Adjustable Prosthesis Helps Boxer Go the Distance
January 2019 Issue
When Rustin Hughes woke from his second amputation surgery on September 11, 2014, he was on a gurney, alone in a hallway, staring at a stark elevator door.
He had undergone a transtibial amputation a few weeks earlier after a blood clot in his femoral artery cut off the circulation to his lower leg. This time, he looked under the sheet and saw that more of his leg was gone. "There was no one around, and that's when I started freaking out," he remembers. "At that point I was so devastated."
A Nagging Pain
Hughes, who was 39 at the time, began to notice a nagging pain in his upper right leg in late 2013. "I thought it was a pinched nerve, but it just kept getting worse," says Hughes, a boxer and mixed martial arts fighter.
Everything reached a climax when Hughes and his girlfriend attended a concert at Red Rocks Amphitheatre near Denver in the summer of 2014. He struggled to walk from the parking lot to their seats, which included climbing rows of stairs. The walk back to the car following the concert proved even worse, Hughes remembers. "It felt like someone had hit the off button on my leg," he says. "I almost couldn't make it."
They went to the emergency room. During an ultrasound, Hughes says the technician told him, "I know I'm not supposed to say anything, but that's the biggest blood clot I've ever seen."
"The doctor told us that it was a good probability I would lose my leg and would be on blood thinners for the rest of my life," says Hughes, who served in the U.S. Army from 1993 through 1997. "I appreciated his bluntness, but I felt like he was speaking to me in a foreign language."
Physicians tried several procedures to save Hughes' leg, including a heparin drip, but nothing worked. "I finally said if I'm going to have to go through it [the amputation], let's get it over with now."
Though Hughes says he tried to prepare for the surgery by strengthening his core and doing one-legged and balancing exercises, the week leading up to the operation was tough. "Waking up every morning knowing that I had to try and prepare myself mentally and physically was pure torture," he says.
Hughes' first surgery was in August 2014. He remembers waking up with intense pain but told himself it was to be expected because of the procedure. The pain, however, continued to intensify. "I couldn't hit that pain button enough times," he says. "Taking oxycodone was like taking Tic Tacs."
Hughes' physicians told him his leg wasn't healing properly and planned to do a debridement. They told him the worst-case scenario was that they would have to take the amputation above his knee. "I was very nervous," he remembers. "But I didn't really think they'd take my knee."
Dial In For Comfort
Hughes, who lives in Fort Collins, Colorado, had his surgeries in Denver and went through rehabilitation at the local U.S. Department of Veterans Affairs (VA) hospital. Care at the VA left him grappling with what he called "a five-gallon bucket for a leg." The prosthesis was so useless that Hughes he says he spent more time using his wheelchair.
Hughes, however, did have a good relationship with his physical therapist at the VA, who referred him to Quorum Prosthetics, Windsor, Colorado, in January 2015. "He saw that I was struggling. He knew Joe [Johnson], and he knew what he could do for me," Hughes says.
Joe Johnson, CP, CEO of Quorum Prosthetics, has firsthand knowledge of prosthesis use. He lost his left leg below the knee in an accident when he was 12 years old.
"I called Joe, and he got me in the same day," Hughes says. "He [and Johnson's brother, Jeff] made a test socket for me that same day. They didn't have any paperwork, any insurance, they just made it for me. They saw a guy who was struggling and having issues, and they made it better for me down the road."
Johnson introduced Hughes to the company's newly patented Quatro compression socket, a socket system designed specifically for individuals with transfemoral and transhumeral amputations. With three RevoFit adjustable dials and three independently adjustable zones on the socket, it eliminates the need for socks as the wearer can dial in or out to control the volume and compression of the socket as the limb expands and contracts throughout the day, Johnson says. The socket design also allows for easier donning and doffing, he says. "All practitioners are looking for a socket that's adjustable," he says.
Because the patient can fine-tune the fit, it gives that patient an element of control with their care, Johnson says. "It empowers them as they take charge of the fitting," he says.
Johnson says the Quatro is a "new twist on a great design," referring to the patented HiFi Interface and Imager System by biodesigns, Westlake Village, California. Quorum has been a licensed partner with biodesigns since 2012.
According to Randy Alley, BSc, CP, CEO of biodesigns, rapid and convenient adjustability has been a relative newcomer to the industry and has been gaining ground with many patients. "In concert with our unique targeted shim system, which apart from managing volume also positions the bone within the interface to patient preference, we also utilize global adjustability when the patient or physiological changes demand it," Alley says. "This can be achieved either through a single rotary dial and cable system or as in the case with Quorum's HiFi Quatro design, a multiple rotary system that places more emphasis on targeted adjustability and individual control."
Alley says Johnson has been a "firm believer" in the HiFi system and the application of targeted adjustability through the rotary dials is unique in the industry. "And patients love it," he says.
Within a week of being fitted with the Quatro, Hughes was back to boxing. Johnson says the Quatro works well for Hughes because of his determination and willingness to try something new.
Hughes called the Quatro socket a game changer. "I could drive down from Fort Collins to Denver to the VA and get crappy service, or I could go to Windsor and get gold service. It was a no-brainer."
Show Me a Path
Hughes, like most people who have had amputations, never thought it would happen to him. "I used to look at it like it was a third-world problem," he says.
The day Hughes woke up after his second surgery alone and facing the elevator door may have been one of the worst days of his life, but it was also the day his life began to change. "I was at a crossroads," he says. "I wasn't really a religious person, but I had a serious talk with the man upstairs and said, ‘What do you want from me?' I said, ‘You need to show me a path.'"
And that's when Hughes says he got the idea for B-Bold, a veteran-owned nonprofit he formed in 2016 to help individuals with disabilities through adaptive sports. He named the business after his late wife of nine years, who passed away in 2012 at age 36 after a long battle with brain cancer. "Brandy was bold. That was her motto, be bold," he says. "She was strong, and that's why she survived so many years."
Hughes competes nationally and internationally in para Jiu Jitsu, having competed in November in the JJIF World Para Jiu Jitsu championships in Sweden. He's also a trainer at Trials Mixed Martial Arts in Fort Collins, where he helps with boxing clinics for those who have Parkinson's disease. And he married his girlfriend in October.
"It's taken a while to see that light at the end of the tunnel," he says. "You gotta go through the bad to get to the good stuff, and this is my journey."
Betta Ferrendelli can be contacted at firstname.lastname@example.org.