- Andy Sandness met Lilly Ross, the widow ho had agreed to donate her high school sweetheart's face to him
- They had a tearful meeting at Mayo Clinic 16 months after Sandness received a face transplant at the hospital
- Sandness and Calen Ross lived full lives before their struggles consumed them, 10 years and 500 miles apart
- Sandness had attempted suicide in 2006, and lived a decade with a face disfigured from a gunshot wound
- Ross killed himself outside his family home in 2016, when his newlywed Lilly was eight months pregnant
- Lilly Ross agreed to donate her husband's face, as well as his lungs, kidneys and other organs to other patients
Published: 02:30 EST, 10 November 2017 | Updated: 07:14 EST, 10 November 2017
Sixteen months after transplant surgery gave a Wyoming man a new face after living a decade without one, he met the woman who had agreed to donate her high school sweetheart's visage to him.
Standing in a stately Mayo Clinic library, Lilly Ross reached out and touched the face of Andy Sandness, prodding the rosy cheeks and eyeing the hairless gap in a chin she once had known so well.
'That's why he always grew it so long, so he could try to mesh it together on the chin,' she told Andy Sandness, as he shut his eyes and braced for the tickle of her touch on new nerve endings in the face that had belonged to her late husband, Calen 'Rudy' Ross.
The two came together last month in a meeting arranged by the Mayo Clinic, the same place where Sandness underwent a 56-hour surgery that was the clinic's first such transplant.
The medical journey came after tragedy hit both Sandess and the Ross family. Sandness put a rifle below his chin in late 2006 in his native Wyoming and pulled the trigger, destroying most of his face. Ross shot himself and died in southwestern Minnesota a decade later.
Lilly Ross, right, feels the beard of face transplant recipient Andy Sandness during their meeting at the Mayo Clinic, Friday, October 27, in Rochester, Minnestota
Sixteen months after surgery gave Sandness the face that once belonged to Calen 'Rudy' Ross, Sandness met the woman who had agreed to donate her high school sweetheart's face to him, who lived nearly a decade without one.
Lilly Ross wipes a tear from her eye as she talks about her deceased husband, Calen 'Rudy' Ross, on October 27 at the Mayo Clinic in Rochester
For Ross, just meeting face transplant recipient Andy Sandness felt like a huge release _ a way to get past a year filled with grieving, funeral planning, childbirth and gut-wrenching decisions about organ donations from her husband
Lilly Ross, left, shows family photos of her and her husband, Calen Ross, to face transplant recipient Sandness after meeting at a library at the Mayo Clinic
Sandness (left) put a rifle below his chin in late 2006 in his native Wyoming and pulled the trigger, destroying most of his face. Ross (right) shot himself and died in southwestern Minnesota a decade later
With her toddler Leonard in tow, Ross strode toward Sandness, tears welling in her eyes as they tightly embraced.
Ross had fretted before the meeting, fearful of the certain reminders of her husband, who took his own life.
But her stress quickly melted away – without Calen's eyes, forehead or strong cheeks, Sandness didn't look like him, she told herself.
Instead, she saw a man whose life had changed through her husband's gift, newly confident after ten years of hiding from mirrors and staring eyes.
'It made me proud,' Ross said of the 32-year-old Sandness. 'The way Rudy saw himself … he didn't see himself like that.'
Sandness and Calen Ross lived lives full of hunting, fishing and exploring the outdoors before their struggles consumed them, ten years and 500 miles apart.
It was two days before Christmas in 2006 when Sandness reached a breaking point. He'd been sad and drinking too much lately. That night after work while 'super, super depressed,' he grabbed a rifle from a closet.
In 2016, 21-year-old Calen Ross shot himself and died in southwestern Minnesota. His wife, Lilly, was eight months pregnant at the time of his deat
Ross already had agreed to donate her husband's lungs, kidneys and other organs to patients. Then LifeSource, a Midwestern nonprofit organization that facilitates organ and tissue donations, broached the idea of a donation for a man awaiting a face transplant at the clinic
Eight months pregnant at the time, she said one reason to go forward was that she wanted the couple's child to one day understand what his father did to help others
Ross (right, with Lilly) and Sandness' ages, blood type, skin color and facial structure were such a near-perfect match that Sandness' surgeon, Dr Samir Mardini, said the two men could have been cousins
He stared at it for a while, then put a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.
