By Kathy Chaffin
Salisbury Post
When Brenda and Bob Boltz got married almost six years ago, they vowed to stay together “for better, for worse.”
The first five years were the “better.”
On May 20 of last year, they encountered the “worse.” They were on their way to visit Bob’s sister and brother-in-law, Jeanne and Jim Gilreath, in North Plainfield, N.J., when it happened.
It was Brenda’s first trip to New Jersey, and she was excited about going. They had talked about going to a couple of Broadway shows and to see “The David Letterman Show.”
“His sister had made us a schedule for the week,” she says. “She kept telling us it was going to be so much fun.”
The Boltzes had left their home on Cloverdale Drive and were on the road for about eight hours when they encountered a two-hour traffic jam caused by road construction in the Catskill Mountains of Pennsylvania. It started raining and rained steadily for about two hours, Brenda says.
When the rain subsided to a mist, they saw a double rainbow in the sky.
“It was the most beautiful thing I had ever seen,” Brenda says. “The colors were so brilliant.”
All around them, motorists were pointing upward.
Shortly after that, traffic had resumed to a normal pace when Bob drove his Ford F-150 onto a bridge, which was noticeably higher than the highway.
“When I hit the bridge, it physically rattled the dashboard,” he says. “On the other side of the bridge, it went down, so the truck was rocking just a little bit.”
He was getting ready to enter a curve when the steering wheel turned all the way to the left while the truck kept going straight.
Bob says he thinks there was oil on the highway. “I’ve driven on black ice before,” he says, “and it felt exactly like that.”
The truck hit the shoulder of the road, then jerked to the left, striking a car next to them on the passenger side, pushing it into a concrete barrier. The car’s tires started up the barrier before returning to the highway and striking the Boltzes’ truck in the front.
Bob had turned to the right, but was unable to avoid the collision. The impact turned the truck at a 45-degree angle, sending it across both lanes head-on into a mountain.
The crash caused the truck to turn over on the passenger side, sliding almost 50 yards before hitting something on the embankment and flipping the rest of the way over.
The next thing Bob remembers is hearing Brenda scream, “My arm is gone!”
“I looked over and saw a bloody mess,” he says. Trying not to scare her, he responded, “No, honey, your arm’s still there. Don’t move.”
Brenda says she couldn’t feel her right arm, and when she reached down with her left arm to pick it up, “it was all bloody and meat was hanging everywhere.”
“I just dropped it back down,” she says. “It scared me. It scared me real bad. I don’t know if I was going in shock or what I was doing, but I started screaming for somebody to help me.”
At that point, Bob says two women came up to the truck and identified themselves as EMTs. “They said, ‘We’ll take care of your wife,’ ” he says.
Brenda says the women started asking her questions. “I guess they wanted to see if I had a head injury,” she says. “They asked me who the president was and things like that.”
Bob, in the meantime, was looking for his cell phone to call his sister to meet them at the closest hospital. His adrenaline was so high that he ripped out the console without even realizing it.
The EMTs said his blood pressure was dangerously high. Bob kept telling them he was fine. They said, ‘No, you aren’t. You think you are.’ ”
One of the firefighters told him they had found some of the tissue from Brenda’s arm at the wreck scene. “They couldn’t save it,” he says.
Bob says he believes Brenda had her arm against the window, which shattered when the truck flipped on her side. As the truck slid, he says the tissue was ripped off her arm.
Rescue personnel used the Jaws of Life to cut the door off of Brenda. She was loaded into an ambulance and driven 100 yards away, where a helicopter was waiting to take her to Lehigh Valley Hospital in Allentown, Pa., a Trauma I Center.
Bob was transported by ambulance to the hospital, where emergency room staff removed glass from his eyes and ran X-rays to make sure no bones were broken.
He says he hardly noticed what they were doing for worrying about Brenda.
When he finally got to see his wife, Bob says her arm was wrapped up. He told her not to worry, that he would make sure she got the best care possible and that he loved her.
Trauma doctors took Brenda in for debridement to clean the wound and assess the damage, then put in an external fixator to stabilize her splintered humerus.
When he saw her again the next day ó a Monday ó Bob says her arm smelled like decaying flesh.
Brenda had another debridement on Tuesday, after which she was moved to the intensive care unit. Afterward, an orthopedic surgeon at the hospital met with Bob and recommended amputating her arm.
