‘I wanted to live’ | Health Beat

On a frigid morning in January 2022, four members of the DeWind family — mother, daughter, granddaughter and cousin — climbed into their Chevy Suburban for a short drive to visit a relative.

As they crossed a small bridge on M-45 outside Allendale, Michigan, the vehicle hit black ice and spun across the centerline.

“I remember my daughter saying, ‘Mom, I’m losing it, I’m losing it, what should I do?’” said Kim DeWind, 54, from Zeeland, who sat next to her daughter, the oldest, in the passenger seat. of five grown children.

She told the kids in the back seat to hold on tight.

“I remember seeing the pickup coming over the hill. And I thought, ‘We’re going to get it bad.’”

Indeed they did.

The truck and SUV collided. Three of the SUV’s occupants were injured, two of them in critical condition.

Kim and her 6-year-old granddaughter took the brunt, each with crushing injuries to the right side.

When Kim’s husband, Jeff, arrived from his workplace down the road, he understood the gravity of the situation in an instant.

“My daughter is a nurse… and she had her daughter, my granddaughter Nora, on her lap. And she said, ‘Dad, I think she’s dying—and I think Mama might be gone by now,’ said Jeff.

“I’ve worked as a first responder at my local fire department for 16 years and I’ve seen a lot,” he said. “I didn’t have much hope that either one would survive, standing there on the side of the road.”

Level 1 trauma

A pair of ambulances transported Nora and Kim to the Level 1 Trauma Center at Spectrum Health Butterworth Hospital. Pediatric trauma specialists received Nora and admitted her to Spectrum Health Helen DeVos Children’s Hospital.

Meanwhile, the trauma team gathered to await Kim’s arrival in the trauma room.

The team’s initial assessment looked bleak: she had low oxygen levels, increased heart rate, low blood pressure, poor tan.

Doctors immediately began basic life-saving interventions: a chest tube to drain fluid from the chest cavity; intubation to open her airway; a central line for administering blood, fluids and medication; and an arterial line to monitor her unstable blood pressure.

Inserting the chest tube posed a particular challenge because Kim’s ribcage had suffered severe damage.

Once she seemed stable enough, doctors took Kim for a CT scan to determine the extent of her injuries. Imaging revealed multiple serious trauma, including one of the most dangerous potential problems: a rupture in her main blood vessel, the aorta.

“This is a potentially devastating injury,” says Alistair Chapman, MD, an acute care surgeon on Kim’s healthcare team.

“The vast majority of trauma patients with an aortic injury do not make it to the hospital alive.”

The ruptured aorta immediately became priority number one. With Kim still in the CT scanner, the trauma doctors began alerting their consultants, starting with the vascular surgeon on call.

When the team took Kim to the surgical ICU in preparation for an aortic repair, Gaby Iskander, MD, chief of acute care surgery, ducked to meet Jeff, who had arrived in the emergency room awaiting news about his wife and granddaughter.

“He gave me a quick overview — that they saw a tear in the aorta and they were going to try to put a band-aid on that and he needed to get moving,” Jeff said.

“So I just signed my name and said, ‘Yeah.’ He said, “Do you have any questions?” I said, ‘No, I’m fine – go.’”

cardiac arrest

In the ICU, as Kim’s doctors discussed their plan to deal with her full list of injuries, they faced another crisis: cardiac arrest.

Kim’s heart stopped right there in the surgical ICU.

The nursing team began chest compressions as the two chief surgeons scrambled to see if they could determine the cause of the arrest.

After several minutes of intense exertion, including the insertion of a second chest tube, Kim’s heart rate returned and the team breathed a collective sigh of relief.

The intensity of that moment has stayed with him, said Dr. Iskander.

“The fact that her heart stopped — it just took a toll on me,” he said.

“We get so attached to our patients, especially in the ICU and in trauma. … You don’t want anything bad to happen to them.”

Although far from stable, Kim needed surgery right away.

As they rolled her into the operating room, Jeff had a brief chance to see his wife. A medical social worker met him in the waiting room and led him down the hallway to take her to the operating room.

“I knew a ruptured aorta was a really bad sign,” Jeff said. “I thought we were probably at the end.”

For the next several hours, the vascular surgeon, with the support of a skilled trauma and anesthesiology team, worked on a stent of her ruptured aorta.

After the successful procedure, Kim came under the care of the ICU team and Jeff was able to see her again – alive, but still touching and going.

All the while, Jeff kept in close contact with his daughter and watched over little Nora at the adjacent children’s hospital.

Although “she wasn’t out of the woods for the first 24 hours,” Nora left the hospital eight days later, he said, and has made a good recovery. She will have follow-up surgery in July to remove the hardware in her leg.

chest wall repair

The next morning — hospital day two — Kim’s vital signs and lab work looked so good that the team felt comfortable sending her to her next surgery, to repair a fractured humerus.

