UMC trauma team helps cyclist hit by truck live to ride again
What Ron LaGrande had planned –– a 10-mile ride on his $8,500 Trek Madone racing bike to get some exercise –– did not include seeing winged people flying or being forced to learn how to fly with them in order to earn a thirst-quenching red soda.
No, he hadn’t figured that bizarre dreams from painkilling morphine would be part of his day. Of course, he never thought he’d get hit from behind by a pickup truck either, one that drifted onto the shoulder at 60 mph to slam into him, a brutal impact that catapulted him off his bike and over a guard rail and left him with multiple pelvic fractures, deep gashes, broken ribs, a cracked hip-joint socket, lacerated kidneys, a fractured elbow and broken bones in his back.
Trauma that caused him to lose more than half the blood in his body.
How the 70-year-old retired California Highway Patrol officer managed to survive –– Dr. Timothy Browder’s emergency surgery at University Medical Center had a lot to do with it –– will be shared Monday by doctors, nurses and LaGrande’s family at the annual UMC Trauma Survivors Celebration.
It is the kind of trauma care you pray for when you or a loved one needs it.
This year’s event, which gives trauma teams and patients and their families a chance to meet again under better circumstances, is at 10:30 a.m. at Caesars Palace. Again, one amazing story of survival after another will support a fact on file at the National Trauma Data Bank: Of those who arrive alive at Nevada’s only Level 1 trauma center –– where many have a less than 1 percent chance to live –– 96 percent survive and are discharged.
In recent years UMC trauma teams have saved the life of a man who had a metal pole driven through his mouth and out through his neck and that of a motorcyclist who lost control at 90 mph and was dragged for 175 feet before the bike landed on top of him. Both men have returned to work.
The UMC Trauma Center services the more than 2 million residents of Clark County and its 32 million visitors per year. The service area consists of 1,500 square miles, including Southern Nevada, parts of California, Utah and Arizona.
LaGrande was evacuated by helicopter from an accident scene outside Lake Havasu City, Ariz., and flown to UMC.
“That is a decision that my family and I thank God for,” said the former cop, recuperated enough now to ride a new bike 20 miles, three times a week. “I spent 17 days in the ICU under some of the most competent medical personnel in the world. … When I was depressed and wanted to die, the staff remained firm and gave me hope. I remember one nurse that was relentless when it came to me eating and spitting out my medicine, so much so that I finally capitulated and told her that if I lived it would be her fault.”
The accident
The day that LaGrande, then 69, only has a partial memory of, Jan. 19, 2012, began as it usually did, with an early morning workout. He had long prided himself on being physically fit, allowing him to carry a well-muscled 190 pounds on a 6-foot frame. His routine was to ride his bike or lift weights after his 1998 retirement.
That fitness, doctors would later say, contributed to his living through the punishing wallop delivered by the right fender of a two-ton Ford F-150 pickup.
Other cyclists in the area noted LaGrande was southbound on Arizona State Route 95 about 10 miles outside Lake Havasu City when he was hit. LaGrande has no memory of the accident called in to the 911 operator by a fellow rider about 7:20 a.m.
Though rescue personnel could see few visible injuries and LaGrande was still conscious but confused, the decision was made to medivac him because internal injuries were suspected.
Authorities also found another confused and dazed man at the scene, 76-year-old William B. Heflin Jr., the driver of the red pickup. He was found to have taken the prescribed sleeping pill Ambien in the hours before the accident. He was charged with two counts of aggravated assault and could serve as many as 15 years in prison. Deputy Mohave County Attorney Jeremy Huss said Heflin is scheduled to appear May 16 in Arizona State Superior Court on the charges.
Attempts to reach Heflin were unsuccessful.
“The only thing I think I remember from the time I got hit –– and I’m not sure of that –– is the sense that I was on a helicopter. … I think I heard someone talking about it,” LaGrande said.
THE RESPONSE
Browder, 40, and his UMC trauma team were told by inbound air rescue personnel that LaGrande was hanging onto consciousness, though his anguished complaints of pain signaled severe internal injuries.
Soon after his arrival about 8:30 a.m., LaGrande required a tube be inserted in his throat to help him breathe. Then Browder noted a dangerous drop in blood pressure, confirming his suspicions of internal bleeding. Blood transfusions began. An ultrasound of LaGrande’s abdomen found fluid, no doubt blood, there.
LaGrande was immediately wheeled into the operating room for what doctors often label a “search and destroy” mission to wipe out the bleeding. Browder, who often listens to Frank Sinatra recordings during surgery as a way of remaining calm, turned on the singer’s “I’ve Got You Under My Skin” in the operating room. Then he cut into his patient’s abdomen and found bleeding there and in the pelvis. Pads were inserted to temporarily cut it off.
Even as he was packing the pads, the physician had staffers call an interventional radiologist to the hospital.
“Trauma is a team effort where every minute counts,” Browder would say later. “Everything has to be done on time.”
