February 6, 2019
On a rainy April evening in 1977 I was happily driving home from my fiance’s with the guest list for our upcoming wedding on the seat next to me and I had a flat tire. My good friend’s husband came to help me and as he changed my tire a drunk driver came out of nowhere going at full speed and hit me. I flew into the air and only know what happened after that through the accounts of others. Miraculously my tire changing friend was an off duty police officer and saved my life by administering first aid and getting me to the hospital quickly. In another bit of luck in what was the unluckiest day of my life my injuries were confined only to my legs. That evening a new chapter began in my twenty three year old life.
For the next 35 years my mobility issues and the attendant pain were significant factors in my life.
Our wedding was postponed because of my three month hospitalization and multiple surgeries. Nine months later I was able to walk down the aisle with a custom built shoe that had a 3” platform and barely compensated for the discrepancy between the lengths of my legs. My husband was my rock and we spent the early years of our life together going through my orthopedic surgeries and living with the challenges imposed by my mobility issues.
The difference in my leg lengths was so severe that I was not able to walk a short distance without putting on my custom built shoes. My doctors at Columbia Presbyterian recommended a colleague who was specializing in a technique from Germany using the Wagner Device. The procedure held the promise that my leg length could be fixed with 3 surgeries: cutting the femur and lengthening it, plating the femur, and eventually removing the plate and screws. However, the procedure and execution were flawed and instead of 3 surgeries and a lengthened femur I had 8 surgeries and a femur that wouldn’t heal. Bone grafts and lots of time were needed for eventual healing but after all the pain and suffering there was still a leg length discrepancy, albeit it a smaller one. Over time my right leg started bowing, placing stress on my right knee and then my left. Walking for any significant length of time was painful not only on my legs and knees but eventually on my back. Living in Manhattan and not being able to walk any significant distance posed challenges. Daily taxis were not an affordable option so I started using a bicycle. My right knee could not bend past 60 degrees, a result of the Wagner procedure, so most of the work was done with my left leg. Cycling this way was not easy nor pretty but it gave me the freedom I craved and allowed me to continue living in Manhattan. My bike(s), about 8 of them since they kept getting stolen, became my legs or wheelchair. Every step I took was painful, but with my bicycle, careful planning , help from family and friends I lived a full life, raised children, and even took my dog for walks , i.e. the short legged Pekinese ran next to me while I would be soft peddling on my bike.
As I got older my leg seemed to bow more and more, or it was my knee, the cartilage being worn away. Because of scars and deformity I never allowed my legs to show but with time one could see the bow in my right leg even in the outline of my pants. My limp was severe. I did my best to avoid mirrors but when by chance I glimpsed my reflection walking by a shop window I was horrified by my limp. My pain and discomfort were growing. I did my best to stay active and limber but pain accompanied my every step. On recommendations I saw several orthopedists, but they did not offer many solutions except keeping my weight down , taking aspirin, soldiering on. After having experienced procedures that were not successful, I was not eager to be experimental. I was managing well enough. I decided to get a pair of Orthotics to see if that wouldn’t take some pressure off my knee and back. My appointment with Dr. Positano at HSS was fortuitous. He took a look at me, had me walk and then said he couldn’t help me. He suggested, however, that I should see Dr Rozbruch down the hall as he felt Dr. Rozbruch might be able to help me. If my memory is accurate I saw Dr. Rozbruch that very afternoon for a preliminary conversation. I returned for an in depth examination. I was immediately very impressed by how the set up for X-Rays was so efficient and accurate in measuring leg lengths. In the past the measuring was done with measuring tape, my legs and hips in different positions and I was always told that the measurements had some degree of inaccuracy. Dr. Rozbruch was familiar with my earlier procedure using the Wagner device and the problems that ensued. He was using the Ilarov method. The irony did not escape me that I as the Russian and German speaking daughter of a Russian immigrant and a German immigrant was contemplating a Russian medical procedure after suffering the bad results of a German medical procedure.
Having had thirteen surgeries and procedures and most with complications, I was skeptical that surgery would make a significant improvement to my life. I was now middle aged and had managed to live a full life in spite of pain and mobility issues.
But listening to Dr. Rozbruch’s explanation of his procedure and plan I heard something very innovative and hopeful.
Dr. Rozbruch’s basic yet very insightful question “How many blocks can you walk?” was a turning point. It was difficult to admit to myself that the answer was barely one. I remember babbling that I could stroll around a museum, that I could take some steps, rest, take some more steps, rest, but walking a block was my limit. Dr. Rozbruch explained the procedure and tried to allay my doubts and fears of calamitous results. My biggest fear was non healing, as I had experienced in my 20’s. Dr. Rozbruch was very optimistic that he could improve my walking ability and with it my life. I wasn’t ready to undertake this procedure but I was seriously considering for a time when I could find six months to dedicate to my right leg and ultimately give a gift to myself. Dr. Rozbruch was very patient with me. I kept visiting and calling, asking questions, trying to overcome my fear and skepticism as I longed for the improvement that Dr. Rozbruch said was possible. Ultimately Dr. Rozbruch had to tell me “I don’t think I can add anything more to this conversation.” The decision was mine to make but I was afraid.
A few more years went by until I finally decided to undergo the life changing procedure with Dr.Rozbruch. My knees had been bone on bone for years now. They were swollen, misshapen, painful and at times I could not unbend the right one. Dr. Rozbruch let me know that he believed, but was not promising, that in his experience with leg straightening it would hopefully add some years to my knees and at any rate with a straightened leg it would be a much more successful knee replacement down the road. Dr. Rozbruch’s plan for me was a 2 step procedure, femur then tibia. I balked and told Dr. Rozbruch that I’d be ok with just the upper part fixed. Dr Rozbruch said then it would only be an 80% improvement. I replied I would be happy with that but Dr. Rozbruch said he wouldn’t take less than 100%. And so Dr. Rozbruch figured out how to do it in a 1 step procedure! The morning of the surgery after several cancellations or close calls as I would call them, I bumped into Dr Rozbruch on the coffee line. He looked surprised and said he thought I would cancel again.
The surgery and the entire procedure went as planned, no surprises , no complications. I was dutiful in following Dr. Rozbruch and the team’s instructions. I had prepared myself for a lengthy home stay and worked on inner and outer healing. The big difference for me between the 2 procedures was that the Illarov method allowed for weight bearing once the lengthening was over (I believe) The weight bearing promoted bone growth and so non healing was not an issue. It also allowed for mobility. Sitting on the bench outside my apartment in the sunlight I soaked up vitamin D and optimism. Limited exercising kept my muscles in shape and once the device was removed, 2 weeks of caution and a crutch for protection. Almost 4 months after the initial surgery, Dr. Rozbruch said I could leave my crutches behind, which I did in his office. I got in my car and drove to a shoe store where I bought a pair of what I like to call my Cinderella shoes, after 30 years of wearing Merrill’s . In the store I happened to walk by a full length mirror and was so surprised to see a bit of a limp but a straight leg. Gone was my deformed leg and with time, lots of PT and Pilates the limp has gone away too.
Now I’m walking all over NYC and truly enjoying the city, Pilates 2x a week, nature walks, Cinderella shoes for special occasions but mostly in my faithful Merrill’s . I’m pain free and my knees as Dr Rozbruch had hoped for are functioning just fine as long as I eat and exercise properly!
Dr. Rozbruch gave 100% and I got a new life at 58! I will always be grateful for his skill and his patience.
Thank you, Dr Rozbruch!