By Alice Reid
Friday, December 14, 2007
Stephan Khangaa's first words after the car crash that morning were, "Mama, I think I'm gonna die."
Mary Khangaa and her son were headed to his first day of kindergarten last year when another car sideswiped their Toyota, sending them careening into a tree beside the Suitland Parkway.
So much for kindergarten. Instead, the two were whisked to area emergency rooms, and Stephan spent hours in a Children's Hospital operating room. There, pediatric neurosurgeon Amanda Yaun worked to save not so much Stephan's life as much of what makes a boyhood worth having -- his ability to walk, to run, throw a ball or lift a spoon to his mouth or even breathe. In short, without Yaun's intervention, Stephan faced a life of wheelchairs and ventilators.
The 5-year-old had been seat-belted in the car's back seat, but the crash had whipped his neck with such ferocity that many of the ligaments holding the top section of his spine together were in tatters. Without that support, a vertebra would almost certainly shift and damage his spinal cord.
"It was the worst spinal injury I've ever seen, in terms of ligament damage," Yaun said. "The ripped ligaments between the first and second vertebra threatened the spinal cord, and at that level, spinal cord damage means you can't breathe."
Already, bone had nicked the sheath surrounding the spinal cord.
"When I made the incision and began to work, spinal fluid spurted up at me," she said.
Yaun fused the top two vertebrae and hoped that the slightly less damaged ligaments holding vertebrae 3 and 4 together would heal themselves. She and Children's radiologists watched closely what they hoped would be progress, and Stephan went on to life with a "halo," a contraption that screws into the skull and fully immobilizes the neck.
Mary Khangaa, a single mom who now lives in Silver Spring, said she recovered quickly from a small fracture in her hip. Stephan was discouraged.
"Mama, I can't walk! I can't ever play basketball!" she remembers him telling her.
Then one day, he said, "Mama, I'm going to walk!"
"And three weeks later, he did," she said.
But his recovery ran into problems. X-rays showed that ligaments elsewhere in his neck were not healing. Yaun was afraid that vertebrae would shift and Stephan would face gradual weakening of his extremities. In July, she and orthopedic surgeon Laurel Blakemore teamed up for the delicate job of fusing four vertebrae in Stephan's neck.
The cervical spine in a 6-year-old is small. Think turkey neck. Once the two surgeons had made their incision, they began the painstaking task of running titanium screws through bone only slightly thicker than the screws. And they had to avoid a lattice of major arteries, nerves and the spinal cord itself, much of which they couldn't even see.
To navigate where any slip might mean paralysis for Stephan, they used a new tool in the operating room, a CT scan called the O-arm. The two surgeons first ran a thin wire where they thought each screw should go. They then used the scanner without having to leave the OR. If all looked good, they inserted a screw.
The process was nerve-racking. "The last thing you want to do is to hurt a child," Yaun said, adding that the doctors also wanted to preserve Stephan's ability to move his neck. "We wanted him to go back to being a regular kid."
Today, Stephan is a healthy and athletic-looking 6-year-old who loves Thomas trains and dreams again of playing basketball.
As for that lost year of kindergarten, forget about it. According to his mom, he passed all the readiness tests his principal at New Hampshire Estates Elementary School in Silver Spring could throw at him.
Today, Stephan is a first-grader.How to Help
The story of Stephan Khangaa is typical of the amazing outcomes at Children's and the commitment of surgeons such as Yaun and Blakemore.
Today, Stephan's mother thanks God for Children's Hospital. "I'm absolutely sure they saved his life," she said.
And they brought all the available care, expertise and technology to bear on his case without asking Mary Khangaa, who was working at a supermarket at the time, how she intended to pay.
The hospital has a policy of treating children first. Families pay what they can, and no child is turned away. That generosity is what this campaign is about: raising money to help cover bills of children whose families don't have insurance or other means to pay.
We hope to raise $500,000 by Jan. 18, with your help. So far, readers have contributed $46,876.
To donate, send a check or money order payable to Children's Hospital to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390. That's the post office box of our bank, Chevy Chase. All funds go to Children's Hospital in Washington.
To contribute by phone using Visa or MasterCard, call 202-334-5100 and follow the instructions.
All gifts are tax-deductible as allowed by law.