Instantly, he knew he'd made a terrible mistake. When the police arrived, an officer who was a friend cradled him in his arms as Sandness begged, 'Please, please don't let me die! I don't want to die!'
He was rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. He'd shot out all but two teeth. His mouth was shattered, his lips almost non-existent. He'd lost some vision in his left eye.
When he woke, his mother was holding his hand. She'd always been a strong woman but that day, her face was a portrait of unfathomable pain. The bullet had obliterated his mouth, so he motioned for a pen and paper.
'I'm sorry,' he wrote.
'I love you,' she replied. 'It's OK.' But all Sandness could think about was how he'd hurt his family – and just wonder what was next.
A decade later, 21-year-old Calen Ross shot himself and died in southwestern Minnesota.
By then, Sandness had receded from contact with the outside world, ashamed of his injuries – surgeries to rebuild his face had left him a quarter-sized mouth, and his prosthetic nose frequently fell off.
Follow his suicide attempt, Sandness rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. He'd shot out all but two teeth. His mouth was shattered, his lips almost non-existent. He'd lost some vision in his left eye
By the time of the sugery, Sandness had receded from contact with the outside world, ashamed of his injuries – surgeries to rebuild his face had left him a quarter-sized mouth, and his prosthetic nose frequently fell off. Sadness is pictured above shortly after his face transplant
Dr Samir Mardini shaves the face Sandness in July 2016, days after leading a team that performed the first face transplant surgery at the hospital
Hope first came in 2012 when the Mayo Clinic started exploring a face transplant program and again in early 2016 when he was wait-listed for the procedure.
ANDY SANDNESS'S SURGERY TIMELINE
Friday, June 10, 2016
10.16am – Rudy arrives at Mayo Clinic
11.53pm – Surgery starts on Rudy
Saturday, June 11, 2016
12.30am: Surgery starts on Andy
Nerves mapped on both Rudy and Andy
Sunday, June 12, 2016
3.14am: Donated face arrives in Andy’s room
4.30am: Bones plated together
6.00am: Vessels reconnected
9.00am: More plates placed on the mandible (jaw bone)
12pm: Problem detected with vessels, fixed by early afternoon
Evening: Nerves reconnected as well as other structures: salivary gland ducts, incisions made in mouth, skin put back and trimmed, eyelids reconnected to new nose
Monday, June 13, 2016
9.02am: Andy leaves OR
Ross already had agreed to donate her husband's lungs, kidneys and other organs to patients. Then LifeSource, a Midwestern nonprofit organization that facilitates organ and tissue donations, broached the idea of a donation for a man awaiting a face transplant at the clinic.
Ross and Sandness' ages, blood type, skin color and facial structure were such a near-perfect match that Sandness' surgeon, Dr Samir Mardini, said the two men could have been cousins.
Ross consented, despite her hesitation about someday seeing her husband's face on a stranger.
Eight months pregnant at the time, she said one reason to go forward was that she wanted the couple's child to one day understand what his father did to help others.
Lilly said she thought: 'He's a donor, and this is my call – we're going to do it.' Because if we could help countless people, why not? That's pretty much why I did it.
'I've been in contact with the liver recipient, I'm friends with the heart recipient on Facebook. There's one guy who got a kidney and a pancreas, we haven't heard anything from him yet; another lady got a kidney, I believe, and then we've not been in contact with the lung recipient. But I sent everybody letters around the same time, they all got pictures.'
She said: 'I knew what needed to be done and I just did what needed to be done' – adding that the process takes several days, as recipients are identified, and it's not an immediate process as often portrayed on medical television drama.
'The process is a long process, but it's worth it,' she says.
More than a year after a surgery that took a team of more than 60 medical professionals, Sandness is finding a groove in everyday life while still treasuring the simple tasks he lost for ten years, such as chewing a piece of pizza.
He's been promoted in his work as an oilfield electrician and is expanding his world while still prizing the anonymity that comes with a normal face.