About the time Browder finished with the pads, the interventional radiologist, Dr. Steven Topham, arrived. Using angiography, in which dye is inserted to make blood vessels visible under X-ray, he introduced a catheter into the primary or femoral artery and advanced it to the pelvic area. He then inserted a metallic coil through the catheter to clot off the vessels.
It took about 90 minutes to largely get the bleeding stopped. LaGrande had needed a whopping 12 units of blood –– people his size usually have 18 to 20 units when they’re healthy. Because of his delicate condition, Browder chose not to try to address any of LaGrande’s other injuries.
Browder told the anxious LaGrande family that he was unsure whether their loved one would live.
“Most people that need that much blood don’t make it,” he said recently.
Early that morning, Mary Ann LaGrande, married to LaGrande for 48 years, had heard from police that her husband had been involved in an accident and she immediately called her daughter, Janice Terwilliger, a Henderson resident. Both women would practically live at UMC for the next 17 days.
“My mother sounded bewildered, like she couldn’t believe it,” Terwilliger said. “I told her to pack a bag and come to Las Vegas.”
Terwilliger, who kept a journal during her father’s ordeal, partly as a way to keep her emotions under control, saw her father when he came out of his first day of surgery.
“He was hooked up to a ventilator and we told my dad he was in an accident and just came from surgery,” she wrote. “I told him I loved him and he squeezed my hand repeatedly to say he loved me, too. I know this because as he kept squeezing my hand I said I know you love me, too. Then he stopped squeezing my hand. He had said what he wanted to say. I’m sure he wasn’t sure if he was going to live and I know he wanted to tell me he loved me. I wasn’t sure either. It was a special moment in the midst of this craziness that we shared.”
THE RECOVERY
On LaGrande’s second day at UMC, he was far more stabilized. So Browder removed the temporary pads to stop the bleeding and called on orthopedic surgeon Thomas Vader to deal with his most serious injuries, multiple pelvic fractures. Using screws to hold what looked like an erector set into place, Vader installed an external fixator onto LaGrande’s pelvis to hold it together.
Unable to move or breathe by himself –– he was on a ventilator for several days –– LaGrande feared that he would be a burden on his family. He remembered how his father couldn’t move for the last six months of his life as he fought cancer. “I didn’t want people changing my diaper the rest of my life,” he said during a recent interview.
As soon as he was able to speak at UMC, he told his wife and daughter “to pull the plug.”
They told him there was no plug to pull and tried to reassure him that doctors said he would walk again. Still, he fought taking his medicine and eating. He dropped 30 pounds. When nurses finally convinced him he would largely fully recover, he began to eat.
Yet LaGrande, who had to fight pneumonia and an infection as he recuperated, had to lie flat in bed for the next three months to heal, most of it in rehabilitation at Advanced Health Care in Las Vegas.
“I would lie in bed totally humiliated with complete loss of dignity while strangers changed my diaper like a baby,” the Army veteran recalled.
His food was run through a blender to prevent him from choking.
“If he hadn’t been in such great shape to begin with, I doubt if he would have made it,” said Browder, himself a cyclist.
It took 89 days for a physical therapist to teach LaGrande, whose muscles atrophied, how to sit up on his own and how to make it to the bathroom with a wheelchair or walker. Friends from his policing days were often there to cheer him on.
REFLECTIONS
What happened to LaGrande has made Browder even more concerned about the cycling he does to stay in shape.
“I think about it all the time,” he said. “We have so many people in Las Vegas who drink and drive or who are under the influence of something. But I can’t let fear dictate how I live my life.”
LaGrande, who hates drugs, still finds the hallucinations brought on by morphine hard to believe.
“I remember I was always thirsty and there were these people with wings flying around and in order for me to get some red soda to drink I had to learn to fly,” he said. “I finally graduated and got some soda.”
Researchers have long described the sleep morphine provides as akin to a warm bath, keeping people free of concerns about mortality and pain. Often people say that a morphine dream is without walls, a ceiling or a floor.
“People say it’s like they’re floating,” Browder said.
As soon as he could bear the pain at the rehab facility, LaGrande got off all painkillers.
Once home, LaGrande still required help getting dressed, taking a shower and gaining the strength to get off the toilet without the use of a potty seat. He’s had to learn to use his left arm and hand again after elbow and nerve damage.
He also had to undergo further surgery for a bowel problem –– he lost 4 pints of blood –– brought on by his accident.
Arduous physical therapy now has him walking every day with his wife and riding a bike again.
On Monday, during the UMC Trauma Survivors Celebration luncheon, LaGrande plans on reading a statement to the trauma team and UMC staff.
“My reason for being here today is to thank you for giving me my life back. Thanks to you and the miracle of your skills, I can enjoy my family and friends. … For all the bad that you hear, there are a lot of good people in this world and you are living proof.”
Contact reporter Paul Harasim at
pharasim@reviewjournal.com or 702-387-2908.
