Madelynne Auwae does not recall many details about the crash that changed her life, as she lost consciousness almost immediately after the impact.
“All I remember was a loud bang, my hand hitting the windshield and the impact from the seat belt on my stomach,” she said, recalling the accident that took place in April 2016. “The seat belt cut my stomach muscles completely in half from left to right.”
While the 29-year-old woman’s skin remained intact after the vehicle struck a pole, the lap belt that saved her life also split her abdominal muscles. Following the crash, she blacked out and woke up in UMC’s Level I Trauma Center, where she received care from trauma surgeon Dr. Paul Chestovich and a team of nurses, physicians and other medical professionals.
“Madelynne had by far the worst seatbelt injury I have ever seen,” Chestovich said, acknowledging his surprise when he analyzed Auwae’s CT scan. “The seatbelt completely transected her abdominal muscles, creating a massive hernia. The opening could not have possibly been any larger.”
Although the benefits of wearing a seat belt far outweigh the risks, Chestovich said seat belt injuries are relatively common, and most do not cause the type of severe damage Auwae experienced.
With her intestines coming through the large internal wound, Auwae remained in stable condition despite her significant abdominal injury, providing Chestovich with a valuable, yet small, window of time to prepare for a complex surgical procedure. If left untreated, the massive hernia threatened to shut down her colon and potentially end her life, Chestovich said. Her abdominal muscles also would have retracted within a few days, making it impossible to reconnect the muscle tissue with stitches.
Faced with the type of case that very few trauma surgeons ever witness, Chestovich planned for a surgical procedure to not only save Auwae’s life, but provide her with the best possible outcome while reducing the risk of future complications. He consulted with colleagues from across the nation while drawing upon his training and experience to develop a plan to carefully repair the injury. After consulting with several fellow experts in the area of abdominal wall reconstruction, he was prepared with multiple surgical options to repair her abdomen based upon what he found during surgery. “This is such a rare injury,” he said. “It cannot be found in any textbook.”
While Auwae said she initially felt nervous about the complex procedure, she gained confidence by speaking with Chestovich, who offered honesty, compassion and valuable encouragement.
“When you’re going through something like this for the first time in your life, you need someone like that,” she said. “You need someone to make you feel like everything is going to be OK, and I knew Dr. Chestovich was there for me.”
Chestovich said communicating with trauma patients requires a measured approach, as these individuals never expect to encounter life-threatening emergencies. “Any of us could be a trauma patient on any given day, so I try to be the type of doctor I would want for my family,” he said.
With the surgery performed within one day of Auwae’s arrival at UMC, Chestovich spent 3 1/2 repairing Auwae’s massive hernia. Auwae spent a total of two weeks at UMC, followed by another two weeks of physical rehabilitation, and her recovery has been remarkable.
“I feel better physically than I did before the accident. I don’t have any pain or any physical problems,” she said, explaining that Chestovich challenged her to lose weight following the procedure in an effort to reduce the risk of a recurring hernia.
Since April 2016, Auwae has lost 50 pounds by making significant changes to her lifestyle. After overcoming a life-threatening injury, she now eats healthier and stays active by going for walks with her friends and exercising in a gym near her apartment.
“This experience completely changed my life. It reminded me how important it is to keep myself healthy and make better decisions,” she said. “Life is too short, and you never know what is going to happen.”
Chestovich said he and his colleagues at the UMC Trauma Center, Nevada’s only Level I Trauma Center, take tremendous pride in their efforts to help critically injured patients like Auwae.
“It’s why we do this job,” he said. “The real satisfaction of being a trauma surgeon is seeing patients on their worst day and helping them get through such traumatic injuries to better days ahead.”