“He said the wound looked like something you would see in Iraq with a war wound or something,” he says. “He said, ‘It’s not worth saving. I recommend doing it on Thursday. You think about it, and let me know.’ ”
Bob asked for a second opinion, and the hospital arranged for another orthopedic surgeon to see Brenda.
In the meantime, Bob’s 79-year-old father, Wilbur Boltz, drove up, and they rented a hotel room near the hospital.
The next evening, Dr. Geoffrey Hallock came in.
The ICU at Lehigh Valley is a busy place, Bob says, but just before Dr. Hallock walked in, it got real quiet.
Right then, Bob says a man walked in carrying an old-timey leather doctor’s bag.
“It was eerie,” he says. “I thought he was a ghost or something. It just felt like it.”
Hallock, an alumnus of the University of North Carolina at Chapel Hill, told Bob he thought Brenda’s arm could be saved. “If you can get her back home,” Bob says he said, “the Carolina boys can put her back together.”
Bob told the surgeon he wanted her transferred to Duke University Medical Center in Durham. Hallock responded, “Well, if you must,” he says, and recommended Dr. L. Scott Levin, chief of plastic and reconstructive surgery at the medical center.
If anybody could help her there, Bob says Hallock said Levin could.
The next evening after the second debridement, the head trauma doctor asked to speak with Bob and his sister. “He kind of smiled and shook his head,” Bob says. “He said, ‘I don’t know what has happened, but her arm has taken a turn for the better.’
“He said, ‘We have nice, bright red tissue now, and at this point, I would have to agree with Dr. Hallock. We don’t need to take her arm.’ ”
Hallock, in the meantime, had contacted Levin and arranged to have Brenda transferred to Duke. “In 10 minutes, it was a done deal,” Bob says.
This all happened on Thursday.
Brenda doesn’t remember anything about her first four days in the hospital other than waking up screaming in pain. She is able to remember part of her last three days at the hospital before she was flown out on a Med Corps Cessna on Sunday.
“I ate soup,” she says. “It tasted so good. I was starving to death.”
Bob left with his father to drive home on Saturday, leaving his sister to stay with Brenda until she was loaded onto the plane on Sunday.
Bob and his niece and nephew, Kitty and Jeremy Moon of Pittsboro, were waiting for Brenda when she arrived at Duke University Medical Center Sunday evening. That night, Bob says they met with a doctor who explained the surgery scheduled for the next morning, Memorial Day.
Levin would take a skin flap ó the removal of skin as well as the tissue and blood vessels down to her muscle ó from Brenda’s right leg to go on her arm. Skin was also taken from her left leg and grafted onto the right leg to cover the indentation where the flap was removed.
Brenda went into surgery around 10 a.m. and got out at 6 p.m. Her right leg was in a wound vac machine, which removed any blood seepage. Her left leg was covered with a mesh-type material stapled to the skin.
When Levin came out after the surgery, Bob says the first words out of his mouth were, “What do you know about this injury?”
The surgeon looked worried, Bob says he thought to himself, and wondered if he was going to be able to save the arm.
Bob says Levin said the best he could hope for is that Brenda’s right hand would be a helper hand. But a helper hand is better than a prosthesis, the surgeon told him.
Brenda was placed in intensive care after the surgery. Bob was fiercely protective of her, reporting two nurses for not taking care of her properly.
Gradually, word of the Boltzes’ accident began to spread, and friends, family and co-workers offered support. Bob’s co-workers at The Hartford Group in Charlotte filled a basket with food, gift cards and money.
Cards began pouring in for Brenda, and her name was added to church prayer lists across the country. Neighbors mowed their lawn all summer and got their mail when Bob was gone.
When a Doppler device monitoring the blood flow to Brenda’s arm lost its signal on Tuesday, she was rushed back into surgery to repair a crimped vessel.
On Thursday, Brenda was moved to an intermediate care room. On Friday morning when Levin arrived to see Brenda, Bob says the batteries in the Doppler machine were dead. After being replaced, the signal was fine until a few hours later when it started to fade.
Brenda was taken back into surgery to correct a clotting issue that had stopped the flow.
“After that,” Bob says, “she didn’t have any more problems with the flap as far as the blood flow.”
Brenda was given medication throughout the days and nights to try to control the pain. Bob says she had to have morphine and Dilaudid to survive the excruciating pain of the morning bandage changes.
Bob didn’t know until later, but part of the flap had to be removed during the Friday surgery and surgeries the next Monday and Tuesday due to infection. More skin grafts were taken from her left leg to cover the areas where the infected flap was cut away.
