By Alyce Collins
THIS WOMAN CHOSE to have her leg amputated after a stroke gave her foot spasms and constant pain and she has since become a one-legged marathon runner.
Process analyst, Sarah Curlee (32) from Nashville, USA, was unaware of an undetected hole in her heart known as patent foramen ovale (PFO) which, when combined with her birth control and the blood clots associated with control, can lead to a right-hemisphere ischemic stroke.
Sarah’s stroke happened in August 2013, when she was just 27-years-old. While in hospital, doctors didn’t notice any residual side effects to be alarmed by, so Sarah was sent home within days.
Although two weeks later, Sarah returned to a kickboxing class and noticed that her arm couldn’t move as quickly, and her punch felt weaker than before. Sarah also noticed her foot spasming and her toes curling involuntarily. Her ankle began to roll as her foot turned inward, causing Sarah to trip often.
Three months after her stroke, Sarah saw an orthotic specialist, but it took a year for them to try repositioning the tendons to straighten the foot. The pain only grew worse and Sarah knew that having her foot amputated was her best option.
Six months after her operations, and 18 months after the stroke, Sarah was diagnosed with two neurological movement disorders, dystonia and spasticity. Dystonia causes a constant pull of the muscles in her left side, causing the problems in Sarah’s foot. The spasticity causes localised muscle spasms, explaining Sarah’s foot spasms.
For three years Sarah saw specialists who tried different remedies but to no promise of pain relief. Amputation was the only option which promised an end to Sarah’s pain. On May 9, 2016, Sarah had her amputation and within three months she was running already.
“While strokes are a thing of mystery and often a root cause can’t be determined, it was likely that mine was caused by my birth control and a hole in my heart,” said Sarah.
“The PFO was a genetic defect that is commonly harmless. But unlike most strokes I didn’t require a long stay in hospital or lots of treatment.
“The stroke was on a Monday and I was out of the hospital that Thursday with no apparent side effects.
“It wasn’t until exactly two weeks after my stroke that I started noticing a real difference. I went back to my first kickboxing class since my stroke and my left arm wasn’t moving as quickly and my punch was much weaker than before my stroke.
“But I was already out of the hospital system so couldn’t query it. The next few years consisted of many doctors who wouldn’t listen and who treated the physical symptoms without thinking about the neurological aspects of my situation.
“I started noticing problems with my foot a few weeks after my stroke. My ankle would start to roll, and I would trip. Then I would get a foot spasm and my toes would curl up.
“After a few months, my foot would always be turned inward, and my ankle would always roll. Then I was constantly walking on the side of my foot. I developed spasming hammer toes and calluses on the top of my toes.
“I was referred to an orthotic specialist about three months after my stroke. It took almost a year of it getting worse before I had a tenotomy and the tendons in my foot were cut and repositioned to try and straighten out my foot.
“The spasticity was still there and with the weakened tendons it had so much more control over my foot and put me in so much more pain.
“I saw a couple of new orthopaedic specialists and after my surgery I was finally referred to a neurologist who tried Botox, which didn’t work at all.
“Every time I would walk into a doctor’s office I would have a list of questions in my head but the first one was always ‘can you take my pain away?’ I also asked if they could make the spasticity stop, but every doctor answered ‘no’ or said, ‘there’s no guarantee’.
“No one could provide an answer that convinced me another surgery was the right thing to do. They all made me know that my mind was on the right track to cut it off.”
Sarah had her amputation in May 2016, and her recovery was so rapid that she was running with a prosthetic limb just three months after.
Since the amputation, Sarah has taken part in marathons, been rock-climbing and on countless hikes, as the choice to amputate has given her more freedom.
“My recovery was phenomenal. I got so lucky and found an amazing doctor who provided me with the opportunity to have an unconventional amputation called an Ertl amputation,” said Sarah.
“This is where the part of the tibia that’s removed during surgery is used to create a bone bridge between the residual tibia and fibula. It provides speedier recovery and more support once walking on the amputated leg.
“I was walking within two months of my surgery and running within three months. The fitting process for a new prosthetic took a couple of years to get right because I was so active, and my stump shape and size were changing so rapidly.
“Not only is my left foot pain gone, my mobility is so much better than it was with my post-stroke foot.
“The stroke was definitely my kick in the bum to get healthier and be more active, but the amputation was what made that possible.
“I have since run two half marathons and countless five kilometre runs. I’m at the gym five or six days a week regaining strength in my left side every day. I also hike to every waterfall I can find.
“Never be afraid to think outside the box. What might seem extreme to others is perfect for you. Trust your instincts and listen to your head and heart.
“Little by little the pain goes away and is replaced with the happier memories of your life if you can just regain an optimistic outlook on life. Remembering where you were makes where you are now that much sweeter.”
You can see more about Sarah’s journey by visiting her Instagram, @sarah_nickel.