Jude’s Rotationplasty Journey

Two outs, bottom of the inning. Oh, it looks like the manager is coming out to the mound. They're going to have to talk it over. That's a good idea. Really, it's a critical decision here. This could affect the rest of his playing career and really the life of the field. I really don't know what you do in this situation. I do know this. Sometimes you've just got to trust your gut.

I haven't really been scared. I just have not been afraid. I haven't had that much emotion about it, really. Kind of makes it hard to make an emotional film, but I just don't overthink it.

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He's always been like the most energetic kid you'll know, and he's super athletic. He can make friends with anyone.

He's always been a special kid. Everybody knows Jude. I mean, he's the youngest of three kids. When he was in second grade, they had all the little awards at the end of the school year program. His award was Most Fun. That nickname has kind of stuck since then.

From a very early age, we knew Jude was an athlete. When he was about two years old, he picked up small football and threw a perfect spiral. He's always been active, always been running, on the bike, throwing a ball.

At our old house in the front yard, there were like clear bases where there was just no grass. You could tell that's first base, that's second base, because he would play so much.

He played a lot of baseball. But Jude's a kid in constant motion, no matter what's going on.

I tell you, this man has a high motor and a laser focus. There's everything else, and then there's the time when he laces up his cleats and heads out to the lines.

We had moved from basketball to baseball season. And Jude uses obviously different muscles during the two different sports. And we noticed him running from first to second with a little bit of a limp.

We had done kind of the traditional just put ice on it and rest it. Thought maybe he had just been too crazy, because he runs around all the time.

My knee was hurting whenever I started running. It would stop like five minutes after I stopped.

Then we saw him running up into the outfield to take his position in between innings, and he had a pretty good limp to him. So it was after that that we decided it was time to call the doctor and get him checked out. We were texting back and forth. Our older child Joseph was playing baseball, so I was at his game.

My husband was texting, asking what's going on.

I kept getting these, you know, just checking in texts and said that, you know, the doctor assumed it was something muscle-related.

The PA came by and he said, "Oh, I'm sorry it's taking so long. I just wanted the doctor to talk to you about something we saw on the x-ray."

Then she sent me a text that said, "Something's wrong." And that's all it said. And she said, "I need see you at home quickly." And so I left the baseball game and came home, and that's when we found out.

This has got to be a shock. I mean, he is doing everything he can to make it safe at home.

We went up in our bedroom and shut the door and got on the speakerphone with the doctor. And Jude was diagnosed with osteosarcoma, which is bone cancer, in his right femur. It was pretty much a shock. You just hear cancer, and you just-- you don't really-- you don't know what's going to happen.

I was a little bit numb. And it took me a little while to kind of let it sink in for, OK, Jude's got cancer.

DR. THOMAS A. OLSON: Osteosarcoma is one of the more common bone tumors. The way our bones grow is first cells divide, and then the cells produce matrix, and then calcium, and you form bone. Osteosarcoma, the process has gone wrong. The cells are not maturing into going. They're not producing good bone. So what they are producing is a tumor.

We talked to him about it very matter of factly. He was silent for a minute. And then it was, "OK, what happens next?" Thursday afternoon we find out there's a tumor in his femur. Saturday we had MRIs and scans. The next week we had a biopsy. And it was very quickly after that we started chemo.

You ready, then?

Yeah.

I've got to attach this to you.

Yeah, that's usually important. To get it into my body.

Yes.

He still kept a very, very positive attitude, just like unbelievable to see him be able to do that. And it's really helped us as a family to deal with it as well. When

We give chemotherapy to prevent the tumor from spreading. And then at about 12 weeks, the surgeon does his surgery. Osteosarcoma is not cured without surgery. Unless you can take it out, it cannot be cured. The whole treatment that showed you could cure people was approximately 32 weeks of chemotherapy. And rather than get the surgery first and then the chemotherapy, they kind of split it. The old way of treating osteosarcoma was to amputate. Subsequently people said, "Let me try to spare the limb." And that's really useful in older people. So when you're fully grown, they basically take the tumor out, take the knee out, and do a knee replacement. And that's a limb spare. But the problem comes in in younger children. When you do a limb spare and someone is not fully grown, what happens in five years when the other side grows? The more joints you have, the better a prosthesis can fit.

