When doctors in Green Bay told Jen Kanzenbach, 38, that they would have to amputate her left arm, she refused to believe this was her only option. Jen had been attacked by a dog and had suffered severe injuries to her skin, muscle, nerves and blood vessels, but she did not want to lose her dominant hand.
“I couldn’t let them take my arm without getting a second opinion,” Jen said. “My life would have never been the same.”
Several years before, a family member was treated at the Froedtert & the Medical College of Wisconsin Clinical Cancer Center on the Froedtert Hospital campus. Jen remembered that experience and requested a transfer to the same hospital.
“He was so well taken care of,” Jen said. “I knew I would be in good hands.”
A Different Approach
The dog attack was on June 29, 2018. Jen was transported by ambulance to Froedtert & MCW Froedtert Hospital on July 1. Patrick Hettinger, MD, plastic surgeon and MCW faculty member, evaluated her injuries with the help of imaging from a CT angiogram, which produces detailed images of blood vessels and tissues, to determine which parts of her arm he could save.
“Jen’s injury spanned from the mid-portion of her left bicep to the middle of her left forearm,” Dr. Hettinger said. “Her brachial artery, which is the dominant artery of the hand, was severed. Her hand was purple because the blood flow was almost nonexistent.”
Despite the severity of her injuries, Jen felt an immediate sense of relief when she met Dr. Hettinger.
“He was confident and said, ‘We can definitely save your arm,’” Jen said. “Those were the words I needed to hear. I put my faith in the Froedtert & MCW team, and they didn’t let me down.”
Jen underwent surgery immediately to remove dead tissue from the limb and repair the many small blood vessels and nerves that were damaged. Because of the significant injury to her brachial artery, Dr. Hettinger also performed a vein graft procedure. He used a 15-centimeter portion of the saphenous vein in Jen’s leg to bypass the damaged part of the artery and restore blood flow to her arm. Jen also needed additional skin to cover her wounds so Dr. Hettinger transferred tissue from her left thigh to her arm by performing a free flap procedure.
“These are repairs and reconstructions that we do every day,” Dr. Hettinger said. “At Froedtert Hospital, we have a high level of microvascular surgery experience and perform the highest volume of these procedures in Wisconsin.”
Restoring blood flow to the arm and the hand was just the beginning. The dog bite had destroyed the muscles on the top of Jen’s forearm. Over the next few months, she would also have several tendon transfer surgeries to allow her to extend her thumb, fingers and wrist. Jen worked with an occupational therapist twice a week to regain mobility.
“I am relearning to write,” Jen said. “It isn’t easy, but I don’t feel any pain. I am also back to using my rolling pin and baking for my dog treat business. I knew it was going to be a long road to recovery, but life is returning to normal.”
Preserving Quality of Life
Despite the horror of the attack, Jen is grateful.
“After the attack, I remember my fingers were still attached, but my arm was shredded, and I lost a lot of blood,” she said. “When I look back on it all, this is a miracle to me. I believe I can regain full function in my hand and arm. Dr. Hettinger and his team did something the doctors in Green Bay could not. I will always be thankful.”
Dr. Hettinger credits Jen’s successful outcome to her and her family’s quick thinking when they requested a second opinion.
“It is important for patients to advocate for a second opinion,” Dr. Hettinger said. “Froedtert Hospital is a tertiary care facility, which means we have the training to treat complex medical conditions and provide highly specialized care. In cases of severe injury or trauma to a limb, we attempt to save all of the tissue possible. A person’s quality of life and function come above everything else, and a dominant hand provides so much function. We will do everything in our power to save it.”