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Nerve Transfer Surgery Improves Function for Tiger Attack Survivor

February 26, 2020

A Topeka zookeeper is on the road to recovery, thanks to the fast action of her colleagues and the expertise of her surgeon.

Kristyn Hayden-Ortega was cleaning the enclosure of a Sumatran tiger, Sanjiv. Kristyn reacted fast when she realized an unlocked door had allowed the animal to enter her space, but the tiger moved faster. Fellow keepers immediately tried to lure 400-pound Sanjiv away from their fallen friend, but before they could catch his attention, he’d inflicted serious wounds to Kristyn's face, neck and arm.

Urgent care at her local hospital addressed her time-critical needs, but as she healed, it became evident that she'd sustained severe arm nerve damage.

She turned to plastic surgeon Ryan Endress, MD, of The University of Kansas Health System.

"Her arm was paralyzed but for the use of her hand and a little bit of extension of the elbow," says Dr. Endress, who has deep expertise in microsurgery of the hand and arm. He recommended a nerve transfer procedure. "Under the microscope, we identify the nerves that are still working. We take those nerves and plug them into the muscles that flex the elbow and move the shoulder."

Dr. Endress hopes for significant improvement to Kristyn's arm nerve damage, but says it can take months for the nerve transfer surgery to bring about its full benefit. The procedure, available in the region only at the health system, can be used to treat a wide range of injuries.

Following the procedure, Kristyn returned to work at the Topeka Zoo in a limited capacity. She looks forward to making progress.

"I don't necessarily want to rock climb, but I would really like to hug my kiddo with two hands," she says.

She'd also like to reunite with Sanjiv.

"He's a great cat and a really easy-to-work-with guy," she says. "This could happen to anybody."

Kristyn Hayden-Ortega comments on the tiger attack, and plastic surgeon Ryan Endress, MD, discusses the microsurgery that improved her arm function.

Narrator: A lot of jobs come with risk, but some more than others. When your job description has you interacting with a 400 pound Sumatran tiger like Sanjiv, the risk is big and the room for error small.

Kristyn Hayden-Ortega: It can happen to anybody. It can happen to the newbie, it can happen to the experienced person, it can happen to the person who's always safe.

Narrator: When Topeka zoo trainer, Kristyn Hayden-Ortega, found herself in the same space with eight year old Sanjiv, she knew instantly something was wrong.

Kristyn Hayden-Ortega: And I just remember some of the sounds that I could hear.

Narrator: But she used her instincts to stay calm. Her colleagues stepped in and lured the tiger back into his enclosure, but not before Sanjiv left a wound on her face, her neck and this scar on her arm.

Kristyn Hayden-Ortega: Sometimes the back part the shoulder blade gets a little achy and it just feels more like tightness.

Narrator: The scars may be healing, but what you don't see is the extensive nerve damage limiting Kristyn for now.

Kristyn Hayden-Ortega: And I really want to be able to hold the bowl to scrape the batter out, and I just can't get to that.

Dr. Ryan Endress: You ready to go? Well, her arm is paralyzed except for use of her hand basically, and a little bit of extension of her elbow.

Narrator: Plastic surgeon, Dr. Ryan Endress, with The University of Kansas Health System is about to perform what's called a nerve transfer.

Dr. Ryan Endress: We get under the microscope and we separate out all the little nerve branches from each other to figure out which ones control the muscles we want to borrow from.

Narrator: Dr. Endress hopes this will improve her movement dramatically.

Dr. Ryan Endress: So we're going to borrow some nerves that are still working that deal with wrist flection, finger flection, take those nerves and then plug them into the muscles, will then help her flex her elbow and move her shoulder.

Narrator: It'll take several months for the surgery to take its full effect. In the meantime, Kristyn is working various other jobs at the zoo, but looking forward to getting back to her most important job as a mom.

Kristyn Hayden-Ortega: I don't necessarily want to rock climb, but I would really like to hug my kiddo with two hands.

Narrator: And eventually she hopes to be reunited with Sanjiv.

Kristyn Hayden-Ortega: He's a great cat and he's just a really easy to work with guy.

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