Rehab Center helps Salinas couple after devastating crash

Sam Karas Acute Rehabilitation Center at NMC restores function after trauma

Written by D.L. Taylor | The Salians Californian

Dr. Anthony Galicia demonstrates an upper body ergometer on Thursday in the exercise room at Sam Karas Acute Rehabilitation Center, part of Natividad Medical Center in Salinas. / Photo by Jay Dunn/The Salinas Californian

SALINAS, CA - November 15, 2013 – It was a beautiful June day in Salinas, and Terry and Wendy Frerkson were spending the day cruising the highways on their Harley Davidson. After church they headed north for lunch in Morgan Hill and then motored to San Juan Bautista before heading back to Salinas. They never made it home.

As they motored through Prunedale, traffic slowed to a crawl as rubberneckers forgot about driving and focused on a crash on the other side of the freeway. Terry began splitting lanes, steering between cars, which is perfectly legal when traffic slows to under a certain speed.

As they pulled alongside a pickup, Terry called back to Wendy through a helmet-to-helmet voice connection.

“Look at this idiot on a cellphone,” he called back to Wendy, gesturing at the driver of the pickup. Not trusting what the pickup would do, Terry sped ahead and got in front of the pickup, but a Suburban in front of the truck suddenly braked, likely a result of drivers in front of it finding a crash more interesting than focusing on driving.

The impact sent Terry face first – literally – into the rear end of the Suburban and launched Wendy into the center divider.

“I could see her back to me and I heard her moaning,” Terry said during an interview in September – three months after his crash – at the Sam Karas Rehabilitation Unit at Natividad Medical Center. He tried to call out to her, but his entire face was crushed and “talking” was a mumble.

Trauma nurses from Salinas Valley Memorial Hospital were also caught in traffic and came to the aid of the couple.

“They told me she was OK and I began to relax,” Terry said. “I didn’t feel any pain but I remember swallowing a lot of blood.”

He was hurt worse than he believed, but the nurses and subsequent paramedics called in a helicopter to fly Terry to a trauma center in San Jose. After weeks in intensive care, Terry learned he had a crushed cervical spine and his face had been crushed flat. Multiple surgeries were required, including replacing the bones around one eye – called an orbital socket – with steel plating.

That would heal, with the help of a plastic surgeon to the point where it is difficult to tell that he had such massive facial trauma at all. But the spine was a different story.

Meanwhile, Wendy was trying to keep the home together with her sore ribcage. She was diagnosed with fractured ribs and sent home to heal. Their son, Justin, took off from his job to help his parents. He was never comfortable with his mom’s injuries.

“When she left the emergency room I noticed a puffiness on the side of her head,” Justin said. In the weeks that followed, while his dad remained hospitalized, he began to notice changes in his mom.

“The whole month after the accident she seemed like she wasn’t there,” Justin said.

Wendy knew she wasn’t herself and had a hard time making decisions. When Terry hit the Suburban, Wendy was flung first to the side, where her head could have easily impacted the pavement – certainly her ribcage did. The bike jerked back up and launched her toward the center divide, where she again could have slammed her head against the ground.

Finally, weeks later she went to her doctor. After a quick examination, her doctor called the emergency room at SVMH and alerted them to a brain trauma en route.

The ER quickly determined that Wendy was suffering what’s called a subdural hematoma – bleeding beneath the dura, or the protective tissue wrapping the brain. With no place to go, the blood and other fluids were exerting pressure on her brain. Left untreated, the condition could become fatal.

“Chronic subdural hematomas can occur days or even weeks after a trauma injury,” said Dr. Gus Halamandaris, a neurosurgeon at SVMH, but who did not treat Wendy. “They are quite common and can occur even after soft bumps to the head.

In few cases the hematomas can be treated medically, but in most cases, Dr. Halamandaris said, a surgical solution is necessary. A surgeon will cut what’s called a burr hole in the skull and dura, and in many cases of chronic subdural hematomas, allow the fluids to escape. If a blood clot is involved, it will need to be removed with instruments.

Meanwhile, Terry was released from the San Jose trauma center to the rehabilitation center at Natividad. Because the injury to his spine was in the neck area, and encompassed several vertebrae, and his spinal cord was compressed at the moment of impact, it resulted in “traumatic cervical cord compression.” It left him with a paralysis on the left side of his body. He would need to learn to walk and use his left arm again.

Both Terry and Wendy ended up at the Sam Karas Rehabilitation Center, a regional center for acute, traumatic brain and spinal cord injuries. Once a patient is stabilized at an acute care hospital like SVMH or Community Hospital of the Monterey Peninsula, they are transferred to Sam Karas to begin a hard journey of getting as close to the mobility and ability they had before their trauma injuries.

“Our goal is to restore function as much as possible,” said Dr. Anthony Galicia, director of the Sam Karas center.

But neuro-rehab centers are challenged by cuts in funding for Medicare and Medicaid.

“Twenty years ago, if a quadriplegic was admitted, we would have three to six months to work with them,” Galicia said. “Now, we have three to four weeks. It would be ideal for the patients to stay longer but that is the reality of the system now.”

After treating Wendy for some balance issues, common after brain surgery, she is back to herself. Terry is a fighter, and Galicia has him walking, though with a limp,

As for the motorcycle, Terry said it is still in the shop, and, well, “I’m still thinking about that.”

Dennis L. Taylor writes about medicine for The Salinas Californian. Follow him on Twitter @taylor_salnews.


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