Ross had fretted before the meeting, fearful of the certain reminders of her husband, who took his own life. But her stress quickly melted away – without Calen's eyes, forehead or strong cheeks, Sandness didn't look like him, she told herself
Ross said that instead, she saw a man whose life had changed through her husband's gift, newly confident after ten years of hiding from mirrors and staring eyes
The medical team that worked with Sandness (pictured above with Ross) have delighted in seeing their patient and friend open up since the procedure, going out of his way to talk with strangers whose gaze he once hid from
'I wouldn't go out in public. I hated going into bigger cities,' he said. 'And now I'm just really spreading my wings and doing the things I missed out on – going out to restaurants and eating, going dancing.'
Life with a transplanted face takes work, every day. Sandness is on a daily regimen of anti-rejection medication.
He's constantly working to retrain his nerves to operate in sync with his new face, giving himself facial massages and striving to improve his speech by running through the alphabet while driving or showering.
'I wanted to show you that your gift will not be wasted,' Sandness told Ross.
Mardini and the rest of Sandness' medical team have delighted in seeing their patient and friend open up since the procedure, going out of his way to talk with strangers whose gaze he once hid from.
'It turns out Andy is not as much of an introvert as we thought,' Mardini said. 'He's enjoying these times, where he's missed out on ten years of his life.'
Last year, Ross wrote to Sandness and the five others who received her husband's organs.
She described Ross, her high school sweetheart, as a 'giving person' who loved hunting, trapping and being with his dog, Grit.
Sandness holds 17-month-old Leonard Ross, the son of the man he received a face transplant from, after meeting at the Mayo Clinic, on October 27
Leonard's mother, Lilly, and Sandness say they plan to forge a stronger connection, and Sandness said he'll contribute to a trust fund for Leonard's education
Andy Sandness, left, gets a hug from Dr. Samir Mardini at the Mayo Clinic on October 27. Over the years, the two say they've become as close as brothers
'I am filled with great joy knowing that he was able to give a little of himself to ensure a better quality of life for someone else,' she wrote.
Lilly was given photos of Sandness before and after the transplant. That's when she learned of uncanny similarities between the two men – not just their passion for the outdoors, but the way they stood in their hunting photos.
'It was amazing how good he looked and how well he's doing,' she previously said of Sandness. 'I'm excited for him that he's getting his life back.'
She also noticed one small detail – a small bare patch in the middle of his bearded chin, just as on her husband's face.
Ross and Sandness say they feel like family now. They plan to forge a stronger connection, and Sandness said he'll contribute to a trust fund for Leonard's education.
On the day of their meeting, the boy stared curiously at Sandness at first. But later, he walked over and waved to be picked up. Sandness happily obliged.
For Ross, just meeting Sandness felt like a huge release – a way to get past a year filled with grieving, funeral planning, childbirth and gut-wrenching decisions about organ donations.
'Meeting Andy, it has finally given me closure,' she said, her voice choking as it trailed off. 'Everything happened so fast.'
FACE TRANSPLANTS: STILL RESEARCH, OR REGULAR CARE?
Is replacing a severely disfigured person's face with one from a dead donor ready to be called regular care, something insurers should cover? Mayo Clinic has raised that question by doing the first U.S. face transplant that's not part of research.
Faces, hands, wombs and even a penis have been transplanted in recent years. Unlike liver or heart transplants, these novel procedures are not life-saving but life-enhancing.
Who pays for care that can cost $700,000 or more is a growing concern. Ethics and liability issues also may arise when they're done without the oversight of an institutional review board, a hospital panel that ensures research participants' rights are protected.
The group that runs the nation's organ transplant system, the United Network for Organ Sharing, plans a conference to help guide policy.
'It's time to come together and really ask the question, 'Is this going to become a standard of care?'' said Dr. Scott Levin, a University of Pennsylvania surgeon who heads the UNOS panel on this.
He has done several hand transplants and no longer considers them experimental, though insurers won't pay. Worldwide, about 100 hand, face or other, newer body-part transplants have been done, and 'that's not a lot of cases' to judge safety and effectiveness for some types, he said.
