Tobacco Valley News Article

Coughlin Clinic in the News: Lorna Burk and her STAR Total Ankle

By Krista Tincher Of the Tobacco Valley News 
Just before Thanksgiving, Lorna Burk was busy about her home, tucked in the misty lee of the Galton Range. She began the holiday feast preparations. She walked to her mailbox, her trusty beagle trailing in her footsteps. It was business as usual at the Burk homestead.

Eureka resident Lorna Burk walks from her mailbox near her home in the Tobacco Valley last week. Burk underwent a new form of ankle replacement surgery in July.

And Burk walked with hardly a limp. A few months ago, her right ankle joint was completely taken out and replaced with a prosthetic joint. She was among the first batch of five to officially receive this treatment in the United States, said Dr. Michael J. Coughlin, a specialist at the Saint Alphonsus Coughlin Clinic in Boise. The procedure was just approved by the FDA in June. And for Burk, that approval seemed a long time coming. She’d been limping along for a year by the time she went under the knife at the end of July. “It was just excruciating,” said Burk last week as she sat comfortably reflecting at her dining room table. “I could walk, but it was hard to walk.” Burk broke her right ankle 10 years ago, an ordeal from which she had long since healed.

Then last year, the same joint began bothering her again. “All of a sudden it started getting bad,” said Burk. She speculated that the break had ultimately weakened the joint. So Burk took a few trips to Northwest Montana doctors. “I had worn out the cushion in my ankle, in between my ankle and leg,” said Burk. Doctors recommended that Burk undergo a surgery that would fuse her ankle. The procedure would alleviate her pain, but cause her to limp with the stiff joint for the remainder of her days. Burk refused. “I’d already limped for a year,” she said. “I didn’t want any more of that. I think that would have been a last resort. ”

Her alternatives, however, were limited – if nonexistent. But Burk continued to search for a better solution. It was then that she caught wind of a foot and ankle specialist in Boise. The son of a local friend had seen the specialist with positive results. So Burk gave a call to the office of Dr. Michael Coughlin at the Saint Alphonsus Coughlin Clinic in Boise. And in March, she was Idaho bound. At that time, the S.T.A.R. (Scandanavian Total Ankle Replacement) surgery had not yet been approved by the FDA. Coughlin anticipated approval any week. He had been the principal investigator in the clinical trial that proved the effectiveness of the S.T.A.R. 3-part joint system.

The system replaces a natural joint with metal and plastic components in a joint that mimics natural ankle motion. “It’s really a big deal,” said Coughlin. “We’re very rigid as to who gets it and who doesn’t.” The person has to meet specific age, weight, and activity level criteria to receive the joint. And prior to June, patients in the U.S. could only receive the joint through Coughlin’s study group. But after a preliminary examination, Burk was placed on the waiting list for the surgery. And the waiting began. “Dr. Coughlin told me they had worked 11 years to get this approved by the FDA,” Burk said. So though her wait seemed long, her overall timing wasn’t bad. March flowed into June, and Burk was still painfully hobbling about. “Finally I called and said, ‘I’ve got to have something done,’” Burk said. The FDA had only just approved the procedure. Burk was put on the roster for July 29, to be the first in the U.S. to receive the approved procedure, she was told. Burk was Boise-bound once more.

This time, she would come away with a brand new ankle, and a lot of work to do. Going into the surgery, she said, she was more nervous about the anaesthesia than the surgery itself. “I’d been in such pain, I just wanted it over with,” Burk said. Doctors put her under, and the next thing she knew, she was waking up in bed with a new ankle joint. A few days later, her husband Arlie whisked her north for the long drive home. Burk was wheelchair bound for three weeks before she could put weight on the cast-encased ankle. The wheelchair experience was devastating, said Burk. “You’re so limited to what you can do,” she said. “And my house is big. ” But soon she began to walk with a walker, and within six weeks of her surgery, she was moving freely about. She had to learn to walk again, and attends physical therapy sessions in Eureka three times per week.

Nowadays, she hardly limps. “It’s just been zip, zip, zip, all the way,” Burk said with a smile. “It went really fast. ” “It still bothers me a little bit,” she added. But at her last examination three weeks ago, she was told that she was making an excellent recovery. “I really feel the whole key is to walk a lot,” Burk said. “If you don’t walk, it’ll stiffen up. ” With her newfound mobility, Burk is already looking forward to bedecking her house with a glowing array of Christmas lights again this year. It’s a tradition she looks forward to every year. “People ask me, ‘Are you going to decorate your house this year?’” chuckled Burk. “I say, ‘Yes, if I can get on the ladder.’” And by gosh, she will.

Meanwhile, Burk has a new appreciation for mobility. “I never realized until I was so crippled how many crippled people there are,” said Burk. “Unless something goes wrong like that, you’re not very aware of it.”