Heroes of Harborview: Surgeons provide expert life-saving and elective care

UW Medicine surgeons at Harborview, known in the Pacific Northwest for keeping trauma patients alive, are equally versed at elective procedures that keep people healthy and fulfilled. Working in both contexts builds complementary skill sets, doctors say.

When Dr. A.J. Amadi performs a cosmetic brow lift, he employs techniques honed in repairing flayed cheeks and splintered eye sockets.

“We deal with some of the most difficult cases — orbital injuries and burns,” said Amadi, a UW Medicine oculofacial plastic surgeon at Harborview and a UW assistant professor of ophthalmology. “Burn victims often end up not having enough skin to close their eyes. It’s our job to help them achieve eyelid closure using various surgical techniques. We also can apply this experience to cosmetic surgery, say, in the case of a cheek lift.”

Elective surgery patient: Isabella Belsito

Surgeon: Dr. A.J. Amadi

Isabella Belsito was a month old when her parents noticed a lump at her left eyebrow, near her nose. Had she bumped her head? Her pediatrician, it turned out, was the fi rst of eight doctors who couldn’t diagnose the bump or recommended a wait-and-see approach.

Isabella’s lump drove her increasingly anxious parents far from their Richland, Wash., home. After six months, referrals led them to Amadi.

“He wanted to do a CT scan but our insurance needed a week’s notice for approval,” mom Tabatha Belsito said. “He wanted the scan immediately because the bump was growing quickly and it was winter; he didn’t want us to have to make another trip over the mountains.”

Amadi tracked down a claims adjustor, advocating successfully for a scan the next morning.

“[Amadi] said he wasn’t going to send us to another doctor—he was going to fi gure it out,” Belsito said. “That was such a relief.”

Isabella’s bump was a benign hemangioma that Amadi recommended be removed. But surgery could be dicey as he couldn’t tell whether the tumor reached her brain.

“He told us our options and all the consequences,” dad Angelo Belsito said. “We agreed, and he did an excellent job. Luckily the tumor was all up front. He took it out and zigzagged his incision so the scar would basically disappear. If you get close, you can see it, but it doesn’t look like she had surgery. It’s amazing.”

Trauma patient: Tyson Eckert

Surgeon: Dr. A.J. Amadi

On successive days in a Yakima emergency room, doctors assured Jeanna Eckert that her son, Tyson, 7, would be fine. He and another boy had collided while running, with Ty’s left eye taking much of the blow. But no injury was visible, and despite the fact that Ty’s left eye wasn’t moving well, the family was sent home.

Eckert mentioned the issue to her doctor the following Monday, who arranged an appointment for Ty that Friday with an ophthalmologist. Ty’s orbital fracture was revealed, and a referral hastily made.

Amadi saw Ty the following Monday. Eckert recalled Amadi’s alarm: “He said, ‘This boy is having surgery today.’ Ty was wheeled into the operating room around 11 p.m.”

Ty’s youthful bones had healed quickly, and in doing so, had grown over the displaced ocular muscle, causing double vision. Amadi had to re-break bone and release the muscle. But scar tissue had formed on the muscle, robbing it of elasticity.

“Dr. Amadi is so good, and was so kind to us,” Eckert said. “We were alarmed and yet comforted at the same time. He explained everything and seemed genuinely concerned with Tyson’s welfare.”

Ty’s injured eye sustained permanent damage — it can’t track up or down — but his double vision went away.

“If it weren’t for doctors like him, who knows?” Eckert said of Amadi. “He needs to keep doing what he’s doing, because it makes a difference.”