Issue link: http://viewer.e-digitaledition.com/i/753672
THE MOMENT MATTHEW WERT, M.D., orthopedist at New York Methodist Hospital, heard Crystal Cardona speak, he knew that something was seriously wrong. The mother of two was having trouble catching her breath, and her voice was raw and scratchy. Dr. Wert suspected that a blood clot in her lungs was the cause and quickly urged her to go to the emergency room at NYM. That was the first time Crystal met Dr. Wert. But her journey to his office, and ultimately, the Hospital ER, started far from her home in Flatbush. A SUDDEN INJURY On July 12, 2015, Crystal, a supervisor teller at a local bank branch, traveled to New Jersey with her parents, Glenn Johnson and Jezebel Cardona, and her two daughters, Nalanie, ten, and Nysanie, five, to spend the day at a trampoline park. "I'm the kind of mom who does all the fun, crazy stuff with her kids," Crystal says. "We run around. We dance. We go on roller coasters. So, of course, I was jumping with them on the trampolines." Crystal and Nalanie were playing basketball on a trampoline when suddenly, Crystal fell to the surface of the trampoline, clutching her knee. "One minute, I was jumping around with no problem. The next, my left knee just didn't bend, and I fell," she recalls. The force of the fall tore the ligaments and tendons holding Crystal's knee together. "My left leg felt like a noodle below the knee," she says. Emergency responders took Crystal to a local New Jersey hospital. When she left the hospital, her knee was braced in an immobilizer. She was instructed not to put any weight on it or use it at all and to see an orthopedic specialist as soon as possible. She would need surgery to repair the injury. The first doctor Crystal reached out to was Dr. Wert, an orthopedic surgeon and director of sports medicine at NYM, her local hospital. On the morning of her appointment with Dr. Wert, Crystal developed a sharp pain in her back, and she started to have trouble breathing. She decided to keep her knee appointment with Dr. Wert instead of rescheduling it and waiting at home for her back pain to pass. That's how she came to be in his office on July 20, 2015, struggling to speak. AN UNEXPECTED COMPLICATION Crystal's appointment to consult with Dr. Wert about her leg was cut short when he recognized the signs of a possible blood clot in her lungs. Crystal's boyfriend, Miguel Cumberbatch, took her to the ER at NYM, where she was admitted and given ox ygen. Imaging tests showed that Crystal had large blood clots in both her lungs. "Clots aren't very common in young, healthy people like Crystal. She was only 28 at the time that the clots occurred," Dr. Wert says. "But there is a risk for blood clots when someone has an orthopedic injury. Because she'd been in the hospital and then told not to use the leg, she hadn't been moving very much, which can cause clotting. Later, we found out that her mother has a clotting disorder. It was a perfect storm." After an initial evaluation in the ER, Crystal was moved to the seventh floor, where attending interventional pulmonologist Keerthana Keshava, M.D., took over her care. "These clots, called pulmonary embolisms, started elsewhere in her body and then traveled to the lungs, where they were big enough to block the small blood vessels that bring blood to the heart," Dr. Keshava explains. "If we hadn't found them and treated her, the clots could have gotten worse and caused her heart to fail." Dr. Keshava started Crystal on blood thinners to keep more clots from forming. She explained to her that, over time, her body would naturally break up the clots in her lungs. The blood thinners helped the process by preventing further clot formation. "I was scared about what was happening, but everyone at the Hospital was so helpful and amazing," Crystal says. "The doctors walked me through every detail about what was going on and how I was being treated, and the nurses made sure I was comfortable and got to see my family." Chest pain from the clots caused part of Crystal's lungs to collapse (atelectasis) as she was unable to take deep breaths. Dr. Keshava prescribed medication to ease the discomfort and started Crystal on deep breathing therapy with NYM respiratory therapists to correct her collapsed lung. It took six days, but once Dr. Keshava said that it was safe, Crystal went home. GETTING BACK ON HER FEET Thanks to the quick thinking of Dr. Wert thrive WIN T ER 2 017/ / W W W.N Y M.O RG 14 T O U C H I N G B A S E