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Ryan: L1 Spinal Fracture

It was January 27, 2019 when the accident happened—on a simple ski club trip with the high school—only Ryan’s second time skiing.

“I thought, ‘I’m 18, I’m active, what’s the worst that could happen to me—a broken arm?’” Ryan began his interview. “I never considered a spinal injury, especially nothing as severe as this.”

Ryan describes his memory immediately following the skiing accident. He was in the park portion of the ski resort jumping off a ramp, but he landed wrong.

“It’s like I was folding in half,” he says. “I was conscious, but my memory just blacked out from the agonizing pain—and not just in my back, but in my entire body. Everyone rushed over that saw me fall and heard me scream.”

That’s when ski patrol brought the sled and took him off the mountain, at which point he could still feel his legs. By the time they got to the lodge, he no longer could.

They sent for an ambulance from the local hospital, but upon the EMTs’ arrival, they almost instantly realized that Ryan needed to be life flighted to Pittsburgh—and now. The level of trauma they were seeing simply couldn’t be addressed properly at a smaller hospital, so the helicopter came ready to transport him to UPMC Presbyterian.

“I remember laying in the helicopter and they said ’20 minutes to Pittsburgh’. They showed me a picture of the sunset outside since I couldn’t sit up, and I prayed the entire time,” Ryan recalls.

The Intensive Care Unit

Upon arrival to UPMC, Ryan describes the EMTs wheeling him through the doors and what seemed like a few dozen people standing at the ready for him.

“It’s incredible how many people were ready to help,” he says. “They cut off my clothes and immediately took me for every test imaginable—x-rays, MRIs, CT scans—just everything.”

All of this happening within minutes, Ryan recalls a brief moment between tests when he got to go to his hospital room.

“My uncle lives in Pittsburgh, so he was the first there. When I saw his eyes, it was the moment I realized ‘wow, I’m in bad shape’. It really hit me then…seeing his reaction,” he says.

Ryan’s mom, dad, and grandpa later made it to the hospital, but just before a nurse came in the room describing the test results. “She said, ‘we need to go into surgery right now,’” Ryan recalls.

What Ryan remembers of his surgery is mostly what he learned about it after, having been under general anesthesia, but he knows it lasted a few hours and was performed by orthopaedic spine surgeon Jeremy D. Shaw, MD and team. Ryan’s imaging showed severe trauma—torn back muscle from the bottom of the spine up into his shoulder blades, and worse, an L1 spinal fracture in which the L1 vertebrae was touching the spinal cord, causing paralysis from the waist down. Fortunately, the vertebrae didn’t puncture fully or sever the spinal cord, so there was potential for Ryan’s recovery.

After surgery, Dr. Shaw proceeded to visit each of the seven days that Ryan was in the intensive care unit (ICU) at UPMC Presbyterian, and even during his three days at UPMC Montefiore waiting to be transferred to inpatient rehabilitation.

“He’d stop by, and we’d just talk—about my condition, but also about anything. What he did was amazing, and he’s such a great guy too,” Ryan says.

He recalls their first conversation after surgery when Dr. Shaw described what he did during the spine surgery: inserted two rods and ten screws, fused his spine together where the fracture occurred, and removed the torn muscle that was dead or going to die.

“I said, ‘will I ever walk again?’ And he said, ‘We’ll do everything we can, but I can’t promise you that,’” Ryan shares. “But, it turns out I would do more than walk.”

The Rehabilitation Institute

There were a few challenges as physical therapists (PTs) in the ICU tried to have Ryan sit and stand up, including a leak of spinal fluid that required him to lay flat on his back for 48 hours to heal. Fortunately, that wouldn’t happen again and Ryan was even able to twitch one of his toes before leaving the ICU. After a short transition stay at UPMC Montefiore, Ryan was admitted to UPMC Mercy for inpatient rehabilitation—where he would push himself to the max and remain for about a month.

“The faster you can try to recover, the better,” Ryan says. “My mindset from the beginning was to work hard. I was only 18 and was going to try my hardest to not spend the rest of my life in a wheelchair. I got very lucky.”

Ryan describes setting weekly goals with his physical therapists—sometimes ones that they would exceed in one day. And the goals became bigger with each passing day. From simply standing up with support, to using a forearm walker with help, then a normal walker, forearm crutches, two canes, etc. He continued to progress at impressive speed, as his will to walk was stronger than the struggle and challenges he faced.

During his last day at UPMC Mercy, Ryan stood at the parallel bars on his own, with one of his PTs watching. He describes her saying “go ahead” and his confused reaction at first. But, he would go ahead.

“I was able to shift one foot ever so slightly, then the other foot, and I made it down to the end and was just bawling. I called my main PT Joe down and all of the other PTs came, and I said ‘I just walked!’ I’ll never forget that for as long as I live. The emotions and pure joy of doing that were overwhelming.”

The Minutes That Mattered

Thinking of his transition from inpatient to outpatient rehab back home, Ryan discusses the key moments that set him on his way to walking again. Without the decision to life flight to Pittsburgh, to immediately do surgery (an advanced and robust one that could only be done on patients in the prime of their life), and to tackle rehab so head-on, Ryan thinks he may not be where he is today.

“Everything that UPMC did in the most crucial moments put me on track for where I am now, and I still continue to improve daily. I loved it there and became so close with everyone…even wheeling out in the hallway at night to talk to the nurses. I still visit them when I can. A blessing from this entire journey is the people I’ve met along the way.”

Ryan got to return to high school to finish out his senior year as he continued outpatient rehabilitation. He won prom king and met a goal he set at the beginning of rehab—independently walking across the stage to get his diploma at graduation. Today, he’s a sophomore at the University of Pittsburgh at Johnstown, studying biology with a dream of becoming a neurology physical therapist and helping others like his incredible PTs helped him.

He currently walks with AFO braces and has actually begun to run recently.

“Now I’m trying to build up more strength and endurance, so I go to the gym a lot. I want to be able to maybe run a 5K or something one day. I like to keep setting goals and push toward them. My lofty goals in the beginning were standing up and walking, and we got there, so I’ll keep going. To be able to be where I am even now is an amazing blessing and a miracle,” Ryan says.

Ryan documented his entire recovery online in two personal videos* (part one and part two), with the goal of thanking the medical staff who helped him and inspiring others who may be going through something similar. In addition to speaking at churches and responding to comments on his videos, Ryan hopes that this story can be a ‘thank you’ to those who have done so much for him and a resource for those who are currently struggling.

“I know others can push through too, and I want to help,” Ryan says.

*These videos were privately produced and published by Ryan, the patient in this story. Links to the videos are provided as a convenience to readers. UPMC is not responsible for the content of these videos.

Ryan's treatment and results may not be representative of all similar cases.

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