My Lawnmower Accident, or How I Got Silicone Implants

Now that it’s warming up outside, it’s important to get your mower ready for use. Along with the normal maintenance issues, make sure your safety equipment is working properly. It only takes a couple of seconds to make sure that the blades stop running if you let go of the dead man lever on a walk behind mower or if you come off the seat on a riding mower. Do that every single time you mow. It only takes a second. Not having a functioning kill switch can cost you dearly. I found out the hard way, using a riding mower at a seasonal park maintenance job I had in 1991.

On Thursday, May 16, 1991, I was working as a seasonal maintenance employee for the local park district and as a paid on call paramedic for a township fire department. I’d been certified as a paramedic – a life long dream – the November before.

That morning, I was mowing with an industrial mower (Steiner mower) at a picnic area with reservable shelter houses when we broke for lunch. I’d been using the big mower (with a 72″ mowing deck) to mow the fields around the shelter houses and planned on going on to mow the trails through the woods after lunch when the sun would be the hottest. We were having an unusually hot spring, it was in the upper 80’s to low ’90’s that day. I forgot to gas up the mower when I was dropped off after lunch, so I took the small mower (with a 60″ mowing deck) and started mowing along the road near the entrance to that part of the park.

With Steiner mowers, the mowing deck was in front of the tractor, then there was a hinge between the engine and the operator’s seat, and with the big mower, there was one lever next to the steering wheel to raise and lower the deck, and another lever a few inches away to go forward and back. There were no foot pedals at all. With the small mower, the two levers were next to each other and bolted together through a pivot point – you had to hold one steady and push the other forward and backward.

I was mowing in a ditch, and started backing up, up a slight grade. The mowing deck came off the ground and the weight of the mower pivoted onto the front wheels, making the back wheels come off the ground. In a solid body mower, when that happens, you lean back into the wheel that’s off the ground, it makes contact with the ground, you then lower the deck, get straightened around, and everything is fine. With this mower, I leaned into the wheel that was off the ground out of habit, the mower bent at the hinge, and the wheel made contact – and since it was a 4 wheel drive mower, when the wheels came in contact and weren’t in line, the mower started bucking like a horse.

At one point, I was airborne, my shoulders were directly above the steering wheel, and I thought, “If I let go (to pull the lever back), I’m going to fall off.” The next bounce, my feet almost slipped off to the side of the mower and I knew I didn’t have a choice – I had to reach for the lever. The next thing I knew I was on my back on the ground, looking towards my left, my left arm straight out to the side as the mower deck was backing over it. I tried to push my hand into the ground, but may well have pushed it up into the blades – it happened very fast. I heard a sound like the mower running over a soggy, half rotted branch, then I saw the edge of the deck move over my chest. I freaked – thinking it was going to take off my left breast. Luckily, it just pushed it out of the way. I felt something punch my side, then the mower was off of me. It continued to back up through the ditch and got bound up and stalled out.

I stood up, looked at my hand – palm and fingers dangling at weird angles from the end of the back of my hand (attached by a strip of skin between the back of my thumb and web space between my ring and middle fingers and, I found out later, one tendon running down the back of my hand to my index finger and another running to my middle finger), saw a flap of skin hanging from my arm – wrist to elbow – about 3-4 inches wide, only attached by a narrow strip of skin near my elbow, and then I noticed a gash in my side about 9 inches long and 2 inches deep. I saw little round globules of tissue, and immediately thought “alveoli” – lung tissue, and started concentrating on how my breathing felt. There was a steady stream of blood pouring out of my hand – it reminded me of a faucet left to run a thin steady stream of water to keep the pipes from freezing. When I walked, when my hand went forward, the wrist end of the flap went backwards.

I got up, saw my arm, and my first thought was, “How am I going to fix this by 4:00?”, then I thought “idiot”, and I think I screamed “God, please don’t let me die!” – I was a little freaked out at that particular moment (looking back, it was funny that I’d say that – I was an atheist). It was the only moment that I really panicked – because the pain level shot up immediately when I did. It made me get myself back under control very quickly. Since I was in the park by myself, I started walking into the park to go to the truck and call for help. After about five feet, I remembered I didn’t have either a truck or radio, so I turned around and walked towards the entrance of the park – in the hopes that someone was home in one of the houses across the street. As I started to round the bend towards the entrance, my knees were getting very wobbly. I didn’t know if I’d be able to make it to the street, then the park manager pulled up. He’d decided on a whim to turn left onto a busy street from the maintenance building to come and check on me rather than turning right to go to another park to run an errand. He called for help and came to help me. I’d walked a total of about 181 feet – with a steady stream of blood pouring out of my arm. When I saw him, I laid down on the pavement to try to help slow the blood loss.

