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There’s no quit in Tom


In his 69 years, Tom Nickel has fought more than his share of health battles.


He was diagnosed with kidney disease before turning 30, had both hips replaced and underwent neck fusion surgery to give him more stability in his spine.

In early 2024, Tom embarked on yet another medical journey. His mobility had been declining and the pain in his back was getting worse. One Sunday morning, however, Tom woke up with no feeling whatsoever in his legs.

“It was totally gone,” he says.

Initially, Tom was taken to the community hospital in his hometown of Waupun, Wisconsin, but it became clear that he needed to be treated at a larger hospital with specialists in spine surgery and kidney disease.

As soon as he could be transferred to Madison, Tom went straight to the operating room, where Dr. Miranda Bice, a UW Health orthopedic spine surgeon, would perform a decompression and stabilization operation to relieve pressure on Tom’s spinal cord that was caused by a narrowing of his spinal canal between his shoulder blades.

“When I was taken to the operating room,” Tom says, “I remember Dr. Bice and the nurses telling me they will do the best they can for me. They couldn’t promise anything, including whether I would ever again walk or regain sensation in my legs.”

After a few days of recovery, Tom was transferred to the UW Health Rehabilitation Hospital on Madison’s far east side. Fueled in part by an unstoppable desire to get better, Tom outperformed expectations with his progress. Rehabilitation can be a grind some days, but Tom’s drive to get better left an everlasting impression on his care team.

Incredibly determined to get better

“Tom was incredibly determined from the first time I met him,” says Dr. Jacob Halvorsen, a UW Health rehabilitation medicine physician. “He said he would walk out of the rehab hospital with a walker, and I honestly didn’t believe him.”

David Grieve, a UW Health physical therapist who spent countless hours working with Tom, says that initially, Tom not only lacked coordination but also proprioception, which is the body’s ability to sense where its parts are in space.

“People without coordination and proprioception are typically confined to a wheelchair,” Grieve says. “They simply don’t have enough control of their muscles to walk safely because they can’t get their arms and legs to move where they want them to. When Tom first got here, his legs would move uncontrollably both side to side and back and forth.”

Rehab Hospital patients receive three hours of therapy each weekday. It’s an aggressive regimen that can overwhelm some patients, but Tom jumped into the routine.

“Tom and I spent a lot of time trying to build up his heart rate using a body weight support system that protects him from falling in case his legs give out,” Grieve says.

“After just a few days at the Rehab Hospital,” adds Dr. Halvorsen, “I knew he would have a good stay. He progressed much more than I anticipated.”

His surgeon, Dr. Bice, says it’s still too soon to know how much more progress Tom can make, but what he has achieved so far is remarkable nonetheless. 

“Many people with Tom’s injury go home wheelchair bound,” says Dr. Bice. “Tom had a great rehab team and his attitude certainly helps too. He’s clearly getting some neurological function back that appeared to be permanently lost.”

Aside from his wife Linda, his two grown children and three grandchildren, Tom’s biggest passion is playing golf, which he was doing three times a week until Thanksgiving 2023.

“I told Dr. Bice that I would be back on the golf course by July (2024) and she said you might want to back off on that a bit,” Tom says.

While he is already practicing his swing in the backyard, only time will tell if he’ll be able to play on a course again.

“Mental attitude is such a big part of the ballgame,” Tom says. “You have to want it more than anybody else.”

Meanwhile, cancer strikes Tom’s wife

Tom is not the only fighter in the Nickel household. Around the time he started kidney dialysis, Tom’s wife Linda was diagnosed with cancer. Despite a very uncertain prognosis, she is doing well following an intensive course of chemotherapy.

“Linda went through so much more than I did,” Tom says. I didn’t want to burden her with the stress of caring for me when she was dealing with a life-threatening illness. I either had to be self-sufficient or go somewhere else.”

Tom acknowledges that his stubbornness sometimes works to his own detriment, but the gratitude he expresses for the care he received from UW Health is nothing short of infinite.

“Everyone at the Rehab Hospital was caring, kind and compassionate,” he says. “I didn’t meet one person who was not always trying to do what was best for me. Everybody radiated positivity, and I could not have made this much progress without them.”

About two days before he was scheduled to go home, Tom told one of his nurses that when it came time to leave, he’d be walking to his car with a walker.

