Spinal Surgery Helps San Diego Man Avoid Paralysis After Beach Injury
Scripps surgeons treat severe neck injury after Hawaii accident
Scripps surgeons treat severe neck injury after Hawaii accident
Last December, Abhi Adappa and his family had a Christmas vacation they’ll never forget. The first day was what holiday memories are made of: sightseeing around the Hawaiian island of Kauai and enjoying quality time together.
On the second day, Abhi, 46, and his teenage daughter, Nishka, decided to spend an afternoon boogie boarding — an activity they’d enjoyed many times at home in San Diego and on previous Hawaiian vacations. They ended up at Brennecke Beach, a popular spot next to Kauai’s famous Poipu Beach. With no indications of dangerous waves and plenty of other kids and adults in the water, the two had no qualms about hitting the surf. But things quickly changed for the worse.
“The first wave thrashed me around a bit, but I didn’t think much of it,” Abhi recalls. “But then I caught the second wave at the top and it immediately faceplanted me to the sea floor. Luckily, there were no rocks in that spot — it would have been much worse — but I hit my forehead hard on the sand. The force of the wave somersaulted me forward and I landed on my neck. Thankfully, I didn’t lose consciousness.”
Abhi regained his footing and instantly knew something was very wrong.
“I was in a lot of pain in my neck and back — in fact, I couldn’t take a full breath, I was in so much pain,” he continues. “My daughter was still in the water, and I turned to look at her and I heard a crunch in my neck. That’s when I knew it was bad. I told her I had hurt myself and was going to take a break, and I walked slowly to shore, keeping my head as steady as possible.”
Fearing paralysis
He made it to shore and gently laid down, trying to catch his breath, knowing that any move could cause more damage.
“I’ve seen enough medical shows to know that any injury to my neck or back could leave me paralyzed, so I kept wiggling my fingers and toes to make sure I could still move,” he says. “Luckily, it was just the top of my body that was affected. My neck and back were spasming and I still wasn’t able to take a full breath, but I was able to move my extremities.”
After about 10 minutes, Abhi’s daughter checked on her father and noticed his head was bruised and bleeding. They realized he needed immediate attention, but they’d left their phones with Abhi’s wife, Manisha, and son, Shaurya, who were having lunch. Brennecke Beach had no lifeguards on duty, but bystanders offered Abhi ice for his head and called for help.
From beach rescue to ER diagnosis
Lifeguards from neighboring Poipu Beach arrived and put Abhi in a neck brace while they waited for paramedics, who gently placed him on a stretcher for transport to a local emergency room. There, Abhi had a CT scan and X-rays to determine the extent of his injuries. With no neurologist or spine specialist in Kauai, Abhi’s emergency physicians contacted a trauma doctor on the island of Oahu.
“He confirmed that I broke the C1 and C2 vertebrae on my cervical spine and also had a compression fracture. That meant I would definitely need surgery,” he explains. “If the injury was milder, they would have recommended a brace, but the force of the impact and the severity of the break were bad enough that surgery was the only option.”
When Abhi learned he would need surgery, he also learned an interesting tidbit about the beach where he was injured. “The emergency room doctor asked me where it happened, and when I told him Brennecke Beach, he said, ‘The locals call that Break Necky Beach,’” he laughs. “The only difference I noticed there was that the waves were breaking where the water was slightly shallower. We’ve boogie boarded quite a bit, so it was really just a combination of bad luck and the way the waves were breaking that day that made the difference.”
Critical flight home to San Diego
Critical flight home to San Diego
Abhi was discharged from the hospital in Kauai to his rental home to decide where to undergo surgery: in Oahu or back home in San Diego. Both options would require a flight, which Abhi — who was still in quite a bit of pain — was not sure he could manage.
A few days later, he and his wife took a short 45-minute commercial flight to Oahu. There, he underwent more imaging and learned that after just a few days of minimal movement, the bony fragments had moved precariously close to his spinal cord.
“The neurosurgeon in Oahu said I needed to either have the surgery there or get a medevac back to San Diego,” Abhi says. “By this point, it was very clear in my mind that I wanted to have the surgery back home in San Diego, where I have my whole support system.”
