UW Health OurConnecting you to health news and resources • uwhealth.org SPRING/SUMMER 2014 Patient Survives Near Fatal Accident Shares Amazing Story and an Important Safety Message There are 19 steps inside the stairwell at the UW Health “We were surprised to get him out of the OR,” Agarwal Rehabilitation Clinic in Middleton, WI. says. “An entire team took care of him and got him through this injury–which should have been fatal.” A child could zip up and down those stairs, without a second thought. But for Mark Friend, every step up and UW Health plastic and reconstructive surgeon Samuel down is a calculated process, as he learns how to Poore, MD and UW Health orthopedic surgeon David manipulate–and more importantly, trust–his state-of- Goodspeed, MD followed up Dr. Agarwal’s work on the-art prosthetic leg. Friend’s amputated leg. But before going into surgery, Goodspeed called Amy Paulios of Prosthetic His prosthetic knee has a microprocessor in it, one that Laboratories in Monona. “He had the foresight to think bends and helps slow the speed of his body as it lowers. about how much of Friend’s leg was needed for a “Once that goes, you’ve got to trust yourself to go to prosthetic limb.” Paulios says, “He was thinking that far the next step,” says Friend, who has to pull his leg back ahead on Mark’s behalf, which I find to be phenomenal.” to trigger the process. It’s a complicated system, one Friend also suffered serious injuries to his right leg and that requires a lot of thought and everything going right underwent major reconstructive knee surgery. Twice a to have success. week since May 2013, Friend has made the trip to see The same could be said of the sequence of events that physical therapist Sandy Grady, who has helped him allowed Friend to survive a nearly fatal accident on learn to walk with his prosthetic leg. January 5, 2013. During a physical therapy session, Friend cracks jokes While working collecting garbage and recycling on a cold and comments on his attitude toward his challenges. morning near Stoughton, WI, a car hit Friend, pinning “Why get mad about it? You can’t change it,” he says. him between the vehicle and the back of his truck. “Most people are going to get depressed and get angry Friend only remembers bits and pieces and says “I do and stuff like that. But I look at it more as, how can I be remember asking the driver to move the car - she was an influence? One of my main goals is to teach my kids unable to.” as they grow up that there’s no such thing as ‘I can’t.’ Why? Why can’t you? I’m missing a leg and I can. Why That was the first thing that went right. Experts told can’t you? There’s no excuse. I want to hear ‘I’ll try’ not Friend that if the car had been moved, he likely would ‘I can’t.’” have bled to death. Stoughton Fire and EMS responded to the accident and contacted UW Med Flight, which During a conversation with one of his doctors, Friend brought a physician to the scene, and then rushed says he was told that about 125 people were involved in Friend to UW Hospital and Clinics, in Madison, WI, saving his life. “Think about that–125 people,” he says. a Level One Trauma Center. Friend doesn’t have to look far to remember them. He Once at UW Hospital and Clinics, his vital signs had fabric patches from UW Med Flight, UW Hospital disappeared. Friend didn’t have a pulse when he got to and Clinics and Stoughton Fire and EMS embedded UW Health trauma surgeon Suresh Agarwal, MD. He into his prosthetic leg, along with one of Bucky Badger. and his team were able to resuscitate Friend and then “I just think you should give credit where it is due,” amputated most of his left leg to stop the massive Friend says. “If it weren’t for them...” bleeding. Friend said he was given 63 units of blood; the human body only holds 10 to 12 units at a time. Even before his injuries, Mark Friend expressed concern about safety for sanitation workers to his legislator. When he started his recovery, he again contacted his legislator and became a driving force for the passage of a law that increased the penalties for traffic offenses committed while sanitation workers are present. Go to uwhealth.org/slowdown to view the Slow Down safety video. Help spread this safety message by sharing it via e-mail and social media. Using Computer Games to Help with Pediatric Incontinence Pediatric incontinence, or daytime successfully potty-train. But we also “This program requires the commitment of time for wetting, affects more than 10 million have adolescents who have been children nationwide. Traditionally, it seeking help for years who find the education sessions and treatment–and the has been evaluated with invasive success with our therapy.” results are well worth the effort.” tests and treated with a combination The therapy is a breakthrough in of medication and surgery. Thanks to –Patrick McKenna, MD treating