LEG AMPUTATION RESULTING FROM CONGENITAL DISABILITY
Macey is a spirited 9-year-old girl who loves to swim and is a blue belt in karate. She’s compassionate, open-minded, and fashionable—right now her prosthetic right leg is adorned in green and purple leopard print. “I asked her if that was the print she really wanted and she said, ‘Mom, if I’m going to have a prosthetic leg, why not have fun with it?’” Melina Collins says.
While Collins was pregnant, an ultrasound showed Macey would be born with clubfoot—her right foot was abnormally turned and would not function properly without therapy and surgery.
Within months of Macey’s birth in 2006, doctors discovered that the condition was much more complex than they had anticipated. “When Macey was born, the doctors started casting her legs to fix the clubfoot, but when she was about 6 months old we realized she was actually missing her fibula,” says Collins. The family went to Shriners Hospitals for Children for specialized pediatric care.
At Shriners, the Collins family was immediately comfortable entrusting their daughter’s care with the medical team. “The doctors made Macey’s condition seem totally manageable. We were so worried about everything but they made us feel like it was no problem and they would take care of everything,” says Collins. Each step along the way, the doctors and care team explained Macey’s condition, and every scan and surgery afterward—especially when they received more unexpected news.
“When she was about 5, she had limb lengthening done. The doctors went in to take out the pins and plates in her leg to straighten out the foot with surgery,” Collins explains. But, upon examination, doctors saw that Macey had very low blood supply to her leg, missing blood vessels, and her Achilles tendon was damaged beyond repair.
Even at 6 years old, Macey’s chronic pain and impaired mobility made a tough decision easy. “Macey was the decision maker,” Collins says, recounting her daughter’s words: “‘You’re asking me about amputation . . . if you’re asking me if this is what I need—cut it off. I’m sick of being in pain and always being at the hospital. I just want to be a kid.’”
Next, the Child Life department at Shriners Hospital invited Macey to their summer camp for kids with limb differences, where kids with prosthetic limbs swim, play sports, and run around pain free to demonstrate what her life would be like after amputation. They also brought in prosthetic limbs for Macey to touch and ask questions about, all of which solidified her decision to amputate her right leg.
In June 2013, Macey had her amputation surgery, but it would take four more months for her body to heal to withstand the prosthetic leg, which meant she’d be back to school that fall without a leg. Shriners’ Child Life department anticipated kids being unsure of Macey’s condition, so the team went to Macey’s school with prosthetic limbs and information for her classmates to learn more about limb replacement. Collins acknowledges that the Child Life team has eased potential bullying and helped kids understand limb differences. “The Child Life department showing up at her school to educate her class gave her those tools now to do that herself by watching how they talked about it.
“Macey is pretty proud of her [prosthetic leg], because she has the tools now to educate people especially kids—who ask her about it,” says Collins.
VEEANN WOOD V
BOTH SHOULDERS REPLACED
At 79, Veeann Wood enjoys taking her horses out two to three times each week to drive or canter the expanse of her Plato farm. She remembers going to Minnehaha Park Pony Concession at age 11 to admire the horses—eventually working at the rides for $1 per day, just to be near the horses. A few years later, she dreamed of a mode of transportation of her own—the four-hooved kind. “I kept saving my money—saved and saved, and finally when I was a junior in high school, I bought a horse,” says Wood. “I’d ride it all over, places like Lake Nokomis—I was such a horse nut.” Her parents even owned the pony rides that used to sit on the plot of land that is now Mall of America. “I put myself through college with the money I earned from those pony rides,” Wood says of her University of Minnesota education.
Wood estimates she’s had a hand in raising, training, and riding nearly 150 horses throughout her lifetime—a feat that wouldn’t be as achievable without the mobility of her shoulders to prepare food and water, and lead and drive the horses she trained. Her caliber with horses and physical agility to work with them even gave her a unique opportunity. “In 1989, I got to ride in the 100th anniversary of the Tournament of Roses at the Rose Bowl. Shirley Temple was the grand marshal—we even met her,” Wood says of the memory with her late husband. Shortly after, though, Wood was in for another surprise—one that would threaten that mobility she relied on.
