Daniel’s Story: Defying the Odds

The hospital room fell quiet as the nurse asked him to wiggle his toes. He thoughtfully gazed down at his left leg through the large metal frame screwed into his bones. He focused intensely on his toes and willed them to move. Three toes complied, and the room erupted in elation.

A groggy Daniel Khan could not remember much from the last five days. But he knew from the reaction of those in the room that this small movement was good. Very good.

Daniel soon pieced together the conversations and decisions that led him to Miami Valley Hospital. How hope, persistence and the skilled hands of orthopedic surgeon Indresh Venkatarayappa, MD, and two of his partners, Brandon Horne, MD, and Jennifer Jerele, MD, helped save his leg. All three physicians are part of Premier Orthopedics, part of Premier Physician Network.

A Race Against the Clock

The date of Daniel’s accident is seared into his memory, along with the dates of 14 surgeries that followed over the next year. It was September 29, 2017. He was standing by his car parked along his Centerville street, cleaning the windshield, when a car came from behind and struck him.

His mangled left leg gushed blood onto the pavement. A quick-thinking police officer applied a tourniquet, saving him from bleeding to death. Daniel arrived at a local emergency department with an open fracture and neurovascular injury. Surgeons repaired the vascular injury but said the overall damage was so severe that they recommended amputation above the knee.

Daniel’s family asked for a second opinion as he lay connected to a ventilator. The next day, he was transferred to a Columbus hospital where surgeons studied his case and also recommended amputation. By this time, his still-open injury was four days old, and infection was setting in.

Desperate to save Daniel’s leg — and with the clock ticking late into the evening — one of his brothers called a family friend who practiced medicine in Centerville. The call led him to Dr. Venkatarayappa, who consulted with plastic surgeon Michael Johnson, MD, FACS. They agreed to take his case.

“We were not expecting it,” Daniel recalls. “We were mentally and emotionally preparing for amputation. I remember my brother telling me about prosthetic legs and how those things were evolving. So we were all thinking, ‘Is this real? Are they really going to do the surgery?’ ”

Wasting no time, Dr. Venkatarayappa arranged for a 6 a.m. surgery for the following day at Miami Valley Hospital. Working together, he and Dr. Johnson performed multiple procedures. They repaired Daniel’s broken bone and then sliced a piece of soft tissue from his healthy leg, sewing it to his left leg, in a rare procedure known as Cross Leg Flap surgery. The shared tissue would feed nutrient-rich blood to Daniel’s languishing leg.

His legs would remain connected by this tissue for 55 days.

They also attached a metal frame to both legs from his hips downward, immobilizing his lower body. A series of surgeries over the next 10 months removed pieces of the frame bit by bit to enable increased movement while keeping his leg bones aligned.

Partner in the Journey

Daniel stayed in the hospital for nearly 40 days. He has nothing but praise for the staff who kept him healthy and comfortable.

“From a service perspective, I’d give them a 5-star rating – the doctors, nurses and the support system – it was all so great.” They even helped him celebrate his 46th birthday just four days after the surgery.

Daniel marvels at Dr. Venkatarayappa’s dedication to his care, as well.

“He checked in on me like every day, even on the weekend. Sometimes just to say hello.” Dr. Venkatarayappa also was in frequent contact with Daniel’s brothers by text, updating them and answering their questions.

Within two months of his limb-saving surgery, Daniel reached his next milestone. He took a few steps with his left leg. He had neared the end of inpatient rehabilitation and was soon to begin in-home physical therapy.

Daniel appreciated the realistic expectations Dr. Venkatarayappa helped him and his family set.

“This was a problem for the whole family. My wife, kids, everybody was following this whole process of care with me.” Dr. Venkatarayappa explained how progress would happen slowly and in phases.

“To build a positive attitude, you’ve got to have the right expectation, and that’s what he gave me,” Daniel explains. “It’s how the brain and the body work together. He really did an outstanding job communicating and letting me know what to expect.”

Over the winter, spring and summer, Daniel made follow-up visits every one to three weeks with Dr. Venkatarayappa and his staff. He received helpful nutrition advice for strengthening his healing bones, and he slowly built his daily steps from around 800 in February to nearly 8,000 steps today.

Daniel’s last three surgeries included a bone graft procedure, removal of the final frame pieces and a final September surgery to remove excess soft tissue.

Finding His Stride

In late August, after the final frame pieces were removed, Daniel returned to work as vice president at Synchrony Financial in Kettering. He had been working from home for the last nine months.

He recalls the surprise of his coworkers upon seeing him return to work.

“They’d say, ‘Is that you? You’re up and walking!’ ” The only outward sign of his traumatic injury is the boot and brace he wears.

Daniel especially enjoyed rejoining his work walking group, which he keeps up with remarkably well, although with a slight limp. His leg nerves have not yet fully returned – something Dr. Venkatarayappa says may take a few more months. Daniel expects it will take another six months before he can resume hiking, something he loves.

For now, he settles for short visits to Sugar Creek Park just about every weekend. He knows he’s come a long way and is fully aware of how things could have gone. Perhaps most telling is a conversation he recalls with Dr. Venkatarayappa.

“He said — even though he’s a doctor and hates to use the word — ‘It’s a miracle, and we’re so glad we did this for you.’ ”