It was Memorial Day Weekend in 2021 when Landyn Keiser’s life changed forever.
His parents, Judd and Daisy Keiser, recall what happened that day in their hometown of Fordyce, Nebraska.
“He had taken our UTV, it had tipped over into a gulley, (Landyn) fell out and the roll bars pinned him face down behind his knees,” Landyn’s mom Daisy Keiser explained.
Landyn, 13, lay there for 45 minutes before she could find him.
“I’m a nurse,” she explained. “But I was panicking as I was trying to be in mom mode, not nurse mode.”
A medical helicopter was dispatched to their farm and based on the extent of his injuries, emergency crews determined Landyn would need more advanced care to include orthopedics and trauma teams.
“We met the helicopter, Sanford Health and Dr. Jared Daniel that night,” Daisy said.
“Landyn, unfortunately, developed compartment syndrome in both of his lower extremities,” Jared Daniel, M.D., told Sanford Health News. “It’s one of those orthopedic emergencies where, to help preserve life and limb, you have to do something immediately.”
Traumatic injuries, emergency surgery
Right away, Dr. Daniel, a surgeon specializing in pediatric orthopedic trauma at Sanford Children’s Hospital in Sioux Falls, South Dakota, took Landyn to the operating room to try and treat his compartment syndrome with a fasciotomy.
“Compartment syndrome is a condition where the circulation, muscles and nerve are affected. So you want to give them more room to give them overall better function. That was just the start,” Dr. Daniel said.
With Landyn’s injuries and more than a dozen procedures came an immense amount of pain and a large collaborative team of providers.
Wound care, pain management part of the team
“He was dealing with surgeries, pain from a severe infection, and nerve pain from all of the inflammation in his legs as well,” said Daniel Mark, M.D.
Dr. Mark is a specialist in Children’s Palliative Care, who helps Landyn and his family manage his pain and try to keep him as comfortable as possible.
“This pain would be something that would last for a while. So I was involved as a request to see if I could come up with some sort of plan for him that was more effective and something he could do at home,” Dr. Mark said.
“There were lots of heavy discussions. It was heart-wrenching to see his family go through all of that,” said Sarah Dorr, CPNP.
Dorr, a pediatric wound care specialist, coordinated much of Landyn’s care from the very beginning.
Landyn and his family faced their hardest decision yet: whether to salvage his legs or move forward with an amputation.
“They were very much on board with trying to do limb salvage which is our number one goal,” Dr. Daniel added.
“We got him to the point of being able to salvage his legs with the understanding that he lost most of the muscle – the muscle that could have died. That muscle doesn’t grow back. The muscle remaining can be conditioned and can be built up, but what’s gone is never coming back again,” Daisy explained.
Landyn is a big sports fan and competitive athlete in baseball, basketball and football.
Driven to get back to sports
His care team knew nothing was going to stop him from pushing forward.
“One of the biggest goals when I first met him was how are we gonna get him back to playing sports,” Dr. Daniel said.
“He’s a kid that he would push through almost any tough situation,” Dr. Mark added.
“Things we’re working with through Josie are building up strength, range of motion of joints that are stiff and tight,” Dr. Daniel said.
“Are there certain orthotic devices, braces, to help with management, to help with overall function or anything in the future from a surgical perspective to improve his overall function.”
“I can see where he was to where he is now and it blows my mind what he can do compared to what the alternative could have been,” Daisy said.
“He’s walking independently, he continues to work with therapies, plays basketball, football and goes golfing with his dad,” Dorr said.
Specialized care in one place
Every step of Landyn’s journey is stronger thanks to his team’s collaboration for care.
“We as surgeons are a small portion of the team. We know there’s a bigger picture. That’s the beauty of having a children’s hospital with those resources at your disposal at all times. Not every institution is as lucky as we are to have resources like that,” Dr. Daniel said.
The Keiser family is grateful for that.
“Someone was always there for us, to guide us, and we never felt alone,” Daisy said.
“Landyn operates on the philosophy of ‘can’t stop, won’t stop,’ and got that from the University of Nebraska football team,” Dorr explained. “It’s something I’ve carried with me in the patients I take care of. There’s always a little piece of Landyn that walks around this castle every day.
“Seeing the difference you can make, when everyone works together, shows you what Sanford Children’s is all about.”
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