Patient Stories: Reconstructing Lives

Every year, nearly 5 million reconstructive plastic surgery procedures are performed in the United States. Many of them are life-changing for patients and for the surgeons themselves. To better illustrate what types of state-of-the-art procedures are being done every day, ASPS created the Reconstructing Lives Blog, which gives members the opportunity to share their compelling stories with the public.

**Reconstructing Lives: Kelsea Henderson
The October 2008 homecoming at Woodstown High School was particularly special for one of its students. This was not just another football game, parade and dance for 18-year-old Kelsea Henderson. She had been elected homecoming queen and this distinction meant more to her than most. Since age 13, Kelsea has undergone numerous complex surgeries to her back and chest as a result of a rare cancer.

“Being chosen for homecoming queen really meant a lot,” said Kelsea. “My friends and other students always knew I was sick, but I never wanted to play the sympathy card. I wanted to be treated like a regular teenager. I was happy they recognized this, saw how I dealt with everything, and respected me for that.”

Overall, 2008 was pretty monumental for Kelsea. Her last reconstructive operation, performed by ASPS and ASRM Member Surgeon Dr. David Low in Philadelphia, was in January 2008. And just four months later, Kelsea attended her junior prom (proudly displaying her scars), and 9 months after surgery she was voted homecoming queen. She wrapped up the season by going on a family vacation to Hawaii through the Make a Wish Foundation were she celebrated her 18 birthday and learned she received a full college scholarship.

“What I’ve gone through has been life changing,” said Kelsea. “Not knowing if I was going to finish high school or go to college was scary. I have a greater appreciation for life now and all that I am able to do and all that I receive.”

Origins of an illness
In June 2004, Kelsea began to complain to her parents of radiating pain in her left chest and side. By summer’s end, the pain had become so excruciating her parents rushed her to the emergency room. A biopsy revealed a large and very rare type of cancerous tumor located in her left chest, adjacent to her aorta and spinal column. The tumor surrounded nerves found outside her spinal cord.

“Finding out your child has been diagnosed with cancer is a numbing experience,” explained Kelsea’s mother Pam Henderson. “It’s something you just don’t want to believe. You almost can’t believe it.”

Initially, physicians at Children’s Hospital of Philadelphia hoped they could treat Kelsea’s tumor by removing portions of it, followed by radiation and chemotherapy. In October 2004, portions of the tumor were removed, but the tumor began to grow. Over the next year-and-a-half, doctors administered radiation, followed by another attempt to remove portions of the tumor, then chemotherapy. However, the tumor continued to grow.

“Chemo and radiation were extremely taxing on Kelsea,” said Mrs. Henderson. “She would be at the hospital for 11 hours straight sometimes. She didn’t like being away from home. But through everything, her personality has always been upbeat and cheerful.”

Chest wall reconstruction “saves” day
It was apparent more aggressive steps were needed to fight Kelsea’s cancer. In April 2006, neurosurgeons removed the entire tumor, which required removal of portions of her vertebrae and ribs, leaving her spine and chest weakened. They inserted rods, screws, and bone grafts to stabilize her spine. Then, Dr. Low reconstructed the large rib defect in her chest wall using artificial mesh and bone cement. The combined operation took more than 40 hours.

“People say to me all the time, ‘I don’t know how you got through this,’ and I say, ‘I don’t know either,'” said Mrs. Henderson. “We have a really close family. When something like this happens, you really don’t have a choice.”

But Kelsea’s troubles weren’t over. Over the next year-and-a-half, she developed a serious infection that required removing all of the mesh and bone cement Dr. Low had used to reconstruct her chest wall, as well as, some of the materials used to stabilize her spine. And her previous radiation treatments caused fluid to accumulate in her left chest and led to an air leak in her lungs.

“Eventually her neurosurgeon needed to remove all of the remaining materials used to stabilize her spine and asked me to provide tissue to help seal the leak from her lung and cover the exposed bone,” said Dr. Low.

In early January 2008, Dr. Low transferred Kelsea’s right back muscle, with a flap of skin attached, to the left side of her back. He then reattached the blood vessels and nerves on her left side to the transferred muscle. A portion of the muscle was then tucked into her chest wall defect to seal off the air leak from her lung.

In late January 2008, when most high school juniors prepare for their SATs, Kelsea underwent her seventeenth, and final, operation. Dr. Low took a bone from Kelsea’s leg (fibula) and placed it along her spinal column to give it support and used a major vein from her leg to reestablish blood supply.

The reconstructive procedures Dr. Low performed on Kelsea’s defects were so innovative and challenging, he was awarded “The Best Microsurgical Save of the Year Award” during the American Society for Reconstructive Microsurgery’s (ASRM) annual meeting in January.

“What made this case so rewarding is that throughout her multi-year ordeal, Kelsea never lost her courage and optimism,” said Dr. Low. “She was never discouraged, even when presented with the need for multiple complex surgeries.”

“I can’t thank Dr. Low and the rest of my doctors enough,” said Kelsea. “Words can’t express how much he means to me and what he’s done for me. He saved my life.”

When reflecting on time missed from school and friends, Kelsea replied, “I missed out on things in high school, and it was upsetting at times. But I tried not to let it get me down. I’ve been able to attend school my entire senior year, was homecoming queen, and received a full college scholarship. I feel like this is a good end to my high school career.”

“Kelsea is a beautiful young woman who faced repeated adversity, seemingly incurable cancer, a long list of painful and lengthy operations, and yet has triumphed magnificently and now looks forward to what she humbly calls ‘a normal life,” said Dr. Low. “Her story is truly inspiring.”