Life-saving ECMO after brain injury

Flying airplanes at heights some people can’t fathom came naturally to Brandon Johnson, but it was a fall from a golf cart that landed the fearless 34-year-old pilot and flight instructor in the hospital – fighting for his life – with a life-changing head injury.

On April 27, 2019, his parents, Mary and Paul, were awakened by police at their home in Ramsey with news every parent dreads. “They told us Brandon was taken to the hospital after an accident,” said Paul.

“We immediately drove to Mercy Hospital in Coon Rapids. That drive seemed like it took forever – like everything was going in slow motion.” “They were upfront with us when we arrived at the hospital,” explained Mary. “Brandon was in bad shape, with multiple skull and facial fractures, bleeding inside his brain, as well as a hairline fracture of his pelvis.” He was sedated and intubated and doctors carefully watched for improvement, but unfortunately, Brandon’s condition deteriorated and he ultimately developed respiratory failure.

“We were called two times at night to tell us that Brandon would not make it,” Mary shared. “He somehow made it through those episodes and doctors decided he needed to be put on ECMO. We didn’t know exactly what it was, but as a parent, you think, ‘Do whatever you have to do to save my son.’”

ECMO stands for extracorporeal membrane oxygenation. It’s used to support the heart and or the lungs of critically ill or injured patients until the underlying problem has been resolved.

“In Brandon’s case, when the doctors at Mercy Hospital called about ECMO we knew immediately that HCMC was the right place for him,” explains Hennepin Healthcare’s ECMO Medical Director Matthew Prekker, MD, MPH. “We are the leading Level 1 Trauma Center in the state and one of the only trauma centers able to provide ECMO to adults.”

“ECMO support involves pumping a patient’s blood at very high flow rates through a membrane oxygenator outside the body, before returning it to the patient. The membrane oxygenator does the job of the lungs while they heal, so preventing the blood from clotting in the circuit is very important. However, patients like Brandon with traumatic brain injuries that cause bleeding in or around the brain can’t be safely given the blood-thinning drugs we’d typically use during ECMO. With the newest technology and very close monitoring, we’re able to use ECMO without blood thinners for up to a week or two for patients in Brandon’s situation, and thankfully he responded well.”

Hennepin Healthcare’s ECMO Program recently received the Award for Excellence in Life Support – Platinum Level, the highest designation level given by the Extracorporeal Life Support Organization (ELSO). This award recognizes programs worldwide that distinguish themselves by having exceptional personnel, procedures, and systems in place to support critically ill patients with ECMO while also advancing the exciting science in this area.

Brandon was on ECMO for two and a half weeks. The Johnsons visited the hospital each day, staying focused by taking one day at a time.  “We’d call HCMC to check on Brandon before we went to bed each night. It was so reassuring to be able to call anytime and get an update. The nurses and other staff were so transparent and supportive. They told us that this journey would be like a rollercoaster ride – with lots of ups and downs. They also told us to get some rest because Brandon would need us when he started to feel better – and they were right.”

“ECMO saved my life.”

When Brandon was well enough to be removed from ECMO, he still required the ventilator and it became clear to his doctors that his brain injury would prolong the recovery of his lungs and body.

That’s when therapy began. His parents could see his familiar self-motivation kick in almost immediately.

“He was used to making decisions at 500 miles per hour,” said Paul. “We wondered how that would change after the accident. Our first encouraging sign was when he used his password to unlock his cell phone. He was not yet able to speak but was able to recall how to swipe the symbol on his phone to open it up. That’s when we knew he’d be ok.”

Brandon was transferred to Regency Hospital for acute care and rehabilitation after he was medically stable. That’s where he continued to surpass expectations and was discharged to Abbott for additional rehab – where he was finally discharged to home after he launched a campaign to do so on July 4, 2019.

“I wanted to celebrate my country, and being alive!” he asserted. “While I don’t remember it at all, ECMO saved my life. I’m so grateful to the doctors, nurses, and everyone at HCMC for using that technology to keep me here. I’m also thankful to the staff at Mercy, Regency, and Abbott for everything they’ve done.”

His mom said that they knew Brandon wanted to fly since he was 3 years old. “He saw an airplane, and that was it. He ended up getting his pilot’s license before his driver’s license.”

He was enjoying a successful career as a pilot, but of course, Mary and Paul were concerned about how Brandon would adjust to understanding that he wouldn’t be able to fly after his accident. Those concerns were quickly put to rest when they saw how well he’s accepted and adjusted to his limitations, and most of all, that he does not feel sorry for himself.

“I was very aware of my injury,” Brandon explained. “And that I could not fly.”

He remains connected with friends and colleagues at the airport, which he also believes is an important part of his overall recovery. He has been on a plane a few times with his flight instructor and has used a flight simulator to refresh his skills.

“It’s been very therapeutic,” he said.

During his recovery period his own flight instructor license was coming due, and to keep it active he needed to renew it by taking more than 20 tests to recertify. Brandon took his time completing the difficult tests – and passed! This was a tremendous accomplishment – an example of his motivation to succeed.

After such an incredible injury and amazing progress, Brandon is again living independently in his Ramsey home. His knowledge of all things aviation is remarkable, and it’s interesting to consider if those skills have helped him chart his course through the healing process. For most people, the sky’s the limit. But not for this survivor, who’s been there and back.