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Hyperbaric treatments give injured hiker renewed opportunities to reach new summits

Posted at 5:19 PM, May 25, 2023

COLORADO SPRINGS — Sarah Thilenius has always loved the high adventure in Colorado's outdoors.

“I have grown up in the outdoors. I grew up here in Colorado Springs, and my parents are very outdoorsy,” she said, adding that with three older brothers, “I've always just been keeping up. Sports have always been a huge part of my life.” 

In November of 2022, Sarah was hiking Mount Yale with her boyfriend, Kendall. As experienced hikers and rock climbers, they were well-prepared, properly dressed, and had a Garmin inReach GPS unit with SOS capabilities. Knowing they knew would be running out of daylight, they did not attempt to summit and had started back down the mountain when Sarah took a fall off the trail above the treeline and tumbled some 500 feet down a steep rock field. Sarah says she doesn’t remember much.

Sarah recalls, “I remember the start of the fall. I remember landing. I remember Kendall keeping me awake, waiting for them.” 

“Them” was Chaffee County Search and Rescue - North. Kendall immediately called for help with his Garmin. But once rescue teams – several other Search and Rescue teams also responded - reached Sarah, it was too late to safely get her off the mountain. Sarah was in rough shape. “I had multiple cuts and gashes and wounds,” she said. “My whole face was fractured.”

Sarah now realizes she was lucky; her injuries could have been much worse. “After falling a distance like that, not sustaining any major injuries to my back or my neck or spine or really any breaks, besides my face. Looking back, it’s kind of funny to say, ‘I broke my face.’ Now we joke about that.”

Search and Rescue personnel stabilized Sarah and did their best to keep her warm overnight, but by that time, seven hours after her fall, the cold had already done serious damage to her toes and feet.

Dr. Robert Price with UCHealth is one of the many healthcare providers who have been involved in Sarah’s care. “Sarah has an incredible story. She took a fall from Mount Yale the evening or afternoon of November 18th. She had to spend the night on the mountain and then the next day was taken by life flight to the Anschutz Medical Campus up in (metro) Denver and received care for multiple injuries.” 

In addition to receiving treatment for the injuries she suffered in the fall, Sarah was also treated for the frostbite on her toes and feet at the UCHealth Burn and Frostbite Center.

Dr. Price explains that the damage frostbite causes is very similar to the damage caused by a severe burn. “Frostbite is a full-thickness injury of the skin and the tissue under the skin. The burn unit is the best place to manage those severe cases.” 

After several days in the hospital, Sarah became aware of how badly her feet were injured. “Monday rolled around and they took bone scans looking at my feet. It wasn't looking good.”   

Amputation of the damaged parts of her feet and toes was a real possibility. Sarah, 26, says the news wasn’t easy to digest. “It definitely was a harsh reality in that moment. But at the same time from hearing it I very much accepted it early on. It was something that I made peace with. Accidents happen, mistakes happen, I'm young, I'm active and I just knew that I could come away from it and that I would grow from it. I'm Catholic and my faith has always been really instrumental throughout this entire journey. I just had a lot of trust, a lot of faith that whatever happened, it would be OK.”  

Dr. Price recalls from the medical perspective, “It looked really bad initially. All of her toes had complete loss of the skin, and about 20% of the front part of her foot was also severely injured. At that point it was about five days after the injury and it was not good. We wanted to treat her immediately.’’

Dr. Price is the medical director of hyperbaric medicine at UCHealth Memorial Hospital Central in Colorado Springs. He knew time in a hyperbaric chamber was Sarah’s best chance for healing the skin grafts and the damage to her toes. He explains that a hyperbaric chamber is “an acrylic tube that we pressurize with 100% pure oxygen. The patient is in there for a total of 90 minutes and breathes in 100% oxygen. It’s like taking a person down in pressure to what they would feel below the sea. The increased pressure compresses everything and gives the tissue what we call supernatural levels of oxygen. That stimulates growth factors and also helps with oxygen delivery to that tissue that’s healing. It’s was key in helping the multiple skin grafts that Sarah got over the past three months heal. Breathing in 100% oxygen instead of the 21% we do normally allows us to achieve very high levels of tissue oxygenation which not only helps with healing but in stimulating those growth factors.” 

