Surgery Update

Last week’s operation to clean up Suzanne’s right leg scar tissue went well. The procedure took approximately two hours and resulted in a single night stay at the hospital. She was happy to be home for Gabby’s birthday on the 30th. Today the stitches were removed and she has been ordered to remain off her legs for another 2-3 weeks pending another follow-up. They were not able to remove all of the area causing the irritation, so they’re going to want her back in early January to finish cleaning up the scar tissue on that side. In the meantime, tomorrow is her birthday.

Driving & Operating

Suzanne will be going to the NRH next week for driver training. She was there a few weeks ago for an evaluation, to determine whether her motor skills were sufficient enough to proceed to the next level. They are. So she will be getting behind the wheel again to drive for the first time in two years. The photo here was on August 24th, when the evaluator was demonstrating the various equipment needed to drive without legs. Based upon his initial assessment, he is confident that she will be able to drive as well as she ever did, after a few lessons. Sue will need to have one of the cars outfitted and complete a test at the DMV before she’s “Street Legal.”

On September 29th, Suzanne has another surgery scheduled on her right leg. This is the first surgery in over a year, and it has been a long time coming. The goal will be to remove skin graft scar tissue and smooth out the wound on the end of that leg. This should increase the comfort and fit of her prosthesis, and reduce the leakage from the wound and sharp pains she experiences when standing. She is expected to be in the hospital for 2-3 nights following the surgery – just in time for Gabby’s second birthday.

August 17, 2009

Suzanne just returned from her last scheduled physical therapy at the NRH. They are confident that she has the tools and determination to take what she has learned at the NRH to use with a local therapist; the commute will not be missed. There has still been no news on the pending right leg revision, which would address the pain and discomfort on that side. However we have heard rumors that it may be late October.

On a different note, an article just appeared in the Daily Mail (UK) about an elephant, in Thailand, who has received an artificial leg after having stepped on a landmine. The story is here.

August Update

To update you on the “Walk With Suz” scheduling, the intended date was going to be slated for some time in October of this year. However, this has been pushed to the spring, at the earliest. We had hoped that Suzanne’s healing would have progressed a little more steadily. But due to continual changes in the shape of her right leg, in particular, the fit and function of the prostheses is greatly diminished. As a result she has had a lot of discomfort when standing and walking. The scar tissue on the lower right leg is still not completely healed, from her last operation, August 26th of last year. She has met several times with her prosthetist for adjustments. But they are temporary measures that only last a short time. Her surgeons have tentatively scheduled her for a September revision surgery, but no date has been selected. And it is subject to change based upon the number of urgent care surgeries which take priority. As a result, Suzanne, has been discouraged lately by the lack of progress. But she has begun to put in a few hours per week on the phone for work. The increased responsibility is helping sharpen her mind and distract her from the pain and discomfort of the legs.

In other news, there have been several recent articles highlighting some of the great strides other amputees have made lately.

Double amputee loses legs, finds a cause; CNN

Amputees complete 500-mile transcontinental bicycle journey; Daily Journal, Vineland, NJ

Nearly 50 physically-challenged athletes compete in para-triathlon; Daily Herald, Chicago

Also, Suzanne credits much of her recovery to a sepsis drug called Xigris. There is another drug in the works right now. Here are some details:

AstraZeneca pushes ahead sepsis drug; Reuters

Best Foot Forward

We recently came across an article in the Boston Magazine, about an inventor who built himself robotic legs after having his own amputated due to frostbite from a Mount Washington hike gone awry. With his original prosthetics, he returned to mountain climbing and made an important discovery.

“He was later fitted with a pair of acrylic legs, and one day, several months after the surgery, he took his legs and some tools and headed for the mountains near Lancaster… He noticed his body got colder and achier as he climbed but his legs did not. He was able to move faster and higher than before, in part because the amputations had left him 14 pounds lighter. And up there on the mountain that day, Herr made a leap that changed his life and may someday change yours: Why can't fake limbs outperform real ones?"

The story is incredible and a the article highlights his leaps from a small college in Pennsylvania to MIT and Harvard, to a grant for 7M from the US Government to develop his designs further. Well worth the read.

Regarding Suzanne's progress, she has been continuing with her therapy at the NRH and is meeting tomorrow with her prosthetist to adjust the fit and comfort of her right socket. It has now been 11 months since she had her last leg operation and it has not been an easy journey. Due to an ever-adjusting shape and fit, her right leg has never been comfortable enough to sustain prolonged wearing and walking. And without the confidence to walk unassisted for extended periods, the hand revisions have also been delayed. Suzanne is in good spirits, though and looking forward to Gabby's second birthday.

