Sarah Thilenius and her boyfriend, Kendall Westhoff, set off to hike Mount Yale, a jewel in Colorado’s Collegiate Range but decided to turn around before they reached the summit.
As daylight began to fade on that Friday before Thanksgiving, the unthinkable happened.
Thilenius slipped and tumbled 500 feet down a snow field, finally coming to a stop in a field of rocks.
Westhoff could see her face down. She was not moving. He descended down the snow-filled gully to reach her. She was bloodied and bruised, with multiple facial fractures and a broken nose. Remarkably, she was still conscious and able to talk to him.
“I chipped my tooth,’’ she said.
That she was unaware of her other injuries spoke to her foggy cognitive status. Westhoff stayed calm and used his Garmin inReach to contact rescuers from Chaffee County Search and Rescue. After receiving the call, SAR gathered cold weather gear, ice axes and crampons. They’d have to head out on foot. There was no way, with winds whipping, steep terrain, blowing snow and nighttime, that they could land a helicopter.
In the pitch black of night on the side of the mountain, with a wind chill of minus 15 degrees as winds gusted 20 to 30 mph, Westhoff did all he could to make sure Thilenius, 26, stayed conscious and aware.
Every 20 minutes, he’d say: “Hey, Sarah.” She’d answer, “I’m here.”
He wrapped her in an emergency blanket as well as all the extra layers he pulled from his pack to keep her body temperature up while waiting for SAR.
Seven hours later, a five-person crew from SAR arrived to help. They loaded Thilenius on a sled, wrapped her in more blankets and moved her to treeline. They built a fire and waited for sunrise.
Survival following a fall and frigid night on Mount Yale
Once morning broke, an improvement in the weather allowed a helicopter to pick up Thilenius and fly her to UCHealth’s Burn and Frostbite Center on the Anschutz Medical Campus in Aurora, Colorado.
In the helicopter, Thilenius was quite alert, she recalled.
“They were joking with me, and I was joking with them. I was saying, ‘Do you know why I can’t open my eye?’ And they were like, ‘Yeah, you put on a little too much makeup this morning. I think the purple was a little dark for your coloration. Maybe try a different shade for tomorrow.’’’
At the hospital, a dozen medical personnel swarmed around her. It was the first day of a 5-day hospital stay followed by more than 100 visits to hospitals and clinics over the next six months.
In the emergency room, caregivers did a full-body assessment. She had multiple cuts and facial fractures, but the biggest concern was severe frostbite on her toes and feet. They were blackened and blistered – an inflammatory response from the body to combat injury. Optimally, frostbite is best treated within eight hours of onset, but it had already been much longer.
Thilenius’ parents, who live in Colorado Springs, drove up to the hospital that morning to be with her. Her three brothers, who had planned to gather for Thanksgiving at the home of their parents, came to Colorado sooner to provide support for the family.
A multi-disciplinary team of doctors met Sunday and Monday to discuss the best options for Thilenius, an athlete who had played high school and college sports and reveled in the outdoors.
One of the options was to amputate her toes and part of each foot.
Treating severe frostbite: hyperbaric chamber
“It definitely was a harsh reality in the moment,’’ Thilenius said. “But hearing it, I very much accepted it early on. It was something that I had made peace with.
“Accidents happen. Mistakes happen, and I’m young, and I just knew that I could come away from it in a way that I would just grow from there. I’m Catholic, and my faith has been instrumental throughout my entire journey. I just had a lot of trust and a lot of faith that whatever happened, it would be OK.’’
On Tuesday, doctors suggested Thilenius try treatment in a hyperbaric oxygen chamber at UCHealth Memorial Hospital Central. Doctors could not guarantee results, but they thought it would be worth a try. Besides, in Colorado Springs, she could stay with her parents and receive additional support.
Westhoff drove Thilenius from UCHealth in Aurora to Memorial Hospital on Wednesday – the day before Thanksgiving, 2022. Upon their arrival, they met a team of nurses led by Dr. Robert Price, medical director of hyperbaric medicine at the hospital. A military veteran, Price honed his skills in hyperbaric medicine while working with special forces who acquired diving injuries while diving underwater.
Hyperbaric medicine is often used for patients who have frostbite, diabetic foot wounds and radiation injuries after cancer treatment. Inside the chamber, patients receive 100% oxygen at a higher pressure, and doctors like Price speak of the pressure in terms of “atmospheres.’’
