A Love Story: Rehab Helps Amputee to Dance on His Wedding Day
Zero-G Aids Todd Pugliese in Reaching His Goal at Reading Hospital Rehabilitation at Wyomissing
With Lady Gaga singing "You and I" from a nearby CD player, Todd Pugliese took fiancée Nancy Samsel in his arms to practice dancing to their wedding song while wearing his new prosthetic leg. He paused when he heard someone say, "Hold on a minute." Karen Decker, PT, Pugliese's physical therapist at Reading Hospital Rehabilitation at Wyomissing, wanted to make a few adjustments to the harness on his leg.
Decker had been working with Pugliese since his amputation surgery on May 17, 2018. This dance was a watershed moment in Pugliese's six-year journey toward managing problems in his right foot that began shortly after his type 2 diabetes diagnosis. The 51-year-old Temple, PA, resident had developed Charcot's joint disease, a progressive bone degeneration that is common among people with diabetes. After enduring three surgeries, numerous health issues, and ongoing foot pain, Pugliese opted for amputation five inches below his knee.
He had been working hard at Reading Hospital Rehabilitation at Wyomissing with Decker, occupational therapist Jenna Best, PT, and physical therapist assistant Joe Zona, PTA, toward his primary goal - dancing at his September 15, 2018 wedding. Pugliese had been gaining confidence in his movement with the prosthesis using the ZeroG® Gait & Balance System, a body-weight support device that uses a harness and an overhead track assemblage, permitting movement without concerns about falling.
He was about a month from his wedding day when Samsel brought along a Lady Gaga CD to his therapy session with Decker and the ZeroG. Buoyed by the harness, Pugliese had taken a few choreographed spins with his fiancée when Decker interrupted.
"We had already done the Chicken Dance and several other challenging exercises previously," Decker said. "I knew it was time to take the training wheels off. So, I told Todd I wanted to make an adjustment to the harness. And unbeknownst to him, I unhooked it."
Samsel noticed what Decker was doing.
"I told Todd to be careful, and he said not to worry because of the ZeroG," Samsel said. "I realized he didn't know what Karen did. She did not want him thinking about the harness, only about the dancing."
Lady Gaga began again, and the couple moved rhythmically across the rehab area floor. Onlookers applauded when they finished, and an exhausted Todd sat down. Then he found out he had just soloed without the ZeroG.
"I was shocked, let me tell you," Pugliese said. "Karen got me. I was so happy to be moving and grooving, I had no idea I didn't have my security blanket working for me. Then I realized I could do it on my own, and that felt really good."
Pugliese developed foot pain and says he got "the double whammy" - diagnoses of type 2 diabetes and Charcot's disease. "I had shattered bones in my right foot and had metal plates put in to stabilize it. Then I developed a bacterial infection and the plates had to be removed. Later, I had a third surgery in another attempt to ease the pain in the foot."
Over six years, Pugliese endured the three surgeries and a lot of time staying off the foot in the hope that he would be able to walk normally again. "At one point I sat for 14 months," he said. "I ballooned up to 385 pounds. I knew I had to do something about that."
Pugliese had a Stomach Intestinal Pylorus-Sparing Surgery (SIPS), a form of gastric bypass surgery that results in weight loss. Bariatric Specialist Stephan R. Myers, MD, performed the 2 ½-hour procedure at Reading Hospital in June 2017. Pugliese lost more than 150 pounds and continues to work with Reading Hospital's Weight Management Center to maintain his weight loss.
"The procedure actually changed Todd's hormonal structure to the point where his diabetes disappeared," Dr. Myers said. "Weight loss surgery will often resolve the effects of type 2 diabetes. Most people with diabetes aren't aware they have this option."
His weight under control, Pugliese saw one last specialist to see if his foot could be rebuilt and stabilized. When he was told there were no guarantees it would work, he discussed it with his fiancée and his family and decided on amputation.
"Todd was feeling a little down after his surgery," said Haiping Mei, MD, PhD, Physical Medicine and Rehabilitation -Tower Health Medical Group. "It is a life-changing experience. We are fortunate to have a great amputee support staff where a peer who has gone through a similar experience provides important emotional assistance."
Following his surgery, Pugliese spent two weeks in inpatient rehabilitation while his leg healed and his prosthesis was being prepared. "At first, we teach the skills needed for when he goes home in his wheelchair," Best said. "Once the prosthesis is in place, we move to working with a walker and finally just the prosthesis."
After a few weeks at home, Pugliese returned for 10 days at inpatient rehab learning to walk with the prosthesis. The ZeroG played a key role.
"We are the first rehabilitation facility in Berks County to get a ZeroG system, and it has been a real benefit to our amputee patients," Dr. Mei said. "Todd ended up being very motivated and positive. His success is a testament to both our excellent rehabilitation staff here and his own determination."
After completing rehab, Pugliese knew he was ready to dance to Lady Gaga.