Dateline MSNBC Article from Last Night.

Visit msnbc.com for Breaking News, World News, and News about the Economy

Links from the program: Challenged Athletes; Team Cody

Continued Therapy

Suzanne has now been to a few physical and occupational therapy sessions. One exercise she had to complete was balancing on one leg, while the other rested upon and manipulated a grapefruit sized ball. While it may seem easy at first, the exercise demonstrated how the balance normally derived from the calves and ankles needs to be compensated in the hips, thighs and back muscles. Another therapy on her hands, was placing pegs in a pegboard using the thumb and various digits. Due to Suzanne’s inability to touch her thumb to pinky, the task proved exceedingly challenging. The therapy sessions are meant to bring Suzanne back to a baseline level of competency. Many more sessions are planned for the coming weeks.

In other news headlines, here are a few articles which stand out and somewhat related to Suzanne’s situation.

1) Iraq Amputee First Person Fitted With Revolutionary 'Bionic' Legs.

2) First double hand transplant in the US completed.

3) Disabled Vet completes marathon in 13 days.

4) Double amputee faces eviction over medicinal pot.

Back at Home

Suzanne's stay at the NRH lasted a few days longer than we all expected. She was released on Wednesday afternoon, with a promise to her doctors to continue her therapy on her own and as an outpatient. The NRH therapists had her using parallel bars and stair climbers to advance her balance and leg strength. And on Tuesday, Gabrielle, joined her for mother-child independence therapy. Friday she again visited with her prosthetist for further adjustments to her limb sockets. The sturdy fiberglass does not mould to her legs and needs constant tweaking while she is adjusting to the fit.

Next on the agenda will be further revisions to Suzanne's right leg, to remove granular scar tissue and to improve the fit and comfort on that side. Her hands and arms will be addressed as well, in the near future, to remove scar tissue and release some scar-muscle tissue adhesions. However, with that said, things are moving forward and Suzanne has found a new confidence in her ability to walk unassisted with and without a walker. She just needs to build up her tolerance to be able to wear the legs for more than an hour or two at a time, due to the pain and discomfort she is currently dealing with.

Side note: Last night, 60 Minutes aired a segment about DARPA spending $100M+ on technological advancements to artificial extremities. It is posted below.

60 Minuntes Article About Bionic Arms

Watch CBS Videos Online

Sue Returns to the NRH

This morning, Suzanne, checked back into the NRH for a one-week inpatient therapy session. Since receiving her second leg, back in January, she has been without any formal training or rehab, to maximize her ability to walk comfortably. Because of the delay in the approval process, she was permitted to take a two week trip to Wisconsin, with her parents and Gabrielle, where she had more floor space to walk around, aided by the walker, than the townhouse. Approval was granted last week for Sue to return today. There, she is anticipating three, hour-long sessions daily. Interestingly, Suzanne has been assigned the same room where she stayed over one year ago. And having kept in touch with some of her therapists, everyone is arranging schedules so they are able to work with her. Once she has had a chance to learn the best exercises and a therapy regimen, she will make it part of her regular routine at the gym after returning home.

Standing Tall

Today Suzanne received her second prosthetic leg. This is the first time in over 15 months that she has stood upright, on her own. There is a great deal of discomfort in the pair, as she is now putting all of her weight onto her patellar tendons. Over the course of the coming weeks, and after much physical therapy, she should be able to walk unassisted. However for the time being, she has a walker and her wheelchair to get around. We are all very excited about this milestone and look forward to her increased mobility and comfort. (Click Image to Enlarge)

More details about Suzanne's prosthetic feet here and here.

Brazilian Model Dies from Sepsis

A 20-year-old Brazilian model, Mariana Bridi da Costa, whose feet and hands were amputated due to a septic infection has died. Da Costa fell ill on December 30, but was initially misdiagnosed with kidney stones. By the time the cause was detected, she had developed septicaemia from Pseudomonas aeruginosa. This story highlights the rapid deterioration resulting from sepsis and the unfortunate inability of the medical community to recognize the signs and symptoms of this deadly illness. More 1 2 3

Amputee Fights for Coverage of Prosthetics

Good Morning America reported this morning about a Virginia woman, Susan Bailey, who fell ill after eating an E. coli infected meal. Because of the course of the infection, doctors were forced to perform a double above-knee amputation on Susan. The GMA article does not focus on the infection or treatment, but rather the decision by her insurance company not to pay for the high-end prosthetic legs. "Anthem Blue Cross Blue Shield refused to pay for the more expensive C-Legs because they were experimental and not medically necessary. More than 25,000 C-Legs have been used by amputees." There was a "happy" ending to the story as a result of GMA contacting the Virginia Bureau of Insurance, which regulates insurers. They reviewed her case and within a few weeks, the state overruled Anthem and ordered them to pay for her new legs. There is a six minute long video at the GMA website, if you are interested.
This story highlights some of the unfortunate circumstances that occur between insurance providers and amputees. Because Suzanne has below-knee prosthetics, she has not encountered the same sort of resistance, as of yet. We hope this remains true going forward.

