Peaks and valleys: Surviving a paralyzing ski accident

Celeste Madden suffered crippling injuries after tumbling down the snowy slopes of a Vermont mountain trail. Ohio State nerve surgery specialists gave her renewed hope and a path forward.

“See you at the bottom!”

Celeste Madden shouted that out to her husband and a close friend before heading down Stein’s Run, a popular mountain trail at central Vermont’s Sugarbush Ski Resort. The advanced ski run was familiar terrain to Celeste and her fellow adventurers, who were all veteran skiers.

Celeste was an active emergency room pediatrician from Syracuse. She loved the invigorating thrill of Saturdays on a snowy, evergreen-dotted mountainside. Her parting words before starting down Stein’s Run are the last thing she remembers before waking up five days later in a hospital intensive care unit.

On the day of the accident, temperatures were subzero, but the sun was bright. The free-spirited, 66-year-old mom eagerly hit the trail, but her husband and their friend watched in horror as Celeste lost control on an icy patch. She wore a protective helmet but lost consciousness after her head hit the ground. Skis and poles scattered as she tumbled down the steep slope. She eventually came to rest against a tree in the woods at the bottom of the trail.

Celeste had been in intensive care for a week when doctors gave her the bad news. She had a spinal cord injury, three broken bones in her left arm, and other muscle and nerve damage on the left side of her body. She lost function on both sides of her upper body, with the worst injuries on her left side — particularly devastating to Celeste, who is left-handed.

Uncharted terrain and troubling news

In pain and without use of her hands and arms, Celeste’s next challenge would be a long, three-year trek. After leaving the ICU, Celeste spent five weeks in inpatient rehabilitation. She had to relearn how to walk, and she tried to use her left arm and hand.

“My walking was coming along,” Celeste said, “but it was months before it became clear that I had completely destroyed my brachial plexus — almost all the nerves — on my left side. This meant I had no arm or hand function from my shoulder down.”

She began searching for a specialist. As a physician, Celeste understood the complexity of the injury, which helped focus her search. She chose doctors in St. Louis who had surgical expertise and took a team approach to addressing nerve injuries.

“I began working with Dr. Amy Moore to rebuild my life,” Celeste said. “She is a star. When I described the 12-hour surgery, my friends and colleagues were amazed by its complexity and my rapid recovery. The surgery required incredible endurance and focus as Dr. Moore transplanted nerves from other body areas to bypass the injured nerves to my arm.

She said she was in awe of Dr. Moore.

“Because of my medical background, I am aware of the unique skill set that Dr. Moore possesses in order to do this work. She exhibits a combination of personal and professional qualities that are rare to find in one physician.”

Starting over, from the ground up

When she first met Dr. Moore, Celeste couldn’t use her left arm or hand. She couldn’t move her elbow, hand or fingers. She didn’t feel anything below her left shoulder.

“Unfortunately, I was able to feel intense nerve pain caused by the injury,” Celeste said. “I needed a splint to hold up my elbow and hand. I continued to limp from my weak left leg.”

“Before the accident, I was left-handed and fully involved in my pediatric practice,” she recalls. “After the accident, I had to leave my practice and my beloved patients. I had to learn to do everything with my right hand. Everything was harder to do and took more energy. It was frustrating to change from a fully independent, active and contributing person to a dependent and limited lifestyle.”

Twists and turns on the road to recovery

After her first major surgery to repair complex muscle, nerve and bone injuries, Celeste describes her recovery process simply:

“Therapy, therapy, therapy!”

She went several times a week. It helped her get stronger and improve balance, but it didn’t improve her arm function.

“I took a driving course to get an adaptive license and reclaim some independence. I tried acupuncture, massage and nerve pain medications without improvement.”

Dr. Moore worked with Celeste’s rehab specialists to maximize the benefit of postsurgery therapy.

“Initially, I made gains in my arm muscles,” Celeste said. “I showed more shoulder strength, and biceps and upper arm activity.”

“When my improvement plateaued and my biceps still could not hold up my arm without a sling, Dr. Moore and I discussed a second complex surgery.”

The procedure involved removing an entire muscle along with its nerve from Celeste’s leg. Dr. Moore would transfer this nerve to the left arm, which required connecting many delicate nerves and blood vessels.

