How A Team Approach Helped One Woman Heal

On June 4, Traci Muszynski set her right foot into place as she saddled atop her boyfriend Nick Fackelman’s Yamaha Bolt motorcycle.

The ride took a devastating turn when a car T-boned the two-wheeled vehicle on Monroe Street near Franklin Park Mall, with Traci’s right foot being the point of impact. Nick sustained a broken collarbone, but it was Traci who had the most serious injury.

Traci, 25, was transported to the ProMedica Toledo Hospital Emergency Center, where she was introduced to Jason Tank, MD, an orthopaedic surgeon who performed several surgeries on her severely damaged foot.

“He informed us I’d have to have two toes amputated, a bone removed, and possibly the whole foot,” recalled Traci. “He looked at me and said, ‘If you’re willing to fight to save the foot, we’ll do everything we possibly can to work with you to save it.”

Working as a team

It was the beginning of a multiple-month recovery process for Traci that was assisted by two other physicians and their staffs — creating a team approach to her care.

After three surgeries in the first couple of weeks following the accident, Dr. Tank — concerned about the extensive skin damage the foot had endured — called Manuel Gigena, MD, a plastic surgeon.

traci and doc
Traci with “Dr. Manny”

“Dr. Tank had the bone structure to the point where he could get it, and now it was more of a skin issue,” said Traci’s mother, Heather. “What can we do with the tissue and skin?”

Dr. Gigena, referred to by Traci as “Dr. Manny,” said it’s common for him to incorporate a team approach to a patient’s care.

“Working in conjunction with another doctor as a team, sometimes you get better results than trying to do it all yourself,” he said. “But it can be a double-edged sword. Sometimes with too many doctors, there’s not good enough communication between them, and you can underdo and overdo things because you don’t know what the other one is doing.”

That hasn’t proven to be a problem in his experience at ProMedica, Dr. Gigena said. He said the orthopaedic and plastic surgeons communicate almost every day, creating what he calls a “harmonic” working relationship.

“There’s no doubt that working as a team, you can get further in life. The same thing happens in medicine,” he said.

Inside the hyperbaric oxygen chamber

Dr. Gigena used a series of screws and pins to hold the broken bones in place but at the same time kept the skin exposed to allow for more complete healing. Next, Traci began treatments of hyperbaric oxygen (HBO) therapy to help blood flow to the foot and minimize the dead tissue.

“That did so much,” Traci said, unable to contain her excitement and relief about the 60 HBO treatments she underwent several weeks after the accident. “It was amazing.”

Traci in the hyperbaric oxygen chamber.

Heather said Traci grew very close to Dr. Gigena as well as the hyperbaric team, led by Steven Gale, MD, a vascular surgeon.

“At first when he brought (HBO) up, I was oblivious — I had no idea what it was,” Traci said. “They said it was going to hopefully help, so I said ‘OK.’ Seeing this clear tube I was going to lie in, it was a little nerve-racking, but overall it wasn’t too bad. Having the opportunity to watch TV or listen to music really helped relax me to be able to get through the two-hour treatments.”

Traci was in the hospital for one month. In July, she went home, where Heather took over wound care — although Dr. Gigena was never far away.

“We never felt alone or that they didn’t care,” Heather said. “They were very caring and very supportive throughout the whole thing. They gave us cell phone numbers… The slightest bit of redness or something that looked different in the wound from the night before, just taking a picture and sending it to Dr. Gigena. He’d call me within minutes and say, ‘It’s OK, it’s normal. He was on the ball with everything and made us feel very comfortable and made us feel like he was right there with us every step of the way. Both (Dr. Tank and Dr. Gigena) and their whole teams were just amazing.”

The healing continues

After more than five months of bed rest, Traci is continuing her recovery, which is going as well as she and her doctors could have hoped. In November, she had a skin graft done, which was followed by three more weeks of bed rest. She is now undergoing weight-bearing rehabilitation at ProMedica SportsCare at Wildwood Medical Center.

“Every day is a progression,” Traci said. “I started out with a walker, went down to a crutch and now I’m between one crutch and a cane, depending on how my foot is feeling that day, but it’s going really well. The bones are healing really well and the skin is doing really well.”

Dr. Gigena said it’s not only the physicians who are part of the care team.

“It starts with a smile from the receptionist,” he said. “If they don’t smile, we have a problem. From the receptionist to my medical assistants to my nurses to the OR nurses — that is also the team. It’s not just the doctors. We don’t work alone.”