Pioneering doctor eases amputation pain with TMR

COLUMBUS, Ohio – Emilee Lester has come a long way in two years.  

Just four days before her college graduation, she was driving back to school when a large piece of debris was suddenly on the roadway. 

"Even though I know you aren't supposed to, I swerved to avoid it and hit another car head on," Lester said.

The impact crushed Lester's right foot between the ankle and toes. 

"My family, we like to describe it as taking a handful of chips, crunching them with your hand, putting 'em on the table, and trying to put them back together.  Too many pieces. Pieces don't exist anymore. Too hard to put together," Lester said.

Lester made the decision to have doctors amputate. During the surgery, Dr. Ian Valerio also performed another procedure designed to eliminate stump pain and phantom limb pain: the feeling of pain in a limb that is no longer there. 

Valerio is pioneering the use of primary targeted muscle reinnervation, or TMR, rerouting the nerves that are cut during amputation into surrounding muscle, lessening the pain.

"By hooking the peripheral nerve up to the motor nerve, it sends new signals as the nerve regrows, thus reinnervating the muscle," Valerio said.

One week after her amputation, Lester's college held a graduation ceremony for her in the hospital.

Three months later, Lester went to Parris Island, South Carolina, for her brother's graduation from Marine boot camp, walking five miles on her new prosthetic leg. 

"It has not stopped me from doing anything I want. If I have to figure out a different way to do it, I do," Lester said.

Valerio and his colleagues at The Ohio State Wexner Medical Center say TMR was traditionally performed months or years after the amputation. 

Valerio said when TMR is done at the same time, most patients will be off pain medication within three months.