On a crisp February day in Breckenridge, Colo., Brandon Gaidano conquered a black diamond on his first ski run of the day. It was a hard-earned triumph. Nine months earlier, he endured multiple surgeries to repair severe pelvic fractures, a ruptured bladder, chest injuries and a broken ankle.
“When ski season came, it was like nothing ever happened,” the 44-year-old Santa Ana father marveled. “I never thought I’d be able to walk again. I’m so very grateful.”
Gaidano was leaving a bagel shop on a Saturday morning in May 2020 when his pickup truck was T-boned on the driver’s side by an impaired street racer going more than 100 miles an hour.
Paramedics extracted him from his crumpled vehicle. Given the severity of his injuries, they rushed him to UCI Medical Center — Orange County’s only Level I adult and Level II pediatric trauma center.
“When they wheeled me into the main emergency room, I remember everybody was cutting my clothes off and I was trying to figure out what was going on,” he says.
After a series of X-rays and other tests, the trauma team doctors told Gaidano he needed surgery to repair his pelvis. They also worried about internal bleeding and injuries to his chest and ankle. “Just lying there, I’m thinking, ‘How can this be happening to me?’” he recalls. “I was just going to get breakfast!”
Each year, UCI Medical Center treats thousands of severely injured trauma patients. When a patient like Gaidano arrives, the trauma and critical care surgery team responds immediately to resuscitate and stabilize the patient. Even with a crush of COVID-19 cases during the pandemic, the trauma team is relentless in its stop-at-nothing approach to caring for patients.
Saving lives around the clock
“Our No. 1 priority is saving life,” says Dr. Michael E. Lekawa, director of the trauma center. “We have developed a smooth, systematic approach for these very complicated cases where patients have multiple life-threatening injuries and need a multidisciplinary team of doctors.”
The core trauma team, which includes surgeons who are specialty-trained in trauma and critical care, takes over the patients’ care from the moment they arrive in the emergency department until they are able to leave the hospital.
UCI Medical Center is also the only trauma center in Orange County where every trauma surgeon is a board-certified surgical intensivist with an extra level of training to provide comprehensive care to critically ill patients across all surgical specialties and all age groups.
Fortunately, Brandon didn’t have a brain injury,” says Lekawa, Gaidano’s attending surgeon. “But he did have significant chest injuries, including multiple rib fractures, a collapsed lung that needed draining and a lung contusion. In addition, we had to manage internal bleeding in his belly, his pelvic fractures and abdominal trauma.”
Gaidano also had a ruptured bladder and a broken ankle, but those injuries would have to wait.
“We worked to stop the bleeding from the pelvic fractures and stabilize the patient, then the orthopaedic trauma team took charge,” says Lekawa, a UCI School of Medicine professor and chief of the Department of Surgery’s Division of Trauma, Critical Care, Acute Care and Burn Surgery.
The UCI Health team has a deep bench of orthopaedic trauma surgeons trained in pelvic and hip socket surgery. At least one is always ready to respond to trauma patients.
“The pelvis is a deep, complex bone surrounded by blood vessels that can result in life-threatening bleeding when severely injured,” says Dr. John A. Scolaro, chief of orthopaedic trauma services for UCI Health.
“The skill and confidence to operate in this anatomic area is something surgeons can only develop with additional training. No other Orange County hospital has access to multiple fellowship-trained orthopaedic trauma surgeons who can literally step in at any time.”
Scolaro was enjoying a Saturday breakfast with his family when Lekawa called him about Gaidano, who was bleeding and unstable. Scolaro hustled to the medical center, a few minutes away, to join the rest of the surgical team.
“We have fully functioning trauma operating rooms on weekends and around the clock. Dr. Lekawa and the team got the patient as prepared as possible, then I was able to make multiple small incisions and provide much-needed stability to his pelvis.”
Scolaro’s work wasn’t finished, however. “At that point, it was about saving Brandon’s life.”
As soon as he stabilized Gaidano’s pelvis, a team of UCI Health urologists began repairing the injured bladder.
“The urologists made an incision in the front part of his pelvis, which we used 48 hours later when we finished repairing his pelvis,” says Scolaro, who went on to operate on the patient’s broken ankle that same day.
Gaidano was taken to the surgical intensive care unit to recover. These were the early days of the COVID-19 pandemic, so his family couldn’t visit. His primary nurse became his advocate. “Every time doctors would come in, she would call my wife on speakerphone so my wife would know what was going on.”
After five days, he was transferred to the hospital’s acute rehabilitation unit. “That was a big relief, to be able to stay at UCI. I felt comfortable because if something were to happen, people would know exactly what was going on.”
Final stabilization of Gaidano’s pelvic fractures required additional screws as well as pins and bars outside the skin, a device called an external fixator. The severity of his injuries limited his ability to move for about six weeks.
He was thankful for his ground-floor hospital room and window, which allowed him to see his wife and then 7-year-old daughter as they talked on the phone.
Even with COVID-19 taking a toll on hospital staff, he also felt the support of his caregivers and the entire staff, including the chaplain, Pirjo Carlisle.
“Everybody I interacted with at any level was happy to be there. And they genuinely seemed to care.”
That shared commitment to saving patients’ lives and restoring them to health is the key to their seamless teamwork and excellent patient outcomes, Lekawa and Scolaro believe.
“Everyone is working toward a common goal. We mobilize and do whatever is needed to take care of every patient like they’re family,” Scolaro says.
This all-in approach accounts for the trauma center’s consistently top-level results, Lekawa says.
“I’ve been doing this for 25 years, and it’s taken a long time to build a program of this level of excellence. I’m proud to say that the people of Orange County have a trauma center able to give their loved ones the best possible outcomes.”
Improving little by little
While in the ICU, Gaidano wondered if he would ever walk — or work — again. The screws within his pelvis, combined with the external fixator, provided the stability needed to allow his fractures to heal correctly.
By the time he went home almost a month later, he had increased the range of motion in his legs and was gaining confidence. After two weeks at home, the external device was removed and his physical therapist helped him begin using a walker.
“Little by little, I made progress,” Gaidano says, transitioning to outpatient physical therapy and exercise at home. Three months after the crash, he started a new full-time job with a home appliance company.
“By 3½ months out, I was able to do a little jog and 10 jumping jacks in my backyard,” he says. “I was crying, I was so happy. I was like, ‘It hurts, but I’m going to be OK.’”
His recovery proceeded so well that Scolaro declared him “good to go” when Gaidano asked permission to go skiing for his birthday. “I told him that if he went, he just had to send me a picture.”
Gaidano still feels some lingering pain on his left side and numbness, which he was told will improve over time. “I’m about 90% to 95% back to normal.”
These days, he takes his family rock-climbing, rafting and water-skiing. He’s a fixture at his daughter’s gymnastics, acting and piano events. “I stay positive and I don’t take things for granted anymore,” Gaidano says. “I feel so lucky.”