“One atmosphere is the equivalent of 33 feet of seawater. Most of our treatments are at two atmospheres of pressure. Some are at 2.5 atmospheres,’’ he said.
It takes about 10 minutes to take the chamber to two atmospheres and 10 minutes to bring the pressure back to one atmosphere. In between, patients spend 90 minutes in the chamber receiving 100% oxygen.
“The magic comes by achieving higher partial pressure in the blood,’’ Price said. “Normally, we count on hemoglobin to carry oxygen in the blood, but with the higher pressure, we can force more oxygen into the body. Then, if you have a capillary going to an injured area, because there is higher pressure, oxygen diffuses out further,’’ Price said. More oxygen going to wounds promotes healing.
While Thilenius was still at University of Colorado Hospital, he reviewed her records remotely. When he first saw Thilenius’ toes and feet, her toes and forefoot were bare of skin, such that her toes were at a high risk of amputation. Price believed that there was a 50-50 chance that Thilenius would lose all of her toes and part of her foot.
On her first day at the hyperbaric clinic, Thilenius met nurses Rachel Ayala and Melissa Kelly, who took extra care adding pressure to the chamber. Price was concerned about Thilenius’ facial fractures.
“We didn’t want any air trapped within the fractured sinuses that could then expand, making her injuries worse,’’ Price said. “She had what we call a Le Fort Type 2, which is a mid-facial fracture where her head slammed into one of the rocks. We have to make sure when we have air-filled spaces that when we lessen the pressure and come back to the surface that the air can’t get out because then it could cause more tissue trauma.’’
Hyperbaric treatments stimulate healing
All went well, and Ayala went out to the waiting room to assure Thilenius’ parents and boyfriend to let them know that she could proceed with treatment.
“I was treated that Wednesday, and we had Thursday off for Thanksgiving, and the team (Rachel and Melissa) came in that Friday, Saturday and Sunday because the continued treatment was really important. They volunteered to come in over the holiday,’’ Thilenius said.
Ayala said she and Kelly never gave it a second thought.
“One look at her, and our decision was immediate. We’re coming in,’’ Ayala said.
With that, Thilenius began the first of 30 sessions in the hyperbaric chamber for frostbite, followed by 15 skin grafts in the wound care center applied by Dr. Ava Roberts and an additional 40 hyperbaric treatments to stimulate healing of the skin grafts, made of stem cells from placenta.
Unable to walk without severe pain, Thilenius used a wheelchair and her brothers and father carried her to the bathroom and to a car. At home, her father would spend hours cleaning her wounds.
“My brothers would distract me, and my father was doing my wound care from the beginning. He would do it twice a day, and sometimes it took a couple of hours because he was so diligent for each treatment,’’ Thilenius said.
Hyperbaric treatment for frostbite
Going into the hyperbaric chamber became second nature to her.
“I describe it to friends as going in a clear tube water slide. And you just get slid in, and it is also combined with diving and swimming and pressure, like a change in altitude when going to the mountains.
“It is not very different than being outside of it. You get in, and the pressure changes, and you notice it. It’s like going up in the mountains,’’ she said.
Each week, Price and his hyperbaric team took photographs of Thilenius’ feet, creating a picture story of progressive healing. Six months later, Thilenius is overwhelmed with gratitude. She didn’t break her neck or injure her spine in the fall. She didn’t die. Once facing amputation, she could walk again.
“Honestly, it’s unreal,’’ she said. “It has just been an incredible experience, and I’m just very thankful. It’s what I keep going back to because it is hard to believe, but I have trust in them. A huge part of it has been the people; I’ve just been really grateful for the team around me. They are like family now. One of the doctors came in and said, ‘Oh, so you’ve been here since November? You should be telling me how this goes.’ They’re like family to you.’’
Pushing forward in life
In early May, with her feet and toes intact, she was well enough to return to the outdoors. She and Westhoff took a trip to Moab, Utah, and camped on Porcupine Ridge East of Moab.
On Cinco de Mayo, they awoke and huddled together to watch a beautiful sunrise.
Westhoff wanted to take a selfie together, and Thilenius implored him to take a picture of the red-rock landscape. After all, she was still in her pajamas, a hoodie and a hat.
Westhoff removed her hat and fixed her hair a bit. He started to record a video and then got down on one knee.
“Will you marry me?’’ he asked.
Her answer: “YES!’’
Thilenius threw her arms around her future husband, squeezing him tight as the sun popped over the horizon.
She could not, would not, let go.