Making the decision to return home was easy but getting there was complicated. For days, Abhi’s wife made phone calls, trying to work out insurance and transportation.
Ultimately, Abhi’s employer worked with Scripps to make the transport happen. On New Year’s Eve, Abhi boarded a Medevac jet on a stretcher, his wife by his side, for the 6.5-hour journey home. It turned out, the timing could not have been better for the couple.
“January first is our wedding anniversary,” Abhi says, “so my wife and I were joking that we ended up getting a private jet experience for our anniversary!”
Expert spine surgery at Scripps La Jolla
Expert spine surgery at Scripps La Jolla
“While the other hospitals in Hawaii were very competent, being at Scripps felt more relaxed and I felt that the staff had more time to care for me. The hospital was bigger and newer and, most of all, in San Diego.”
Abhi AdappaOnce the Adappa family arrived in San Diego, Abhi was confident he’d be ringing in the New Year on the road to recovery.
“Just landing in San Diego was such a relief,” he says. “Knowing that after such an ordeal, we were finally home, was a big weight off our shoulders. I wasn’t even thinking about the surgery at all. While the other hospitals in Hawaii were very competent, being at Scripps felt more relaxed and I felt that the staff had more time to care for me. The hospital was bigger and newer and, most of all, in San Diego.”
Abhi was admitted to Scripps Memorial Hospital La Jolla, where he prepared for surgery with Gregory Mundis, MD, an orthopedic spine surgeon at Scripps Clinic Torrey Pines. Scripps’ spine specialists are nationally recognized experts and provide some of the most advanced minimally invasive spine surgery available. Scripps is also consistently ranked as having one of the top orthopedic programs in the country by U.S. News & World Report.*
“This accident was my first experience in the emergency room and my first experience with surgery, but I felt prepared,” Abhi says. “Dr. Mundis came in and briefed me about the surgery, how long it was going to take, what complications were possible and what my recovery would be like.”
On Jan. 2, six days after and more than 2,600 miles away from where he broke his neck, Abhi underwent surgery for a condition that, Dr. Mundis explains, was quite dangerous.
“With a fractured neck, he could have ended up paralyzed or on a ventilator with the wrong movement, but after consulting with his physicians in Hawaii, we all felt he could make the trip,” says Dr. Mundis. “Once he arrived, we had him evaluated and operated on him the very next day. The surgery involved an incision on the back of the neck and the base of the skull. We used live X-rays to place screws into the broken bones and set them, and a bone graft to fuse them.”
Regaining strength and mobility
Abhi’s surgery went off without a hitch. He remained in the hospital for three days, working with the trauma team on swallowing issues caused by the injury and with occupational therapy to kick his recovery into gear.
“The day after surgery, occupational therapists walked me through how to cope with the injury and recovery, and how to be independent,” Abhi explains. “They sent me home with a neck brace and instructions to sleep on my back. I had never been a back sleeper, so that was the most difficult thing — getting a good night’s sleep!”
Abhi wore the brace for four months as he healed. During that time, he was not able to drive, so he worked from home, which allowed him plenty of time for twice-weekly physical therapy. Despite the trauma of the accident, his prognosis is very good.
“The main thing he’ll continue to experience is loss of motion in his neck looking left and right,” Dr. Mundis explains. “He’ll be more limited in that regard initially, but recovery will happen slowly over time, and he should continue to make a full recovery and be able to be as active as he would like.”
Grateful for exceptional care
Abhi is thrilled with how well he is doing and is optimistic that his range of motion will continue to improve as time goes on. He’s grateful to the entire team at Scripps for coordinating care from afar and providing exceptional care once he made it back to the mainland.
“The whole experience at Scripps — thanks to all the doctors, the staff in the operating room, the techs and nurses — was excellent.” he says. “All the staff were responsive and empathetic to what I was going through. They all supported my needs and preferences and made sure I was comfortable.”
Abhi adds, “My family has all been long-time Scripps patients — for almost 20 years now — and we’ve always had a good experience. That’s why, when we really needed it, we had the strong preference to come back home.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.