Almost immediately, everything went in slow motion.
Seconds after diving into the Allegheny River, Sydney Angelo’s head hit bottom.
She couldn’t feel anything.
Angelo floated to the top. Around her, above her, the world crawled to a terrifying, stagnant pace.
“I was like a dead body floating in the water,” she recalled. “I had no control of anything.”
Angelo, 22, had dislocated her spine. She hadn’t realized that the water below her was no more than 3 feet deep.
On that summer night on July 13, all she wanted to do was go after a raft she’d bought at a Dollar Store. It had drifted away from the banks of the North Shore when she dove in after it. At that moment, her life would take a detour she had never expected. It was like time had stopped. And her life, once filled with hiking, swimming and the busy clip of a millennial lifestyle, seemed to be deflating.
Her body stopped moving. Her brain did not.
It told her she was in danger.
“My face was still in the water so I thought I was going to drown,” she said.
Within seconds, a friend jumped in and grabbed her. He carried her into her truck and rushed her to UPMC Mercy a couple of miles away.
From the hospital, a friend delivered the news to Angelo’s mother, Barb: Sydney dove into shallow water and can’t move her body, he told her.
“You can’t believe the words you’re hearing,” Barb Angelo, 59, of Robinson would say later. “That’s something that a parent never wants to hear.”
She hurried to the hospital, where she tried to absorb the details: Her daughter’s spinal cord had been pinched between two bones forced out of alignment by the impact. There wasn’t really a fracture, but nothing was holding her C3 and C4 vertebraes together.
The injuries had caused tremendous damage to Angelo’s central nervous system. When the spinal cord becomes damaged so high up in the spine, it disrupts movement of the limbs and the ability to breathe.
About 17,000 people in the United States suffer spinal cord injuries every year, according to the National Spinal Cord Injury Statistical Center. Vehicle crashes are the leading cause for the injuries, followed by falls, gunshot wounds and diving accidents.
UPMC neurosurgeon Nduka Amunkulor told the family it was one of the worse injuries he had ever seen. Angelo would have a 1 to 5 percent chance of ever walking or feeling again.
For Barb Angelo, the grief was unimaginable.
“You never want to see your kid suffer,” she said.
Quick action by surgeons
When Barb Angelo first saw her daughter after the accident, lying in a gurney in Mercy’s emergency room, Sydney’s face was still caked in mud from the river.
“I’m scared, mom,” Sydney whispered. “I don’t want to be paralyzed.”
Barb Angelo grabbed her daughter’s hand. Together, they prayed the “Our Father.”
“It was the most beautiful ‘Our Father’ I ever prayed, just seeing her lips move,” she said. “She was so scared.”
It didn’t help that, from the very beginning, doctors didn’t have anything positive to say. Every time someone gave them an update, they cried.
“She obviously had a severe force to her head,” said Dr. David Kaufmann, a UPMC Mercy neurosurgeon who operated on Angelo. “All the weight of her body got transmitted to her spine when she hit her head, unfortunately.”
The force was so severe, it dislocated the third and fourth vertebraes near the base of her neck. Her spinal cord, typically known as the highway for communication between the body and the brain, became compressed between the two bones.
As soon as doctors discovered this, they had to act quickly: getting the pressure off the spinal cord was crucial. The longer it is pinched, the greater the chance for ongoing nerve injury. Something that may have been reversed could become irreversible, Kaufmann said.
Angelo would have two surgeries within 48 hours. The first, to realign her spine, would happen at 2 a.m. on the day after the accident.
Amunkulor inserted pins into the bones of Angelo’s skull to hold her head in position. That allowed him to reduce the dislocation and perform a stabilization procedure by placing screws into the upper bones of her spine.
The next day, Kaufmann put a bone graft between the two vertebraes to make sure things held together in the long run. If the bones don’t fuse, he said, the screws and rods can loosen and fail.
Angelo spent the following two weeks in Mercy’s trauma unit, oblivious to what was happening — unaware of the tube lodged in her throat, and the heavy doses of pain killers coursing through her veins.
If anyone could endure the physical and mental challenges of a spinal cord injury, it would be Angelo, her family said.
Sitting on her daughter’s hospital bed, inches away from her wheelchair, Barb Angelo described the youngest of her three children as a tomboy.
“She is special,” she said, holding back tears. “I don’t want to cry. … She just is. … You just want to be around her. She is upbeat. She wants to try new things and she is adventurous.”
Five years ago, Angelo joined the Army Reserves, before the start of her senior year at Montour High School. The experience of going through boot camp was brutal, she said.
“Every day you’re facing a new obstacle,” she said. “You may be rappelling off a 40-foot wall, or you’re going through a gas chamber. It’s testing your body through new limits every day. If you’re not mentally fit, you’re not going to be able to succeed.”