In November 1990, a horse Wood was leading got spooked by flickering holiday lights and pushed her into a fence, tearing the rotator cuff in her shoulder. The rotator cuff is filled with tendons that support the arm at the shoulder, allowing movement. The injury caused searing pain. She worked through the pain until deciding to have her first rotator cuff surgery the following May.
Though the surgery was a success, more shoulder accidents occurred within the following 25 years that caused consistent shoulder and arm pain and prevented Wood from caring for the animals she’s loved since childhood. “A few years after that first surgery, I fell on that shoulder and injured it again. And by then, I was already having pain in my other shoulder—I had tore that one, too,” she says of the repeated accidents.
For almost 20 years, Wood saw a primary care doctor who advised exercises to alleviate pain. Eventually, though, she was sent to Sports & Orthopaedic Specialists where she met Dr. L. Pearce McCarty III, an orthopedic surgeon. “I had such bad pain, I was not sleeping, I was hardly functioning from the pain,” says Wood. “It got so bad I couldn’t even reach up into the cupboard for a cup. I couldn’t raise my arms, and it was just getting more painful.” Not being able to move her arms didn’t just impair daily activities, it also impacted her ability to judge horses for the Western Saddle Clubs Association—something she’s done since 1974. The work of McCarty and the team at Sports & Orthopaedic Specialists suddenly became paramount to Wood’s future.
After putting Wood on a regimen of physical therapy exercises, McCarty also started her on a round of steroid shots—a last-resort treatment that alleviated pain for several months. But, an MRI showed Wood’s left shoulder rotator cuff was gone. Surgery was now necessary.
In January 2013, 77-year-old Wood had reverse rotator surgery on her left shoulder followed by her right the following October. The surgeries sound worse than they actually were. “Gosh it was amazing. I went into the hospital for surgery, stayed one night, and then I got to leave and have home care with physical therapy,” she says, adding she regrets not getting her shoulders replaced sooner.
Ongoing physical therapy and movement helps Wood sustain mobility. And, she credits McCarty and the care team for giving her life back. “Horses are my lifestyle,” she says.
HIP AND KNEE REPLACEMENTS
Randy Wittman is looking forward to the upcoming months when he can walk without pain. The former head coach of the NBA Washington Wizards came to Minnesota for surgery on his knee and hip, entrusting the doctors at Twin Cities Orthopedics.
Wittman’s career began in 1983 as a shooting guard for the Atlanta Hawks, then he played for various teams until 1992 when he became an assistant coach for the Indiana Pacers. By then, he admits the injuries he had as a player caused pain as he coached for another 20-plus years.
“I’d had three knee operations prior to having my knee replaced [in July],” says Wittman. “My knee was total bone on bone. I wore my right hip bone down compensating for my left knee.” Unfortunately, Wittman’s story isn’t uncommon. Many people fight through the pain and compensate for their injury with the opposite side of their body before seeing a doctor.
After spending a day on the golf course or working around the yard at home, Wittman needed to take over-the-counter pain relief for the pain, and ice his knee. He waited for so long out of stubbornness and the fear of limited mobility while healing from surgeries.
Despite coaching for the past seven years in Washington, Minnesota was the logical choice for Wittman’s surgeries: “I felt most comfortable going to Dr. Brian O’Neill [an orthopedic surgeon] at Twin Cities Orthopedics.”
In May, O’Neill performed hip surgery, providing Wittman instant relief. “After I healed from surgery, I was able to immediately get out and walk. I got to the point, six weeks after surgery, where I was walking almost five miles a day. But that caused my knee to flare up, so I had to go back in for my knee replacement,” he says.
O’Neill replaced Wittman’s knee this past July, and Wittman says he already feels a significant boost in his lifestyle. Continued rehab at home and at Twin Cities Orthopedics, where he spends two days each week working with physical therapists on movements and strength training, allow Wittman to do what he loves—travel, golf, and walk without pain. Wittman’s pain-free lifestyle was easier than he anticipated.
