surgical nerve repair alleviated Benjamin’s chronic arm pain

a simple mistake

Benjamin was leaving the house for work, just like any other day. When he shut the back door, it wouldn’t close properly. He tried again. It still wouldn’t close. He gave it one final shove, sending his arm through the window, slicing it and causing it to bleed profusely.

Benjamin was rushed to the hospital, where he underwent emergency surgery to save his life. Fortunately, his surgeons were also able to save his arm. But after surgery, he found himself in agonizing pain.

“It felt like someone had put it [my arm] in a vice grip and was cranking on it,” Benjamin said.

The pain prevented him from sleeping more than a couple hours a night. It also severely impacted his livelihood. The pain was so unbearable that he was unable to work.

finding someone to listen

Benjamin tried to push through the chronic pain and move on with his life, but the pain was relentless. And worse, people kept dismissing his concerns.

“I was trying to get help and nobody really believed me. They just kept telling me that I needed to get back to work and move it. I kept telling them that something wasn’t right,” Benjamin said. “I have a high tolerance for pain, but people didn’t understand the pain I was going through every day, all day long.”

help at last

Finally, after struggling to find someone who understood his pain, Benjamin was referred to Dr. Brandon M. Smetana at Indiana Hand to Shoulder. Instead of dismissing Benjamin’s concerns or suggesting more pain medication, Dr. Smetana believed he could alleviate some of Benjamin’s pain with surgical nerve repair.

During surgery, Dr. Smetana discovered three or four areas along Benjamin’s forearm where his nerve was damaged and neuromas had formed after his injury and were causing the pain. Neuromas are tangled areas of scar tissue in the nerve that send inappropriate signals to the brain. He removed the neuromas and then used Avance® Nerve Graft to bridge the gap and allow the nerve to repair itself.

Dr. Smetana explained that nerve injuries like Benjamin’s can be easily missed. “With trauma, the main goal is to save your life and then your limb. It’s actually quite frequent to have smaller nerve injuries that go unrecognized for longer periods of time. I see a lot of patients that have seen a number of physicians and they’re seeking their third or fourth opinion, or have been told that there wasn’t anything that was wrong and are sent to chronic pain management to manage their continued pain. There is a growing respect for how debilitating nerve injuries can be and a growing understanding of what types of nerve injuries can cause continued pain afterwards.”

the healing continues

After a neuroma is removed, patients may experience immediate improvement. From there, the nerve continues to recover over time, which can improve function and reduce pain.

Today Benjamin is back to building his business, working nearly six hours every day.

“When I was able to get back to work, I felt really good. I could provide for my family again. That means a lot to me. I’m a survivor one way or another. And it made me feel good to start surviving again.”

Dr. Smetana is a paid consultant of Axogen Corporation.

surgical nerve repair gave achilles his life back

the crash that changed everything

While on an afternoon motorcycle ride with friends, Achilles had to make a snap decision. When a train gate came down faster than he was ready for, would he have to speed through and try to make it, or hit the brakes? He decided to slam on the brakes and, in the process, took a dive. The motorcycle accident left Achilles with a fractured tibia and fibula.

Achilles underwent surgery on his leg two days after the accident. Doctors placed eleven screws and rods into his tibia, repairing the fractures, but after the surgery, Achilles was left with immeasurable pain.

“It kept getting worse and worse,” Achilles explained. “Nothing was helping.”

when the pain takes over

 Not even an abundance of pain medication made a difference. Achilles remembers being prescribed 300 pills at once. And these weren’t just any pills—they were narcotics—and he was told to take them as he needed for the pain. Which he did. But Achilles’ family began to notice a change in his behavior. He was in pain, he was over-medicating—he was in trouble.

“The pain was insufferable,” Achilles explained. “It had taken over my life and I wasn’t able to engage with my family or enjoy much of anything.”

