July 10 (Bloomberg) -- Injured survivors of the Asiana Airline Inc. plane that crashed in San Francisco face a recovery often seen in devastating car wrecks, from months of pain for broken bones to years of therapy for brain and spine trauma.
While most of the 307 passengers and crew walked away from the crash of the Boeing Co. 777 jetliner with minor wounds, more than a dozen people remain hospitalized at San Francisco-area hospitals, including at least three in critical condition. Two 16-year-old girls died in the July 6 crash. Three patients still in the intensive care unit at San Francisco General Hospital may be there “for months,” Margaret Knudson, the hospital’s chief of surgery, said in a telephone interview.
Most of the damage was similar to whiplash in car accidents, Knudson said. The passenger’s lap belt led to injuries caused by the upper body being snapped forward, then back. The seats, too, intensified the effect.
“One patient told me that the seat in front of her hit her in the chest,” Knudson said.
At Stanford Hospital, surgeon David Spain saw five spinal column fractures. In the less-serious cases, the bone was broken but the spine was stable. Patients with that kind of broken back generally are put in a brace for about three months to prevent loss of height and maintain their posture.
“They hurt an awful lot,” Spain said. “There are a lot of muscle spasms and a considerable amount of pain for several months.”
At least one of his patients faces a lengthy recovery with the possibility of more long-term effects, he said.
Rehabilitation for spinal cord injuries varies depending on the site of the trauma, with a great deal of variation in programs, said Charise Ivy, a rehabilitation specialist at the Center for Rehabilitation Medicine at Northridge Hospital Medical Center in Northridge, California. It’s also not clear at early stages of treatment how much someone will recover. Ivy isn’t treating any of the patients in the plane crash.
Common responses to spinal injuries include muscle weakness, loss of control of the bowels and bladder, and sensory losses, such as an inability to feel vibrations or to sense heat and cold. Some patients experience pain from damaged nerves, as well as severe, painful muscle spasms that can limit mobility and independence. The rehab process can be anywhere from a few months to a few years, she said.
“It’s a very long course of care, and you don’t use the word recovery, because recovery isn’t guaranteed,” Ivy said in a telephone interview. “It can be between a few months to a couple years before people know what their final function will be, and complete 100 percent recovery is pretty rare.”
Recovery from brain injuries is similar, said Benton Giap, the chairman of the physical medicine and rehabilitation program at Santa Clara Valley Medical Center in Santa Clara, California. About 80 percent of traumatic brain injury is mild, and those patients generally do well, he said. However, brain injury affects each patient differently, and can have effects on thinking, mental skills, judgment, behavior and mobility.
“You have to create an individual treatment plan,” said Giap, who isn’t treating any of those injured in the plane crash. “And if someone was severely affected mentally and physically, you’d need to have them in a rehab hospital.”
Common side effects include headaches, vision and balance issues, sensitivity to light and noise, and difficulty sleeping, Giap said. About 70 percent of patients with spinal cord or brain injuries also experience anxiety and depression.
“These are catastrophic injuries that typically impact people’s ability to take care of themselves, and they affect the whole family as well,” Giap said.
Another difficulty treating those most seriously injured in the Asiana crash are that many don’t live in the U.S., said San Francisco General Hospital’s Knudson. The hospital is working on a plan to collaborate with their home countries for rehabilitation efforts, she said.
“One thing people forget about is we have to deal with families that aren’t prepared to come here and see their loved ones seriously injured,” Knudson said. “A lot of families are just arriving, so we’re dealing with the families now.”
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