I told him how to put on a tourniquet and told him to loosen it and re-tighten it from time to time to keep from cutting off all blood supply to my arm and effectively writing off my arm. About the time he was getting the tourniquet on, someone stopped to see if we needed help, he said “no, I called it in already,” the passerby did a u-turn, and flagged down a police officer on his way to a non-emergency run. The police officer got there before the dispatch came through for the city fire department, so he called the medic crew directly. The medic crew happened to be doing station checks at the station less than a half mile away, and were on the scene just before the dispatch came through from the park relaying info to them. I asked the medic crew to let the guys at the station I ran out of know I was supposed to cover for someone (a neighboring department, but they knew who I was and who to contact). One of the medics shook his head and said he would. They asked me to rate the pain on a scale of 1 to 10 – 10 being the worst pain I could ever imagine feeling, and I told them “25” (being dead serious).

The medic crew called for Careflight (the local hospital helicopter), and they happened to still be in the air on their way back to quarters after being cancelled from another run – and they were nearly directly overhead when they were called for me. The time from the very first call coming in to Careflight lifting off with me was 16 minutes. Outrageously fast – it’s never less than 45. When we got to the local trauma hospital, they did a hot offload (leaving the blades running) running me into the ER on a gurney – just like in the movies.

In the trauma room at Miami Valley Hospital (the local trauma hospital), they cut off all my clothes, checked me for additional injuries, took pictures of the initial injury (Dad happens to be friends with the photographer, so I have copies), got me stabilized, gave me a little morphine (they couldn’t give much because I was going to be going into surgery) then they called St. Vincent’s Hospital in Indianapolis to see if they could send me there. Hand surgery was pioneered at St. Vincent’s, and my hand was more than they could fix at MVH. They put a gown on me, literally ran me out to the helicopter, loaded me on hot again, and flew me to Indianapolis. It took about 26 minutes by air, it’s a 90 minute drive. In flight, I kept looking at the cardiac monitor, and asking if it was supposed to have the funny little bumps in the line (it was artifact from my raising my head up and reading the monitor). They told me to lay down and be quiet, so I tried a little relaxation exercise – since I was hooked up to a monitor and all. I slowed my heart down a little (using biofeedback), the flight nurses got all excited and shook me to make sure I was still alert and awake. I told them I was just trying an experiment, and they said “Well, don’t do that!” So I agreed to be good and not slow my heart down again, but then I got bored, so I decided to try to speed it up a bit. I hadn’t promised not to do that. Well, the nurses got all excited again and this time they figured out what I was doing, turned off the monitor sound to my headphones and turned it so I couldn’t see it anymore. For the record, flight nurses have no sense of humor!

At St. Vincent’s, the doctor asked me if I had any other personal belongings. I only had my glasses and my hospital gown, and I told them “Nope, I travel light”. Then I told them I knew it was bad, and it was okay with me if they ended up having to amputate. They got me ready for surgery, knocked me out and spent the next nine and a half hours trying to put my hand back together.

That morning, Indianapolis had been having a storm with torrential downpours. The helicopter at St Vincent’s had been grounded because of the weather, but the rain was letting up when the hospital here called them, and it looked like it would be safe for Careflight to bring me to them. By the time we got there, the rain had let up to a light sprinkle, they offloaded me hot again, and I found out later, that shortly after Careflight left their airspace, the clouds opened up with more torrential downpours and their helicopter was grounded for the rest of the day and most of the evening. I was the only patient who was able to arrive by air that day.

