Wednesday, April 14, 2004

Bob Smith: Wheel-chair bound -- but determined

He had surgery in China after being paralyzed in a diving accident. ?Every week is better,? he says of his life today.

April 13, 2004 - BY PATRICIA ANSTETT - FREE PRESS MEDICAL WRITER

The first American to undergo experimental surgery in China for a spinal cord injury is making steady progress and remains hopeful about his recovery.

"Every week is better than the last," says Bob Smith, 46, of Harrison Township.

These days, Smith can shave, take off his shirt, grab milk from the refrigerator and pour himself a glass. He's starting to take steps on a treadmill and is able to lift his buttocks off an exercise mat. He couldn't do any of that before his surgery Oct. 23.

Recently, he surprised his longtime card-playing friends by being able to deal a deck of cards.

"I'm quite a ways ahead," says Smith, a onetime Chevy salesman at Gordon Chevrolet in Garden City.

He says he can't wait for the day when he can reach across the card table and pick up a pot of winnings.

Smith, who was paralyzed in a July 4, 1999, diving accident in Lake St. Clair, has become a symbol of hope for the nation's 400,000 people with spinal cord injuries.

He underwent a procedure that transplanted 10 million olfactory ensheathing glia (OEG) cells from the ridge of his nose to the site of his spinal cord injury. These cells have protective properties that help shore up nerve growth and connections.

They hold promise for people with spinal cord injuries, Parkinson's disease, Lou Gehrig's disease and degenerative spinal cord diseases. Still, experts urge caution because their use is largely unstudied.

That makes for even more intense following of Smith's progress.

Sharing pain and progress

Thousands are following Handi Bob's OEG Surgery Report, written by Smith for a leading Web site for people with spinal cord injuries.

He posts his progress reports twice a month at the CareCommunity Web site, www.carecure.atinfopop.com.Smith heard about the China operation through the Web site and is committed to sharing as much information about his progress as he can.

"My philosophy is, if we have guys going to Iraq fighting for what may not be a good idea, why can't I do this for other people?," he says.

Smith shares details some might consider personal. Like his renewed ability to, well, pass gas.

"People just don't realize how much that can affect your life," Smith wrote in his March 23 Web update. "I now have very little, if any, stomach discomfort."

Smith has tried to make the most of any gains he may achieve from the surgery with an intense physical therapy program. He's midway through his second series of 30 physical therapy visits approved and paid for by the Health Alliance Plan.

His paralysis is from the middle of his chest down, a so-called C5, Asia C injury. The classification describes the site and severity of his injury. Asia A is the most severe.

A day in therapy

Smith's therapy is a workout for both him and his longtime therapist, Betty Lauhoff, at the Rehabilitation Institute of Michigan's Warren center. By August, the institute plans to open a new Spinal Cord Recovery Center at its Detroit headquarters to offer some of these newer therapies.

One involves a machine with a harness that hoists him over a treadmill. Its aim is to trigger a type of memory in the nerve cells in Smith's spine to remember tasks like walking.

The harness, strapped around Smith's groin, makes him look like a World War II parachute jumper.

Therapy is no place for big egos.

"There we go," says Lauhoff at the start of a recent session at the Warren center.

"Piece of cake," Smith says. The harness lifts Smith's 230-pound, 6-foot-3 frame above a treadmill, and Smith and his team take one arduous step after another.

After initially needing therapists to move both his feet onto the treadmill, Smith now can move both feet slowly with little assistance. "And my endurance has improved dramatically," he writes on his Web update. "The first time, five minutes of standing was tough."

Balance is part of the learning process.

"I lost the feeling of shifting my weight side to side," Smith says.

"I'm relearning how to do that."

Some weeks, Smith feels more progress than others.

"The rule in my house is: If Betty's excited it must be good," Smith says of his therapist.

Lauhoff helps Smith do a series of exercises on a large, low table covered with a mat. She asks him to see whether he can do what he did the week before: raise his buttocks from the mat and hold for a count of 10.

Smith does the exercise several times.

He puffs and takes a break before arm wrestling with Lauhoff, an exercise to build arm strength.

He says he'll be able to go home and tell Karen, his wife of 23 years, and his three children that "Betty was happy today."

Smith's tests show small signs of improved muscle function in his legs. He hopes his insurance continues to pay for his rehabilitation, an issue many patients face.

"When he gets more muscle function below the level where his injury was, he'll be better prepared for walking," Lauhoff says.

In the meantime, Smith accepts whatever gains he achieves.

"People don't believe it," he says. "I'm here to help them believe."