ONE BRAVE BOY August 20, 2020 How compassionate care at Horizon’s The Moncton Hospital helped one family through a childhood injury Every parent knows accidents happen. A tumble here, a scratch there, maybe even a broken bone. But what parents don’t expect is an accident leading to three surgeries and weeks in hospital, all during a global pandemic. GET TO THE HOSPITAL Five-year old Nathan Lewis and his twin brother Nicholas were heading outside to build a fort at their home in Petitcodiac when disaster struck. The busy boys were in the garage when curiosity got the best of them. Nathan turned on his dad’s band saw and cut his thumb almost completely off- it was only holding on by one tiny piece of skin. Nathan’s mom, Cyndy, was in Moncton picking up a new washer and dryer and received the call no parent ever wants to receive. Her son was in an ambulance on his way to the hospital, and she needed to get there – quickly. Cyndy raced to the hospital and arrived before the ambulance. She didn’t know what to do with herself, she had so many questions and was filled with uncertainty. “I walked in and didn’t know what to expect, because of COVID-19,” Cyndy recalls. “I didn’t even know if I would be allowed in the hospital, which was the scariest thing ever.” As soon as she was greeted by the triage nurse, Cyndy broke down in tears, trying to explain why she was there. After being screened for COVID-19 symptoms, she was brought into the trauma area, which was ready and awaiting Nathan’s arrival. In those moments of chaos and fear, Cyndy received kindness and compassion from staff at Horizon’s The Moncton Hospital (TMH) Emergency Department. They took care of her, bringing her water and cold compresses, so she could be ready to take care of Nathan when he arrived. Due to COVID-19 visitor restrictions, Nathan’s siblings had to get creative with their visits. They had many window visits during Nathan’s hospital stay. SURGERY NUMBER ONE Once Nathan arrived, the health care team in the Emergency Department got to work. Dr. Brent Howley, plastic and cosmetic surgeon, explained to Nathan’s parents what to expect and all the possibilities, informing them Nathan would need surgery. Within an hour of arriving at TMH, Nathan was in the operating room (OR), his parents anxiously awaiting his return. Dr. Jayson Dool, plastic surgeon, was called to assist with the surgery. Through it all the family felt informed and empowered; they were provided information and answers as soon as they became available. “We were told Dr. Dool was amazing at micro attachments (Microvascular Surgery), so we felt confident,” Cyndy said. Microsvascular surgery is used to reattach severed fingers, hands, arms, and other amputated parts to the body and is performed by reconnecting the small blood vessels before the injured tissue begins to die. After the grueling first hour of pacing, the family was brought to an in-patient room where they could comfortably wait for Nathan. While there Cyndy met Shannon Kolanko, a registered nurse. Cyndy explained how it felt like a weight had been lifted off her shoulders to have Shannon by her family’s side. Shannon would call the OR to check on the surgery, without being asked, and made them feel at ease. “They never once made me feel like I was bothering them, like I was a nuisance,” said Cyndy. “The operation lasted ten hours and Shannon kept us updated the whole way through.” After a long ten hours, Dr. Howley returned to tell Cyndy his thumb had been attached, but there was a 50/50 chance Nathan could still lose the thumb despite the initial success. The vessels are extremely small and all it takes is one tiny vessel to clot off for the replanted thumb to die. “I couldn’t believe they put that much time into a little thumb,” recalled Cyndy. “But they did all that to save it by doing a vein graft on his leg. Basically, they were trying to attach a hair back in place.” Nathan, in his hospital room, surrounded by the many Lego sets he assembled during his long stay. LEECHES, SURGERY, AND MORE SURGERY What followed the initial surgery, was a long road, filled with two more surgeries, leech therapy, lots of physiotherapy, pins and a cast. “For his first surgery, Nathan required a microvascular replantation of his thumb,” said Dr. Dool. “This was followed by several weeks in hospital at which time we used leeches to help prevent coagulation of blood in the small blood vessels of his attached thumb. Also, they helped prevent clotting from occurring.” As such we had Nathan in the hospital for a longer period of time using drugs and leeches to prevent clotting from occurring. After weeks of leech therapy, Nathan’s second surgery took place, but a part of the tissue died. “There was a small section of the thumb that did suffer necrosis (premature death of cells) after replantation,” said Dr. Dool. “We created a pocket underneath the skin of his chest and sewed the thumb into his stomach for three weeks before releasing the thumb and using the skin from his chest to complete the coverage of the thumb.” For three weeks, Nathan lived with his thumb implanted into his stomach to help promote cell regrowth. He spent most days with his little body wrapped in bandages to keep his arm in place. His final surgery to release his thumb from his stomach was a success, and he was finally able to return home for good, after spending almost two months in hospital. “He is an extremely sweet young boy,” said Dr. Dool. “Of all the words I could think of to describe Nathan, I would have to say that ‘brave’ springs to my mind for obvious reasons. He endured a lot of surgery and a long stay in hospital to get through this ordeal.” NATHAN AND THE GIRLS These days, Nathan can talk about his accident with confidence and humour. He can explain the sounds an ambulance makes and how fast they drive. But in the days following his accident, he became a shell of himself, a quiet, scared boy, unrecognizable to those who know and love him. With the help of staff, Nathan slowly became his lively self again. Derek Kidd, a pediatric physiotherapist, was the first person to break through and get a smile from Nathan. After Derek joked with Nathan and managed to get him to crack a smile, the smiles kept coming. Nathan and Horizon pediatric physiotherapist Derek Kidd. “Derek’s quirky attitude got him out of bed,” said Cyndy. “from that moment on, things started looking up.” He laughed and played with anyone who came into the Pediatrics unit. According to Cyndy, Nathan “walk(ed) around like he owns the place.” Staff became his family, his playmates, his lifelines. He affectionately called the nursing team in Pediatrics “the girls” and cracked everyone up by naming his IV pole “Karen” after a character from SpongeBob SquarePants. Board games and Lego became the highlights of his hospital stay -anything to keep him busy between appointments, physiotherapy and dressing changes. “Nathan was an awesome patient,” said Grace Osburne, licensed practical nurse. “He went through a lot as a young boy but managed to take it all in stride.” Grace worked with Nathan daily, helping with dressing changes, going for walks and providing comfort. She said she’ll always remember him for his sweet smiles and warm hugs. Nathan and Horizon licenced practical nurse Grace Osburne. LOOKING BACK Most people will remember 2020 as the year of the COVID-19 pandemic, but Cyndy will remember it as the year she and Nathan lived at TMH. And while it’s been a bumpy road, she is thankful -thankful Nathan is ok, thankful he’s recovering and thankful to have had a positive experience. “We won’t look back on this as a negative,” she said. “What could have been a very negative experience for Nathan was made better by the staff. There are not enough words or enough I can do or say that will show my appreciation for this floor. Nathan has a piece of all their hearts and they have a piece of his.” Nathan thinks the world of everyone he dealt with through his hospital experience. And the staff who met him know he has a bright future ahead. In fact, he wants to be a nurse when he grows up, like the nurses he says saved his life. Staff helped Nathan decorate his hospital room door with plenty of Paw Patrol pictures.