Rapid transport saves lives

The sun was setting after a full day of snowmobile riding for Nick Wallace and his friend and co-worker, Brett Heishman, near Keystone, Iowa, where Wallace raises grass-fed cattle and organic grain on land that's been in his family for five generations.

Nick Wallace uses the functional electrical stimulation bike with therapists Barb West and Megan Andresen.

It was the first week in January and Wallace, 35, hadn't been snowmobiling all season because his wife, Pascale, had just given birth two months earlier to their second son, Maddock. The night was cold, and as the two headed back to their truck, Wallace's snowmobile ran into Heishman's, catapulting Wallace through the air up ahead of both snowmobiles. The force threw Heishman off his vehicle.

"Brett was okay. When he looked up, his snowmobile drove over my head. As the ski went over me, it got under my helmet, ripped off my helmet and broke five parts of my spine," Wallace said.

Heishman called 911 and the Blairstown and Keystone first responders drove to the site, calling St. Luke's Lifeguard Air Ambulance before reaching the accident scene. Deep drifts and heavy snow kept the Keystone fire emergency rig from getting through the field, so they used a four-wheel-drive vehicle to get to Wallace. They dressed deep cuts on his face, put him in a cervical collar, placed him on a long-back board and brought him to their vehicle to keep him warm.

"They made the right call from the start," said Lifeguard Flight Nurse Bev Minear. "Our main goals are rapid transport and taking good care of that critical patient. Without Lifeguard, there would have been a lot of delay because of where they were in the field."

The Lifeguard team assessed Wallace in the aircraft then went directly to the University of Iowa Hospitals and Clinics (UIHC). "En route, we put in the IV and gave him pain and nausea medicine. The flight time from the scene to the hospital was 16 minutes," Minear said. Wallace was in a lot of pain, but he was awake and even joked with the flight crew. "When I got in the chopper, they said I kept saying, 'My wife's gonna kill me'," Wallace said.

Wallace's sense of humor, along with a strong work ethic, determination and incredible support from his family helped him progress through his rehabilitation with surprising speed. Wallace heard St. Luke's had a reputation as one of the best rehabilitation centers in the Midwest. After a short stay at UIHC, he was transferred to St. Luke's Inpatient Rehabilitation Unit. "Once I got to St. Luke's, I was a lot more comfortable," Wallace said, crediting St. Luke's focus on patient-centered care.

Though he had several neck fractures, they were not complete injuries. "The spine just slammed into the side of my spinal cord, cutting off those nerves. It didn't penetrate the spinal cord at all," he explained. "When he came in, he wasn't able to feed himself or put in his contacts. He couldn't stand or walk," said Barb West, St. Luke's occupational therapist. "The only thing I could do was just wiggle my right toe a tiny bit. I couldn't move the rest of my leg at all. I couldn't pick up my arm," Wallace explained.

St. Luke's new functional electrical stimulation (FES) bike was a perfect tool to get Wallace moving again. Electrodes that deliver low-level electrical impulses were placed on Wallace's body to stimulate his nerves and contract his muscles in patterns of movement that enabled him to pedal with his legs or arms, in spite of the fact that he couldn't initiate movement himself. "He got movement in every single muscle group, which was very motivating for him to see and feel," said St. Luke's Physical Therapist Megan Andresen.

"Every time I was on it I would push harder and harder," Wallace said. "I went from wiggling my toe to walking within three weeks." Wallace was discharged from St. Luke's February 12 and refused a wheelchair so he could walk out of the hospital with his family at his side. He continues working with St. Luke's outpatient rehab and has improved his arm strength, hand control and fine motor coordination. "He is still working on getting full function of his arms to return to work tasks," West explained.

"The physical and occupational therapists are doing more than their job. They truly care about the patients they see. They really push you to achieve what you want to achieve. And they're always in a great mood, and that helps," Wallace said.

At home, farm chores have become part of his therapy. And he's working toward his goal of teaching his son, Graham, 3, to throw a baseball. "We've been practicing in the house with oranges," he said. "He's got a wing on him." St. Luke's Inpatient Rehabilitation unit has been accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) for over 38 years.