Andy Sandness' operation last June was Mayo's first face transplant. Worldwide, roughly two dozen have been done, about half of them in the U.S. Four recipients have died.
At Mayo, 'we wanted to do it as a clinical program' and felt there was no research question to be answered because the operation uses standard surgical techniques, said the plastic surgeon who led it, Dr. Samir Mardini. Without a transplant, Sandness would have needed 15 other reconstructive procedures and the cost would be 30 to 40 percent higher, Mardini said.
Hospital management and multiple committees reviewed the case, including an ethics panel, a social worker and transplant psychiatrist, to ensure Sandness knew the risks and was giving informed consent.
'It's critically important that he understand what he would be putting himself through,' Mardini said.
Sandness' insurance company would not agree in advance to pay; so, a fund from a donor to start a hand and face transplant center at Mayo paid. Talks on paying for after-care are ongoing.
The long-term medical and psychological effects will be studied as part of formal research, even though the operation itself was not, Mardini said.
'I don't particularly agree with the argument that it's not research,' said bioethicist Arthur Caplan, who advised New York University on its first face transplant, in 2015.
There's a higher bar to ensuring informed consent for research versus a new therapy, and 'questions about competence, experience and even liability are different' when something is called regular care, Caplan said. 'In my view it's still highly experimental.'
[contf] [contfnew] [hhm]Daily Mail[hhmc] [contfnewc] [contfnewc]
Australia resists calls for tougher climate targets
Australia’s Prime Minister Scott Morrison has resisted pressure to set more ambitious carbon emission targets while other major nations vowed deeper reductions to tackle climate change.
Addressing a global climate summit, Mr Morrison said Australia was on a path to net zero emissions.
But he stopped short of setting a timeline, saying the country would get there “as soon as possible”.
It came as the US, Canada and Japan set new commitments for steeper cuts.
US President Joe Biden, who chaired the virtual summit, pledged to cut carbon emissions by 50-52% below 2005 levels by the year 2030. This new target essentially doubles the previous US promise.
By contrast, Australia will stick with its existing pledge of cutting carbon emissions by 26%-28% below 2005 levels, by 2030. That’s in line with the Paris climate agreement, though Mr Morrison said Australia was on a pathway to net zero emissions.
“Our goal is to get there as soon as we possibly can, through technology that enables and transforms our industries, not taxes that eliminate them and the jobs and livelihoods they support and create,” he told the summit.
“Future generations… will thank us not for what we have promised, but what we deliver.”
Australia is one of the world’s biggest carbon emitters on a per capita basis. Mr Morrison, who has faced sustained criticism over climate policy, said action to reduce greenhouse gas emissions would focus on technology.
The prime minister said Australia is deploying renewable energy 10 times faster than the global average per person, and has the highest uptake of rooftop solar panels in the world.
Mr Morrison added Australia would invest $20bn ($15.4bn; 11.1bn) “to achieve ambitious goals that will bring the cost of clean hydrogen, green steel, energy storage and carbon capture to commercial parity”.
“You can always be sure that the commitments Australia makes to reduce greenhouse gas emissions are bankable.”
Australia has seen growing international pressure to step up its efforts to cut emissions and tackle global warming. The country has warmed on average by 1.4 degrees C since national records began in 1910, according to its science and weather agencies. That’s led to an increase in the number of extreme heat events, as well as increased fire danger days.
Ahead of the summit, President Biden’s team urged countries that have been slow to embrace action on climate change to raise their ambition. While many nations heeded the call, big emitters China and India also made no new commitments.
“Scientists tell us that this is the decisive decade – this is the decade we must make decisions that will avoid the worst consequences of the climate crisis,” President Biden said at the summit’s opening address.
Referring to America’s new carbon-cutting pledge, President Biden added: “The signs are unmistakable, the science is undeniable, and the cost of inaction keeps mounting.”
Read from source: https://www.bbc.com/news/world-australia-56854558
Sydney seaplane crash: Exhaust fumes affected pilot, report confirms
The pilot of a seaplane that crashed into an Australian river, killing all on board, had been left confused and disorientated by leaking exhaust fumes, investigators have confirmed.
The Canadian pilot and five members of a British family died in the crash north of Sydney in December 2017.
