Dr. Ben Phipps, is passionate about. Trained in concussion management, Dr. Phipps has seen the impact a concussion can have on a student athlete.

“Concussions are currently a hot topic in sports medicine and for good reason.  We now understand that this is an injury that has the potential to have long-term effects, not just in sports but in everyday life,” said Dr. Phipps. “The key to helping a concussion is early recognition and treatment. Anything that raises awareness and improves concussion protections will help improve outcomes.”

Torbert admits that she will always have the “put me in coach” mentality, but she understands that concussions are a serious issue and need to be better understood. Because of this, the honors student decided to dedicate her senior project to the topic of concussions.

“I recorded interviews with several coaches, teachers and students about concussions and edited together a video, so it can be shown to student athletes at the beginning of each season,” Torbert explained. “The video is a unique approach to helping my fellow athletes and teammates understand what concussions are, how to recognize the signs and symptoms of a concussion and why it’s important to address concerns.”

AMP athletic trainer and Billings Senior High athletic trainer, Stacy Molt, has worked with Torbert throughout her high school career and commends the 18-year-old for her desire to benefit the community she was raised in.

“Alexa is one of those athletes that want to make a difference,” said AMP Athletic Trainer, Stacy Molt. “She took her experience of having a few concussions and turned it into a learning experience that will benefit the whole school and potentially the whole community. She is a go getter, very spunky and going to make a difference.”

Torbert’s concussions haven’t scared her away from the sport she loves, but she admits she has changed her approach.

“I’m still aggressive,” she insists. “But I don’t take unnecessary risks anymore.”

You can see her 3:46 min. video on YouTube here.

See her story in the Billings Gazette here.