Willis, Neb -- Alex Ramirez had always loved hanging out with his grandfather. The two had even restored an antique tractor together. But it was the very tractor that tied Paul Ireland and his 12-year-old grandson together that nearly caused the boy to lose his right arm.
"We went out to start the tractor, and that's when it happened," remembers Ireland. It was the day after Thanksgiving, and the battery on the tractor had gone dead. Alex attached the battery charger and Ireland started the old machine up. When the engine rumbled to life, Ireland quickly turned it off. "I turned around and looked, and saw Alex bent over the back of the tractor," he said. "I was going to pull him up, but I looked over his shoulder and saw his hand lying on the ground and his arm still attached to the P.T.O."
Alex's sleeve had somehow gotten caught in the tractor's power takeoff. That's the driveshaft at the rear of the tractor used to provide power to attachments or a separate machine. It generally spins thousands of times per second. Unfortunately, power takeoff injuries are all too common. "It was a very substantial injury," said Alex's orthopaedic surgeon, Dr. Nick Bruggeman. "There's no question power takeoff injuries can result in complete amputations of limbs -- legs or arms."
When Ireland started to cut Alex loose from the tractor, he noticed only a small piece of skin still holding Alex's hand to his arm. A medical helicopter took Alex to Mercy Hospital in Sioux City before he was transported to The Nebraska Medical Center. "The whole drive down there, all I could picture was a stub," said Ireland. "I knew the hand was gone. There was no doubt in my mind, the hand was gone."
"The bones were terribly fractured," said Bruggeman. "His skin was open and his muscles were injured. I considered the situation to be a limb-threatening problem." But after several surgeries by both Bruggeman and plastic surgeon Dr. Perry Johnson, Alex's arm was saved. "As young as he is, it was pretty remarkable how calm he was," remembers Bruggeman. His parents and grandparents were incredibly terrified, but he was really tough. I was impressed."
Just two months after the operation, Alex's prognosis is extremely positive. "Kids heal so much faster and better than adults do," said Bruggeman. "His hand is working great and he's really healing well." Alex's mom couldn't agree more. "Alex is doing awesome," said mom Kristina Shetler. "He's back in school and his grades never went down. He can move his fingers. He can wave. He was riding four-wheelers the other day -- he's not supposed to, but that's how well he's doing. He's even going back out for football."
Thanks to the positive experience at The Nebraska Medical Center, the hospital has some new fans in northeast Nebraska. "The people at The Nebraska Medical Center were all wonderful," said Ireland. "Even the people in housekeeping were great." Alex's grandmother couldn't agree more. "Those nurses on the 5th and 6th floors were remarkable, said Patty Ireland. "Remarkable isn't strong enough of a word -- we would tell them they rocked."
Miracles happen on 42nd and Dodge," continued Patty. "I tell everyone that now. You want medical service, you go to 42nd and Dodge."