“That was the first time she almost lost her arm,” he says, but the doctor didn’t tell him that until later.
What Levin did tell him was that he was taking Brenda down to surgery to check and clean the wound.
After spending a week in Pennsylvania and another week at Duke, Bob returned to work. He worked four, 10-hour days a week so he could spend the other three with Brenda.
It would be a long time before Brenda could return to her job selling Lancome products at Belk, but when the store manager found out what had happened, he sent word that her job would be waiting for her when she was able.
When Bob was at work, his father filled in taking care of Brenda. On June 15, she was moved to a nearby rehabilitation center.
Bob became concerned right away when the wound care nurse hurt Brenda doing an initial assessment.
“They did the assessment without waiting for the pain medication to come up from the pharmacy,” he says. “They unwrapped the wound and picked the arm up, which was very, very painful.”
Brenda screamed throughout the assessment, Bob says.
The next day, when a nurse came in with written instructions on how to do the daily bandage change, Bob told her it would take more than one person to do it and asked for the head nurse. He ended up showing them how to change the bandage without causing Brenda excruciating pain.
After seven days in the rehabilitation center, Brenda was taken back to Duke for surgery to replace skin grafts that didn’t take. Because of his concerns about the care Brenda had received at the Durham center, Duke arranged to have her transported to a Salisbury rehabilitation center on June 28.
Bob had been there to check it out. “It looked clean,” he says, “and I knew she would be closer to home.”
But what had seemed like a good idea turned into a nightmare.
It started when the ambulance transporting Brenda broke down on Exit 113 of Interstate 85 with temperatures in the high 90s. Bob says the EMTs pulled her out of the ambulance and rolled her to a nearby hotel until another ambulance arrived from Durham.
Brenda says she spent more than two hours in the room with one of the EMTs.
Bob’s father was waiting on her when the ambulance finally arrived at the Salisbury rehab center. Her pain medicine, however, had not arrived, and staff said it would be between 11 p.m. and 2 a.m. when it got there.
Bob was furious and asked a nurse to call the head nurse and administrator. He says she refused repeatedly.
“I was so mad I didn’t know what to do,” he says.
Brenda was taking Oxycontin, Dilaudid, morphine and other strong painkillers. As the medication wore off, her pain became unbearable.
She finally got some relief when a family member, who had previously been prescribed one of the painkillers, went and got her some of the medicine to use until hers arrived.
The next morning, Brenda says two nursing assistants came in to change her bedding. When they rolled her over and slung her injured arm, she told them they were hurting her. The nursing assistant said, “It will just be a minute, honey,” she says.
The staff, after seeing the extent of Brenda’s leg wounds, contacted the administrator and head of nursing, who told Bob they didn’t realize the extent of her wounds and didn’t have the solution that Duke was using to clean them.
She needed to be hospitalized, they told him.
Bob said, “I thought you talked to Duke and said you could do it.” They responded by saying they didn’t realize then how bad the wounds were.
“Brenda started crying,” Bob says, “and she said, ‘I don’t want to lose my arm.’ ”
Bob called Duke and arranged for Brenda to return. Then he faced the challenge of finding an ambulance service to transport her.
It was Friday, and Brenda’s bandage had still not been changed and blood was starting to seep through.
When an ambulance service arrived to pick her up on Saturday, the EMTs were in a conversion van with only a small stretcher to transport her on. Because the fixator held the arm out away from her body, she needed a wider stretcher.
Bob finally got NuCare Ambulance Services of Winston-Salem to transport her. The EMTs arrived that afternoon, and Brenda says one of them, a woman, laid down beside of her in the back of the ambulance and talked to her the whole way.
After arriving at Duke, a doctor changed Brenda’s bandage and said the arm appeared to be OK.
The next day, on July 1, Brenda turned 48. There to help her celebrate were her mother and stepfather, Mary Rose and Johnny Carter; her brother and sister-in-law, Billy and Carol Carter; her daughter and son-in-law, Stephanie and Eddie Husers and their 4-year-old daughter, Peighton; another granddaughter, 8-year-old Adrienne Shrewsbury; and niece and nephew Kitty and Jeremy Moon.
COMING MONDAY:Read about Brenda’s continued surgeries and battle with MRSA, a virulent staph infection, before returning home to Rowan County for months of physical therapy. Share in Bob’s pain at having to tell her about the death of her beloved miniature Schnauzer, Pookie, and the joy of a special Christmas gift that would help Brenda ó and Bob ó to heal from a year they would like to forget.