November 14, 2018
Quality care, family support inspire Brandon Smith's rapid recovery
Life can change in an instant.
Brandon Smith, then 28, was enjoying his life. He had recently relocated to Kansas City from his hometown of Chicago. He had an exciting new job as a sales representative for a GPS software provider. He was refurbishing an investment property and enjoying time with family and friends.
Then disaster struck.
Brandon was clearing overgrown brush from the yard of his property, where his parents were living as they looked for a new home. While Brandon was burning brush, the gasoline can he was holding exploded. His hands, arms, legs and torso were engulfed. His girlfriend, Cori, raced to help him tear off his flaming clothing, burning her own hands in the process.
"You go into fight or flight mode in an emergency, and fortunately, somehow, I kicked right into fight mode," Brandon says. "My first concern was Cori. I was able to get to the hose and turn it on her and myself to put the flames out. I was fully aware and functional at this point."
Brandon's mother, Tracy, remembers the moment all too vividly.
"I was standing in the kitchen, and I heard screaming," she says. "Brandon ran to the kitchen, directing me, 'Mom, call 911.' When I was put on hold, he said, 'Dad, get me a sheet, and let's go. We have to go.' He still somehow had presence of mind. He guided my husband on the drive, telling him the route, and then ran into the ER on his own to give the staff his medical information."
The power of specialty care
The Smiths understandably targeted the nearest emergency department.
"But the staff there could see immediately that they weren't the resource I needed," Brandon recalls. "They sedated and transferred me. I woke up 2 weeks later."
When he did, he found he was a patient at The University of Kansas Health System. The hospital is home to the Gene and Barbara Burnett Burn Center, the region's only adult and pediatric burn care facility accredited by the American Burn Association and American College of Surgeons. The program earns this certification for its seamless coordination of care across disciplines and resources from multiple service lines – such as nursing and therapy – dedicated to care 24/7.
Brandon suffered third- and fourth-degree burns to 54% of his total body surface area. He spent 21 days in the burn unit and was sedated for 14 of them. His family – mother, Tracy; father, Greg; sister, Lindsey; and brother, Michael – and Cori were constants by his side.
"I was out during the worst days," Brandon says. "I know this was much harder on my family. Hour after hour, day after day, and they didn't know if I was going to survive."
Physical and emotional care
Brandon's siblings immediately traveled to Kansas City to support their brother and parents. Michael arrived from Orlando, where he was in the midst of job training. Lindsey, a nurse who had worked at The University of Kansas Health System before relocating to Florida, came prepared to do all she could to help advance her brother's care and use her clinical knowledge to support her family.
"One of the first of many compassionate things the care team did was ask a burn survivor to come in and talk to us," Lindsey says. "We had never had any experience like this and had so many questions. What do the grafts feel like? What do you wear when you go outside? How do you deal with the pain? Talking to someone who knew how Brandon would feel was a huge help."
At one point in the first days following his accident, Brandon stopped breathing and required emergency resuscitation.
"I'm an ICU nurse, but that is extremely different to see when it's happening to your loved one," Lindsey says. "In a way, it was reassuring, because I saw that Brandon was receiving exactly the right care. That's what allowed our family to go home to sleep at night, that sense of peace from knowing he was in the best hands."
Within the first few days of hospitalization, the staff, led by burn surgeon and program co-director Dhaval Bhavsar, MD, began performing surgeries. Brandon received temporary cadaveric skin grafts to prepare the burned tissue for permanent grafts, and then received permanent grafts using his own healthy unburned skin. The team anticipated Brandon would require multiple procedures, but with youth and strength on his side, the grafting was completed in just 3 surgeries.
"We were told that the rule of thumb is that every 1% of burn surface equals 1 day of hospitalization," recalls Tracy. "We expected several months in the hospital, but Brandon was about to start breaking records."
On Brandon's 14th day of hospitalization, just a few hours before Lindsey had to return to Florida, the breathing tube was removed, and he opened his eyes.
"My family said I told my sister, 'You can't leave. You're my nurse!'" Brandon says. "It was just a little joke, but it made my family breathe a sigh of relief. They saw the haze starting to lift, and it was maybe the beginning of a turning point in my situation."
During these critical weeks, Lindsey appreciated the way the staff included her in communications so that she, as both nurse and sister, could keep fully informed and help educate her family.
"The staff was amazing in the way they worked with us," Lindsey says. "It was a very inclusive relationship, just fantastic."
Advancing to rehab
Brandon's inpatient occupational therapist at The University of Kansas Health System saw him within 24 hours of his admission and worked with him on splinting, positioning and range of motion exercises almost every day. It was clear that he was highly motivated to progress and return home.
"I was ready to do everything I could to get out of the hospital," Brandon says. "My family had been put through so much I was totally unaware of, and I wanted to get us all back home. The doctors started telling me, 'You're breaking records, kid.' I thought they told everyone that."
On his last day in the burn unit, Brandon stood for the first time since the accident. On his first day in rehab, he walked ¼ mile with support from a walker.
"I was ready to work so I could go home," Brandon says. "The therapists saw my motivation and pushed me to do the best I could."
A quality team
Brandon had to learn to swallow, eat, walk and use his fingers. A collaborative rehabilitation therapy team addressed physical, occupational and speech therapies, working with him in 3 sessions each day.
"They were awesome," Brandon says. "I'd take extra walks outside our sessions. I was so determined. I could see the finish line, and I could see results every day, which made me want to go farther."
After 8 days of rehab, Brandon was discharged. He continued rehab as an outpatient, receiving therapy 5 days a week. He relied on support from Cori and his mom, with tasks often taken for granted – such as showering – becoming a 3-hour process, including bandage changes.
"The staff did an excellent job teaching us how to care for Brandon and continue to support his recovery from home," Tracy says. "It was fantastic to go home feeling confident about how to help him progress."
Brandon was well on his way to recovery and credits the team at the health system.
"The doctors, nurses and therapists are nothing short of incredible," he says. "I can't say enough about the quality and skill of this team. They handled my family with such compassion. They saved my life, and I couldn't be more grateful."
Brandon continues to heal, but once he has achieved a full recovery, he hopes to become a Phoenix SOAR® (Survivors Offering Assistance in Recovery®) volunteer to support future burn survivors.
"Anything I can do to help others who experience something similar, I'd like to," he says. "I would like to give back. I have learned that life is fragile. It's a gift. Live every day to the fullest."