One day in June 2013, Michael Gordon, MD, a hand surgeon at University of Colorado Hospital, was called to the Emergency Department. There he met a 28-year-old woman named Kim Hess who had badly broken her wrist and hand.
The circumstance of the injury was unusual. Hess, from Steamboat Springs, had sustained the break on her descent from the summit of Denali (elevation 20,310 feet) in Alaska. Gordon was contemplating what promised to be a complicated surgery to repair three broken bones when Hess made a startling statement. Gordon needed to make her hand perfect, she said. She was going to climb Mount Everest next year.
“She saw the injury as a bump in the road,” Gordon recalled. He anticipated a far more formidable challenge. “I didn’t see climbing Everest as a likely scenario; certainly not in that time frame.”
Not quite three years later, Kim Hess toiled toward Everest’s 29,029-foot summit. Behind her lay tens of thousands of feet of forbidding terrain she had traversed through thinning air. She had reached that point after a long struggle to overcome other barriers – those imposed by her injury. They were in their own way just as daunting as the ice, snow, wind, and rocks of Everest. And just as she and her fellow climbers relied on one another in their bid to conquer Everest, Hess had needed the help of Gordon and other providers to vanquish the physical limitations caused by the Denali debacle.
A downward plunge
That mishap threatened to derail what had been a dream of Hess’s for a good portion of her life: to reach each of the seven summits, the highest peaks on each continent. She had conquered her fourth, Denali, on June 23, 2013, and was the lead in descending with a fixed line – a rope nailed into the side of the mountain. It was snowing as the team attempted to navigate a challenging bulge in the rock. A crevasse lay beneath them.
As Hess put her foot in a kicked-in step for leverage to get around the bulge, it broke away. Weighted down by an 80-pound pack, she lost her balance and fell. The rope wrapped around her left arm and snapped her wrist. She found herself lying across the crevasse, her hand grotesquely twisted. She yelled for help, bringing a team member who made a splint for her hand and began helping her down to camp.
After a time, though, Hess realized she couldn’t feel her fingers. “We need to set this thing better,” she told her team member. They did, he holding her fingers and she pulling her elbow back to reset the splint with her hand at least in the right position. She felt the blood flowing back to her fingers. They got down to camp at about 14,000 feet, and Hess spent the next two days waiting for a helicopter to get her off the mountain.
The pain was excruciating, untouched by Tylenol, the only medication available. She endured. “Shock is a beautiful thing that your body can do. I went into survival mode,” she said.
A helicopter finally airlifted Hess to a hospital in Anchorage, where a specialist unsurprisingly told her she’d needed surgery three days ago. “I’ve been stuck on a mountain,” she told him. Unwilling to stay in Anchorage for two or three weeks post-surgery, Hess caught a red-eye flight to Denver, where her parents live. Her mother contacted a family friend, Patricia Schulof, then a social worker at UCH. Schulof helped to arrange for Hess to get to the hospital’s ED soon after she landed at DIA.
Gordon arrived and hastily arranged what turned out to be a surgery lasting six-and-a-half hours. Hess had broken both of the left radius and ulna bones, which lie on the thumb and pinky side of the forearm, respectively. She had also fractured the fourth metacarpal, the bone of the ring finger. Gordon inserted plates, pins, and screws to set the breaks. Two months later, he performed a second surgery to remove the pins.
By that time, Kim Hess was no longer denying the severity of her injury. She had met some of the world’s great physical challenges, largely on the strength of her will and endurance, but now her hand injury humbled her. Bone breaks were nothing new. She had had 26 of them before the Denali injury. But she wasn’t prepared for the indignity of having to ask her dad to help her put a shoe on and tie the laces, relying on her roommate to open a jar, or asking a friend to braid her hair to get it out of her face. On top of that, Hess had climbed Denali with a broken foot. She couldn’t drive a car or walk on crutches. She was on combinations of drugs to control her pain.
In June 2014, a year after the accident, Gordon removed the plates in the radius and ulna bones and did a carpal tunnel release to relieve numbness in her hand. Hess’s dream of attempting an Everest ascent that year was long gone. Gordon all along had told her that recovery from such a serious injury was going to take a long time, but she hadn’t been prepared for the glacially slow pace.
“It was a year of feeling like I was being beaten down over and over,” she said. “I felt like the dream was over, that I wouldn’t see Everest. I went to a dark place.”
Slow steps back
Hess had returned to Steamboat Springs to go through physical and occupational therapy at Yampa Valley Medical Center shortly after Gordon removed the pins in late August 2013. Emily Tjosvold, MS OTR/L, CHT, a certified hand therapist at Yampa Valley SportsMed Clinic – Steamboat Springs, recalled that Hess had extremely limited range of motion in her fingers and wrist. She couldn’t rotate her hand from the palm down to the palm up position. Van Wieren said she began therapy with tiny steps, moving Hess’s wrist only slightly.
“We did only as much as the wrist would allow,” Tjosvold said. “We didn’t force the bones and muscles to move.”
Hess initially felt crushed by her struggles with seemingly simple tasks: touching each finger of her left hand to her thumb and squeezing putty. When Tjosvold asked her to pick up sponges and put them in a basket, she got a jolt.