The doctors told us that about half way through the surgery, they left the OR, and discussed amputating my hand. They chose to try to reattach it, because I was 29, I was recently certified as a paramedic (amputation would’ve ended my career) and I was a good risk for doing all the exercises I’d need to do and to follow through with the therapy and rehab because of my medical background. They told my parents it was as bad as it could get and still be fixable. They had to do a skin graft to replace the skin on the back of my arm the following Monday, and I wasn’t allowed to eat until Sunday because they thought they might have to go in and take off fingers. They also mentioned that they may have to use leeches to get blood flow going to my fingers if it didn’t start on it’s own. They didn’t need to use them, and I ended up with 100% take on the skin grafts. I lost all the intrinsic muscles and tendons that let you spread your fingers apart. The mower destroyed the bone in the joints for my middle, ring, and small finger and broke all of the long bones in my hand – the metacarpals. I had plates and screws in the metacarpals for my thumb and index fingers. They took the plate out on my thumb during a tendon transplant surgery later on, but they left the one on my index – they weren’t sure the point where my bone had grown back together was going to be strong enough for normal activity without the plate. My left hand used to be about an eighth of an inch longer than my right hand. Now, when I line up the creases at the heel of my hands by my wrists, the tips of my left fingers just barely reach the crease at the last joints before my fingertips on my right hand. So I’m a little short handed now. I lost all the skin across the back of my arm from my elbow to wrist going all the way across from thumb to little finger sides. All the tissue down to the membrane that covers the muscles on the back of my arm was filleted off by the mower blade.  The gash on my side was just below my lowest left rib. Those round globs I thought were lung tissue at first, turned out to be adipose tissue – fat cells. It only got skin and fat. I was never so glad to be overweight in my life. It would’ve been much worse if it’d gotten into either my abdominal or thoracic cavities. Technically, my injury was called an incomplete amputation of my left hand and degloving of my left upper extremity distal to my elbow. The procedure to reattach my hand was called a “re-plant.” I ended up getting four units of blood and albumen shakes twice a day during those first two weeks to get my blood counts back up to where they needed to be.

About six months after the injury, they replaced the Metacarpal Phalangeal joints (MP joints) of my middle, ring, and small fingers with silicone joints. When they told me they were going to replace them, I had visions of Luke Skywalker’s metal hand – I was bummed when I found out they didn’t have that technology yet. They suggested cadaver bones, and opted for silicone. Cadaver bones would’ve given me proper hand length, and natural function, but also would’ve put me at risk for any diseases the donor may have been incubating, increased my risk for infection, and possibly could have been rejected by my immune system. They decided the benefits didn’t outweigh the risks for me. The joints they used are semi soft silicone rubber, pointed on the ends. They drilled a hole into the end of the long bones in my hand and the first bones in my fingers, then used surgical super glue and slid the points into my bones. That surgery hurt as much as the initial injury -although the other joint replacement surgeries didn’t hurt nearly as bad, because they didn’t have to drill anymore. The hinge itself is just a paper thin strip of silicone between the two points. So, now I have silicone implants. Not all implants are fun, but mine let me live reasonably normally.

The joints they replaced on my hand are the middle, ring, and small – in the position of and look like the ones marked “finger implant” in this image.

 

This is what I envisioned when they said “artificial joints”

This is a side view of what I ended up with

(I’m not sure of the brand they used, but I saw the joints – they look like this.)

 

The first two weeks after the accident, I was having horrible nightmares. They didn’t have any other patients in the room with me because the temp had to be kept at 78F to keep my blood vessels open, so they brought in a cot so my Mom could stay with me. One night, I woke up screaming, and Mom – who had been sound asleep – levitated off the bed. I couldn’t sleep more than an hour or two without a nightmare, and I kept hearing the sound when the mower ran over my arm while I was awake, so they put me on Thorazine for a couple weeks and contacted a psychologist to come and see me in my room. I had to stay in the hospital for two weeks. By the time I got to go home, I was still having nightmares and flashbacks, but it had calmed down so I wasn’t hearing the mower noises anymore. During those first two weeks, I was getting morphine shots every four hours for pain control. A few minutes after they gave me the shot, I’d fall asleep in mid sentence. When I’d wake up three to four hours later, I’d finish the sentence.

