Louisville Magazine

AUG 2016

Louisville Magazine is Louisville's city magazine, covering Louisville people, lifestyles, politics, sports, restaurants, entertainment and homes. Includes a monthly calendar of events.

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LOUISVILLE MAGAZINE 8.16 61 local hospital less equipped to handle such a severe injury. "My arm proba- bly wouldn't have made it otherwise," Maysey says. Wide awake after the accident, he called his mother while waiting for an ambulance outside of the plant. "Mom, you need to come here," he said. "I've cut my arm half off." "I just thought we were going to make a trip to the ER for stitches," Alisa says, thinking exaggeration, maybe a bad cut. inking: Mom can fix it with a ban- dage. But she arrived to fire trucks, po- lice cars, ambulances. She was so frantic that an EMT blocked her path, telling her, "Ma'am, there's a lot of blood." She needed to be calm. "When I walked in and saw that there wasn't an arm hanging there," she says, "I just thought about how his life was changed forever." In the minutes before a helicopter landed on the scene, Alisa sat with May- sey as he was given preliminary treat- ment in the back of an ambulance. She rubbed her fingers against his forehead, the constant motion calming. As they prayed together, Maysey said, "Mom, I don't want to die." "You're not going to die," Alisa said. "ey've stopped the bleeding. You might lose your arm, but you're not going to die." Suddenly, panicked: "I'm sweating, Mom! I'm sweating!" "We're all sweating," his mother said. "It's hot in here." Later, she asked him: "Did you think profuse sweating came right before death?" And he said, "Yeah, I kind of did." Maysey was lucky to be in Glasgow, only a 40-minute helicopter ride from University Hospital. e Kleinert and Kutz Hand Care Center hosts the world's largest fellowship for hand and microsurgery. In 1999, its surgeons performed the first successful hand trans- plant in the nation. Dr. Elkin Galvis, the lead surgeon on Maysey's case, says there's a time limit for reattachment: "After six hours, you can't try to replant because the muscles start dying." e team had to reject a potential patient from Georgia, an 18-year-old who lost a limb in a mining accident. e timing was wrong, unfortunate; he'd already spent three hours in a local hospital. ere was too little time left to transport and reattach. After transferring Maysey's iced ap- pendage to a garbage bag — no room in the helicopter for the oversized blue bar- rel — his ride was quick. He was more worried about the view of the ground than what had happened at the factory. "I've made fun of him because he was scared of the helicopter ride," says Alisa, who drove the length of I-65 to the hospital, her phone ringing with worried calls and messages. She arrived at the hospital after the surgery had started. But her fiancé, who lives in Louisville, made it to the hospital in time to see Maysey surrounded by at least 20 OR team members examining the injury, prepping for surgery. e waiting room was already filled, an entire corner of the ER clustered with familiar faces when Alisa entered, faces she'd known from Lyons Missionary Baptist Church. She'd yearned for her parents' support and wisdom on the drive up — both passed away in 2014, 45 days apart. She found it in her church community, in older couples who had acted as surrogate grandparents to her children. "I realized that what I really wanted was just for him to be OK," Alisa says. "When I say OK, I don't just mean not die. I just mean spiritually. A lot of young men would get angry at God for something like this." e machine had fractured most of the bones in Maysey's arm and hand, and the point of severance was an unclean cut. But first, blood flow. Galvis had never replanted an upper arm. He and two others rejoined the arteries to continue pumping blood to the limb, racing against that six-hour time frame. ey plated the humerus bone with a bar of metal and screws, joining the two halves of the break. e surgeons lacerated the side of Maysey's arm to reduce the swelling that occurred during transport, which could have led to compartment syndrome — a condition in which blood flow is impeded, that could have resulted in Maysey losing his arm all over again. e surgical team had toiled in the operating room from 3 p.m. to 9 p.m., four hours longer than Galvis' shift, when Dr. Huey Tien, another Kleinert and Kutz surgeon, took over the lead, working for another two hours. (Klein- ert and Kutz hosts fellows from all over the world, already-practiced surgeons shadowing lead surgeons, learning the trade of microsurgery. Galvis, a former fellow, is a transplant from Colom- bia; Tien arrived from Taiwan.) After reattaching the veins, Galvis met with Alisa. In 10 minutes, he told her, they would remove the clamp on Maysey's arteries. In 30 minutes they'd know if blood would return to his fingers. e team's main goal in reattaching Maysey's arm was to save his elbow, to give him that natural bend. Galvis told Alisa that he expected that blood would not return to the fingers, that they'd amputate as many inches away from the elbow as they could, and fit Maysey with a prosthetic hand. at 30 minutes became two and a half hours. Finally, Galvis relayed the good news. "We did some arterial sutures, and we saved the fingers," he told her. ere are three nerves in the hand that control motion. Galvis and his team discovered that the nerve that con- trols wrist movement and hand closure was destroyed. But the nerve controlling fine motor functions — like pinching or writing cursive — was functional. So they made a switch, connecting the fine motor nerve to the end of the other. Since the replanting, Maysey has been in and out of the operating room. "In surgery every third day for the last month," Galvis says. Now, back home in Glasgow, Maysey receives rehab, lucky that a semi-retired hand specialist lives there. Maysey will need to make periodic trips to Louisville. Right now, he's working on moving his fingers, waiting to see if any feeling returns. "Mom, you need to come here," Maysey said. "I've cut my arm half off."

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