The same day Sarah was discharged from the UCHealth University of Colorado Hospital, she came to UCHealth Memorial Hospital Central, which has hyperbaric capabilities.

Before her first session in the chamber, there were concerns, however, that Sarah’s facial injuries would prevent her from being able to withstand the pressurized pure oxygen environment that could also save her toes. 

Sarah recalls: “They were worried because they didn't think I'd be able to do the chamber because of my facial fracture. I had fractured my jaw and nose and so they thought the pressure was going to be too hard for my face and that I wasn't going to be able to withstand the pressure.”

But by increasing the pressure in the chamber very slowly, Sarah’s other injuries were able to remain stable, and it became a near-daily part of her critical wound care. “I'd be there for three hours, so it was very long days heavily focused on healing.”

Now, six months later – after dozens of sessions in the chamber and with the expertise of wound care specialists and many others - Sarah has made a remarkable recovery.

Dr. Price says, “Medicine is a multidisciplinary team sport, and in Sarah's case it really is. From the search and rescue guys in Chaffee County to the flight crew that flew her to the team at Anschutz team to our team here (in Colorado Springs). We have the happiest patients in the hospital because our nurses get to see these patients every day. They bond with them, they connect with them and they provide, in her (Sarah’s) case, limb-saving care that saved her toes and the front part of her foot.”

When Sarah was discharged from the hospital she had to be carried everywhere or transported in a wheelchair. While she is still wearing a special foot brace on one foot, she’s getting around just fine on her own. 

Sarah says it’s not lost on her the army of people it took - and that includes her family and friends - to literally help her get back on her feet.  “From the very beginning I had friends and family visiting me in the hospital and then my brother staying longer (over Thanksgiving) to help take care of me. It was my entire family, all my friends.”

She also says her dad holds a special place in her heart for all he’s done for her, especially in those early days after she had been discharged from the hospital, when her feet were so badly injured she couldn’t bear to look at them.

“I couldn't even look at my feet when I first got out of the hospital. I had to hold pillows so I couldn’t see them, and my brothers would distract me while my dad was doing my (home) wound care. He did it from the very beginning, twice a day. Sometimes it took a couple of hours because he was just so diligent.”  

Her new family at UCHealth also revels in her recovery. Dr. Price says, “This is a huge win. Sarah is a young, vibrant woman in the prime of her life who suffered a traumatic event and came to us with toes that were black and had dead skin. We knew as an active young woman it was important to keep those toes. It is such a pleasure and privilege to see her go from where she was before Thanksgiving to where she is now. She didn't lose any of her toes. The skin on the top of her toes, where months ago we could see her tendons, is now completely healed. It's the why and what this multidisciplinary team of nurses, techs and doctors does. It’s why we come to work every day.”

Sarah says, “All the people here at UCHealth, all the doctors, all the nurses have been a huge part of where I am now and who I am now. I had a great team of people around me. Looking at it now, it's hard to believe I've grown so much in the last six months and it's been a very incredible and blessed journey.” 

Kendall, who was with Sarah on Mount Yale when she fell and instrumental in getting her help and supporting her while they waited for rescue teams, has been at Sarah’s side every step of the way. On a recent sunrise hike in Moab, Utah, that Sarah says was more of a walk, Kendall asked Sarah to marry him. She said yes. 

The couple has many goals in their planned life together including going back and summiting Mount Yale. Sarah says, “I don't have a timeframe in mind. I'm not in any rush, but I would like closure. That’s something I'm excited to do. I'd love to have the experience in a different way.” She laughs. “We'll try it in warmer weather when I'm out of the boot and the wounds are all healed up and I'm able to walk, and train and condition for it. Then I’ll get back to it.”
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