The accident was undoubtedly worse than boot camp, she said.
She can no longer do the things most people take for granted. She can’t move her arms to use her cellphone. She can’t feed herself. She can’t dress herself. Someone else has to take her to the bathroom, bathe her, brush her hair.
Instead of backpacking or working behind the counter at REI, where she had been employed since January, she goes to rehabilitation sessions that take up most of her day: two hours of occupational therapy and two hours of physical therapy.
She is constantly surrounded by people. Nurses wake her at 6 a.m. to take her vitals. Therapists wheel her to the shower. Friends drop by with take out, sometimes spoiling her with meals from Butcher & the Rye and Umami.
While strapped to an exercise bike on a recent Sunday, she managed to increase her level of exercise. One day it took her 20 minutes to travel just over a quarter of a mile on the bike’s first level. The next day she jumped to the bike’s third level and did a half a mile in the same amount of time.
“They push me, and I love it,” she said.
In her room at Mercy, not far from where Steelers linebacker Ryan Shazier received treatment for a spinal injury in December, pictures of a vibrant Angelo cover a wall across from her bed.
The pictures give everyone a reminder of Angelo’s life: her senior picture wearing an Army Reserves uniform; at her sister Alex’s wedding; sitting with her Pappy.
Angelo says she can feel everything, a couple of places more than others.
She can move her legs upward, she can shrug her shoulders, and she can slightly move her fingers.
When asked if she’s in pain, she’s quick to answer yes — mostly in the back of her neck and her shoulders.
Yet she remains optimistic, laughing with her friend Hannah and joking with her mother, even as they recalled the accident, which happened on a Friday the 13th.
“You don’t like 13 any more do you mom?” she ribbed her mother.
The laughs and jokes are a crucial part of her recovery.
“You have to pay attention to the mental state of the patient to make sure they stay positive and motivated,” Kaufmann said.
Angelo relives the accident every day, but focuses on moving forward.
“Getting better is my number one priority,” she said. “Being sad isn’t an option. You have to be strong.”
The ultimate goal is to walk again. Kaufmann said it can take up to a year — or longer — for patients with spinal cord injuries to improve to the best of their ability. Angelo has two advantages: her young age and her top physical condition prior to the accident. She regained so much strength in her legs last week, it prompted Kaufmann to say he anticipates she’ll eventually walk independently. But her arms and hands remain weak and she has trouble balancing when therapists lift her from her wheelchair to stand with a walker.
“It’s impossible to look far down the road — there are too many variables,” Kaufmann said.
The uncertainty scares Angelo.
“What if my arms don’t come back? Or what if I’m making such great progress now and what if I plateau?” she asked.
One thing the family knows: Angelo will eventually have to leave the comfort of the unit at Mercy, where therapists, nurses, doctors and other professionals keep a close eye.
She won’t go back to her South Side apartment, which has already been vacated. The plan is to move her to her mother’s two-story house. Before that happens, the house will need extensive remodeling to accommodate a wheelchair and other physical needs.
“Her spirit is so beautiful and she has so many friends and family praying for her that, really, I feel like deep inside that she’ll soar to heights that you or I can’t experience because she’s been to the lowest low,” Barb Angelo said. “You can’t get to the highest high if you haven’t been to the lowest low.”
“That’s motivational,” her daughter interrupted.
“It’s the truth,” her mom replied.
Angelo envisions a future in which she can help others who’ve experienced similar injuries, or even a career as a nurse. The Army boot camp more than prepared her. She recognizes that, even with the support of family and friends, a lot of what happens next will rest within herself.
“Things aren’t handed to you,” she said. “You go to do it yourself. I try to look at it as, ‘This happened to me and I’m alive.’ I’m supposed to do something greater.”
Luis Fábregas is editor of the Tribune-Review’s Valley News Dispatch and Pittsburgh digital editions. You can contact Luis at firstname.lastname@example.org or via Twitter @LuisTrib.
Sydney Angelo, 22, of Pittsburgh (left) laughs with Sarah Hershberger, physical therapist for UPMC at Mercy, August 25, 2018. Angelo dislocated her spine after diving into shallow water in the Allegheny River.
Sydney Angelo, 22, of Pittsburgh takes a break during physical therapy at UPMC Mercy on Aug. 25, 2018. Angelo dislocated her spine after diving into shallow water in the Allegheny River.
Sydney Angelo, 22, of Pittsburgh (left) laughs with Sarah Hershberger, occupational therapist for UPMC at Mercy on Aug. 25, 2018. Angelo dislocated her spine after diving into shallow water in the Allegheny River.
Sydney Angelo, 22, of Pittsburgh at UPMC at Mercy on Aug. 25, 2018. She dislocated her spine after diving into shallow water in the Allegheny River.