By the time Dr. Spencer Misner had carved away the dead and diseased flesh from Bobby Rice’s right foot last year, little remained other than bones and tendons.
“I couldn’t believe it. It didn’t look real. It looked like something out of a movie,” recalled Rice, a Whitfield County resident.
Today, the ankle has almost completely healed. It looks like Rice had simply scraped it. And Rice’s foot has largely healed, too. Misner credits cutting-edge stem cell treatments for saving Rice’s foot and leg.
Rice, who has diabetes, stepped on a piece of glass last fall and his foot quickly became infected. After trying a home remedy, Rice eventually went to Dalton’s Hamilton Medical Center emergency room, where doctors found he had a rapidly spreading necrotizing fasciitis, or in layman’s terms, flesh-eating bacteria.
Physicians treated the infection with antibiotics. However, Rice had one toe amputated. Doctors had to strip away much of the flesh from Rice’s foot and a great deal of flesh along his ankle.
“We did what we had to do,” Misner said. “We got the infection out. We saved his life. But what do you do next? We’d normally say all you can do now is cut of his leg so he can get on with his life.”
But Misner had another idea. He contacted Ed Fickey, a sales representative for Osiris Therapeutics and asked about using the company’s new stem cell technologies to rebuild the foot and ankle.
Stem cells can grow and differentiate into many different types of cells. Stem cell treatments introduce these cells into damaged or diseased organs to repair them.
“The problem is that Bobby is an indigent patient and didn’t have the financial resources. Ed spoke to the company, and they agreed to donate the products for free,” Misner said.
Osiris provided two products called Grafix and Ovation. Fickey said they are made from adult stem cells derived from donated placenta and do not come from embryos.
“They hadn’t had a case of this magnitude before,” Misner said. “Stem cells are starting to be used pretty extensively. They are used on burn patients to regenerate skin. But this involves muscle, bone, tendon, fat, skin, so many types of tissues.”
Misner said he asked the company for some guidelines.
“They basically said, ‘You let is know what the guidelines are because we don’t have a record of anything like this being done before.’ I did a literature search, and I couldn’t find anything like this before,” Misner said. “They did connect me with a doctor in Washington, D.C. who has used stem cells quite a bit. But when I sent him the pictures (of Rice’s foot and ankle), he basically said ‘Good luck.” He helped me with some general guidelines, but there was no recipe to follow.”
Misner started the treatments in November 2011, and Fickey recalls just how tricky it was.
“He (Misner) had a syringe, and he was looking for some tissue to push it into. But there was nothing but bone there,” he said. “Now, there’s a whole fleshy foot.”
Misner has applied the stem cell treatments nine times now, and he describes the foot as more than 90 percent healed. He had to perform the first treatments in an operating room at Hamilton Medical Center because of how complicated they were. But he has been able to do the last few treatments in his office. He expects to have to do at least three more before the foot has completely regenerated.
Fickey said Osiris has been watching “the Dalton foot” very closely.
“Each time we do an application, I send the latest pictures back, and they have always been very impressed. They wanted to see if there has been muscle growth and the answer has been yes. They wanted to see if there has been vascularization, blood flow, and there has been,” Fickey said. “The most impressive thing is that Bobby has feeling back. We were here a couple of weeks ago and the nurse tickled his foot and he kind of jumped. We didn’t expect that. Now, we are starting to have some other cases around and we can tell them ‘This is what we want to see.’”
Rice said he never dreamed he would regain his foot.
“I know what it looked like. I expected he would just have to take it off. To see where it is today is just amazing,” he said.