These words from Isabel Varela capture the moment when she witnessed her son, Ivan, running around and playing in the yard, like a carefree and normal child. You could feel the relief and joy in Isabel’s voice as she shared this emotional milestone – one that she worried may never come following a devastating car crash just a year earlier.
Today, thanks to a multidisciplinary team affiliated with Children's Memorial Hermann Hospital, Isabel and her children are starting to see a brighter future ahead after experiencing a traumatic moment as a family.
Recalling the car accident
It was Mother’s Day in 2022, a day that started off full of happiness. Ivan and his younger sister spent the weekend at their grandparents’ house, having a great time playing and being showered with love and attention. Mom and Dad were able to celebrate the day together, and now it was time to pick up the kids.
The family loaded up the car and started to head home, taking a familiar route they had driven time and time again.
“We were only a few minutes down the road. The kids were talking about how much fun they had over the weekend,” Isabel recalls. “Out of nowhere, a passing truck’s tire exploded. The driver lost control, and the truck hit us from the side. It was a major collision. It all happened in a split second.”
Due to the severity of the impact, Ivan’s seat flew out of the car, and he became trapped in his seat belt. It took two hours for an emergency response team with special equipment to remove the family from their vehicle. Tragically, Ivan’s father lost his life in the traffic accident.
In the midst of the turmoil, Ivan was rushed to the pediatric emergency center at Children’s Memorial Hermann Hospital, where he would be treated for serious abdominal, kidney and colon damage.
Arriving to a multidisciplinary care team
Being transported to a pediatric emergency center with a trauma response team that specializes in pediatric care is critical to a child’s ability to recover from such major injuries.
As a certified Level I trauma center, the Memorial Hermann-Texas Medical Center campus–which includes Children’s Memorial Hermann Hospital–is uniquely equipped to provide advanced, lifesaving care to pediatric patients like Ivan and his sister, but also to his mother and other adults, showcasing the trauma center’s capabilities to treat the whole family at a single location after an emergency.
Isabel recalls some early moments at Children’s Memorial Hermann Hospital after the accident: “Even though I was in shock and scared, I could see right away that the medical staff really teamed up together. Whether it was the immediate response needed when Ivan first came in or the follow-up procedures over the coming weeks, it was definitely a team approach. They were honest and direct – even about the risks – and I appreciated that right from the start.”
The ability to pull in a diverse team to manage traumatic injuries allows patients to receive an optimally planned, often very complex series of surgeries. Ultimately, over a period of weeks, Ivan would need a robotic kidney reconstruction from a urologist, a flank hernia procedure from a pediatric surgeon and a spinal procedure from a neurosurgeon.
The primary team of doctors affiliated with Children’s Memorial Hermann Hospital caring for Ivan included Jason Au, MD, a pediatric urologist and pediatric surgeon, and Danielle Hsu, MD, a pediatric surgeon along with a specialist from the pediatric neurosurgery team.
This multidisciplinary team worked together to create a collaborative, step-by-step plan for treating Ivan, and to serve as a collective partner for Isabel as she navigated the challenges of a young child in a high-risk situation.
A complex series of surgeries
The aftermath of the car crash had significantly impacted Ivan's organs. He was grappling with extensive swelling, noticeable bruising on his abdomen and substantial urine leakage into his flank. Prior to embarking on any surgical repairs, addressing the urine leakage was of utmost importance, as it was causing severe tissue damage by infiltrating various organs.
To address this issue, Dr. Au recommended to have interventional radiology place a nephrostomy tube, which would help drain urine from the compromised kidney. This approach aimed to reduce tissue and organ irritation, thus easing the strain on Ivan's compromised urinary system and creating a suitable environment for future reconstructive procedures.
The timing of this procedure carried weighty implications, given Ivan's need for multiple interventions. Dr. Au and Dr. Hsu discussed various options, including the prospect of simultaneously performing a robotic kidney procedure and a flank hernia repair. Eventually, the decision was made to begin with the robotic kidney procedure, a pyeloplasty – a surgical reconstruction of the renal pelvis and ureter, to reconnect what had been disrupted from the horrible accident.