“I looked at this woman and said, ‘Are you serious right now? My brain’s not broken. I just broke my arm and hand,’” Hess recalled. Then she tried to pick up the sponges. She realized she couldn’t. She started crying.
“I said, ‘I’ve climbed mountains and I can’t pick up a sponge? What?’ I almost felt like a paraplegic, like I couldn’t do anything and my life had been robbed,” she recalled.
“I don’t think Kim realized the severity of her injury until she moved the hand outside of the splint for the first time,” Tjosvold said. “There was frustration on her part at doing what she considered low-level tasks. It’s part of our job to reassure patients that it’s okay to be frustrated on any given day. It’s not the end of the process.”
Tjosvold helped Hess stay the course. She looked at X-rays and communicated with Gordon to develop a plan to progressively strengthen Hess’s wrist and hand joints and eventually her upper arm and shoulder. Hess had showed up at her first OT appointment needing help to get out of the car and pushing a walker, but she was ready every day at 7:30 a.m. to get to work, Tjosvold said. “She’s an athlete and she pushed it.”
With time, Hess began to draw confidence from incremental improvement. She gradually increased the range of motion in her wrist; Tjosvold made sure she saw the data that proved the progress. Brushing her teeth, making a sandwich, and carrying a glass of water without dropping it became milestones in her drive to get back to Everest. The long hours of therapy delivered an important lesson, Hess said. She had denied for a time the injury she saw on X-rays, but her body wouldn’t buy into her mind’s deception.
“You can’t run away from the reality of what you can and can’t do,” she said. “That’s where I found myself feeling frustrated but also healing.”
One day in the midst of the long road back, she found herself making a keynote presentation to an audience at a sales meeting. She described her seven summits aspirations and the injury on Denali.
“Breaking my arm was the greatest thing that ever happened to me,” she told them. “It taught me to be patient and to ask for help. It doesn’t mean you’re weak. It just means you need help.”
Comeback cut short
Early in 2015, Gordon told Hess what she had been waiting so long to hear: She had improved enough to give Everest a try. In doing so, he set aside his personal reservations and anxiety – and his conservative clinical instincts.
“It was hard for me to imagine a patient being so committed to something that by my estimation was crazy,” he said. “But this was her passion. This is what she wanted to do and needed to do.”
For nearly anyone suffering an injury like Kim Hess’s, simply regaining “reasonable function” would have been a success, Gordon said. But he realized he couldn’t apply that standard to her. “It was not her intention to lead a normal life,” he said. “It took an enormous effort to get back to functional status, let alone meet her personal goals.”
“Kim’s attitude was different than many other patients,” added Tjosvold, who ultimately worked with Hess two-and-a-half years. “She had a very complex and significant injury, and I knew the recovery was going to be a long road. So many other people would have stopped. But I told her, ‘If anyone is going to do it, it’s going to be you.'”
In April 2015, Hess finally began her ascent of Everest. What began as the fulfillment of a dream, however, turned into a nightmare when a massive earthquake in Nepal triggered avalanches on the mountain that killed nearly two dozen climbers and wreaked devastation on Kathmandu. Hess escaped, her spirit shaken, as she described movingly in her blog.
To the peak
Yet she was undeterred. Gordon performed a fourth and final surgery on her wrist in November 2015 to relieve lingering pain from tendinitis and Tjosvold continued to work with her, providing welcome relief. She’d also learned from the April climb to add extra protection to her left hand, which had become very sensitive to cold since the injury.
“It never prevented me from being able to climb, but was a constant reminder of what happened on Denali,” she said.
In the early spring of 2016, Hess returned to Everest, this time with her oldest brother, Steve, to take on the mountain again. On May 21, she reached the summit, snapping one photo before the numbing cold knocked out the battery on her cell phone. She had completed an odyssey that began when a step on Denali gave way, plunging her into a crevasse and later into doubt that she would rise to those heights again.
The hand and wrist that had confronted Hess with a great physical and mental challenge stood the test. “Dr. Gordon gave me my life back,” she said. Van Wieren had extended Gordon’s work, playing a vital role in getting Hess back to the mountain. “Therapy was where so much of the magic happened,” she said.
She is now planning summit number six – Mount Vinson Massif in Antarctica (elevation 16,066 feet). No matter when that happens, Hess said she will carry the Denali experience with her. She found that recovery is defined by the goals of the individual.
“I never thought I would say that I would be grateful for the experience, but it taught me a lot of life lessons and how to deal with obstacles,” she said. “It’s important for people to realize that. It doesn’t matter if you’re climbing Mount Everest or simply want to walk down the street, we’re all humans. If you’re a 70-year-old woman who broke her hip or an athlete, we all feel the same way.”
For his part, Gordon felt both relief and satisfaction when he received the call that Hess had summited Everest – “one of the most dangerous things in the world,” as he put it.
“It gave me a good feeling that she had the drive and determination to do it,” he said. “I feel that I was part of that, but it was nothing compared to what she went through to get there.”
Just a few days ago, Kim Hess returned to UCH to give Dr. Gordon a picture and thank you card for helping her reach the summit. Monday, seeing him for the first time since her successful summit of Mount Everest. … Hess is featured in a new series of advertisements for UCHealth, giving her a platform to thank those who’ve helped her and spread the word that anyone can do anything they set their mind to.
To read more extraordinary patient stories, visit UCHealth Stories.