Confidence-boosting reassurances from an “all in” surgical team

As she considered the second surgery, Celeste learned that Dr. Moore was selected to hold the Ruberg Chair and direct the Plastic and Reconstructive Surgery Department at The Ohio State University Wexner Medical Center. Celeste decided to have the procedure, even though it would have to be delayed until Dr. Moore settled into her new role.

Celeste began to get cold feet as she worried about the outcome. “Was I too old?” she wondered. “Was I healthy enough to undergo an even more complex surgery?”

She accessed scientific articles to research the procedure and her chances of success. Celeste shared her hesitation with Dr. Moore, who reviewed the literature and her personal results with Celeste.

“Dr. Moore methodically and supportively shared why she thought I was a good candidate for the procedure,” said Celeste. “She reviewed procedural details and helped me become comfortable with the plan. I felt like we were working as a team to plan my care.

“From my own experience and those of other patients, Dr. Moore is regarded as confident, supremely skilled in her surgery, always reassuring and honest about expected outcomes."

What Dr. Moore has achieved with her patients is truly life changing and life affirming. If there is a possibility for improving the quality of life, she and her team are ‘all in’ for the patient.”

A big step forward, with microscopic attention to detail

Another complicated, 12-hour surgery required coordination of multiple surgical teams led by Dr. Moore. The team included Julie West, PA, and Brachial Plexus Program Director Kim Bjorklund, MD, from the Ohio State Wexner Medical Center’s collaborative partner, Nationwide Children’s Hospital.

“The plastic surgery resident/fellow team and high-quality postop nursing care on 12 James were also significant contributors to my successful recovery,” Celeste noted.

High praise for Ohio State’s team, talent and teamwork

Celeste remains deeply appreciative of her experience at the Ohio State Wexner Medical Center.

“It is all about the team and recognition that the team is key!” she says. “Each brings their own talents so the team and patient benefit.

“I have witnessed many examples of how Dr. Moore values the team approach. She fosters the philosophy that we can all learn from each other to make things better. It is a humble approach and, combined with the excellent skills of Dr. Moore’s team, guarantees the best possible patient care.

“My husband, also a physician, recognizes the unique talents of Dr. Moore and her team. 

"My children, one of whom is a physician, are incredibly thankful for our relationship with her. They appreciate how she has been able to improve my quality of life.”

Donations toward a Center of Excellence for complex nerve injuries

Celeste sees great promise with Dr. Moore at the helm of the Ohio State Wexner Medical Center’s multispecialty Plastic and Reconstructive Surgery program.

Dr. Moore’s goal is to improve patient care, as well as mentor students of medicine and improve teamwork. As a recent addition to the Ohio State Wexner Medical Center’s faculty, Dr. Moore wears many hats that require support to realize her potential.

“Any funding to support a ‘Center of Excellence’ to optimize her tremendous technical and leadership skills is welcomed,” Celeste says. “It is paramount to furthering this work, which can change the lives of everyone who has suffered a nerve injury.”

A multispecialty Center of Excellence can help people of all ages and walks of life, including:

  • Children with accidental and postinfectious injuries 
  • Young adults with tragic injuries limiting potential 
  • Military personnel suffering life-changing wounds 
  • Older people who suffer accidental trauma or other nerve damage

“My humble opinion as a patient/physician would be to use initial funding to support dedicated projects for Ohio State’s Plastic and Reconstructive Surgery Department,” Celeste says. She emphasizes the need for donations to Ohio State’s Plastic and Reconstructive Surgery Department, and support for targeted plastic and reconstructive surgery funds.

Celeste’s wish list includes:

  • A dedicated and specialized inpatient care unit 
  • Dedicated therapy support staff to provide wide-ranging services to optimize patients’ functional recovery 
  • Support for research projects to improve patient results, including pain specialists focused on studying and treating nerve pain 

Happy trails ahead for Celeste and others like her

Celeste has regained function in her arms and grows stronger every day. She’s ready to blaze new trails in life. Whatever the path, her Ohio State Wexner Medical Center team, family and friends know Celeste well enough to say, “See you at the top!”