Blair’s Journey: Fortitude Personified

By on 06/13/2017

It was May 12, 2015, and Blair Berman was returning to New York following a long weekend visit with her parents and two brothers in Gwynedd Valley. They were celebrating Mother’s Day. The 24-year-old aspiring clothing designer boarded the train at 30th Street Station in Philadelphia as she had done countless times before. But her train wouldn’t make it to New York that evening. Amtrak 188 derailed, killing eight passengers and injuring hundreds more, as was reported.

Blair had been sitting in Car 1, which sustained the most damage by far. She awoke barefoot in the woods to the sound of screams and tried to pull herself up against a tree. She remembers four police officers carrying her to the street, where she would be rushed by ambulance to an area hospital. When the medical team assessed the severity of her injuries, they transferred her to Einstein Medical Center Philadelphia.

Blair’s injuries, both on her right side, included a broken elbow and a broken heel bone. One of the first physicians she encountered was orthopedic surgeon Anthony Ndu, MD, a foot and ankle specialist who was on call and already onsite to treat another patient.

“I met Blair and her parents that night,” recalls Dr. Ndu. “Blair had a severe calcaneus fracture—calcaneus is a fancy word for heel bone. The calcaneus is like an eggshell—the outside is hard but the middle is soft. Blair cracked the outer shell, which then fractured into multiple pieces.”

Blair and her parents would also soon meet James Raphael, MD, chairman of Einstein Orthopedics and a specialist in hand and upper extremities—including wrist, elbow and shoulder—who would tend to Blair’s elbow injury. Like her heel bone injury, Blair’s elbow injury was severe.

“All fractures have their own personalities,” says Dr. Raphael. “Blair’s fracture to her distal humerus bone—her elbow—had a bad personality because of how close it was to the joint and the fact that the bone was broken into several pieces. It would prove to be a very challenging injury.”

Both Dr. Ndu and Dr. Raphael would need to wait several days before they could operate, when the swelling had subsided, and the skin and soft tissue began to recover. With injuries to both her upper and lower extremities, Blair was immobile.

Her elbow surgery came first, six days after the accident. Dr. Raphael made a long incision from her elbow to her shoulder and performed a controlled fracture of another bone to gain access to the injury. He would insert two plates and several screws to rebuild the bone. Two days later, Dr. Ndu would operate, inserting a plate and screws to rebuild Blair’s broken heel bone.

After 10 days at Einstein, Blair was transported to Einstein’s rehabilitation hospital, MossRehab, for a two-week stay. Her therapists worked with her every day to prepare her for life at home, from getting in and out of bed or the shower to preparing food for herself. She would spend the remainder of the summer in a wheelchair.

“That was challenging,” says Blair, who would continue to visit MossRehab—the top ranked rehabilitation center in Pennsylvania—several times a week for physical therapy. She would have to relearn how to balance and to walk, and how to use her right arm. In November 2015, she would undergo a second surgery on her elbow with Dr. Raphael.

“Injuries like Blair’s can sometimes require another surgery because of additional bone growth and the formation of scar tissue,” explains Dr. Raphael. “Relative to her injury, I’m very happy with Blair’s overall outcome. Unfortunately, the nature of her injury means that she will always have stiffness, as well as limited motion and functionality. She will have to work on this with therapy and exercise for the rest of her life.”

Blair also underwent a second foot surgery with Dr. Ndu in June 2016, common with a heel injury like hers. “Surgeries like Blair’s often require revision,” says Dr. Ndu. “Blair healed well, but there was one piece that slipped out of place. She was having trouble with her gait and with wearing shoes. Blair is a petite girl, so we’re looking at small pieces. I needed to cut and reposition the bone and put new screws in.”

“It’s been draining,” admits Blair. “I’m so young and I have not been able to live the life of a normal 24- or 25-year-old. But it could have been way worse. My friends and family have been super supportive and understanding. They help me when times get tough.”

Blair is still undergoing physical and occupational therapy for her foot following the last surgery. She completed outpatient therapy on her elbow this past summer and continues to perform her exercises at home every day.

“Blair’s heel and elbow injuries are chronic,” says Dr. Ndu. “The amount of force it takes to break the calcaneus means the trauma you’ve done to your fat pad—the soft cushion on the bottom of the foot—is significant.”

Dr. Ndu and Dr. Raphael have worked very closely with Blair’s therapists at MossRehab, and will continue to see Blair on an ongoing basis. Both are extremely impressed with her fierce determination and indomitable spirit, despite the severity of her injuries and the road that remains ahead.

“What I always tell patients with injuries like Blair’s is that there are a lot of pieces that predetermine the outcome—how it happened and the force of impact of the injury,” says Dr. Raphael. “I tell them it takes a team to make it better—myself, the therapist and the patient. All three are equally responsible for the outcome.

“Blair has been very committed to her recovery,” Dr. Raphael continues. “She is unbelievably strong, highly intelligent, interested in understanding her care, tolerant of the injuries she sustained and completely focused on getting better. I never once heard a complaint from her, not once, which is remarkable given everything she’s had to endure. She’s a great kid with a great family to support her, and she’s doing everything she can to get the best possible outcome.”

“And my therapists at MossRehab—[occupational therapist and certified hand specialist] Diane Hunt for my arm and [physical therapist] Janett Smith for my foot—have been amazing,” she adds, “helping me with strength and range of motion, and getting me back to walking. My family and I are super happy with the care I’ve received at Einstein. I’m getting ready to pick my life back up again.”

If you or a loved on is in need of advanced orthopedic care—from traumatic injuries to everyday aches and pains—turn to the experts at Einstein. Call 1-800-EINSTEIN to schedule an appointment.



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