Achilles tried to stop taking his pills cold turkey and ended up in the emergency room from withdrawal symptoms.

a better approach

Instead of trying to figure out what was causing Achilles’ pain, most of the treatment options he was given focused on pain management through medication. No one stopped to ask what was causing the pain, or to consider a different approach, until Achilles met Dr. Rodriguez.

In his very first appointment, Dr. Rodriguez really listened to Achilles and was able to determine the cause of the pain right away. Achilles had a nerve injury that had resulted either from the trauma of the motorcycle accident, or the surgery to repair his broken ankle. A neuroma, which is a tangle of broken or damaged nerve fibers mixed with significant scar tissue, had developed in his tibial nerve—the nerve that runs on the inside of the leg into the bottom of the foot. This nerve was the culprit for the pain Achilles was experiencing.

one procedure, a lifetime of relief

Dr. Rodriguez told Achilles that surgical nerve repair was an option. During surgery, Dr. Rodriguez removed the neuroma from Achilles’ leg, and the resulting nerve gap was repaired with Avance® Nerve Graft and Axoguard® Nerve Protector.

“It worked,” Achilles said. “He changed my life.”

Today, the pain and tingling Achilles dealt with for so long is gone. He’s a dad who can crawl, run and play with his young son. He is happy. He is back to being himself again.


surgical nerve repair got david back on his feet

surviving the worst

You can look at someone and never know what they’ve been through, and what they’ve had to survive. David is one of those people—a survivor. In 2018, when David and his wife arrived home from work, they walked in to find they were being burglarized by a violent intruder. The burglar shot and killed David’s son, and shot and injured David and his wife in the process.

David and his wife suffered the worst type of pain a parent can imagine—the loss of a child. To add to their emotional pain, the gunshot David sustained in his right leg made it difficult to walk and left him with excruciating physical pain. He was unable to work and barely able to leave the house.

a painful reminder

To make things worse, doctors struggled to find a solution for David’s leg injury. He was prescribed pain medication and sent home with crutches and a brace, but he quickly found out that neither would be much help. His leg was in very bad shape.

“I couldn’t walk and I could hardly sit,” David said. “I had my family helping me move around the house, [and even] bathing me. I couldn’t get into the front seat of the car—they had to put me into the back seat to take me to my doctor’s appointment. I couldn’t work and I was in constant pain at that time.”

a different approach

After struggling to find a physician to help, David was referred to Dr. Kolovich, a surgeon who specializes in nerve injuries. Dr. Kolovich determined that the gunshot had severed a portion of David’s sciatic nerve, impacting his ability to walk, and was also the cause of the unrelenting pain.

Instead of treating the pain with medication, which often only offers temporary relief, Dr. Kolovich recommended a different approach—repairing the source of the pain through surgical nerve repair.

During the surgery, Dr. Kolovich removed a painful neuroma—a tangle of broken and damaged nerve fibers mixed with scar tissue—that had formed in David’s sciatic nerve. He then repaired the damaged nerve using Avance® Nerve Graft and Axoguard® Nerve Protector. While he knew it would take time, Dr. Kolovich was confident David could recover from the damage to his leg.

finally feeling better

Today David is living pain free and has also regained most of his mobility. At first, he began to feel his toes, then a few weeks later he had movement in his foot. Now he is walking with a nearly normal gait, and is much further along than he ever thought possible.

“I thought the pain would be something I would have to live with the rest of my life,” David said.

Sensory wise—David can feel everything now. And it will likely continue to get better. He is making a huge recovery every day, and Dr. Kolovich is just happy to know he’s out of pain.

“Thinking about what happened to me and what happened to me with my son, I know he’d look at me and want me to live my life and move on,” David said. “When I look at my life and where I’m at now, I know it’s a miracle.”


surgical nerve repair alleviated Beth’s chronic foot pain

anything but routine

Beth had an old high school injury that occasionally required surgical “clean up.” This was typically a routine procedure. However, after Beth’s most recent visit to her surgeon, she’d begun experiencing electrifying jolts of pain in her foot throughout the day. Normally very active, Beth found the pain debilitating.

