A New Hampshire nurse horribly disfigured when she was sprayed with lye has a new face and renewed outlook on a life doctors feared was near its end when she first reached the operating table in 2007 after a brutal attack.
Carmen Blandin Tarleton waited more than a year before doctors found a suitable donor whose family agreed to donate the facial and neck tissue needed for the 17-hour procedure earlier this month at Brigham and Women's Hospital in Boston.
"This greatly improves my quality of life and my physical comfort level," Tarleton said in a statement read by her sister during a news conference Wednesday. "This is a momentous opportunity in my life and I want to convey to the donor's family what a great gift they've given me."
The hospital said Tarleton was watching the live webcast of the news conference at Brigham and Women's, which included the lead transplant doctor.
"I am so grateful for all that have been watching over me with such tenderness and loving care," Tarleton posted in a blog entry Wednesday. "I know how truly blessed I am, and will have such a nice reflection in the mirror to remind myself what selfless really is."
Tarleton was referring to the anonymous donor and her family, who needed to give official consent to allow the tissue to be used. Registering as an organ and tissue donor on a driver's license is not accepted as consent when it comes to face transplants. In order to protect the donor family's identity, doctors would not give the exact date of the transplant.
Thrilled with results
Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women's, said doctors were able to control an early episode of tissue rejection. He said he is confident Tarleton is progressing toward the next stage in her recovery — typically 10 to 14 days after the surgery, when nerves regrow and the face gradually regains function.
So far, doctors and patient are thrilled with the results.
"She was very pleased and I think probably the very most immediate reactions were actually from the family when we brought her to the intensive care unit for the initial couple of days," Pomahac said. "I think she looks amazing, but I'm biased."
A long battle
Tarleton, of Thetford, Vt., was a nurse at Dartmouth-Hitchcock Medical Center in Lebanon when her estranged husband brutally attacked her June 10, 2007, hitting her with a baseball bat, then dousing her with the highly corrosive chemical lye. The attack left her blind, with burns over 80 percent of her body. She was initially treated at the hospital where she worked, then transferred to Brigham and Women's.
"Her injuries were among the worst I've seen in my career," Pomahac said. "She was unrecognizable to anyone who know her. Our expectations for Carmen's survival were low but Carmen is a fighter — and fight she did."
Tarleton spent three months in a medically induced coma as doctors performed 38 surgeries trying to repair what damage they could. There were another 17 operations over the next five years, including a cornea transplant that led to limited use in one eye, but Tarleton remained in constant pain, her face a grisly mass of scar tissue.
"Despite all of our best efforts, Carmen was left as you see in this image, severely disfigured and in constant, everyday pain," Pomahac said, pointing to a pre-transplant photo of Tarleton.
Recovery was limited and painful, but Tarleton continued to push through it. She appeared in a Vermont courtroom and gave a statement Feb. 11, 2009, before ex-husband Herbert Rodgers was sentenced to a prison term of 30 to 70 years after pleading guilty to a charge of maiming.
Tarleton's nursing career had included some transplant work. When Pomahac first approached her about the possibility of a face transplant, further complicated by the dozens of surgeries, blood transfusions and skin grafts, she had no qualms.
"Carmen's response was the same as it has been since the first time that we spoke," Pomahac said. "She's tough. She will do what needs to be done. She wants to live her life to the fullest."
Tarleton was approved for a face transplant on Dec. 5, 2011. In February, a viable donor was identified and the family gave its consent. Doctors started the 15-hour procedure connecting vessels, arteries and nerves, then working their way out to the skin.
Pomahac said it could take more than a year before Tarleton reaches whatever facial function she will have. He said she should not expect to look like her former self, nor like the woman whose death has already dramatically changed Tarleton's life.
The woman's family also provided a brief statement Wednesday, saying her organs were also given to three other patients in need of transplants.
"While we are heartbroken at the loss of our beloved mother, sister and friend, we are comforted by the fact that she chose to be an organ and tissue donor. In a life defined by kindness and caring for others, she has given the gift of life to four people."
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