On July 4th, 2001 I was hit by an oncoming car while riding on my motorcycle, the driver was a kid who had recently received his drivers license.  I was in the hospital for 5 weeks –they managed to save my foot–which had basically been torn off at the ankle (just hanging on with ligaments and tendons) when his bumper hit my foot.  I also broke my femur on the handle bar –which made me do a flip into the intersection.  They took a muscle from my stomach and attached it to my foot to get blood flow back to my foot and took skin graphs from my thigh.  I also had a rod put in my femur and I had an external fixator on my foot and shin keeping my foot on while it healed.  If not for the amazing skill of the doctor I’m sure I would have never been able to keep my foot.

Over the next 3 years I went through a lot…  using a wheelchair, crutches and/or cane, and I was stuck in the dilemma of wondering whether it was worth keeping my foot.  Although having that choice was very difficult at times –I’m glad I had a chance to know what life would have been like if I had tried keeping it, it was much easier to make the final decision to amputate.  I had tried scopes, ptb braces, acupuncture, drugs, orthotics, special shoes, and 8 surgeries including an ankle replacement.

One day after weighing the pros and cons of keeping my foot, I realized it all comes down to a lifestyle choice.  I could live in pain the rest of my life and be limited to walking short distances and gritting my teeth everyday. Or, go back to doing most everything I could do before my accident and just have the mild inconvenience of putting a prosthetic foot on everyday.  With the way technology has improved in prosthetics –even in just the last 5 years, I was really amazed at what’s out there once I had decided to research it.

I had the ERTL procedure on Sept 3rd 2004 performed by Jan Ertl.  I learned many things leading up to it.   I learned while researching the options of amputation that many amputees wound up having to go back for revision surgeries for pain they were having when weight bearing on their limbs, and they all talked about how they had this ”ERTL“ procedure done and how it totally got rid of their pain.  Once I heard this I realized I wanted my amputation to be the last and only surgery I’ll ever need again…  the ERTL procedure. 

I was lucky enough to consult with both William and Jan Ertl when they were in town  –it turns out they both grew up right down the block from where I currently live.

The procedure makes so much common sense that I can’t believe more doctors aren’t performing it.  Not only did I have virtually NO PAIN coming out of surgery –I really didn’t even need the pain meds. But the ”phantom pains“ which came and went –virtually disappeared into ”phantom feelings“ after only a month. 

The Ertl procedure does more than just cut you limb off and sew it up.  They create a bone bridge, reattach your remaining muscle, veins and ligaments and cut the nerve ending off as high up into your leg as possible to give them protection from rubbing in the prosthetic.  All of this gives the amputee a stronger, tougher stump.  In my case I can actually still flex my calf and other lower leg muscles. Many revision amputees wind up growing the muscle back that they all but lost after their original amputation.   The procedure takes into account that you’re going to have to turn your remaining residual limb into a weight bearing end that has to hold your weight when you walk, run, jump etc.  It seems to me that most doctors are only being taught how to remove the limb -with out giving any thought to what your going to do once you leave the hospital and how that limb is going help you walk again.

I’m currently about 10 weeks out from my amputation –I’ve been walking with my prosthetic for 2 weeks now. Even though my overall leg has grown weak over the last three years of walking with a cane or crutches. I can already do much more than I was doing before the amputation.  I can already see major improvements in the strength of my knee and thigh and I hope to be back to 100% by the end of the year.

I wish the Ertl procedure was performed by more doctors, because I know the frustrations of dealing with pain and going through surgeries which don’t work.  Amputation is difficult enough as it is –and if you wind up with pain after amputation you could fall into thinking that that’s the way its always going to be… but you don’t have to live with it.  Luckily the internet is available to let people know their options and research what’s out there.  If you’re facing amputation or pain after amputation there are still options that can work for you.

–Mike Berg (email)