My accident made the local news a couple nights, and made the front page of the big, city newspaper and the local town newspaper, and had a follow up in the big, city paper a week or so later. Apparently, it also made the news in other towns in Ohio – I ended up getting cards and flowers from individuals, lawn care companies, fire departments, and parks from all over the southwest corner of the state. The outpouring of support was incredible. I ended up with two cork boards, two bedside tables and the window sill and AC unit covered in cards and planters – mostly from people I didn’t know. When I got home, and was finally able to drive, I’d go places by myself. People I’d never met before would greet me like an old friend and ask me how I was doing. I appreciated the concern, but it kind of freaked me out a little. They were recognizing me from my picture being in the paper – several times – and the splints. It freaked me out bad enough that still I prefer not to use my picture for anything online now.  Later on, after I’d been home for a while, I was interviewed for a story on an Indianapolis TV station about lawn mower safety and the Hand Center. One of the radio stations here in town invited me to come and sit in with them one morning. I went, we talked about my accident and lawnmower safety, and I compared scars with the hosts – and was declared the winner. After I was released as a patient, my doctors used my case as a case study for at least one symposium.

I had an external fixation device holding my index finger and thumb apart – so I’d have a web space and usable digit when I was done instead of a claw. I also ended up with lots of plastic splints that were held in place with Velcro. Each splint performed a different function, and I had to rotate through them every 20 to 30 minutes from when I woke up to when I went to sleep, and I had to do exercises and tape my fingers down into a fist about once an hour. I carried a fanny pack to keep all my “stuff” together. The pack was big enough to hold the bandages I needed, and the finger socks, tape, therapy putty, Nerf ball, and other equipment I needed to exercise my hand. I lengthened the straps to full length and Velcroed the splints to it – it looked like a ladder – I had eight or nine I was rotating through everyday at one point – and it let me stay mobile so I could go visit people and do things without sacrificing my therapy. One day, I was at a training session for the fire department, and was unwinding the tape from my left hand. I was distracted while I did it, and ended winding it around the finger tips of my right hand – and got stuck. One of the paramedics sitting near me got overcome by the giggles while he watched me struggle to get it off.  Didn’t offer to help, but he got a good chuckle out of it. We’d been friends for quite a while, so I just made a face and hammed it up for him. Anything for a laugh. 🙂 

I ended up having something like nine surgeries in the first two years after the accident, and then I’ve had two joint replacements since then. When I had my accident, there were only two other people in the country under the age of 65 with artificial joints in their hands like I had, and they really didn’t know how long they would last. The first set lasted seven years, the second only lasted two. Seems they don’t hold up well to weight training. This set has been in since 2000, but my ring finger joint has failed. When my joints fail, my fingers drop down a little and drift across each other. My ring finger’s been doing that for a couple years now. It’s not painful until all three joints fail and I start getting muscle spasms, but that hasn’t happened yet. I’m trying to hold out as long as I can before I get them worked on again. When they go in to replace them, they do them all at once. I have at least 2 of them need it before they do it. I have to go back for x-rays and an exam by my hand surgeon at least once every ten years so my worker’s comp case stays open. That way, if something happens and they need to go back in and work on it, it will be much faster to get approval for the procedure.

I have something like an 84% loss to my left hand – mostly sensory. Things either feel scalding hot, freezing cold, or neither, but not warm or cool either. Also, if I’m looking at what I’m touching, it feels exactly like it should, but if I’m not, I can’t tell the difference between a t-shirt and Kleenex, or between jeans and a sweater. I lose things in that hand all the time. I’ll grab my keys in my left hand out of habit (did I mention I’m left handed?) while I’m doing other things getting ready to leave the house. I’ll forget I picked them up already, go looking for them and get frustrated and start tearing the house apart. Then I’ll reach for something with my left hand and see them. If I try to walk holding something thin, like a pen or pencil, in that hand, it’s guaranteed to be dropped within a few steps. The last time we measured it, my left hand had a 4 pound thumb/index finger pinch, my right hand had an 18 pound pinch. Normal for a woman is about 12-14 pounds. My left hand grip is also very weak, and my right hand grip is stronger than average to compensate. I also can’t turn my thumb so I can touch the pad of my thumb to the pad of my other finger tips. The tendons that weren’t cut in the accident are too long for my hand now, so my index and middle fingers droop at the end. I can’t spread my fingers apart, and when I type, I use all the fingers and thumb on my right hand, and the ring finger and occasionally my thumb on my left hand. I’ve gotten so I can type faster now than I could before the accident. Video game controllers are difficult to work, but I do fine with a mouse. 🙂  When I run water over the backs of the tips of my index and middle fingers, it feels like my whole hand is under running water. I still tend to reach forward to test temperature with my left hand, even though it’s not an accurate gauge and I have scorched my fingers a couple times.

