For Jason Kapera, Fourth of July was never the same after 1990.
He was 10 years old when, while watching people light off fireworks on the sidewalk, one of them rained down on him, burning his arm. He went inside and looked in the mirror.
"I was shocked," he said.
He told his dad he didn't want to go to the hospital because his injuries didn't warrant it. Later on, though, the pain became unbearable, so he sought medical attention.
At the hospital, the staff put his arm in a solution that kills infections, then placed it in a cast. He was out of commission for a couple of months; he had to miss a family vacation.
The experience affected him not just physically but mentally as well.
"Ever since that happened, I'm terrified of fireworks," said Kapera, a 38-year-old independent contractor who lives in Hammond. "I'm just traumatized. Every time I look at the scar, I remember that day."
The Region, with its abundance of fireworks shops, has accidents like the one Kapera had every year around this time. In a recent high profile incident, a 37-year-old man was killed and another man critically injured when the fireworks they were lighting detonated prematurely. And when these accidents occur, Northwest Indiana health care professionals are ready.
"We treat a lot of these injuries, especially around the Fourth of July," said Dr. Airron Richardson, an emergency physician for Methodist Hospitals, which has a Level III trauma center at its Northlake Campus in Gary. "Hands and arms are probably the most common. People try to light firecrackers and throw them before they explode. Totally ridiculous stuff I can't believe I did when I was little."
Treating the wounds
Depending on the severity of the injuries, treatments can range from cleaning and putting antibiotic ointment on the burns to skin grafts, Richardson said. People also sometimes rupture their eyeballs. The most severe cases are transferred to Level I trauma centers, with the nearest being in Oak Lawn or Chicago, or burn centers in Chicago.
Dr. Robert Frank, a Munster plastic surgeon, generally sees a few patients with fireworks injuries every year. They tend to be hand injuries, as people hold onto the fireworks too long after lighting them. People also damage their faces.
What makes these injuries unique is that carbon material from the fireworks often gets stuck in the skin or soft tissue, Frank said. This is known as "traumatic tattooing," discoloration of the skin caused by the foreign material underneath the skin.
To treat fireworks injuries, Frank generally makes sure blood is circulating to the extremity involved, removes any skin that is devascularized, scrapes away foreign material and, if needed, does a skin graft or flap.
Some of the patients have lifelong scarring, he said.
Munster orthotist Brian Steinberg said his practice has had its share of patients who have lost fingers to fireworks injuries. The people can be treated with silicone attachments or mechanical devices.
"We're just trying to restore back the functionality or the cosmetics of the particular extremity," he said.
That can be more difficult based on which fingers are lost, with the thumb and index finger being oppositional and thus the most crucial to functioning.
While he hasn't treated fireworks injury victims, Munster prosthetist Vikram Choudhary has had clients with severe burns.
He has to use different materials on people with burns: less-irritating materials meant for sensitive skin, like Thermoskin, which moistens the skin and allows for good cushioning; or silicone, which prevents swelling in scar tissue.
Burns are generally treated by softening the tissue, doing range-of-motion exercises and splinting to allow for stretching of the joints, Choudhary said. He also warns patients that they will sweat more in the areas that aren't burnt.
Telling a victim's story
Four years ago, Northwest Indiana resident Deanna Moes was at a friend's house where they had a fireworks "fountain" that would intermittently shoot off bottle rockets. It tipped over, and she bent forward to shield the 2-year-old child she was holding. One of the rockets hit her in the eye. She immediately lost her vision. She looked in the mirror.
"Through the massive swelling, I opened my usually blue eyes and all I could see was red with my red pupil," she said. "Talk about panic."
She went to the emergency room and was diagnosed with hyphema, a hemorrhage on the inside of her eye. She had to sit and sleep upright for 12 weeks while the blood drained. She had to go the eye doctor two or three times a week.
She took two months off work as her job as a intensive-care nurse. She has permanent scarring, which has significantly impacted her vision.
"Such a scary experience, but thankful it was not any worse," she said. "Just goes to show that even with proper safety precautions, fireworks can be so very dangerous."
Local health care professionals say that if you're going to light off fireworks this time of year, at least do it safely.
"I would encourage to not mix alcohol if you're going to light fireworks, keep a safe distance, make sure there's water nearby in case you put out a fire," said Richardson, the emergency room doctor. "Sometimes there's a delay in the explosion — you have to be careful about picking up or approaching undetonated fireworks."
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