Saving Serena

Spring 2019

When Serena Tejpar was brought into the trauma bay at LHSC’s Victoria Hospital, she was clinging to life.

The 18-year-old Western University medical sciences student had been involved in a serious collision on Highway 401 and, after being stabilized at Woodstock General Hospital, she was moved to London in an effort to save her from the critical injuries she had sustained.

The assessment of her injuries was extensive: sheared aorta; laceration to the bladder; broken pelvis, broken sacrum; brain bleed … the list goes on.

But there was one insidious injury that put her life in peril more than any other. A pulmonary laceration - a tear in her lung - was causing her lungs to fill with blood, making it increasingly difficult to get the vital oxygen that she needed to survive.

Dr. Rob Leeper, a trauma surgeon and intensive care physician at LHSC, was just about to start his day when he got a call asking him to come to the Operating Room immediately to help assess and treat Tejpar.

 “All of her injuries were severe and traumatic, but none on their own was imminently life-threatening, except for the tear in her lung. The blood pooling in the lungs was putting her into respiratory failure, and we needed to act quickly. We needed to find a way to maintain her oxygenation until we could stabilize her enough for surgery.”

So severe was the damage to her lungs that the ventilator, a machine designed to breathe for patients, simply could not ventilate her.

That meant the medical team had to manually push oxygen into her airway, squeezing an air-filled bag attached to a breathing tube, literally sustaining her life one compression at a time.

“It was incredibly tough to get that air into her because her lungs were so full of blood,” says Dr. Leeper. “We had to press so hard, our hands would start cramping within minutes. So about a dozen of us – physicians, nurses, residents, medical students – surrounded her bed and took turns. As long as she was fighting, so were we.”  

Together, the team continued providing that oxygen for five hours. And those five hours where counted five minutes at a time.

The goal was to prepare Tejpar to be placed on a machine that would pump and oxygenate her blood outside the body, allowing the heart and lungs to rest, and give the team the time needed to repair her lungs and some of her other injuries.

Tejpar, thankfully, doesn’t remember anything that happened that evening or in the days that followed. Her last memory was saying goodbye to classmates before she headed off for Toronto with friends.

What she does remember is waking up in the Critical Care Trauma Centre four weeks later, connected to a ventilator and wondering where she was. Her family had flown in from Calgary, and by this time, her medical teams were all very familiar with the young woman who refused to give up.

“Those first days after I came out of my coma were extremely tough for me,” says Tejpar. “I was confused and all I wanted was to be free from the restraints and be disconnected from the machines. I wanted to be able to communicate with my family, friends, and doctors.”

Tejpar’s next steps to recovery wouldn’t be easy though. With a tracheostomy, a curved tube placed in the windpipe to facilitate breathing, and too weak to speak, she started using an iPad to communicate, but even that was challenging. Her muscles were too weak and her injuries too severe, impacting her ability to sit, stand, and walk, leading to months of physical therapy. A traumatic brain injury made everything more difficult.

Physicians and staff quickly realized that as a medical sciences student, Tejpar was curious about, and understood a great deal of, what was going on around her. Her doctors shared her scans and X-rays to help explain the injuries and her treatment path. Nurses advocated for her and helped her advocate for herself.

“My nurses and doctors were incredible. They were always there to offer gentle encouragement on the days that were particularly difficult, and to give me strength when they knew I still had so much fight left in me.”

Everyone was thrilled when Tejpar was transferred to her hometown of Calgary, where her friends and family could offer support through the many months of rehabilitation ahead of her.

True to her determined nature, Tejpar didn’t only focus on healing once back in Calgary, but also on catching up on missed school work. As a result of a grueling six-month effort, she returned to Western with the goal of completing her undergraduate studies.  

Then the unthinkable happened.

“I was at a physiotherapy session one day, about a month after I returned to classes, and suddenly I couldn’t feel anything in the lower half of my body,” says Tejpar.

She collapsed and had to be taken to LHSC by ambulance where she learned she was in congestive heart failure and needed surgery to re-line the stent implanted in her aorta after her collision.

“I felt like I was reliving my worst nightmare and didn’t know if I could go through it all again,” says Tejpar. “I remember Dr. Leeper coming to see me and telling me that he refused to let me give up. The incredible nurses who had cared for me during my time in Critical Care also came by to offer their support and encouragement. They all helped me get through a challenge I thought was insurmountable.”

Tejpar once again returned to her studies following a recovery period, working through the physical and cognitive challenges which remained from her injuries, and graduated with a Bachelor of Medical Sciences - Honours with Distinction.

Now a master’s student in Global Health Studies at McMaster University in Hamilton, Tejpar continues to live with the challenges and side effects of that fateful night and is mindful that she has an uncertain future ahead of her.

“Every day I feel pain. And every day I suffer from new challenges. But I often have to remind myself of everything I’ve been through and realize that just making it this far is an accomplishment in itself. I hope that by sharing my story, others who are facing medical uncertainty of their own are encouraged, and can recognize that their recovery is within reach too,” says Tejpar.

 “I hope to continue on to medical school, so that I can bring the same compassion, empathy, and dedication to my patients as I received while I was in hospital. When I go back to LHSC for follow-up visits, I look for the nurses who cared for me and comforted my family in those dark days, and they continue to be a source of reassurance. I’ll never forget their kindness - from promising my mom that they would take care of me as if I was their own child before she arrived in London to be by my side, to the nurse who carefully braided my hair while I was in a coma – I never felt like I was just another bed number.”

From the moment she was attended to by Emergency Medical Services, she was in the very best hands. One of her first responders was also a Respiratory Therapist who works in the LHSC Intensive Care Unit.

“He knew how to find an airway despite her extensive injuries. The physicians and staff at Woodstock General Hospital did everything they needed to stabilize her for the trip to LHSC, including resuscitating her when she went into cardiac arrest twice. And from the moment she was wheeled into our trauma bay, she had a team of medical professionals dedicated to doing all we could for her,” says Dr. Leeper.

 “Serena has impacted everyone who has met her during her time at Victoria Hospital. To see a young person, with so much promise ahead of her, survive and recover the way she has – she’s that ray of hope that keeps me and my colleagues going.”

 

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