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On the road again

Shawn Van Gruen is looking forward to a career as a commercial truck driver after surgery at Cowichan District Hospital relieved the chronic pain he endured for years following amputations to both his legs.

The 50-year-old Parksville man has had 25 operations to deal with a condition known as popliteal artery entrapment syndrome. It occurs when a lower limb artery is compressed by adjacent muscles and tissue.

Two of those surgeries are particularly memorable for Van Gruen.

On Sept. 10, 2001, Van Gruen’s right leg was amputated below the knee because of a growing risk from blood clots related to the syndrome. As he dealt with the dramatic change in his own life, Van Gruen recalls watching television coverage of airliners crashing into the World Trade Center and wondering if the post-surgery medication was causing hallucinations.

Van Gruen has a strong but positive memory of another surgery performed June 25, 2012, by a medical team led by Dr. Alexander Anzarut at Cowichan District Hospital.

“What a difference. I went from excruciating pain to no pain,” says Van Gruen. “It went from night to day. It was so much better.”

Van Gruen’s quality of life had been declining for several years. In 2002, his left leg was amputated because of blood clots and he was in constant pain. He had worked as an electrician but had to give up the trade because of the agony he felt particularly when he walked and put pressure on the nerves at the site of the amputations.

“I was disabled and on narcotics for chronic pain with little hope for the future,” said Van Gruen.

Initial attempts to relieve the pain through surgery failed and Van Gruen was referred to Dr. Anzarut by Dr. Corrie Graboski of Vancouver Island Health Authority’s Orthotics, Prosthetics and Seating Team.

Dr. Anzarut, a Duncan-based cosmetic and reconstructive plastic surgeon, determined that Van Gruen’s pain originated from trapped nerves that were susceptible to pressure.

Dr. Anzarut first performed surgery on Van Gruen in 2011 but his patient’s recovery was thwarted when Van Gruen fell while walking with crutches.

In June, Dr. Anzarut and his team performed a second operation. In both surgeries, the B.C.-born doctor used techniques he had learned at the University of Alberta Hospital and University of Pittsburgh Medical Center.

“I took the nerve that was there and rather than cut it back, I moved it to a new location up into the thigh – to a soft area where if there’s pressure, it won’t cause pain. I had to meticulously follow the nerve to make sure there were no sprouts left behind,” says Dr. Anzarut.

The surgeon trimmed back the end of the nerve and created a cap from the surrounding tissue. The truncated tube around the nerves is intended to keep them from sprouting out again. It was the first time the surgery was performed at Cowichan District  Hospital.

Van Gruen credits the hospital staff and Dr. Anzarut for giving him the opportunity to work again and pursue some of his favourite activities such as mountain biking.

“Thanks to Dr. Anzarut and the surgery he performed in June, I’m now pain free, off of the medication, able to walk again, and have completed my training to be a commercial truck driver.”

Van Gruen’s successful training at the Mountain Transport Institute in Castlegar earned him certification to drive standards commercial trucks – vehicles that have not been adapted for those with disabilities.  He can use both of his prostheses to manage the clutch, brake and gas pedal.

“Shawn’s case was not unique, but it was the first time such a complicated nerve surgery has been performed at the Cowichan District  Hospital,” said Dr. Anzarut.  “It’s a credit to the hospital and its  staff  that I was able to provide the surgery and there has been such a positive turnaround in Shawn’s quality of life.”

— Submitted by VIHA

 

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