While I was in the hospital the first two weeks after my accident, I asked my parents to bring me a coloring book and crayons, and started coloring using my right hand. Within a few months, I’d moved on to writing with my right hand. Around a year after my accident, I found some notes I’d written before the accident and compared my right handed writing to it. Aside from the slant to the letters, I couldn’t tell them apart. At the 4th anniversary of the accident, I realized I was picking up pens and pencils with my left hand again without thinking about it, so I started working on my left handed writing again. My writing now is just as bad as it was before the accident. After I started writing left handed again, I started to do artwork – initially making dream catchers and eventually doing wildlife paintings on suede disks mounted in leather wrapped metal hoops (shields or mandalas). I’d had visions of becoming an artist, then realized that when I painted something for someone specific, it turned out well, when I painted to get things ready to take to an art show to sell, I got garbage. So it’s just a hobby now. One I haven’t done in a while though. Here are a couple of my better paintings. These were all painted with my reattached hand.

                                                                                                                               

 

I ended up with post traumatic stress disorder and saw the psychologist for over a year and a half. During that time, I discovered that taking any aspect of my injury and finding a way to laugh at it helped make it less frightening. I still have problems with hearing mowers first being used in the spring, but that only lasts until about mid June or so now. I also found it’s amazing what you can do when you have no choice. I worked my butt off keeping up with the exercises and changing splints, and I got so I could recite the pre-op rules without going through them with the nurses first.

 

I’m going to reach the 21st anniversary of my accident on May 16th of this year. Ever since the first anniversary, I’ve been jokingly saying I have two birthdays – so, when I went to the hand center, I’d tell them I was either 31 or 2 – depending on my mood. Now that I’ll be either 50 or 21 this year, using my second birthday for an age is becoming more appealing. 🙂  A friend of mine said she wants to go out and celebrate my 21st birthday with me this year. Should be fun. I’ll be just over five weeks post op for another procedure – not hand related -and should be able to get out and about pretty comfortably by then.

 

I was extremely lucky. I survived a life threatening injury and came out of it with a functional, if different, hand – and I was able to regain enough use to go back to writing with it again. I don’t have enough finger strength to use an ATM with my left hand. When I need to use one of those, I have to open my car door to make room for me knees, and I have to turn so I can use my right hand to push the buttons. I also have a hard time grabbing the cylinders for the drive up windows at the bank – they’re a little to big in diameter for me to grab with my left hand. I have to grab drinks at the drive throughs at restaurants by the bottom for the same reason, and if I try to catch change from drive throughs in my left hand without my right hand being close or the person giving me back my change being very careful to press it into my hand, I’m guaranteed to drop at least one coin – and usually most of them. 

 

Every year, there are approximately 180,000 people who are injured or killed in lawn mower accidents (according to Technology Associates Engineering Experts at http://technology-assoc.com/articles/lawnmower-accidents.html among other sites) Had the timing for any step of the help I had to get to the first hospital been any different, and if the rain hadn’t let up in Indianapolis when it did, chances are, at best, I wouldn’t have my hand. Had I had the same accident on the trails, no one would’ve known to come look for me until I didn’t show back up at the maintenance building at 4:00 pm. My accident happened around 1:30 pm. I would’ve bled out by the time they would have found me. It could have been even better and not happened at all, if the previous manager at that park reserve had not disconnected the kill switch the summer before. I knew the kill switch wasn’t working and used that mower anyway. That was stupid. Even more so because of that industrial safety engineering degree I have. When we sued the park district because the kill switch wasn’t working, because of that degree, the settlement I got was only a fourth of what I would’ve gotten if I hadn’t had it. The money itself didn’t really matter that much to me, but it did make the park district change how they handled mower maintenance, and grass mowing after that. It also let me live by myself, on my own, with a job that didn’t pay all that well, until I got my first paycheck from a job that did six years after we settled. And it let me get started with doing cat rescues.

 

Don’t take stupid chances. If your kill switch doesn’t work, don’t mow until you get it fixed.