It takes a special patient. Rotationplasty I recognize is not for everyone or every family. The ideal candidate for rotationplasty is a young patient who is active in competitive sports and wants to continue to be active in competitive sports. The rotationplasty allows kids to return to those activities, whereas the other reconstruction options do not.

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GRETCHEN HILEY: The rotationplasty is really hard to describe. In my mind, I had to visually look at it.

It kind of sounds wild to me at this point.

When we first saw it, we were like, what the heck is this?

He gave us a couple of websites to look up and to see.

And my first initial reaction is, you're not doing that to my kid. No way I'm going to let you remove his leg and put it on backwards. Until you start reading about it. And you start reading some of the stories. You start looking at some YouTube videos of kids that have been through it, kids playing baseball. It just seemed like the right thing to do.

DR. NICKOLAS B. REIMER: In rotationplasty, you basically take out the knee. You cut out the tumor in the femur or in the tibia, but you leave the muscles and the nerve hooked up. And you flip the lower leg around, with the foot facing backwards. When that heals, you basically have created the knee joint. And now, as that heals, that person has an extra joint to get a better prosthesis.

He knew as soon as he heard about it that that was what he wanted to do.

Because I can play sports again. That's the only reason, really.

After hearing how the implant surgery would keep him from being able to play any sports pretty much, and be able to ever run or anything, just would have changed his life so much, that that wouldn't have worked.

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Well, the trainer's out there tending to this young man. And I'll tell you, you just don't know what's going through his head right here. His career could be in jeopardy. You really hate to see that.

Still hard to comprehend that like in a week, he's going to lose his leg. I am worried that's going to affect the rest of his life. Like once he gets to high school, what it's going to be like for him there, if he's going to have a lot of friends, or if he's going to be sort of lonely. Or even into adulthood. I'm just hoping, really hoping that people will see him for who he is.

I said, "You know, Joseph's worried that people might make fun of you or what they might think or that it looks weird." And he stopped and he looked at me and he said, "Well, that's their problem." And I just said, "You know what, you're exactly right."

Don't think too much about it or you'll make yourself scared. It's just easier just to, just think of the good side of everything, I think.

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Wait, wait a minute. It looks like a glimmer of hope here for the young man. He could have made his way out of this after all.

Probably an hour after I come out of surgery, I'll be able to wiggle my toes. I don't know if I'll be able to pick it up, yet, but I'll be able to wiggle my toes.

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There's really no wrong answer here. He's got to make his decision and let the chips fall where they may. This is where legends are made.

Surgery day was one of the longer days I've spent through all of this, and we've had some pretty long days. Reading it, and watching, seeing some graphs, kind of understanding the process, the surgeon kind of went through each aspect of the surgery with us. Even knowing that, your kid goes away from you, they wheel him out of the prep room, and you don't see him again for eight hours. It was one of the longer days I've spent, just not knowing exactly what was going on,

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Man, his teammates really have stepped up around him. It's like they're feeding off of his energy. It's really exciting to see.

Not two minutes after we saw him in the recovery room, his toes were wiggling. It was just the most amazing thing.

It does take a while, 'cause still if I like play with one, my calf, I still feel it.

No, just take one picture.

One, two, three.

Make sure to work on those [INAUDIBLE]

We brought him home five days after surgery. And then everything was like having a baby again. Every movement needed assistance.

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They will start around four to six weeks after the surgery to measure him for the prosthetic. And then it will take about two to three weeks after that for the prospect to be ready. And from there, he'll be learning to walk again.

Wow, this is fortitude. This is grace under fire. This young man is what sports are all about. Testing yourself to the limit, and leaving it all on the field. You really got to love his never-say-die attitude.

He was up on the walker as soon as he can be on the walker, to be up and mobile and to gain back a little bit of his independence and privacy.

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Up. Up. Up. Way harder than it looks, you know? Wow! He's good. I think he is doing spectacularly.

Prosthetic's been interesting. Seeing him stand up on it for the first time was pretty amazing.

Feels really weird.

