One Graham's View

Friday, January 12, 2007

New year means new hopes for OGV

Good evening,

Soon, I’ll be undergoing a surgical procedure that will affect the rest of my life in one of two ways. Ever since my life changing accident thirteen years ago, I have had to deal with a nerve condition called Foot Drop. From the injury I received in my right knee, I damaged the sciatic nerve and it no longer works to raise the foot. Whenever I take a step with that foot, I have to raise the leg higher than usual because the foot cannot raise itself-- hence, the condition’s name.

I have worn an assistive brace on this foot for the past thirteen years that helps raise the foot when I walk, but, while it helps me walk safely, it has its downside as well. The brace, called an ankle-foot orthesis or AFO, is L-shaped and hinged with springs to assist in lifting the foot when I walk. It is kept in place by a velcroed strap at the top of the device, which goes around the top of my calf, and another velcro strap that goes over the top of my foot. The straps have to be pulled very tight to keep the AFO in place and this means that it can get uncomfortable after a long period, especially the one that goes across the top of my foot.

One more thing is that the brace causes my shoe size to go up on that one foot. This translates into buying two pairs of shoes every time I buy new shoes, one a size 13 to accommodate the AFO and also a size 12 for the other foot. This always leaves me with a pair of shoes that don’t match and that I can’t wear.

A recent Houston Chronicle article told about a University of Texas lineman who had received a similar injury in an auto accident that left him with foot drop. The first prognosis was that he would be lucky to ever walk again, and they offered virtually no hope that he would ever play football again. He and his family would not take no for an answer and he was able to connect with another doctor who had pioneered a procedure where a tendon is transplanted from a cadaver. This young man underwent a tendon transplant to restore mobility to the leg with Foot Drop and he played his senior year at full tilt this past fall.

After reading this news story, I followed his medical trail by contacting the doctor who had performed his surgery. That doctor’s nurse told me that I was not a candidate for that surgery, as it had to be performed within six months of the injury. Being I was thirteen years out from my injury, I told her I understood. She did, however, recommend another surgery that may offer hope for me and referred me to a specialist who performed this procedure.

Before I called the doctor’s office, I figured I should do my homework and see what this doc was about. It turned out that he is an ankle/foot specialist who works with many of the Houston Rockets and Dynamo, our professional basketball and soccer teams respectively, as well as the Houston Ballet. I figured if these professionals can trust their million dollar feet to this man, then I should be able to do the same. So, I called a made my appointment.

On the phone, I asked his clerk if she knew of any time line within which the surgery had to be performed. She said she didn’t know of any and that the doctor had performed the operation on some people several years after their initial injury. I told her mine was thirteen years ago and she said, “Oh. I don’t think anybody has been that long after their injury. But, come on in and let’s see what the doctor says.”

I went in to see the doctor to see if I was actually a candidate for this procedure. He checked out the foot and asked about my medical history. He said the key is that the muscle tissue has not been damaged and mine appeared to be intact.

He also explained the procedure to me. He said the sciatic nerve comes down to the foot and splits into two tendons, one goes to the inside of the foot and the other to the outside. The inside tendon causes the muscles there to push the foot down and pullit inside. The outer tendon raises the foot and pulls the foot outward. He said my outer tendon is not working and that this procedure takes the good tendon and transfers it to the other side to work the muscles. This explains why the muscles must be intact. He also said that the inside has other muscles and nerves that will continue to work to support the muscles without the moved tendon so there will be no lapse in strength what has been the strong side of the foot.

He deemed me a good prospect for this surgery, but cautioned that this isn’t a guarantee. They are having an 80-85% success rate with this surgery. I reasoned that if I didn’t have the surgery, I would be wearing the AFO for the rest of my life. So, if I happen to be in the 15-20% of the cases where this doesn’t work, I’m no worse off than if I didn’t have it. I told the doc I had one question: “Where do I sign up?”

That was right after Thanksgiving. I had my pre-surgery physical this week and will have the operation in a week and a half. The doctor who performed my physical is also another one associated with professional athletes. According to his Methodist Hospital web site, he is the team physician to the Houston Texans, Rockets, and Astros. Borrowing a sports metaphor, I’m batting a thousand when it comes to lining up quality physicians.

The procedure will take about an hour and a half. I’ll go home in a cast that same day and cannot bear weight for two weeks. Following this, I will wear a cast for another six weeks. After that, I will still wear the AFO for another 12-18 months while the muscles in the foot build up. The doctor told me that these muscles strengthen very slowly, so to be patient. Wearing the AFO will protect the newly formed connections that will allow the nerve to innervate the muscle and make my foot operate as it is supposed to.

As you can probably guess, I’m excited about the prospect of what this can mean for me. I live with some moderate pain every day. Its just something I thought I’d have to live with and have learned to tolerate the discomfort. From the time I get up in the morning to the time I lie down at night, I deal with discomfort and am constantly repositioning my foot throughout the day so that I can find some level of comfort. I hadn’t even thought about how much I did this until I read that article.

When I discussed this procedure with my various family members, I told them that, due to the pain, this Foot Drop bothered me more than being blind. Think about it. Being blind doesn’t hurt…unless I run into something. The Foot Drop causes me a constant pain daily. Besides, having the ability to fully use my foot will give me stability I have not known since being blinded.
I’ve had three surgeries since I left the Lubbock hospital in January of 1994. Two of these were to repair bone/joint problems that occurred from the same knee injury that damaged the sciatic nerve and caused the Foot Drop. Perhaps I’m minimizing how much these surgeries meant when they took place, but I don’t think I was as excited about getting any of those like I am about this procedure. Maybe that has to do with the settling I’ve done with for so long just to walk.

And, don’t worry too much about me. Mom is coming down for a spell to help out while I’m at the non-weight bearing stage. I’ve got a ball of energy named Austin and an equally energetic hound that will need some things I won’t be able to give them for a little while. Maybe I’ll be able to play on her sympathies and talk her into cooking one or two of my favorite meals that she makes.

I’ll be back with more after the surgery and keep you up on how I’m progressing.

Till I get back, stay safe and, with the coming cold front threatening to bring sleet and ice even to the Bayou City, stay warm out there!



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