During the robotic pyeloplasty, Dr. Au utilized a specialized surgical robot. This advanced system, which he controlled from a console about 10 feet away from Ivan in the operating room, is part of Children's Memorial Hermann Hospital's drive to enhance patient outcomes through robotic and minimally invasive procedures.
“Robotic pyeloplasty revolutionizes how we approach traumatic urinary system disruption. Traditionally, this required a large, highly invasive and painful incision. In Ivan's case, only three small incisions were necessary,” explained Jason Au, MD. “Recent X-rays confirm that Ivan's kidney is healing perfectly. The minimally invasive robotic approach not only primed Ivan for upcoming surgeries but also ensured greater comfort and a speedier recovery—vital factors for optimal pediatric outcomes.”
The pediatric urology program at Children’s Memorial Hermann Hospital was the first in Texas to perform urological pediatric robotic surgery and continues to routinely perform personalized complex surgical solutions to patients.
Danielle Hsu, MD, further explained, "Dr. Au and I thoroughly discussed the sequencing of Ivan’s surgeries. Considering that he would require stent removal following his kidney procedure, we recognized the opportunity to perform the flank hernia repair while he was under anesthesia again. Our goal was to avoid overwhelming Ivan’s body by tackling too much at once."
Flank hernias occur when abdominal organs or fatty tissue protrude through weakened muscles or connective tissue in the flank region (side of the abdomen), causing discomfort, pain and a noticeable bulge. The surgical correction of this issue, known as flank hernia repair, aims to alleviate discomfort and restore abdominal wall integrity.
Once Ivan's herniated tissue was skillfully repositioned, Dr. Hsu and her team shifted their focus to successfully reinforce the weakened abdominal wall to reduce the risk of the hernia happening again.
Isabel shared her feelings at the time, stating, "Learning that both Ivan's kidney surgery and flank hernia procedure were successful brought us major relief. While there was still spinal surgery ahead, we were gaining confidence in his healing process."
Addressing Ivan's spinal injury was a critical step in his overall recovery. The car crash had taken a toll on Ivan's spine, necessitating surgical intervention for his long-term well-being. The intricate spinal surgery aimed to stabilize Ivan's spine, prevent further damage and lay the foundation for his ailing body to strengthen on his road to recovery.
The spinal surgery was a success. Although surgical repairs of this nature require a moderate amount of recovery time, the precision and planning involved demonstrated the effectiveness of a multidisciplinary approach to care.
As Ivan's journey through this intricate series of procedures unfolded, the collaborative efforts of the entire medical team at Children's Memorial Hermann Hospital underscored the importance of specialized care, innovative techniques and a patient-centric approach.
Hope and recovery: A bright future ahead
With the passage of time, Ivan's remarkable progress started to become evident. Subsequent medical assessments, including renal ultrasound, provided a clear picture of his steady recovery. The results were excellent – Ivan's body was responding well to the procedures, with urine draining perfectly and no lingering issues in sight.
“Ivan is doing great now. Sometimes, it was hard to watch him struggle during his recovery, but now he is running around like a normal, energetic 7-year-old boy,” Isabel shared. “He has some scars, but he acts like nothing happened. He is physically strong, and it brings me great joy to see him this way. I am so grateful for the team at Children’s Memorial Hermann Hospital.”
In a heartwarming update, Ivan just took a family trip to Mexico with his grandparents – a testament to his restored health and the possibilities that now lie ahead.
Ivan's story is a celebration of the dedicated individuals who make up the medical team at Children's Memorial Hermann Hospital, each playing a vital role in Ivan's transformation. And it's a tribute to Ivan himself – a young boy who faced adversity with determination and emerged stronger on the other side.
Learn more about the pediatric urology, pediatric surgery and pediatric neurosurgery teams affiliated with Children’s Memorial Hermann Hospital who cared for Ivan.