Partially paralyzed surgeon back to work in OR

O'FALLON, Mo. (AP) - In the fall of 2010, Dr. Ted Rummel was performing orthopedic surgery at Progress West HealthCare Center in O'Fallon.

It was a typical Monday in the fast-paced active life of Rummel, who has jumped out of airplanes as a member of the Green Berets, walked with penguins in Antarctica, hiked in Colorado and frequently participated in more common physical activities such as golf, skiing and biking.

But during surgery that day, Rummel started experiencing pain in his back.

"I finished the day and was continuing to have a lot of back pain, so I went home and thought I'd just rest," Rummel, now 53, recalled on Thursday. "I woke up the next day and I had numbness in my left leg."

Rummel then called a physician and saw a neurologist. He said doctors started administering steroids through an IV and took an MRI of his back. What they found was a cavernoma that was leaking blood.

"My spinal cord was becoming inflamed," said Rummel, who grew up in Pagedale and graduated from Normandy High School.

Doctors continued treating Rummel with steroids and by Wednesday of that week, he had continued numbness, now in his right leg. By Thursday morning, Rummel couldn't walk and was numb from the waist down. He was transferred to Barnes-Jewish Hospital in St. Louis, where on Oct. 1, 2010, he had surgery to remove the cavernous hemangioma, a blood-filled sac in a nodule of his spinal cord. He remained in the hospital for rehabilitation until Nov. 20.

Rummel had been in medicine from his time as a U.S. Army Special Forces medic in the late 1970s and early 1980s, but he said he wasn't prepared for an extended stay in a hospital.

"If you ever become hospitalized for a couple months, you become institutionalized," Rummel said. "You can't go anywhere. People are nice and everybody's doing their jobs, but you feel caged."

For months after his release from the hospital, Rummel, who is 6-foot-2 and weighs 225 pounds, went to rehab and tried to resume a life, now with paralysis from the waist down. Getting used to performing basic tasks was the first thing Rummel said he had to master.

"Most of it was trying to figure out how to function every day," he said. "How to put on your clothes. How to take a shower. Getting yourself into a position so you can eat. The clumsiness of everything. You get out of bed, take a shower and put your clothes on - that takes most people 15 or 20 minutes. For me, it's an hour to do that."

For months Rummel lived with a great deal of pain. He said he took several medications to try to make the pain subside but at times felt like he had a third-degree sunburn.

Once he was able to stop taking pain medications, he was able to drive a specially equipped van, which gave him a renewed sense of freedom. "You can function in the community again," he said. "You can go see friends."

Rummel carries a ramp in his van, so that when he visits people at their houses he can get into the home.

Last fall, Rummel told Lisa Weindel, surgical services manager at Progress West HealthCare Center, that he was thinking about returning to the hospital so he could resume his duties as a surgeon.

Weindel manages all of the operations and personnel for the operating room, pre- and post-anesthesia recovery and the central sterile processing department that cleans and sets up all of the instruments. She met with her peers at other BJC hospitals and asked if they ever helped a paralyzed surgeon get back into the operating room.

It had never been done at BJC, Weindel said.

"I then thought about it practically," Weindel said. "What do we need to do? What I suggested to Dr. Rummel, which is what we did before (Progress West HealthCare Center) opened and didn't know any of the doctors, was to set up a mock case. So we did a trial. I had him come in on a Sunday morning because I didn't want the first time to be on a real patient. I wanted to see if it would work."

Weindel and others who would assist Rummel during an operation put him on a stretcher, put his scrubs on and got him back in his wheelchair, which had to be covered with a sterile blanket.

"I rolled him into the (operating) room, I gowned him, and he sat like he was doing an arm case," Weindel said. "We didn't hit knees or anything like that. It worked out perfectly. He was able to do what he needed to do. Once we finished the trial run, we gave each other high fives and said, 'This is going to work!'"

As a general orthopedist, Rummel used to replace hips and knees and work on trauma cases, but he is more limited now. He trained with a good friend who is a hand surgeon and spent months brushing up on hand procedures. Rummel now operates mostly on upper extremities: shoulders, hands, elbows.

Rummel maintained his state license as a physician, was given a review by the Board of Orthopedics and was cleared to practice medicine again.

Before becoming paralyzed, Rummel said he performed 800 to 1,000 procedures per year. In his first year back on staff at Progress West, he estimates he'll perform 150 to 200 surgeries.

"I can't bend over and hold myself up," Rummel said. "I don't have that truncal strength to bend over and do procedures where you have to stand a lot."

A specially designed chair might solve that problem. Rummel said Progress West is helping him pay for a stand-up operating chair that would allow him to perform other types of surgery. He said the chair would cost about $50,000 and provide the chest support he needs to stand and operate for long periods of time.

"Progress was very good," Rummel said. "I talked to some other hospital administrations, but to be honest, Progress is a new hospital, the facility fits me because the hallways are big, so when you're in a wheelchair you need more space. The nurses here ... it took me back, how truly excited they were for me to come back. It meant a lot."

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