“I couldn’t step on my foot or really use it at all,” Beth said.

life on hold

Unable to take care of her farm or do the things she loved, Beth began to feel depressed and increasingly hopeless. She decided it was time to seek help. While doing internet research, she stumbled upon Dr. Thomajan, a surgeon who specializes in nerve injuries.

“At my first appointment, he stood outside the doorway and just looked at my leg and knew there was a severe nerve injury going on,” Beth said.

After closer inspection, Dr. Thomajan confirmed his suspicions. Beth’s previous surgeon had damaged the main nerve to her foot, causing a painful neuroma to form—a tangled mass of scar tissue mixed with broken and damaged nerve fibers. Not all neuromas are painful, but others, like Beth’s, cause unbearable, life-altering pain.

a smarter approach

Instead of managing the pain with medication, Dr. Thomajan recommended repairing the source of the pain through surgical nerve repair. This involved removing the neuroma, in order to stop the pain signals to the brain.

During the surgery, Dr. Thomajan identified and surgically removed the neuroma. To bridge the gap created by its removal, he used Avance® Nerve Graft, which would provide a healthy structure for the nerve to regenerate. This technique made it possible to remove the painful stimulus and restore the normal signals to the brain.

fast fix

Almost immediately after surgery, Beth felt better.

“The next day I knew there was a change,” she said. “Even with the extensive surgery that was performed, the pain dulled in comparison to what I had been in. For the next few weeks, while everything was healing, I had no pain. I could get on crutches and move around. I could cook for the family again. It was absolutely amazing. I even went out to the animals when I wasn’t supposed to.”

Beth is now pain-free and back to her busy life on the farm and her favorite hobby—endurance horse racing.

“The conditioning took a while, but overall, I am so physically fit right now,” Beth said. “I have a 60-mile race ahead of me. I cannot wait. The horse looks good. I’m feeling good. I have high hopes.”

Dr. Thomajan is paid consultant of Axogen Corporation.

after amputation, surgical nerve repair gave Ronnie a new lease on life

the moment everything changed

In September of 2017, Ronnie was working at a sawmill when his arm was accidentally caught in a conveyor belt, resulting in amputation of most of his arm. Adjusting to life after this devastating injury was difficult, but about a year after the injury, he also started to suffer from phantom pain. Progressively, the pain continued to get worse. By November of 2018, it was unrelenting.

Pain after a traumatic injury is understandable, but after months with no relief, Ronnie realized he needed to find someone who could help. Fortunately, he was referred to Dr. Ducic, a nerve specialist from the Washington Nerve Institute.

addressing the source of pain

Dr. Ducic explained that several nerves injured as the result of the amputation were causing Ronnie’s chronic arm pain. Rather than offering a temporary solution like pain medication, Dr. Ducic recommended surgical nerve repair. During the procedure, he would remove the source of the pain—several neuromas (masses of scar tissue that form in the nerve and can disrupt normal nerve function) that had formed—and then repair the nerves to restore more normal nerve function.

a fresh start

Dr. Ducic explained that because nerves are destined to grow, he needed to provide a structure for them to regrow more properly or neuromas might recur. After removing the neuromas, Dr. Ducic reconstructed the nerves by connecting them to nerves located in Ronnie’s muscle. In order to make that possible, there were large gaps that needed to be bridged. Dr. Ducic used Avance® Nerve Graft to bridge those gaps, allowing Ronnie’s nerves to regenerate and restore normal signals to his brain.

“We really live in a new era of nerve surgery,” said Dr. Ducic. “Prior to Avance Nerve Graft, it would have been very difficult to reconstruct nerves like I was able to do in Ronnie’s case.”

Nerve repair surgery gave Ronnie his life back. Today he’s back on the job and adjusting to his new life, pain-free.

Dr. Ducic is the Medical Director for Axogen Corporation.