pediatric incontinence. It uses an innovative non-invasive evaluation Chief of Pediatric Urology computer games originally developed and treatment program at UW by NASA to help astronauts practice provides biofeedback to help children dedication of our nursing staff.” He Health’s American Family Children’s muscle strengthening while understand how to use their muscles adds, “In fact, this component alone is Hospital in Madison, WI, incontinence experiencing weightlessness. The to further master the game. McKenna so powerful that it can cure about 20 and related issues, including recurring games use biofeedback to teach says, “It can be very difficult to teach percent of our patients.” urinary tract infections, are children how to correctly flex and children what muscles to contract and successfully treated through a The treatment has been very relax the pelvic muscles that control relax. That is why the games are such program comprised of education and successful in helping children achieve the bladder. The treatment is non- an important part of the program.” biofeedback using computer games. dryness. “And once daytime dryness invasive and very private. Children are Equally important is the education is achieved,” explains McKenna, “it According to Patrick McKenna, MD, fully dressed and hooked up the component. Using a four-point usually helps any nighttime wetting chief of pediatric urology at American computer game using small EKG-like “elimination education” program, issues as well.” In helping patients Family Children’s Hospital, the pads. The children then must nurse practitioners focus on diet– achieve dryness and learn proper program is designed to treat children correctly use their abdominal and eating enough fiber and drinking voiding habits, the program has the who are unable to be toilet trained or pelvic muscles to master the game, in enough water–and hygiene, which added benefit of decreasing recurring who have been previously trained and this case, a golf game. includes proper wiping and no bubble urinary tract infections by 95 percent then start having accidents. He “Doing this correctly or incorrectly,” baths. McKenna says, “This education and has decreased pediatric surgeries explains, “Many children come to the says McKenna “is the difference is crucial to the program’s success for vesicoureteral reflux from 120 program at age four, when parents between a drive or a slice.” The game and would not be possible without the annually to close to zero. realize they are not able to The program’s success is a direct result of the dedication and commitment of staff, as well as that of the children and their families. McKenna notes, “Often people look to medication or surgery as a quick fix to solve their problem. This program requires the commitment of time for the education sessions and treatment - and the results are well worth the effort.” McKenna reflects on a patient who had been dealing with incontinence for 11 years. “As children grow, there are social ramifications, including embarrassment and the inability to spend extended time with friends. This child, after 11 years of seeking treatment, went through three sessions with us and achieved dryness.” This story, like many others, is why the program continues to grow. It is offered at UW Health’s American Family Children’s Hospital and now at the UW Health East Clinic. To learn more or make an appointment at 11 year old Reagan, attends one of her biofeedback sessions, taught by our dedicated pediatric nursing staff. either location, please call (608) 263-6420. Advancements in Stroke Recovery Stroke recovery can be long and Currently, stroke rehabilitation uses of underwent nine to 15 rehabilitation changes in using this device over time difficult. But a new stroke rehabilitation a functional electrical stimulation (FES) sessions for up to three hours. The as well as changes in the functionality device may speed recovery and system that automatically activates sessions lasted over a period of three of their arm, hand strength, and improve function for some of the nerves in paralyzed portions of the to six weeks. Before, during and after activities of daily living. Some 800,000 people in the United States body without the use of brain activity. the rehabilitation period, patients also participants said their mood and ability M O who suffer strokes each year. underwent functional magnetic to communicate improved.” C “When patients use our device with an K. C resonance imaging (fMRI) and a TO S Vivek Prabhakaran, MD, director of electrode cap and a computer, we ask The researchers hope to study 40 R E second type of MRI (diffusion tensor TT functional neuroimaging at UW Health, them to imagine or attempt to move stroke patients with upper extremity HU S imaging) that maps the rate that water M collaborated with University of their hand,” says Prabhakaran.