- Associated Press - Friday, November 6, 2015

INDIANAPOLIS (AP) - Fifteen years ago John Rogers likely would not have survived the car crash. Had he been taken to another hospital, John might not have had the specialty surgery that helped reattach his head to his spinal cord. And had the 11-year-old boy allowed himself to mire in despair after the accident, he might have made little progress since that morning in June left him unable to walk.

But paramedics saved John at the scene and rushed him to Riley Hospital for Children at Indiana University Health, which has four of the nation’s 135 pediatric neurosurgeons. There, surgeons could try to correct the dramatic injury that John had suffered: “internal decapitation.”

Those pieces of the story deal with medical progress.

Then there is the part of the story that has to do with individual grit in a motivated child.

A kid so motivated that, against his doctors’ expectations, four months after the crash he can stand and walk about 30 feet with the help of a walker.

A kid who has made so much progress that in just the past month since leaving the hospital he has hit new milestones, milestones that his physical therapist Angela Keyler notes instantly.

“Hi,” John croaked Wednesday afternoon as his father wheeled him through the halls of Riley to greet Keyler, who has not seen him since the beginning of October. John still has a surgical incision in his neck to help with his breathing, but it impairs his speech.

“Is he talking? He wasn’t talking!” she said. “I love hearing your voice!”

To understand how far John has traveled, go back to that Monday morning in June. His grandmother Donna Niblock was driving John and his mother, LaDonna Rogers, to a bank in Fountain Square, a 10-minute drive from their home. Afterward, Niblock planned to drop John at school, said Daniel Rogers, John’s father, reliving that day.

A theft suspect fleeing police rammed into their pickup truck at Prospect Street and State Avenue. The crash killed Niblock and sent LaDonna Rogers to Eskenazi Hospital in serious condition.

When the paramedics delivered John to the hospital, doctors there feared he had suffered a serious brain injury. At the scene, John had lost his pulse a few times.

Plus, he had critical injuries. The doctors ordered an MRI right away. They knew that John’s best bet at recovery would require extensive intervention, and they feared that might not be worth it.

But the scan did not confirm their fears.

“Our question was if it was a catastrophic brain injury, we weren’t going to put him through anything,” said Dr. Laurie Ackerman, pediatric neurosurgeon at Riley and Goodman Campbell Brain and Spine, who treated John at Riley. “When we saw a brain that looked pretty good, we were all in.”

Still, the neurosurgeons knew it would be a challenge. The crash had strained all of the mechanisms that exist to hold John’s head in place on top of his spine. Basically, the impact had lifted John’s head off his spine on both sides, said Dr. Daniel Fulkerson, a pediatric neurosurgeon with Riley and Goodman Campbell.

It’s a rare injury that is more likely to occur in youngsters whose large heads perched on small necks make them the human equivalent of “bobblehead dolls,” Fulkerson said. Two decades ago, surgeons could offer little to people with this injury, but now there was hope.

First, the doctors whisked John to intensive care, where they worked to reduce swelling in the brain that came from the bleeding from the injury at the base of his skull. Ackerman placed a tube in his head that would simultaneously relieve the swelling and also monitor the pressure.

The next day, as soon as doctors deemed John medically stable, he underwent spinal surgery. The doctors did not want to wait any longer. John’s injury had left him so compromised that it was not even safe to gently roll him over.

Fulkerson inserted a series of rods and screws to stabilize John’s spine until his body can heal on its own, a process that can take up to a year. It’s a procedure he only performs a handful of times a year or so for injuries such as this one - and the outcome is not always favorable.

Even in John’s case, the doctors did not start thinking about his long-term future and what he might or might not do until weeks had passed.

“At that point, we didn’t know. At that point our goal was (for him) to survive to the next day,” Fulkerson said.

For weeks John remained on a ventilator to help him breathe. The muscles that he had injured in the top of his neck also play a critical role in helping to move the diaphragm to breathe. Doctors kept him heavily medicated. He didn’t smile, didn’t move.

Then he wiggled a toe.

Bit by incremental bit John improved. He moved onto the rehab unit, where he did eight hours of therapy a day, divided between physical therapy, occupational therapy and speech.

John was so motivated and doing so well that his hospital stay grew longer and longer as the therapists helped him pass milestone after milestone.

“Because of his progress and hard work, we kept extending him,” Keyler said. “The biggest thing was he wanted to be independent. The only thing he wanted to do was get back to where he was.”

John learned how to sit up on his own, toss a ball back and forth, stand and even walk about 30 feet with the assistance of a walker. At the beginning of October, John went home.

On Wednesday John, along with his father, Daniel, returned to Riley.

Daniel helped John out of his wheelchair, and the boy sat up - sat up! - on the edge of a rehab bed for about 10 minutes as Daniel talked about John’s progress. His mother has returned to work, and Daniel, who has a seasonal job, spends his day with his youngest son of five.

John could not speak much; he still has the tracheotomy. But he laughed frequently, often gazing at his father with love in his eyes. Now a fourth-grader at Indianapolis Public School 114, John attends class for three hours a day. After Thanksgiving, if he feels strong enough, he will extend to five hours a day.

A nurse comes nine hours a day, seven days a week to help John with school and at home.

While the boy has made what all agree is remarkable progress, Ackerman said, he will likely never return 100 percent to normal. He will always have some issues from the accident.

Still, Daniel said he has high hopes for his son.

John’s only sister is getting married next year.

“I’m going to have you walk her down the aisle instead of me,” Daniel said. “I think we can get it done.”

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Source: The Indianapolis Star, https://indy.st/1L01cr0

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Information from: The Indianapolis Star, https://www.indystar.com

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