Health Day reporter
WEDNESDAY, June 23, 2021 (HealthDay News) – You might not believe it, but Florida firefighter Carsten Kieffer was incredibly lucky when a 12ft alligator jumped into his boat and bit him front- right arm.
Hardly anyone else thought so, and it doubled for Kieffer: the two main bones in his arm were broken and a big bite had been taken on the back of his forearm. After the attack, the arm was mostly hanging down from the remaining muscle.
“I knew that when I walked in I was probably going to lose my arm,” he recalls. The doctors who initially treated him were equally doubtful of his prospects.
But thanks to the type of specific damage the alligator caused to his arm – with talented surgeons and hard work in rehabilitation – Kieffer returned to active duty with the Tavares fire department in April, just eight months after the attack. .
He was lucky that the alligator bit him where he did, sparing the nerves, muscles and tendons that were essential to his recovery, explained Dr Karan Desai, the hand and an upper limb surgeon who treated him at the Orlando Regional Medical Center.
“I still have a bit of a way to go to get back to full fitness, but it’s getting better day by day,” said Kieffer, 42, of Grand Island, Fla. “There are days when I don’t even realize my disability or injury.”
The incident happened in August 2020, when Kieffer was hunting alligators with friends at Lake Jesup.
The Florida Fish and Wildlife Conservation Commission estimates that the 16,000-acre body of water near Sanford, Florida contains around 13,000 alligators, according to the Orlando Sentry. Only the mighty Lake Okeechobee contains more alligators in the state.
The men grabbed the reptile with a 12-foot-long tear-line, then stuck it with two harpoons to bring it closer to the boat, Kieffer said.
Unfortunately, they were in shallow water which gave the gator some weight to defend itself.
A sudden attack
“He was able to push off the bottom and get into the boat,” Kieffer said. “I was holding on to a few ropes that were attached to the harpoons that we rode into the alligator to grab it. I was standing in the boat, holding onto the ropes, and it just came back and cracked and he grabbed my arms.”
Kieffer’s friends sprang into action, one grabbing his pants and the other slipping a metal pole into the gator’s mouth to try and crack it open.
The alligator “shook its head once and lifted my body 6 to 8 inches off the boat. That’s when I could hear the skin tearing and the bones breaking,” he said. Kieffer said.
The attack ended under gator conditions. “He just let go and went back into the water,” Kieffer said. “We cut the lines and went to get help.”
As it turns out, it was Desai’s first day on call as an attending physician at the Orlando Regional Medical Center. Fresh out of his medical training in New York City, Desai was pretty sure someone was laughing at him when another doctor called him to treat Kieffer.
“One of the residents came to me and said, ‘We have a patient who got his arm bitten by an alligator,’” Desai said. “I thought it was a joke at first because I was new to Orlando Health and thought they were just giving me a hard time as a new guy. But then they showed me the radios and the Pictures.”
Doctors initially gave Kieffer little hope that his arm could be saved, but Desai – trained at the best trauma centers in Atlanta and New York – upheld the verdict. Perhaps he had never seen an alligator bite, but he had helped treat countless limbs mutilated in car crashes and industrial accidents.
“I don’t make quick judgments in the emergency room when I see these patients,” Desai said. “I think every patient deserves a look in the operating room, to fall asleep and examine everything very closely before making decisions on things like amputations.”
The bite had ripped out pretty much the entire muscle on the back of Kieffer’s forearm and shattered both bones. “The arm was basically hanging over the muscle that was still there,” Desai said.
Desai had three initial concerns, starting with the damage to the limb by some blood loss. “At first there was concern that the hand would not have blood circulation and would appear dark and gloomy,” he said.
Blood loss, nerve damage and infection
The surgeon was also concerned that the nerves in his hand were severed by the bite, which would prevent Kieffer from fully recovering his functions.
And finally, there was the risk of infection.
“The mouth of an alligator is full of large amounts of bacteria, being found in a swampy environment,” Desai said. “Lots of alligator bites led to amputations because no matter what was done, they couldn’t clear the infection there.”
Luck was on Kieffer’s side when it came to the damage done. Many blood vessels were affected but easily repaired, Desai said, and because the bite was on the back of the forearm, it did not sever the two nerves responsible for the majority of the function of the hand of a person.
These are located on the top of the forearm, and they were “bruised but intact,” Desai said. “They weren’t cut, so it was very, very lucky. If you could pick one side to do the most damage, you would pick” the other side, he added.
Desai started by stabilizing the bones, fixing the fractures with two plates and 17 screws. He then deep cleaned the damaged tissue in the arm, washing the wound and removing “anything that was not alive and appeared to be contaminated,” Desai said.
The muscles that flex the fingers and wrist had been torn off by the alligator, but the upper part of the forearm had been spared to the point that Desai could steal tendons from there and move them downward forward. -arms.
“I moved them to the back of her arm and reconnected them to the tendons on the back of the arm to bring her fingers up and her wrist up,” Desai said.
Eight months later, back to the fire department
It took over 20 hours of surgery, according to Desai’s estimate, and even then it was not certain that Kieffer would return to much function. Kieffer ended up spending 11 days in the intensive care unit and lost count of his surgeries.
“The point of everything would be for me to be able to lift a glass of water and drink it,” Kieffer said. “It would be a good goal.
Kieffer, however, wanted to resume his work as a firefighter and so he embarked on his rehabilitation work. Rehab appointments were three times a week, but he made his recovery a daily job.
“Every time they gave me a new workout to do, I would go home and buy the training equipment so that I could work out every day,” Kieffer said.
“Mr. Kieffer is one of the most motivated patients I have ever had,” Desai said. “He’s given 150% in rehab, and he’s actually starting to feel a lot of strength.”
Kieffer’s recovery was such that Desai cleared him for active duty in April.
“I can lift whatever I want. I can do just about whatever needs to be done,” Kieffer said. “The only thing I can’t do is curl my wrist all the way, but it happens. It’s getting better and better.”
There is one thing, however, that he will never do again.
A network of alligator hunters are committed to finding the alligator that bit Kieffer. He will not join them on the lake.
“I thought I would never be able to get my daughter back or play ball with my son again, so these are things I will never take for granted again,” Kieffer said. “My children were quite traumatized when the attack happened and I promised them that I would not hunt alligators again.”
The Florida Fish and Wildlife Conservation Commission has more information on alligators.
SOURCES: Karan Desai, MD, hand and upper extremity surgeon, Orlando Regional Medical Center, Orlando, Florida; Carsten Kieffer, 42, Grand Island, Florida.