Continued Strides

It has been a busy couple of weeks for Suzanne. Last Friday she met with her prosthetist again, so that he could assess the fit and comfort of her left leg. He also made a mold of her right leg during the visit to proceed with ordering the prosthesis for that side. Suzanne has also been making twice weekly trips to the NRH to strengthen her core and prepare for her gait training which will immediately follow the arrival of the right leg prosthesis. Yesterday, Suzanne was reunited, for the first time, with many of her SOCMA colleagues at their Christmas luncheon. It was an opportunity for everyone to see Suzanne’s progress, meet Gabby and was a chance for Sue to catch up on the office gossip. When she has finished with her gait training, probably in January, she will soon be taking back some of her old responsibilities.

First Steps Redux

Today, Suzanne met with her prosthetist to receive the first of her new prosthetic limbs. Because she is a bilateral transtibial amputee, once she has the second limb, she will need to return to the NRH for "Gait Training" which will help her walk more naturally. Before then, she is going to be building her upper body strength with the parallel bars, walkers and crutches as an outpatient. Below are some images from today.





For Larger Versions of these images, click on the slideshow to visit the folder where they're located.

One Year Ago Today

Sue spent the night of October 26th 2007,  in the Emergency Room. You know the rest.

Simply Amazing

It is truly a miracle, what some of the surgeons are able to accomplish. Details Here.

Happy Birthday Suzanne

Suzanne met with her prosthetist on Tuesday to begin the casting process for the molds which will be used to snugly fit the prosthetic limbs, once completed. A detailed description of the process can be found here. But simply, the process is to create a negative mold which will be used to create an identical limb to Suzanne residual limb.

The left leg was completed on Tuesday. On Wednesday she visited with her surgeon again to assess the progress on her right leg. Because she is still waiting for the tissue to heal from her last surgery, the prosthetist did not want to make a mold of the right. But Her surgeon is gung-ho and thinks she is ready to be cast for that side as well. This will allow Suzanne to begin walking with both legs, rather than just one, on a temporary basis, as was originally planned. Now we need to get her back in there for the right mold. Stay tuned for an update on the delivery of the new legs. In the meantime, she is celebrating her birthday today (35), and happily celebrated Gabrielle’s over the last week. It is hard to believe that it has been a year since this all began. But looking forward is a lot easier than backward – more comfortable on the neck.

Mother Warriors, Monica appears on Oprah

All of us here at the "Bionic Mom" blog are familiar with the story of Monica Sprague. Now Oprah has brought Sepsis to the front of everyone else's minds. Monica appeared with Jenny McCarthy today, and Suzanne was fortunate enough to be home to see it. Sue said she was glad to to see how strong Monica looked. She was glad that Monica was up and walking and had such high energy. Since removing the staples in her right leg, she met with her prosthetist about measuring for the left leg. Nothing more to report right now.

How It's Made

Now that Suzanne has had the staples removed, from her right leg, she is moving even closer to her prosthetic fitting appointment. None has been set, because there is still significant healing to be done at the incision site. But when the surgeon has determined the skin to be strong enough, she will proceed. The left leg may be fitted soon though. Below I am including a video from the TV series "How It's Made." The first segment in the video features the prosthetic manufacturing process. It is oversimplified, but still interesting to watch.

One more down...

Suzanne's operation yesterday was successful. During the three hour surgery, the doctors were able to shape the right leg to properly fit in a prosthetic socket. The final decision will be determined once the staples have been removed and the grafted skin from the earlier surgeries is tested in the prosthetics. Because the grafted skin is not as durable as natural skin, there may need to be future, skin stretching, plastic surgery to strengthen the ends of the limbs for shear strength. Info about grafted skin can be found here (Note graphic images included with article). Sue is expected to be in the hospital for two to three more nights, to manage the pain and wound from the surgery. She should have the staples out in about two weeks, once the wound closes completely and preliminary prosthetic fitting can follow within weeks of that.

Olympic Amputees

We are all aware of Oscar, but were you aware of Natalie or Natalia? Natalie competed in Beijing for South Africa, in distance swimming. Natalia is already a Paralympics ping pong medalist, competing for Poland in Beijing this year. These are just two more examples of how athleticism and sportsmanship know no disability. But for Natalia and Natalia, nobody is complaining that they have a mechanical advantage.

