A Rare Comparison
Fourteen-year-old Tyler Stedham was born with flat feet that never developed arches, a normal condition that affects approximately 20% of the population. But unlike most flat feet that are flexible, Tyler’s were rigid, which created so much stress on the joints of his heels and ankles that over time he could not walk without pain.
Surgical resident Dr. Ron Quam checks Tyler Stedham’s foot for sensation during a postoperative check up.
Tyler underwent surgery on both feet in San Diego when he was 10, but the pain and rigidity of his feet worsened. By the time the Arlington High School freshman and his dad, John, met Children’s orthopedic surgeon Dr. Vincent Mosca, it was clear he needed more surgery on his feet.
The procedure, called triple arthrodesis, would immobilize the joints below Tyler’s ankles — and eliminate his pain — by fusing together the three severely degenerated joints of each heel and allowing the bones to grow solidly together while preserving range of motion in his ankles.
After waking from the surgery on his right ankle in September 2006, the first thing Tyler felt was pain - lots of it. “It was bad,” he recalls. “They gave me pain meds by mouth during the seven days I was in the hospital, and I was still in pain for a couple weeks after I went home.”
In May 2007, it was a different story. Before this second surgery, Children’s anesthesiologist Dr. Laurilyn Helmers inserted a catheter that delivered regional anesthesia into Tyler’s upper leg. The regional block numbed the nerves in his leg, ankle and foot for the first few days of his recovery.
“When I woke up from surgery the second time, I didn’t feel anything because my whole leg was numb,” remembers Tyler. “When they took the numbing thing out after three days, my leg still didn’t hurt. I left the hospital after only five days, and I got off the pain pills faster at home. My second ankle seems to be healing quicker, too.”
“Once you get behind in pain control, it’s hard to catch up,” explains Dr. Robert Sawin, Children’s surgeon-in-chief. “Regional anesthesia evens out the peaks and valleys of pain control and keeps you ahead of the pain.”
“Tyler’s experience with regional anesthesia is common,” says his surgeon, Dr. Vincent Mosca. “My patients who receive regional blocks are more comfortable, alert and less nauseated. It really improves their overall hospital experience.”