“I’m sorry, Tom,” replied the nurse. “We always take patients to their vehicle or medical transportation van in a wheelchair.”

You can probably guess how that story ended. Hint — it did not involve a wheelchair.

 


This story originally appeared on uwhealth.org.

Hip preservation surgery has Coach Petesch running better than ever


For more than two decades, Nathan Petesch has put on a staggering amount of mileage — not only on his cars but his body. The Orthopedic Surgery team at UW Health couldn’t do much to reverse the mileage on Nathan’s vehicles, but they did a masterful job restoring his left hip.


Before landing his current position as assistant men’s and women’s track/cross country coach at the University of Wisconsin – La Crosse, Nathan coached runners at a half dozen colleges around the country. Part of coaching duties include plenty of running himself, usually as the “pacer” who leads the pack of student athletes at a certain speed that varies according to the distance of the race for which the team is preparing.

After years of running 70 to 90 miles a week, however, Nathan’s hip started to show its wear and tear not long after he turned 33.

“The pain started in the spring of 2021 and I just kept running through it for a while,” he says. “Unfortunately, my hip just kept getting worse as the year went along. By late fall, I was pretty hampered and missing a few days of training.”

A sports medicine doctor in La Crosse diagnosed Nathan with a tear in his left labrum, which is the cartilage that lines the hip socket. Soon, Nathan found his way to the UW Health Sports Medicine Clinic, where he met with Dr. Andrea Spiker, an orthopedic surgeon who specializes in hip preservation surgery.

“Nathan described increasing hip pain as well as loss of range and motion,” says Dr. Spiker. “He also was hearing snaps and pops as he moved around. When we looked at his imaging, we found that in addition to the labrum tear, Nathan was experiencing hip impingement, which occurs when the ball at the top of the femur, or thigh bone, is not as round as it should be. This prevents the hip joint from moving smoothly and was the trigger for his symptoms. He tried physical therapy and anti-inflammatories, but things did not improve over several months.”

Knowing that a well-functioning hip was essential not only for running but a better quality of life, Nathan realized that surgery would be necessary to achieve his goals.

“It was a little scary facing surgery at 33 thinking that my quality of life could be severely impacted, given what I do for a living,” Nathan says. “When I met with Dr. Spiker, I felt very comfortable and confident that I would be in good hands. Her experience and positive patient reviews only enhanced my comfort level.”

Quite the finish to Nathan’s day of surgery

As the big day approached, surgery was not the only thing on Nathan’s mind.

“Our men’s team had a track and field meet in La Crosse that evening, and I was thinking about one of our athletes who was racing to qualify for the NCAA Championships. I felt bad that my surgery was the same day.”

The operation itself could not have gone more smoothly.

“I performed a hip arthroscopy, which is a minimally invasive outpatient surgery to restore a more normal shape to the bone, repair the torn labrum and restore smooth function to the joint,” says Dr. Spiker. “It not only allows the patient to enjoy a pain-free lifestyle and return to high levels of activity,” she adds, “We also believe that improving the mechanics of the hip will prevent future hip arthritis.”

Nathan was out of surgery late that afternoon. It wasn’t long before his girlfriend pulled the car up to the front of the hospital and the two were heading back to La Crosse.

After a round trip from La Crosse to Madison with a hip surgery thrown in for good measure, most people would call it a day and hop straight into bed. Nathan, however, couldn’t help himself. He showed up at the track that evening to see his runner compete in the 10,000 meters.

“He not only won the race but broke the school’s 42-year-old record and has since won three national titles. There are only so many moments of magic in an athlete’s career and I was grateful to be there for one.”

After finally making it home, Nathan took it easy for a few days. He began weaning himself off crutches after a few weeks. Home exercises assigned by his physical therapist allowed Nathan to start building up his strength and range of motion. 

Within three months after surgery, he started light running. By late fall, he was feeling 100 percent with no pain and no restrictions. For the past year or so, he is back to a weekly pace of 70 to 90 miles, which is at least as far as he was running before the surgery.

“I have nothing but positive things to say about the whole experience,” Nathan says. “We’re lucky to have some of the best medical professionals here in the state. I would certainly recommend the UW Health team to anyone who is dealing with injuries that have hampered their ability to stay active.”

 

 


This story originally appeared on uwhealth.org.