Sepsis in the News

This video was taken from the Wall Street Journal's, August 14th, online edition. A lot of interesting information is included in both the video and the linked page. Please click on the play button and wait for the "Sponsor Message" to complete.

VIDEO DISABLED BY WSJ

UPDATE: Here is another WSJ article from August 27th, focusing on Sepsis

Next Surgery Date Set

Suzanne’s next surgery date has just been set. The revision of her left leg has been healing successfully, while the right leg has largely been ignored since she was released from the hospital in February. This is in part due to the desire for continued physical and occupational therapy but also to allow some sores to heal. Because she had a staph infection on the end of her right leg, the surgeons did not want to introduce this to the operating room. Now that she has recovered from the Staph, the revision for sculpting can proceed. The date has been set for Tuesday, August 26th – which is still a month away. Hopefully this will be the last leg surgery needed before proceeding to prosthetics. However, the surgeon has indicated that due to the shorter length on the right, he may need to do two small surgeries instead.

Britain's "Beauty Season"

An article found here introduces a new show in the UK based on the "next top model" franchise. The show features eight models who have some sort or severe disability. Says the article "The show's creators hoped the series would challenge pre-conceived notions of beauty and raise disability awareness." I agree that it will challenge preconceived notions about disability, but I'm not convinced it isn't just a ratings grab. (UPDATE: Series Complete - Official Website HERE)

Forever Friends

This weekend some of Suzanne's friends, from her college sorority, trekked down from New Jersey to pay a visit to her and the baby. They all took time from their own hectic lives to carpool down to Virginia to be there for Suzanne. They can be seen here with Suzanne...
Front Row: Kris Anne, Sally and Lori. Back Row: Suzanne, Denise, Christine (Holding Gabby).
This is just another example of how wonderful her family and friends have been through the whole ordeal. Suzanne is lucky to have such good people in her life.



Suzanne would also like to express her sadness at the departure of her home care occupational therapist, Carly, who has recently relocated out of the area and will not be able to continue participating in her recovery. Carly had been assisting Suzanne twice a week to regain function in her hands. Thank you Carly. Keep in touch!

Home Again

Suzanne returned home on Friday, as was originally planned. Before leaving she took a couple photos with some of the nurses and staff who made her stay so comfortable, all those weeks. They were all glad to see her progress and look forward to her self-propelled return visit. Here are some of them: Ron, one of her physical therapists, who has a wonderfully cheerful disposition that always keeps Suzanne going, and Karen, her case manager, who is a life-saver with all of Sue's paperwork (L). Aubrey, one of Suzanne's most dedicated nurses. Aubrey just got married and brought in her wedding photos to share with Sue. Congrats Aubrey! (R). And Marie, one of the aides who frequently switched rooms to be with Suzanne as often as possible (L). Sue wanted to recognize here some of the people who have been spending countless hours with her. These are only a few of many, so we plan to post more people as we go on. For those of you who haven't seen Sue lately, how do you like the haircut?

One step closer...

Suzanne came out of the operation with flying colors. She spent several hours recovering in the PACU, before moving back to the 3E wing, with the same nurses from her previous stay. There was a parade of hugs and well wishes from the nurses and technicians who became an extended family over the winter months. Suzanne said it was “like a homecoming” and she was glad that she was with the nurses whom she knows.
The operation focused on the shape and structure of Suzanne's left leg. The two bones, tibia and fibula, had fused together during her original hospital stay, probably due to her increased metabolism for healing and scarring. By waiting until she has returned to homeostasis, the chances of a repeat fuse are unlikely. Dr. Jordan has indicated he would like to address her right leg in about 4 weeks. But overall, today was a success. She will stay for 2 to 3 nights for observation before returning home for further recovery.

Surgery Tomorrow

This morning, Suzanne will be heading to the WHC for blood work, in preparation of her surgery tomorrow. The operation is going to focus on shaping her left leg, but may include the right. However, they are not scheduled to work on her hands. She will have an overnight stay to monitor her vitals, but she’ll be home on Wednesday. Suzanne is, understandably, not looking forward to the operation but is anxious to have them completed.

ESPN Magazine Article

Last week's issue of the ESPN Magazine featured a story about athletes who have prosthetic limbs. They get into an in depth discussion about whether some may give their users advantages over other "able bodied" athletes. The man to the right, Alex Zanardi, had both of his legs amputated after a crash during one of his races. I look forward to Suzanne driving again. She has a meeting with the hand specialist tomorrow, to go over the results from last week. But the next leg operation is still pending. Other than that, Happy Mother's Day!