Modern Medicine Changes a Life

by Suzette Epperley

One morning at the age of nine my right leg began to severely hurt and swell and by the next morning I had an extremely high fever. At the hospital after tests for polio, a spinal tap for meningitis, and daily X-rays for two weeks, it was discovered that I had a bone infection in the femur called osteomyelitis.

It was believed that an injury from falling off a teeter-totter at the park earlier in the summer had caused the infection. This infection destroyed the head of the femur and it was surgically removed. This stopped the growth in that leg after the age of nine, leaving me with a 5 inch leg length discrepancy. I walked on crutches until the age of nineteen. At that time I was told to start walking with a shoe which had a 5 inch build-up on the sole. It was very difficult to balance and walk, especially outdoors.

On one occasion when walking on a rock walkway I turned my ankle causing me to fall and injure my knee. This resulted in my suffering with pain and swelling for several weeks. There were numerous other times that I fell because of the shoe. I lived most of my adult life walking on that horrible built-up shoe.

In 1990 I first heard about Llizarov limb lengthening. The limb lengthening process works by gradually growing new bone and soft tissues by distraction (pulling apart) of them at a very slow rate of approximately 1millimeter per day. The distraction is done using lengthening devices called fixators.

External fixators are devices that attach to the bone by means of thin wires or thicker pins. At that time I talked with my orthopedic doctor and he was highly against it because of my previous history of infection. He considered it high risk because he feared it would reactivate the infection. He was concerned that I might lose the use of my leg.

This seems to be the skeptical attitude of many orthopedists in spite of the high success rate of the procedure. So at that time I did not pursue it further. Then in 1998 I saw a feature story on television about Dr. Dror Paley and how he has had such great success with limb lengthening. He studied under Dr. Ilizarov who developed the procedure.

I decided to go to Baltimore and be evaluated by someone who had been performing the procedure for twelve years. It took two months to get an appointment to be evaluated. At the appointment I learned that there has only been a 3 percent failure rate with the procedure. Most cases achieve good to excellent results. Dr. Paley stated that he had done the procedure on a lot of patients with a previous history of osteomyelitis. Because there had not been any active infection in my leg for many years, he was very comfortable in doing the surgery.

It was another year before I could get an appointment on his surgery schedule. Another year seemed like forever since I had wanted this for so many years. I spent the next year exercising to build up my strength for surgery and was also advised to give my own blood for the surgery.

Mentally I tried to prepare myself for what I knew would be a painful operation and months of endurance through the lengthening procedure by believing that the end result would be well worth whatever was necessary. The next year when I was past the age of forty I had the surgery done on my femur. They placed a titanium steel rod in the femur and an Orthofix fixator on the outside of my leg. It had an Automator attached which is a computer device that extends the fixator 1/360 millimeter every few minutes.

Within the first two weeks the Automator alarm went off indicating that it was not functioning properly. On returning home that day the alarm started going off numerous times.

A month after the surgery I got sick with pancreatitis. The pancreatitis was caused by gallstones in the pancreatic duct. During my hospital stay for gallbladder surgery the Automator's alarm began to go off every ten to fifteen minutes meaning that it had stopped moving the fixator. Sometimes the Automator does not work well with my type of fixator. This meant it had to be removed so that I could turn the bolts on the fixator manually with a wrench.

Because of my pancreatitis, I did not want to make the trip to Baltimore. I was fortunate enough to get the technician who designed the Automator to travel to Harrisonburg. We met at the Cracker Barrel restaurant there. He removed the Automator in my car in the parking lot.He made adjustments so that I could manually turn the fixator 1/4 millimeter four times a day.

Within about three weeks after the surgery on my leg I no longer needed the narcotic pain medication. I was just using Tylenol. Also, I was on a regimen of high dose Calcium and Vitamin C.

I was unable to drive because the surgery was on my right leg. When I tried just using my left leg, I found that my right leg was in the way and that it was to painful for me to keep it out of the way. Limb lengthening requires two hours in physical therapy every day.

Several members of our church helped transport me to therapy each day. A schedule was organized where each person was utilized one day a week. Physical therapy is extremely important to keep the muscles and other tissues growing and functioning properly.

After the lengthening was complete, therapy continued three days a week for another ten months. Daily cleansing around the steel pins that connect the fixator to the bone with a saline solution was very important so that there wouldn't be any infection. I was fortunate that during the lengthening process I was still able to take a shower.

Two months after surgery I began to get some numbness and tingling in the calf of my right leg. This concerned me because I thought it meant that I had nerve damage and that would result in the doctor and therapist not continuing with the limb lengthening.

The nerve test demonstrated that the major sensory nerve and that I only had skin tingling. It turned out not to be serious so I continued with the lengthening. I also experienced another interesting sensation on occasions during lengthening. I felt like a rubber band was popping me in the muscle. The doctor and therapist both told me that this sensation was a normal part of the lengthening process. As I flexed and extended my leg, the muscles would kind of snap back sometimes.

About three inches into lengthening I started needing narcotics to relieve the pain that I had at night. My doctor limited the amount that he prescribed so that I wouldn't become addicted to it. He also prescribed a TENS unit for me to help me with the pain. As the pain increased near the end of my lengthening, I found the TENS unit especially helpful during physical therapy.The entire lengthening process took seven months.

My fixator was removed the day before Thanksgiving so I had Thanksgiving dinner in the hospital. I was released from the hospital the day after. Thanksgiving was truly a day for me to give thanks that year.