Stephanie Nielson's Story: After Tragic Crash, Mom of Four Nearly Lost It All

May 12, 2011 — -- Stephanie Nielson loved being a mom, calling it her "divine purpose" in life. The beautiful mother of four shared her joy in her blog, the Nie Nie Dialogues, an unabashed celebration of motherhood with fans the world over.

But a plane crash left Stephanie, then 27, so injured and disfigured that it threatened to forever change her relationship with her children. At first, they couldn't even look at her. Stephanie began to wonder if they would be better off without their mom.

"I felt guilty that I didn't look like the mother that I was," she said. "I thought it would be easier if everyone just sort of forgot about me."

See photos of Stephanie Nielson and her family here and watch the full story on the latest episode of "20/20."

The crash happened on Aug. 16, 2008. Stephanie and her husband Christian had gone off on a day-long joy ride from their Mesa, Ariz., home to New Mexico in a small Cessna airplane while Christian's parents babysat the children. Christian, a licensed pilot, was flying the plane that day alongside his friend and flight instructor, Doug Kinneard. After a fuel stop in New Mexico, trouble struck just after liftoff and the plane went into a stall. The Cessna fell from the sky, smashing through powerlines, barely missing some homes. It careened out of control across the pavement and erupted in flames, leaving Kinneard and the Nielsons badly burned.

Read the 20 tips for surviving a plane crash from "20/20" here.

Medivac helicopters raced all three to the Arizona Burn Center at Maricopa Medical Center in Phoenix, but Kinneard's injuries proved overwhelming. The husband and father of four died at the hospital.

Both Stephanie and Christian Nielson were put into medically-induced comas. Stephanie Nielson's burns were so widespread that family members said they could only recognize her feet.

"The only thing that... resembled our sister was her red toenails," said Stephanie Nielson's sister, Courtney Kendrick. "That's the only way we knew."

Jaimee Rose, a reporter with the Arizona Republic, and photographer Cheryl Evans, spent months reporting on Stephanie Nielson and her family. View the series and Evans' photographs here.

Doctors said the prognosis for both Christian and Stephanie was not good. But the family, including Christian Nielson's father, believed otherwise.

"I said, you know, you're going to see a miracle," Russell Nielson said. "You're going to see something you've never seen before."

Indeed they did. After five weeks, Christian was awake and recovering.

Rousing Stephanie would take much more time.

For three months, she slept in a cocoon of gauze and tubes, undergoing countless procedures, growing new skin and healing from the crash. Finally, it was time to wake her.

Her first memory, she said, seeing "November 5th" written on a white board. Later, she saw her own body.

"I remember them doing a dressing change. And I remember looking, looking at my body, looking at my hands, uh, and my legs, it was burned, and it was black and swirly with pinks and purples and I couldn't even comprehend what my face looked like," she said.

It took her five weeks after waking up to finally look at her own reflection. Her face, as she feared, was completely transformed. Gone were her eyebrows, her bee-stung lips and her trademark freckles.

She examined her new face with a small hand mirror.

"I did it slowly, started with my lips, and went up to my head, and just sort of kind of took it all in piece by, piece by piece," she said. "It was hard, it was so hard ... but I saw my eyes, and I had eyes, and my eyelashes were there. And so I, I still felt like, you know, I, I was there."

Stephanie's new face and body were the result of months of surgeries and skin grafts by Dr. Daniel Caruso, director of the Arizona Burn Center, and Dr. Salvatore Lettieri, Stephanie's plastic surgeon.

Reuniting With Her Children

The burns on her face were so bad, doctors said, that they had to cut all the skin away. They employed a process known as excision, in which all the burned skin is removed and raw muscle and tissue are left behind. Then, a layer of cadaver skin is added to the open wounds, tricking the body into thinking it is new skin.

"It actually starts to heal a little bit. It allows the body to retain some of the moisture that it otherwise would be just overwhelmingly losing," Lettieri said.

Eventually, they used her own skin -- the few parts that weren't burned, including her scalp, inner arm and back -- to replace the cadaver skin and graft it on to the wounds. In other areas, they used cultured skin grown in a lab in Boston.

The lab would "send us a little rectangle, about 60, 70 square centimeters, at about $2,000 a sheet," Caruso said. Doctors used some 150 sheets on Stephanie.

As the patchwork of skin healed, it created thick, tender red scars that made movement painful. But the most excruciating part of Stephanie's awakening was yet to come.

At the time of the crash, all of Stephanie's children were under the age of 7. For four months, they had lived with family and Stephanie had missed the things she loved most as a mother -- birthdays, the first day of school and Halloween.

Their reunion was bittersweet.

The first to walk into the hospital room was Jane, her younger daughter. The girl was speechless when she saw her mother.

"I was like, 'Hi Jane.' And then I just will never forget her look that she gave me...And then she put her head down. She wouldn't look at me for the rest of the time. I wanted to die," Stephanie remembered. "It was awful to not have your own daughter not want to look at you just felt very, word, words just don't even describe that feeling."

Stephanie's older daughter, Claire, would only talk to her mother through a curtain.

There was more heartbreak to come; while Stephanie's older son, Oliver, greeted her calmly, her youngest child -- Nicholas, who was just 18 months-old at the time of the crash -- didn't know her. Stephanie's sister Lucy Beesley had been caring for Nicholas and he now called her "mom."

Nicholas, Stephanie said, would cry for his mom.

"I was like, 'That's me! You know, but I can't touch you, because my body hurts,'" she remembered. "It was awful."

Stephanie said the rejection by her own children and the limitations imposed by her injuries were almost too much to bear. She said she couldn't do all those little things that mattered so much.

"Just combing my daughter's hair, putting a little bow in her hair, or building blocks with my son, just simple things that mothers take for granted every single day... And I couldn't do it," she said. "So once those little things were taken away, it felt like my life was gone."

Stephanie's family pushed her to fight, just as she had fought for her life in the hospital. And her blog fans lent their support too, in jaw-dropping numbers: thousands of mommy bloggers, Stephanie's family said, spread word about the crash and donations poured in from around the globe. Stephanie's fans held garage sales, balloon launches and even benefit concerts. Support poured in from around the globe, including China and Australia. In all, a startling $250,000 was raised to help the family.

That outpouring notwithstanding, it was advice from Stephanie's father, she said, that finally helped her turn a corner.

"He was telling me, you know, 'This is just this in your recovery. You know, you won't be walking like this forever. And your face is going to get better...And look at this beautiful family you created. You can't just give up on them. And you're a mother, that's your job, that's what you want to do. And do it.'"

And she did, winning back her children in the process. By her third visit to the hospital, her daughter Claire was ready to talk without the curtain.

"She said, mom, I lost my tooth. I said, come show it to me," Stephanie remembered. "You know, so she finally came in with the tooth in her hand, and you know, looked at me, and we smiled, and we laughed like we used to."

Read Stephanie Nielson's blog, the Nie Nie Dialogues, and learn more about her long road to recovery on "20/20" Friday at 10 p.m. ET.