With that settled, doctors prepared for the next day’s surgery—her reconstruction of the chest wall and repair of the diaphragm.

For that kind of work, Dr. Chapman the hospital’s go-to surgeon.

“I’ve spent a few days examining her CT scans, thinking about how I’m going to handle this once she’s stable enough to have a really long surgery,” said Dr. chapman.

Kim’s chest wall injury was probably the worst he’s ever seen.

“Her chest cavity was basically crushed and the ribs that should be on the outside of the chest were almost adjacent to the heart, in the center of the chest,” he said.

Kim had what doctors call flail chest, meaning much of her ribcage had loosened from both the spine and sternum.

“The entire right side of her chest wall was not contributing to her breathing,” said Dr. chapman.

In total, Dr. Chapman 15 snaps with 12 titanium plates and 94 screws—the most hardware he’s ever used in a chest wall repair.

Now, just two days after the car accident, major surgeries were over and Kim’s health care team was able to take stock of her additional injuries, including trauma to the mid and lower back, a lung laceration, liver laceration, shoulder blade fracture, collarbone fracture and vertebral artery injury.

All of these, they determined, could be treated non-surgically while she rested in an artificial coma, fighting a fever, attached to a ventilator.

Power to fight

The big question that loomed in the background had to do with Kim’s neurological function. An early MRI of her brain showed she had suffered multiple strokes, likely from the disruption of blood flow caused by her aortic injury.

When her neuroexaminations continued to go bad on day six in the hospital, the ICU team placed a tracheostomy in her neck, knowing it would make it easier for her to eventually come off the ventilator.

They also inserted a feeding tube to deliver nutrition into her digestive tract.

While the ICU team watched her around the clock, Kim’s family, church and community prayed.

Around day eight, Kim remembers hearing her daughter’s voice.

“I don’t think I was awake… but I remember these words, and she just said, ‘Mom, if it’s too much, we understand and we can let you go.’ She said, ‘Mom, do you even want to fight? Do you have the strength to fight?’”

And Kim nodded very softly—her first bit of communication since arriving at the hospital.

“I remember that, so that’s pretty cool,” Kim said. “I knew I was in bad shape, but I just decided that I would fight with everything I got because I wanted to live.”

Fighting she did, with seemingly miraculous results.

The next day Kim was able to nod her head. The next day, she opened her eyes and responded better. She recognized relatives and spelled words by pointing to a letter board.

It wasn’t long before she was off the ventilator and then off the feeding tube.

“Every day was super substantial, noticeably better,” said Jeff.

On day 13, Kim left the ICU. Just two days later, she was discharged to Mary Free Bed Rehabilitation Hospital, where she spent two weeks in acute rehabilitation before going home.

“To see how unbelievably far she’d come in four weeks was just, you know, the wonders seem to never end. She survived the aortic tear. That’s so rare. She didn’t suffer any brain damage from all that, I think that’s also very rare,’ Jeff said.

“And then the fact that she’s only at Spectrum for 15 days and then another 14 at Mary Free Bed — all those things are just incredible to me.”

Jeff is not alone in his surprise. Kim’s doctors also expressed their awe at her survival and recovery.

“Given all her injuries and what her injuries looked like, it’s just a miracle she’s alive,” said Dr. Iskander.

She overcame huge odds of surviving this event, repeated Dr. chapman.

“An aortic injury — the chance of surviving that injury is less than 1%,” he said. “And then the chance of surviving a blunt cardiac arrest is also less than 1%.”

Much of the credit goes to his colleagues on the trauma and ICU teams, he said.

“When you think about having a well-functioning trauma system, there are many elements to maintaining that,” said Dr. chapman.

“It’s just cool to see how it works out for a patient the way it did for her.”

‘A great moment’

When Kim returned to Butterworth Hospital for her first appointment at Spectrum Health’s Multidisciplinary Trauma Clinic, several of her doctors came to see her.

“It was an immense joy…to see someone who was seriously injured go back to their family, back to their granddaughter, back to their daughter and enjoy this – enjoy their family, and their family enjoy them,” dr. said Iskander.

“I still get emotional every time I think about this patient.”

For the DeWinds, the reunion was equally meaningful.

“You could just feel this emotion in the room, from all of us,” Kim said. “It was a great moment.”

Back at home, Kim continues a long process of physical and occupational therapy to help her upper body regain strength and function.

Day after day, week after week, she sees progress.

“I’m surprised how tired I am. But I’ve been on it for over a week,” she said. “I’m winning.”

She eventually hopes to return to the part-time job she loved, working at a small family restaurant, where the regulars have become friends.

But even when she goes back to work, she doesn’t plan on filling her schedule the way she used to.

“We want to finish our plate and enjoy life,” Kim said. “I’m going to live life a little fuller,” cherishing her six grandchildren and the other loved ones who nearly lost her.

The whole experience remains overwhelming for her.

“In a good way,” Kim said.

“Oh man, I appreciate things so much.”