All were found to have higher than normal levels of carbon monoxide in their blood, a final report has found.
It recommended the mandatory fitting of gas detectors in all such planes.
British businessman Richard Cousins, 58, died alongside his 48-year-old fiancée, magazine editor Emma Bowden, her 11-year-old daughter Heather and his sons, Edward, 23, and William, 25, and pilot Gareth Morgan, 44. Mr Cousins was the chief executive of catering giant Compass.
The family had been on a sightseeing flight in the de Havilland DHC-2 Beaver plane when it nose-dived into the Hawkesbury River at Jerusalem Bay, about 50km (30 miles) from the city centre.
The final report by the Australian Transport Safety Bureau (ATSB) confirmed the findings of an interim report published in 2020.
It said pre-existing cracks in the exhaust collector ring were believed to have released exhaust gas into the engine bay. Holes left by missing bolts in a firewall then allowed the fumes to enter the cabin.
“As a result, the pilot would have almost certainly experienced effects such as confusion, visual disturbance and disorientation,” the report said.
“Consequently, it was likely that this significantly degraded the pilot’s ability to safely operate the aircraft.”
The ATSB recommended the Civil Aviation Safety Authority consider mandating the fitting of carbon monoxide detectors in piston-engine aircraft that carry passengers.
It previously issued safety advisory notices to owners and operators of such aircraft that they install detectors “with an active warning” to pilots”. Operators and maintainers of planes were also advised to carry out detailed inspections of exhaust systems and firewalls.
Read from source: https://www.bbc.com/news/world-australia-55862128
Australia unlikely to fully reopen border in 2021, says top official
Australia is unlikely to fully open its borders in 2021 even if most of its population gets vaccinated this year as planned, says a senior health official.
The comments dampen hopes raised by airlines that travel to and from the country could resume as early as July.
Department of Health Secretary Brendan Murphy made the prediction after being asked about the coronavirus’ escalation in other nations.
Dr Murphy spearheaded Australia’s early action to close its borders last March.
“I think that we’ll go most of this year with still substantial border restrictions,” he told the Australian Broadcasting Corporation on Monday.
“Even if we have a lot of the population vaccinated, we don’t know whether that will prevent transmission of the virus,” he said, adding that he believed quarantine requirements for travellers would continue “for some time”.
Citizens, permanent residents and those with exemptions are allowed to enter Australia if they complete a 14-day hotel quarantine at their own expense.
Qantas – Australia’s national carrier – reopened bookings earlier this month, after saying it expected international travel to “begin to restart from July 2021.”
However, it added this depended on the Australian government’s deciding to reopen borders.
Australia’s tight restrictions
The country opened a travel bubble with neighbouring New Zealand late last year, but currently it only operates one-way with inbound flights to Australia.
Australia has also discussed the option of travel bubbles with other low-risk places such as Taiwan, Japan and Singapore.
A vaccination scheme is due to begin in Australia in late February. Local authorities have resisted calls to speed up the process, giving more time for regulatory approvals.
Australia has so far reported 909 deaths and about 22,000 cases, far fewer than many nations. It reported zero locally transmitted infections on Monday.
Experts have attributed much of Australia’s success to its swift border lockdown – which affected travellers from China as early as February – and a hotel quarantine system for people entering the country.
Local outbreaks have been caused by hotel quarantine breaches, including a second wave in Melbourne. The city’s residents endured a stringent four-month lockdown last year to successfully suppress the virus.
Other outbreaks – including one in Sydney which has infected about 200 people – prompted internal border closures between states, and other restrictions around Christmas time.
The state of Victoria said on Monday it would again allow entry to Sydney residents outside of designated “hotspots”, following a decline in cases.
While the measures have been praised, many have also criticised them for separating families across state borders and damaging businesses.
Dr Murphy said overall Australia’s virus response had been “pretty good” but he believed the nation could have introduced face masks earlier and improved its protections in aged care homes.
In recent days, Australia has granted entry to about 1,200 tennis players, staff and officials for the Australian Open. The contingent – which has recorded at least nine infections – is under quarantine.
Read from source: https://www.bbc.com/news/world-australia-55699581
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