You read about how long it takes for a kid to sort of go through PT and recovery and getting adjusted to using a prosthetic. He stood up and walked on it day one. Determination. He was going to be mobile again.

He's playing outside right now. As soon as he could, he was like OK, now they're done with me. Now I can go grab my lacrosse stick and go outside and play by myself. And OK, I'm going to run back and forth for absolutely no reason.

We had taken Jude in for one of his checkup appointments, and the nurse said, "Oh, Jude, do you have any questions?" And he said, "Yeah, I have a question."

I was just bored and I was just kind of randomly thinking. I was like wait, what's going to happen to my leg?

She's like, "What do you mean?" He said, "What's going to happen to my leg from the surgery?" And she said, "Oh, OK, so they're going to take it and they're going to rotate it around. And they're going to attach it up here. And he said, "No, I know all that. No, what's going to happen with my leg?"

And I was like, I kind of want a piece of it or something. It's mine. It's a part of me.

Her eyes got real big and she looked at us like, "What do you want me to say here?" And he said, "Well, I don't know, they could have it in a box like when you get cremated or something."

It just kind of dumbfounded everybody. Just everybody got silent. And he's like, "Well, I want my leg. That's mine, I want it."

I was very surprised by that at first. But I heard it's not really unusual from people, from the orthopedic surgeons. I said, "OK, but it's handled just like through the mortuary. It's strange."

I got a phone call and they said, "Hey, your leg's ready." So I drove to the funeral home and picked up a little box about that big and full of the ash from Jude's leg.

I just wanted to keep what was part of me and once belonged on my body. This is a Matt Kent jersey.

I'll hold it up for you.

You see, Matt Kent, he plays baseball for the Braves. He came to the hospital to visit the kids and stuff. And then he gave me his jersey.

Kids will ask a lot of questions. Kids are brutally honest. And I think Jude appreciates that. If they ask, "What happened to you?" he's more than happy to explain what has happened. It's the adults that stare I think that bother him a little bit. A couple of times I've seen him, when we've been in the grocery store, if somebody's kind of looking at him or does a double take, he'll look straight at him and say, "Hello, how are you?" and just try and engage them.

At first I was like, no he should keep the leg. You should do the other option, the other surgery, because I didn't see it as being worth it to not have a leg for the rest of his life. But it is the healthiest way. The next year, two years probably, is going to be really, really difficult. But it's important to keep a positive attitude. In the end, it's all going to be OK.

Well, here we go, folks. It's game day. You work all off-season to be able to get out there on the field. Fans are filling in. And I know one young man who is no doubt chomping at the bit to get out between the chalk. The folks that make the prosthesis and work with him in physical therapy were excited as Jude was to have him throw out the first pitch. So typically, when you get your first prosthetic, it's a fairly basic looking device. Because of what he was getting to do with throwing out the first pitch, they made sure to wrap it in the Braves logo. So he's got a Braves prosthetic to get started, which is pretty cool.

You ready?

Yes ma'am.

Let's run.

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I really believe in sports. And in fact, that's one of the reasons I try to push more children to have a rotationplasty, rather than limb spare, with an extender, which they can never do sports or do anything. Certainly he has potential to be a Paralympian. One of my former patients has won medals.

Let's see what you got.

Folks, this young man you see walking down on the field has been through it all this off-season. Six weeks of chemo, five hours of surgery, followed by six more weeks of chemo, and undergoing extensive physical therapy.

Jude has taken every bit of this in stride. He will get back to baseball. He will get back to playing lacrosse at some point. He was playing basketball with his buddy yesterday. Jude will get back to being Jude. It's a pretty bold surgery. Once we sort of pitched the idea to Jude, his first question was, "Can I still play baseball?" and the answer was yes, he said, "Well, then that's what I'm doing." I'm pretty sure I wasn't 100% sold at that point. But he made his decision already. It didn't take him two minutes to decide this was the best option for him. In retrospect, it's the perfect option for him.

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This is it, folks. It's what we've all been waiting for. He throws the rubber. He's set. I've seen a lot in my career. You've got to tip your cap to this young man right here.

How did it feel to get back on the court, Jude?

It looks fun and Try

Yeah, what about the rotationplasty?

That's pretty good.

Are you pleased with your decision?

Yes.

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