Auger victim can walk, still in pain four months after accident

ADVANCE, Mo. -- When Josh Blankenship reported for work the morning of Dec. 13 at MFA Agri Services in Advance, he had no idea that his life would be forever altered.

It was about 9 a.m., and Blankenship and his longtime friend, J.D. Cavener, also an employee at MFA, were busy cleaning an emptied grain bin.

A sweep auger was in use, with blades churning, collecting the last of the bin's grain through three holes in the floor.

"It was dark and dusty inside the bin. I set my shovel down. We had a big push broom leaning against the wall. I stepped back to get it, and when I did, I stepped into one of the holes," Blankenship recalled.

"I knew what I had done immediately, before I even got all the way in it," Blankenship, 29, said. "I looked at J.D. and said, 'Help.'"

It was too late. Blankenship was trapped in the auger up to his hip. His right leg was still on the floor of the bin, leaving his body twisted, half in the auger and half out. The auger blades had locked on his left leg in four places. They had chewed into his upper leg, severing his femur, and tearing through bone, muscle, nerves and tissue. His foot was nearly severed.

Cavener's first instinct was to grab his friend in a bear hug from behind and try to lift him out, but that was a futile effort.

"He realized that the auger was stronger than he was, and that he had to do something," Blankenship said. "So, he took off to get it shut down."

The auger was still running, making noise and kicking up dust, but something had stopped the blades. They would realize later that a belt on the auger burned up shortly after the blades tore into Blankenship's leg. When the belt broke, the auger stopped its churning, and that, Blankenship said, kept him from going any deeper into the machine.

A call to 911 was made, and Cavener returned to the bin to be with his friend until help arrived moments later.

It quickly became evident to emergency personnel that Blankenship, once removed from the augur's grip, could bleed to death before reaching Saint Francis Medical Center in Cape Girardeau.

Stoddard County Ambulance District director Dave Cooper arrived on the scene shortly after his emergency personnel and learned the auger blades were serving as a tourniquet, keeping the leg from bleeding.

"I had experienced a limb extrication involving an auger in the past," Cooper said. "I spoke with medical personnel at the scene, and we had a real concern about major bleeding once we let the pressure off the leg."

About that time, a medical helicopter that had been summoned from Cape Girardeau landed at the scene. Aboard was flight nurse Chris Foster, who agreed to make a call to Saint Francis to speak to a surgeon.

"It was amazing how perfectly things fell into place that day," Cooper said, looking back. "When the call was made to Saint Francis, it happened that Air Evac's second helicopter had just delivered another patient to the hospital, and a trauma surgeon was just going off duty and became aware of the situation."

Within 30 minutes, a second helicopter carrying Dr. Orlando Morejon arrived. It would mark the first time in the history of Saint Francis that a surgeon would be flown to the scene of an accident.

Blankenship never lost consciousness during the rescue efforts. He was given massive doses of morphine and other pain medications through an IV while rescuers worked to free his leg. It would take nearly three hours of grueling, delicate work, both by the surgeon and emergency personnel, before the leg was free of its entrapment. Morejon quickly clamped off the main artery in Blankenship's leg, which had been cut in two.

A second doctor, an emergency room physician living nearby arrived to help.

"It was a tough day," Cooper said. "But when I look back at how so many agencies came together and the teamwork and cooperation between all of them, I realize it was one of the greatest days I've ever experienced."

Making the day more difficult for Cooper was the responsibility of having to tell Blankenship's family members that they could not enter the bin to see him during the rescue.

"I knew they didn't need to enter that scene," he recalled, "but it was very difficult to have to tell them that. I think they understood."

Morejon accompanied Blankenship on his flight to Saint Francis.

"I was conscious the whole time," Blankenship said. "I remember the pain being horrible. I remember Dr. Morejon telling me on the helicopter that I was too tall for the stretcher, so he said his hands were going to serve as a pillow for the flight. I remember my head in his hands, and feeling the helicopter take off, and then I went into shock."

He recalls nothing of the next couple of days. He underwent surgery at Saint Francis before being moved by ambulance to Barnes-Jewish Hospital in St. Louis.

"The next thing I remember is waking up at Barnes," he said.

During five subsequent surgeries during a two-week period, surgeons worked to save Blankenship's leg. Bones were reconnected by screws. Metal plates were put into place up and down the leg. The femur was reattached and screwed into position. His foot, literally snapped in half, required extensive reconstruction involving bone, nerves and muscle reattachments. Several inches of muscle in his leg were gone. Skin was grafted from one part of the leg to another.

The worst day came on Christmas.

"I've never experienced such pain," he said. "It was worse than the accident itself."

Blankenship was talking about removing the material put in place to secure three wound vacs to his leg. The wound vacs promote healing by applying a vacuum through a sealed dressing.

"It took 20 minutes to unwrap my fingers from the rails on the sides of my bed when it was done," he said. "It was just horrific."

Almost four months have passed since Blankenship's life-changing and near-death experience. Today, he is able to walk for short periods of time with the use of a cane, having graduated from a walker. He returned home Dec. 27 and celebrated a late Christmas with his wife, Misty, and 3-year-old son, Hayden, and their families. Home health nurses visited him regularly for several weeks, and intense therapy twice weekly began about two months ago at Saint Francis. He recently began driving himself to the sessions.

There were those on the scene that December day who doubted Blankenship would survive the accident. Others thought, despite their efforts, his leg would likely be amputated. They would be amazed to see him walking around his rural Zalma, Mo., home on his road to recovery.

The pain for Blankenship, though, has never left. Despite daily medications, he deals with regular significant pain.

"I haven't been without pain since the accident," he said. On a 10-point scale, his is at a constant three to four.

Accounting for a significant amount of his pain are the nerves in his leg that were mangled. Nerve endings, he explained, are sending signals to places that no longer exist since so many of his nerves were severed.

"Nerves can be your worst enemy. I've found that out," he said. "It's like a horrible electrical system."

After being on his feet for just a few minutes, Blankenship described the sensation in his foot "like walking on glass."

Doctors at Barnes, where he visits often to be checked, have said a nerve transplant might be an option for Blankenship in the distant future.

Morejon moved his medical practice in Florida shortly after the accident. Blankenship was never afforded an opportunity to thank him for his work Dec. 13.

"Without him and without all of the people who came together that day -- all of the emergency personnel who came -- and all of the friends and family who have been by our side, I would never have made it this far. To say 'thanks' hardly seems adequate."

After the accident, a fund was established for Blankenship and his family to help with expenses they face as a result of his inability to work. The fund is at First Commercial Bank in Advance where Josh's mother, Tina Blankenship, is employed. Additional information may be obtained by calling the bank at 573-722-5599.

Pertinent address:

Advance, Mo.

Zalma, Mo.