When the young motorcycle-accident victim arrived at UC Irvine Medical Center, he was supposed to need just one thing: treatment for a pseudoaneurysm, a vascular injury in his neck that could eventually cause a stroke if it went unaddressed.
Instead, UC Irvine Health doctors also saved him from lifelong paralysis.
Thomas Watermeier had already spent nearly a month at a community hospital in Los Angeles County, where he’d been taken immediately after the accident and had been treated for a multitude of serious injuries: Broken limbs and multiple fractures of other bones. Contusions, a concussion and a lacerated liver. The list went on.
The smaller hospital’s doctors lacked the expertise to treat the pseudoaneurysm, so they transferred Watermeier to UC Irvine Medical Center for placement of a specialized stent in a blood vessel in his neck.
Untreated fracture discovered
But when his new doctors examined him, they discovered that he had a much more immediate medical need: Watermeier’s spine had been fractured in the upper back, but the fracture had never been treated, leaving him at risk of permanent paralysis. Nor had the spine been stabilized to relieve pressure on the spinal cord and prevent further injury when he was being handled or transported.
“They didn’t even mention the spine when he was transferred,” said Dr. Li-Mei Lin, one of the UC Irvine Health neurosurgeons who treated Watermeier. “They may have thought there wasn’t any need to treat it since he was already paralyzed.”
Watermeier’s mother, Elizabeth Watermeier, said the doctors had told her that her son would be a paraplegic, never able to move his legs or control his bodily functions, and that use of his arms and hands would be severely impeded.
But the previous doctors were wrong.
'He started moving his legs'
“He was not completely paralyzed,” Lin said. Her colleague, neurosurgeon Dr. Sumeet Vadera, performed a spinal fusion and stabilized Watermeier’s spine with screws and rods to align it properly. One immediate result: pressure on the spinal cord was relieved and the patient regained sensation in his legs.
Watermeier felt the difference immediately, said his mother. “He started moving his legs. And then he started using both his hands.”
Watermeier doesn’t remember much about the accident that landed him in the hospital, though it appears that he was struck by a van. But he remembers the moment when doctors told him he wasn’t completely paralyzed.
“They told me, ‘You’re actually able to move around. We’re able to repair your back.’ Later on, I was able to move a lot more.”
Treating the pseudoaneurysm
After several weeks of rehab to rebuild some strength in his severely weakened limbs, it was time for the specialized surgery on the pseudoaneurysm in the carotid artery at the base of his skull.
In a true aneurysm, all three layers of the blood vessel are weakened, causing the wall of the artery to bulge, with the eventual danger of rupture resulting in life-threatening hemorrhage. A pseudoaneurysm, Lin explained, involves a tear to the artery that doesn’t include all of the layers. It represents a double threat: Like a true aneurysm, it can rupture, but it also can form blood clots that could travel into the brain and cause a stroke.
Until recently, doctors used coils — loops of fine platinum thread — to fill the pseudoaneurysm sac. It doesn’t cure the problem, though, which is the tear in the parent artery. “It’s not a durable treatment,” Lin said. “There’s a high risk of recurrence.”
Experience with aneurysm treatment
In 2011, the FDA approved a new stent for treating aneurysms on the carotid artery called the Pipeline embolization device; it is designed to keep the blood flowing through the artery while diverting blood flow away from the aneurysm or pseudoaneurysm. At the same time, the stent-like device provides a scaffold for the body to build a new blood-vessel wall, sealing off the pseudoaneurysm for good.
“In California, there are still not many doctors experienced in using the Pipeline,” Lin said. “When the FDA approved it, it had a requirement that new users have to be proctored with an experienced doctor who knows how to use it.
“Fortunately, I was trained by one of the world’s experts. I have been a proctor for this device. I’ve traveled a lot in California and throughout the U.S. to train other doctors.”
Road to recovery
A year and a half have passed since Watermeier’s traumatic crash.
Now 26, he’s living with his mother in Fullerton. A former truck driver, he taught himself computer programming from a book after the accident and has remade his career. Though he still uses a wheelchair, he can turn over in bed, transfer himself from bed to wheelchair, control his bodily functions and use his arms and hands. The man who once needed 17 medications per day is down to a single baby aspirin each day.
The road to his ultimate recovery will take time — and work. Right now, his big concern is his left arm, which was broken in the accident and is still weak and painful. He’s been told it might need to be rebroken and reset, along with his left leg. But doctors also have told him that with long-term physical therapy, there’s a possibility that he could walk again.
“I think the main lesson here is, it really does make a difference which hospital you go to and who your doctors are,” he said. “The doctors at UCI are great doctors. They really care about their patients.”