Troy Clark was 25 years old when he went off-roading on Mount Vaca in November 1992. His Toyota Land Cruiser veered off a narrow, curving road and rolled down the hill, breaking his neck and leaving him a quadriplegic.
“I was awake the whole time,” he said. “I recall everything. I remember a lot of crashing, crunching sounds. I’m not sure when my neck broke, but something must have snapped.”
His vehicle came to a stop at the bottom, landing upright, with Troy hanging out of the driver’s seat, held up by his seatbelt.
If you think that’s the end of the story, you don’t know Troy Clark.
Today he has a wife and five children (three at home), holds down a teaching job in Dixon, and drives his own customized white Ford van. He has regained some movement in his arms, which means he can maneuver his wheelchair with precision and even handles grocery shopping chores on his own.
But while that wheelchair provides an amazing degree of independence, it can also disguise hidden hazards. In Troy’s case, a deflated air cushion led to a serious pressure ulcer in 2017.
“The problem is that I can’t feel the pressure sore forming until it’s really severe,” he said. “And that means months and months of treatment.”
That’s how he became acquainted with the staff at NorthBay Wound Care and Hyberbaric Medicine.
“Once someone like Troy gets these pressure ulcers on his sit bone, it is very difficult to treat and heal,” explained Wound Care Specialist Thomas Erskine, M.D. “Any pressure on the ulcer can delay or inhibit wound healing. To avoid this, the patient needs to stay in bed much of the day and night, so they are not sitting on the ulcers. This is very difficult when you have an active life.”
At first, Troy’s course of treatment involved conservative wound care, including different types of dressings and negative pressure therapy.
“Unfortunately, he developed an underlying bone infection,” said Dr. Erskine. “When this occurs, a long-term IV line and antibiotics daily for six to 10 weeks is needed. And if that’s not enough, we add in use of the hyperbaric oxygen chamber.”
NorthBay Healthcare is one of the few nonprofit, community health care systems in the state with hyperbaric oxygen chambers. David Grant Medical Center at Travis Air Force Base also has hyperbaric chambers, but they are not available to the general public.
The decision to use the hyperbaric chamber led to another challenge: How to get a 6-foot-2 quadriplegic patient from his wheelchair into a special hyperbaric chamber gown, and up into the chamber itself?
“While Wound Care staff could do it, we realized that help was only a phone call away,” said Patti Bales, R.N.
That came in the form of Atlas Lift Tech coaches, who have worked side by side with clinical professionals at NorthBay Medical Center and NorthBay VacaValley Hospital since 2012, ensuring that patients are moved in the safest possible way — for both the patient and the clinical staff. Although NorthBay Wound Care is across the parking lot from VacaValley Hospital, the Atlas team is always happy to respond when the call comes in, pushing NorthBay’s “Liko Golvo” — the Cadillac of lifts — across the parking lot.
“I like the fact that I can assist nurses with safe patient handling mobility,” explained Laura Ramirez, one of a handful of lift coaches stationed at the Vacaville and Fairfield hospitals. “I’m an advocate for the patient and I work with the nurses so no one gets hurt.”
While the nurses may be capable of using the lift on their own, they appreciate the extra set of hands, she said. “It’s all about safety.”
Patti agreed. “It took a while, but our team has the whole routine down to a science. And Troy is the perfect partner. He tells us how we can assist. He’s very involved with his health and a very good advocate for himself.”
A Skin Substitute?
One of the Wound Care and Hyperbaric Medicine’s most progressive treatments uses bioengineered skin substitutes to cover an open wound. The skin substitute is applied like a skin graft, though without surgery. It is covered with a special dressing and left in place for several days so the growth hormones and nutrients can be absorbed into the wound area. The patient regenerates their own skin in its place.
When hyperbaric appointments swung into high gear — 60 treatments in a three-month period — lift coaches and nurses would go into action, changing Troy into a hyperbaric-safe gown, lifting him using the “Liko Golvo” onto the gurney, sliding him into the chamber, and then returning after treatment to do it all in reverse.
Treatments would last anywhere from 90 minutes to two hours.
“It’s 100 percent oxygen pressurized,” said Patti. “It allows better oxygenation into the blood vessels, which increase blood flow and oxygenation to the skin, which helps wounds to heal.”
During his treatments, Troy could watch television or movies. It didn’t cause any distress, only a little bit of pressure in the ears. He compared it to being in an airplane.
Troy was beaming when the entire Wound Care staff dropped everything to come and join him for a photograph in the hyperbaric chamber in January. Atlas Tech coaches came, too. They’re all part of Team Troy.
“The staff is amazing,” said Troy. “When I was next door in the hospital recovering from a surgery, they would come over to visit and tend to my wounds. It is like another family for me.”
Patti said the feeling is mutual.
“Despite all his pain and suffering, Troy always has a smile on his face,” said Patti. “It’s amazing; he’s always so upbeat, even when he knows he’s going to have surgery. He really brightens my day.”
For the Wound Care team, that type of connection is not unusual.
“We become very close to many of our patients,” said Dr. Erskine. “Typically, we see our patients every week, and sometimes every day for several weeks, depending on how serious their wounds are. We get to know them and they get to know us. Many become part of our extended would care family. Even when they have healed and no longer need to come in, we try to make it clear to them we are only a phone call away if they need help again.”