Keith Knurr, PhD, and Corinne Henak, PhD, receive ICTR grant for knee osteoarthritis research


Keith Knurr, DPT, PhD, assistant professor, Department of Orthopedics and Rehabilitation, and Corinne Henak, PhD, assistant professor, Departments of Mechanical Engineering / Orthopedics and Rehabilitation / Biomedical Engineering, were recently awarded the UW Institute for Clinical and Translational Research (ICTR) Advancing Translational Research and Science (ATRS) project planning grant.

Their project, “A Step Towards Precision Medicine: Collaborative Team Building to Leverage Quantitative MRI for the Clinical Management of Knee Osteoarthritis,” aims to develop a pipeline for creating patient-specific knee models that can provide estimates of the loads experienced by the cartilage across various tasks, such as walking, running, and jumping. These models may provide better insight into an individual’s risk of osteoarthritis onset and progression.

To make these models patient-specific, Drs. Knurr and Henak will use an individual’s knee shape acquired from standard knee MRIs, cartilage mechanical properties from advanced quantitative MRIs of the cartilage, and movement biomechanics from three-dimensional motion capture analyses within Badger Athletic Performance.

This project will also leverage data from a separate study, partially funded by a Department of Orthopedics and Rehabilitation Freedom of Movement Fund Award, investigating factors associated with early signs of knee osteoarthritis in former collegiate athletes with a history of anterior cruciate ligament reconstruction. The team chose to apply these patient-specific knee models to individuals following anterior cruciate ligament reconstruction because they are at a high risk of developing osteoarthritis.

Timothy McGuine, PhD, receives 2024 Chancellor’s Award for Excellence in Research: Independent Investigator



Timothy McGuine, PhD, a distinguished scientist in the Division of Sports Medicine, Department of Orthopedics and Rehabilitation. Photo: Bryce Richter

Each year, the University of Wisconsin–Madison recognizes outstanding academic staff members who have excelled in leadership, public service, research and teaching. Timothy McGuine is one of those exceptional individuals who brings the university’s mission to life and ensures that the Wisconsin Idea extends far beyond the campus and the state.


April 26, 2024 – Timothy McGuine, PhD, began his career as an athletic trainer and remains one at heart. His “on the sidelines” expertise imbues everything he researches, contributing to his national reputation as an expert on injury prevention in adolescent athletes.

McGuine’s 81 peer-reviewed papers address some of the most pressing issues facing young sports participants, from reducing concussions and ankle injuries to the efficacy of football helmets and soccer headgear.

Recently, he took a leading role in researching the impact of youth sports participation on overall health during the COVID-19 pandemic, becoming among the first to present on this emerging topic.

One of McGuine’s most important contributions has come in the standard he has set for clinical field research. His multi-site studies take place at the point of injury and at the point of care. McGuine’s studies also have had a profound impact on professional clinical practice — one ankle injury and balance intervention study, for example, has been cited over 1,500 times.

“Tim is nationally recognized for his contributions to adolescent sports medicine, which grew out of his background as an athletic trainer. His models have set new standards for research, and his widely cited work has informed safety policy in high school sports. Tim founded the Wisconsin Sports Injury Research Network, which partners with schools around the state to gather data on athletic training interventions that’s led to some important innovations — for example, he has conducted the largest injury prevention studies for sports injuries ever undertaken in his profession — resulting in new strategies used by medical providers across the country.

The working relationships Tim has developed with schools have helped him advance discovery on other health challenges, like researching the impact of youth sports participation on overall health during the Covid-19 pandemic. And his service on national medical advisory committees for high school sports brings a valuable research perspective to policy decisions.”

Jennifer Mnookin, PhD, Chancellor of the University of Wisconsin–Madison

“Dr. McGuine has crisscrossed the state, time and time again, putting thousands of miles on his car in an effort to educate high school athletes, their parents, athletic directors and athletic trainers regarding his population-based studies and the impact they would have on the participants and on the lives of others.”

Tamara A. Scerpella, MD, Professor and Chair, Department of Orthopedics and Rehabilitation

 


Excerpted and adapted from an article that originally appeared on news.wisc.edu.

2024 Residency Match Results


We are thrilled to announce our new class of outstanding Orthopedic Surgery and Physical Medicine and Rehabilitation residents (our first class of four since our PM&R program’s complement increase!).


(Click images to enlarge.)


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Congratulations and welcome to the University of Wisconsin School of Medicine and Public Health Department of Orthopedics and Rehabilitation family!