Before his surgeries, Wittman signed up for the Excel program at Twin Cities Orthopedics, which pairs a care coordinator with the patient from the initial visit through surgery and treatment, to any follow-up appointments. This designated nurse acts as a project manager for the patient’s care, alleviating the stress of translating information and medical terminology between doctors and patients, having multiple medical bills coming in, and not knowing the next step.
“I’ve gone through a lot of surgeries—back, three knee replacement operations—and the Excel program was the best. It wasn’t like being in a hospital. I went from the surgery center to a private suite, and was connected to a nurse for the whole process of both my hip and knee—that nurse is like a sister to me now,” says Wittman. “And for insurance and billing—you get one bill. That’s it, at the end of the process. It made everything so much easier for me to use the Excel program.”
For now, Wittman is anticipating the State Fair, where he’ll be able to walk pain free, spending time with his out-of-state family, and “anything my wife’s been trying to get me to do for the past five years.”
SLAP TEAR SHOULDER SURGERY
Standing on the pitcher’s mound, Jason Beckett stares down the field toward the batter, winds his right arm, and throws the pitch—without the chronic shoulder pain he had since college baseball, more than 20 years ago. The retired Columbia Heights police officer attributes his newfound pain-free lifestyle and pitching for the Southwest Outlaws adult baseball team to the doctors at TRIA.
Before surgery, Beckett suffered through pain every day when he tucked in a shirt or lifted his right arm above his head. “There was this constant, dull, aching pain,” Beckett says. “And other times there would be a real sharp pain, and then my arm would give out.” In 2008, Beckett entrusted his future in Dr. Jonathan Braman, an orthopedic surgeon at TRIA.
Before surgery, doctors thought Beckett had a quarter-inch tear, but when they went in they saw that it was fully torn. Most patients with a slap tear—a rip in the cartilage that causes pain from movement and gets progressively worse—need six months of healing and physical therapy before going back to work. Beckett was back at the Columbia Heights Police Department in one month for light duty, and was back on patrols in three months. At St. Francis in Shakopee, therapists had Beckett use a hand bike to keep his arms and shoulders moving, weighted ball throwing to boost strength, and gave him regular stretches and ultrasounds to massage the shoulder from the inside.
“If you have surgery, physical therapy is 110 percent part of getting better,” says Beckett.” This positive mindset and his own experience inspire his volunteering for the Minnesota Association for Injured Peace Officers, where he connects families of slain or injured police officers to resources as they heal.
CANCER-CAUSED TIBIA SURGERY
Nick Manzoni takes deep breaths of fresh air as he zigzags across the soccer field, passing the ball from one foot to another, grateful to again feel the beat of a soccer ball against his legs. The 22-year-old Drake University senior was 17 when pain in his right calf after a soccer game brought him to a doctor who diagnosed him with Ewing’s sarcoma, a soft tissue and bone cancer found in only 200 people in the United States each year. That summer day in 2011, Manzoni was resilient: “I’m competitive on the field so I tried to relate my treatment to soccer and look at it as me versus the cancer. That’s what worked for me.”
Manzoni had four months of chemotherapy to reduce the lump before surgery. He suited up with the team for practice when he felt well enough, but his alternating weeks of chemo kept him on the bench during games.
Dr. Denis Clohisy, head of orthopedic surgery at the University of Minnesota Department of Orthopaedic Surgery, was in charge of Manzoni’s surgery to remove the tumor and the affected slice of his tibia bone, and replace it with a cadaver bone. Manzoni’s leg accepted the cadaver bone, and within 15 months, the plate and screws were removed—thanks to diligent physical therapy.
“I started physical therapy at the hospital about two weeks after surgery—very basic movements like standing up and bending down,” says Manzoni, as well as group fitness classes to boost strength.
“After four months of physical therapy, I worked with Fairview Sports and Orthopedic Care with the U of M for four more months. I also joined a group called Tiger Athletics, where I did the elliptical to get my cardio back, some pool rehab, and took barre classes,” he says.