Trauma Center Patient Story: Greg Phelps

Greg PhelpsAfter being hit by a car, Greg Phelps survived his injuries and is putting his life back together thanks to family, friends and the Trauma Center.

Longtime runner Greg Phelps was out for a six-mile jog on a Sunday morning in 2010. It was already 10:30, but the streets of downtown Pewaukee, Wis., were all but deserted because it was the Thanksgiving holiday weekend. Suddenly, the driver of a passing car lost control of his vehicle. The car shot onto the sidewalk and hit Greg from behind. Greg slammed into the windshield and flipped over the back of the car.

A local couple on their way to a birthday party witnessed the impact and called 911. Greg was unconscious, bleeding from a large cut on the back of his head. The couple helped as best they could, trying to keep Greg’s airway clear and his back straight. Emergency medical services paramedics were soon on the scene. They quickly evaluated his injuries, inserted a breathing tube and prepped him for transport. Within minutes, Greg was on his way to Froedtert & the Medical College of Wisconsin.

Greg’s wife, Marlene, received the awful news by phone from local police, who drove her and the couple’s two children to the hospital. Greg’s parents, who live in Oregon, also got a call from the hospital, and they flew to Milwaukee.

Level I Trauma Center

Unfortunately, Greg’s story is not unique. One out of every three people in the United States will be touched by trauma during their lifetime. Traumatic injury is the No. 1 cause of death for Americans younger than 44.

Froedtert & Medical College of Wisconsin is the only adult Level I Trauma Center in eastern Wisconsin. It offers around-the-clock access to medical services and equipment most important for injury care, not readily available anywhere else.

For more information on the Level I Trauma Center resource, access the Trauma Center Annual Report.

Research shows that injured patients who are treated at a Level I Trauma Center have a 25 percent lower risk of death, according to a study published in the New England Journal of Medicine. For people in eastern Wisconsin who suffer serious trauma injuries, treatment is available at Froedtert & the Medical College of Wisconsin, the only adult Level I Trauma Center in eastern Wisconsin and the longest-running center in the state. Froedtert & the Medical College’s Trauma Center has specialized trauma surgeons and critical care physicians on site at all times, and neurosurgeons and orthopaedic surgeons who are at the ready. Dedicated surgical facilities, trained trauma nurses and key support specialists are also available at any hour.

When Greg arrived at the Trauma Center, the team was ready. Led by Karen Brasel, MD, MPH, a Medical College of Wisconsin trauma surgeon, team members checked his airway, breathing and circulation, then systematically evaluated his injuries. Greg was in a coma and non-responsive. CT scans revealed a skull fracture, several rib fractures, a broken shoulder blade. Worst of all, Dr. Brasel said, was the hemorrhage putting Greg at risk.

Neurosurgery

“As soon as we saw that on the scans, we called the neurosurgical team,” Dr. Brasel said. Marjorie Wang, MD, MPH, FAANS, a Medical College of Wisconsin neurosurgeon, was soon scrubbing for surgery. “The blood was pushing Greg’s brain over to the other side of his skull,” Dr. Wang said. “With that much shift, he had a very high risk of death.”

Surgery began just after noon. Dr. Wang removed a piece of bone from the left side of Greg’s skull, and took out a dangerous pool of blood, or hematoma, that was located under the tissue enveloping the brain. The entire procedure took about three hours. To avoid neurological damage, Greg’s brain needed room to swell, so the skull bone wasn’t immediately replaced. In the Intensive Care Unit, several members of the trauma team cared for Greg, including trauma and critical care surgeons Travis Webb, MD, MHPE, and David Milia, MD.

On Monday, Dr. Milia met with Greg’s wife, mother, sisters and other friends and family. “They had a lot of questions, and we had a very serious discussion regarding the severity of his brain injury,” Dr. Milia said. Even if Greg survived, there was a high risk of cognitive disability. “A lot of tears were shed.”

Resiliency After Trauma

Yet even as the family was meeting, Greg was showing signs of resiliency. “He came out of the coma the very first day after surgery,” Dr. Wang said. “He opened his eyes and was able to follow requests – to hold up two fingers, squeeze hands, give a thumbs-up.”

On Tuesday, Greg looked even better. His breathing tube was removed, and Dr. Wang asked him what month it was. “April,” he said. Although he was confused, shades of the old Greg were emerging. He became agitated if his smart phone was not nearby, for example.

On Wednesday, Greg was well enough to transfer out of intensive care. With his neurological condition stabilized, the trauma team focused on his other injuries.

In mid-December, Greg began to make rapid strides. He started inpatient rehabilitation and quickly progressed from sitting up to getting out of bed to walking. Finally, after a miraculous four weeks, Greg was ready to go home.

“I was discharged on Christmas Eve,” he recalled.

Throughout early winter, Greg wore a helmet to protect his still open skull.

“If I would have slipped on the ice without my helmet, it most likely would have been fatal,” he said.

Brain Injury Rehab

Life slowly returned to normal. Greg attended his children’s school events. He also returned to Froedtert & the Medical College every day to continue therapy in the Brain Injury Rehabilitation Program. The program utilizes the skills of rehabilitation physicians, therapists and a psychologist who specialize in helping patients with neurological injuries regain their abilities and compensate for deficits.

“When a patient has a broken leg or pneumonia, it’s easy to see,” said Mark Klingbeil, MD, a Medical College of Wisconsin rehabilitation physician. “But you can’t very easily see problems with the brain, especially problems with thought processes.”

Greg worked with physical therapists to improve his strength and balance, while occupational therapists helped him relearn basic skills like writing. Speech therapy addressed cognitive skills like attention, concentration and problem solving.

“There were several different mental drills,” Greg said. “They used word association and other exercises to get my memory back in swing.” Meanwhile, Greg’s brain swelling continued to subside. In February, Dr. Wang performed a second surgery to reattach his skull bone. After almost three months, Greg was back in one piece.

Trauma Center Is Community Resource

The Trauma Center does more than provide patient care. Team members help coordinate the regional trauma system, provide trauma education to the community, lead injury prevention efforts and conduct research.

“Our Level I Trauma Center is an incredible health care resource for our local and regional community,” said John Weigelt, DVM, MD, MMA, Froedtert & the Medical College’s Trauma Center medical director. Greg has not just survived, he has made a remarkable recovery, both physically and mentally.

In April 2011, he returned to his job as sales director for a pharmaceutical company. Although he experiences ongoing pain, he works out regularly and helps coach his children’s sports teams.

“Greg is a very optimistic, positive person with amazing resiliency,” Dr. Klingbeil said. “I saw him recently, and he wanted to know what he could do to improve his pace during running. He’s looking at getting back to the way he was before his injury. Given his tremendous determination, he will probably reach that goal and even surpass it.”

In 2012, Greg ran in a number of races and marathons. He and his wife have formed a friendship with Jeff and Tiffany Fisher, the couple who helped Greg after he was hit.

“They are just wonderful people who were in the right place at the right time, and jumped in and helped,” Greg said. He is also thankful to the staff at the Trauma Center.

“I received wonderful care from everyone at Froedtert – the doctors, nurses and all the staff. They treated me with a level of empathy, dignity and personal interest that just highlighted their professionalism and expertise.” Greg’s sense of personal gratitude has grown as he has worked to put the pieces of his life back together.

“Life can change very quickly,” he said. “I now try to live life every day, support other people and be the best person I can be.”