By Maureen Gilmer, IU Health senior writer, firstname.lastname@example.org
Christy Graham will never forget the fear and helplessness she felt when she got the news.
Her teenage daughter had been injured in a car accident in their hometown of North Vernon, Indiana, but Graham couldn’t get to the scene.
It wasn’t until she arrived at Riley Hospital for Children in Indianapolis that she learned the extent of her daughter’s injuries.
Natalie Hamilton, then 15, had to be revived twice after the May 26 accident, which happened in front of her boyfriend’s parents’ house when his car was hit from behind, then pushed into oncoming traffic. Natalie, sitting in the passenger seat, absorbed the brunt of the impact when another vehicle struck her side of the car.
She suffered a stroke and two seizures following the accident, which also left her with multiple broken bones, a fractured pelvis, lacerated lung and a traumatic brain injury.
Natalie was airlifted via IU Health LifeLine to Riley, where she underwent multiple surgeries and was placed in a medically induced coma for several weeks to allow her brain to begin to heal. She was on a ventilator for 13 days.
LONG ROAD TO RECOVERY
Dr. Samer Abu-Sultaneh was one of many physicians who treated Natalie in the pediatric intensive care unit at Riley.
“She was very sick,” he said, explaining how her injuries led to other complications during her recovery. “We were worried about her, but she started to turn the corner and improve.”
As a Level 1 Pediatric Trauma Center verified by the American College of Surgeons, Riley offered her the best chance at survival, he believes.
“We have all these subspecialties working together from a physician standpoint, and we have our nursing team, our respiratory therapy team, our rehab physicians, and physical therapy, speech therapy and occupational therapy,” Dr. Abu-Sultaneh said.
Collaboration was key. The journey in the ICU is critical, of course, but it continues in inpatient rehab and even after going home, because therapy will continue for months, if not years.
Natalie spent three weeks in the PICU, before being transferred to Riley’s inpatient rehab unit for the next 10 weeks. There, she learned how to walk and talk again with assistance, as well as other self-care skills using her right arm, which is noticeably weaker than her left.
BABY STEPS = BIG RESULTS
Last week, Natalie was working hard in physical therapy, where PTs Kate Lindemann and Jalayna Gahs gently pushed, supported and cheered on their patient.
“She has worked really hard,” Lindemann said. “When she started with us, she was a dependent transfer out of bed; she couldn’t put weight through her legs. Now, she walks with a walker and has made great progress.”
After PT, Natalie moved on to speech therapy with Katie Smith, who incorporates different strategies to help her patient find the words she wants to say and put them into sentence form.
Smith, who has worked with Natalie since she came to rehab, explained that the teen suffered severe aphasia (difficulty understanding or expressing speech) as a result of the traumatic brain injury.
“We started off with really simple things like yes and no questions, following simple commands, looking at pictures and being able to label them,” Smith said. “She is making great progress with that. There are still some things that are tricky for her to get out, but she does a great job of figuring out ways to work around it and ask for help.”
Natalie’s mom also does a good job of guiding her toward the words she is searching for, Smith said, by choosing a letter or giving her the first sound in a word.
SCARS TELL A STORY
When her daughter was in a coma, Graham considered sharing her story because of the daily miracles she witnessed, but she decided to wait until Natalie could decide for herself if she wanted to tell her story.
That day came last week when Natalie said she was ready. She told her mom she wanted to share her story because she was a survivor.
“Your scars tell your story, don’t they,” Graham said to her daughter. “You are a walking testament.”
If Natalie speaks haltingly, the miracle is that she is speaking at all, her mom believes. She said her first words since before the accident just a few weeks ago.
During therapy when Graham says that her first words were “mom” and “boogity” (the latter a word Natalie had never previously said), Natalie corrects her.
“Mom, you understand that’s not my first words.”
Graham looks puzzled, then remembers a brief moment during a bath when Natalie looked up at her and whispered, “Goodbye.”
“I said, ‘Where are you going?’ and she said, ‘I’m going home.’ She said it twice, first a real soft whisper, then it got louder, then soft,” Graham recalled.
“I had happy tears and the nurse did too, then I got to thinking, what does she know that I don’t know? Is there something going on inside her that I don’t know?”
Graham, who refused to leave her daughter’s side for the duration of her stay, said even the Ronald McDonald House next to Riley was too far for her to go.
“I have bad knees. I couldn’t get here fast enough if I had to,” she said with a chuckle. “I would sleep on the floor if I had to.”
That night, after her daughter first said “Goodbye,” Graham said she was determined to watch Natalie’s heartrate and breathing all night, fearing that “going home” meant a final goodbye.
“I don’t think I slept, girl,” she told her daughter. “You have fought too hard to be leaving now. You’re not going anywhere.”
Indeed, the only place Natalie is going is home. She has her eye on that prize and can’t wait. Her mom admits to being excited and scared at the same time.
“It’s going to be very emotional for us to leave,” she said. “I will cry because this place has become home. These people have become family.”
FINDING THE WORDS
As part of Natalie’s speech therapy session with Smith in rehab, the teen offers bits and pieces about her recovery, with her mom filling in the missing pieces.
“I’m Natalie Hamilton and I was in a car accident on May 26. Been here three months.”
Her mom prompts her, “And you had a stroke.”
“Stroke,” Natalie repeats.
“And a seizure,” her mom says.
“Seizure,” Natalie says, nodding her head.
“And you had a lot of broken bones.”
“Yes,” Natalie says.
Natalie remembers nothing from the accident except what her mother and boyfriend have told her. But she was able to meet and thank the first responders who saved her life at the scene and transported her to Riley.
After achieving multiple goals in rehab, Graham and her daughter were granted a day pass to attend a fundraiser/birthday party Aug. 7 in North Vernon, where hundreds gathered to wish her well.
The tears flowed freely that day. Tears of relief, joy and gratitude.
“I have my little girl back,” Graham said. “She’s still my teenager, but she’s my little girl.”
Asked how she has been able to hang on through these past three months, Graham said simply, “God. A lot of faith in God. And I have nothing but the utmost respect for this hospital and thank them daily. I thank them and I thank God.”
BELL AND BUTTERFLY
On Aug. 23, it was Natalie’s turn to ring the bell and pin her butterfly to the wall of the Riley rehab unit. She had watched many others go before her, but this was her time to shine.
After three months in the hospital, she couldn’t wait to get home to her own bed and to eat at her favorite Mexican restaurant.
“She came in in a bad way and she’s walking out in a good way,” Graham said of her daughter, who turned 16 on Aug. 8. “She is determined. We have to take the wheelchair and the walker, but we are walking out of rehab.”
As Dr. Abu-Sultaneh said, there is an entire team of people who worked to get Natalie to this point, and he was beyond excited to hear that she was going home to continue her recovery.
“It is a group effort,” he said. “First, having all the people coming in and helping to save a life, then the collaboration with inpatient rehab and other services to make sure kids are recovering and getting to their maximum potential.”
Photos and video by Mike Dickbernd, IU Health visual journalist, email@example.com