Not many 13-year olds are on a hugging basis with their doctors, but Paine Cowart and surgeon Jill Flanagan go way back, to a October day two years ago.
Payne was 11, rounding up friends to play football in his Lawrenceville neighborhood.
He says, "I remember seeing a few cars passing by, but no other cars passing by."
That’s when Paine stepped into the road.
He says, “All I know is I got hit. Everything went to black."
He came to on the sidewalk.
Paine says, "The first reaction was, ‘Whoa, what just happened!’ So, I tried standing up, but my leg was stretched and twisted. So, I knew it was broken."
Paine and his mom Jenni were rushed by ambulance to Children's Healthcare of Atlanta at Scottish Rite, where Dr. Flanagan, a pediatric orthopedic surgeon, was waiting for them.
Flanagan remembers, “He was in pretty bad shape."
Paine's tibia and fibula, the two bones in his lower left leg, were broken at the same point. He needed surgery, and metal rods, to stabilize the leg.
Dr. Flanagan says, "The tibia it normally surgery, high-five, we're done, great, and then he'll heal from that."
But, Paine developed a much more challenging complication: acute compartment syndrome. Flanagan says it’s a known complication of bone fractures and traumas. The muscles and blood vessels in our arms and legs are grouped by compartments, each covered by a tough membrane called a fascia. Acute compartment syndrome occurs when the injured muscles swell, causing pressure to build up and cutting off blood flow in the leg.
Dr. Flanagan says, "It's like a heart attack of the leg. What happens is his leg swelled so much from the trauma of the injury and the surgery, his leg swelled and swelled, he was losing the blood supply to his leg."
If Dr. Flanagan couldn't reopen the blood supply, they'd have to amputate Paine's leg. Hours after his first surgery, he was back in the O-, where Flanagan cut open the lining around his leg muscles, to release the pressure. It was the beginning of a long road back.
Dr. Flanagan says, "Rather than one surgery, he had five."
The pain, the main warning sign of acute compartment syndrome, was like nothing Paine had ever experiences.
He says, "It was horrific."
Jenni Cowart, Paine’s mother, says, "I just figured I'm in one of the best hospitals in Atlanta, so they're just going to do whatever they have to save the kid."
They did "save the kid." But over the last two years, Paine has endured a bone infection, more surgery to remove dead bone and tissue, and the stares and pain of wearing an external fixator. Slowly, healthy bone grew back. Today, Paine still has a slight limp, but he's back on his feet.
He says he’s grateful the surgeon who helped him get back to feeling like a normal 13 year old.
Looking back on the last two years, Paine says, "I'm like wow, I went through all that just to keep my leg."