When I think of a career in surgery, and those who have trained me, I think this picture sums up quite a bit.
What does this picture represent? Well, it is an unofficial “passing of the torch.” Let me explain…..
As a fully trained surgeon in plastic and reconstructive surgery and general surgery, I then completed a fellowship with Dr. Lee Dellon (right) in peripheral nerve surgery. After completing that fellowship, I then worked with him closely for two more years and was his partner for over 10 more years. He is a dear mentor, teacher, and friend. This picture includes a young man who had been diagnosed by Dr. Dellon after his official retirement from performing surgery. Dr. Dellon referred the patient to me.
He thought that we could help this young man who was suffering from intense pain in the
This young man (in the middle) presented to us with a complex history of left lower extremity pain. He complained of tremendous hypersensitivity to the top of the foot starting at the lateral knee and hypersensitivity and pain in the sole of the foot as well. He had a number of different injuries to this leg in the past. The most recent injury was a fall into a very narrow space wedging he leg tightly causing significant pain, and he had a temporary dislocation of the small bone in the outer lower leg called the fibula. Soon after this he began to notice substantial pain in his left leg significant numbness and color changes in the left leg. He then spent the next year on crutches!
He started to see many different physicians. His pain and numbness worsened and he started to lose muscle function. He had difficulty raising his foot, and curling his toes under. One day his pain was so intesnse that he was vomiting and had to go to the ER to control it.
The patient spent several years in pain management and physical therapy. He had aggressive medical treatment but his pain was never well controlled, but they fought hard to give him the best relief that they could. He had reached out to Dr. Dellon, who then referred him to us…. in order to try to help him with several problems (one of which I was able to teach Dr. Dellon about after my fellowship….. This is a case of the student teaching the teacher!) How cool is that?!
When we saw him he had several main complaints. Terrible hypersensitivity and burning pain in the inner calf from the knee to the inner ankle, pain and numbness in the sole of his foot, and pain from the outside of the knee to the top of the foot. Breaking this down this pain included the saphenous nerve, the common peroneal nerve, and the tibial nerves!
After making the diagnosis we noted that he felt that we could help him with a surgical approach involving several nerve decompressions. These included the saphenous nerve, the proximal tibial nerve at the soleal sling (this is the one I got to teach Dr. Dellon about), and the common peroneal nerve, and the tarsal tunnel at the ankle. It was a lot to consider.
He chose to move forward. We could not be more excited for his outcome. IF there is ever a “grandslam” in peripheral nerve surgery, he is it. I could not feel more privileged or blessed to have been allowed to participate in his care. I honestly praise the Lord for his improvements and credit Him for designing a system, the human body, that heals itself and allows a person to recover function and heal. The human body is truly amazing.
When a nerve is pinched and compressed, it does not work well. The nerve needs to be released and DE-compressed. That is what we did. Now it works well. No medication was able to DE-compress a nerve. It might cover the pain, but it does not FIX the nerve. If the pinched nerve needs more oxygen – we need to DE-compress the nerve to give it more oxygen and restore blood flow.
This young man was essentially pain free a few weeks after the operation after years of pain. He now fences on a competitive team! He uses his foot and leg normally. He has no hypersensitivity. He 98% pain free. He is off all of his pain medication no pain. He loves to smile. He loves school. He is looking forward to college. He had an incredible summer and went to camp without pain meds! (something we would all take for granted)
This is what peripheral nerve surgery is all about. In one photo…. A mentor passing the touch to one of his MANY pupils. A pupil teaching a mentor one new trick. A patient seeking medical care for terrible pain and loss of muscle function. A diagnosis made. A plan proposed. A procedure performed. A result that we thank God for because we are truly fearfully and wonderfully made!!!! What a blessing! Thank you Lord for a great day in clinic! I do give You the glory and thanks for this, and all that this picture means to ME, and those in it!!!