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Paul Nese with Dr. Michael Rose of the Institute for Advanced Reconstruction
Imagine your body—bones, muscles, and skin—collapsing like a building. Now, imagine an actual building doing the deed. That’s what happened to construction worker Paul Nese, when, in October of 2011, he went into a building to oversee a job—a simple task that would be over in 15 minutes when disaster struck. From 22 feet above him, 60 trusses, weighing 300-500 pounds each, came down, some of them landing directly on top of him.
The results were a tibia and fibula (major bones) broken in his right leg, which also tore through his skin, a broken femur, fractured ribs, bone chips in his spine, and severely herniated disks in his lower back. The 39-year-old Plainsboro, New Jersey, resident was rushed to the hospital, where he underwent several surgeries, lasting a total of approximately 15 hours.
Among those surgeons treating Nese, at this point at Jersey Shore Medical Center, was Dr. Michael Rose, who repaired the leg in which the bones had torn through muscle and skin. Dr. Rose salvaged what he could of the damaged muscle and did a skin graft from Nese’s thigh to his lower leg.
After undergoing some months of rehab, and additional surgery for what became the need for a full titanium hip replacement, Nese realized he had yet further damage. “When bones tore through my leg, they also tore tendons and caused nerve damage.” This caused Nese to experience foot drop as a result of the traumatic nerve damage, and also a severe case of traumatic neuropathy. “It was so painful from the calf to the tip of my toes. Do you know that painful tingling you experience when coming in from the cold? That’s what I had, only 24 hours a day.”
“This type of neuropathy is often overlooked in the aftermath of a life-changing injury when there are more pressing issues to which to attend. That being said, Paul (and others like him, who come into contact with me and our practice) was fortunate that I am familiar with and skilled at treating traumatic nerve injuries,” said Dr. Rose.
In all of Paul Nese’s misfortune, he had a stroke of good luck: a connection to Dr. Rose, who is among a handful of plastic surgeons trained in nerve decompression surgery for those suffering from all forms of neuropathy.
Nese is one of nearly 20 million Americans who suffer from neuropathy, a chronic condition that results from damage to or compression of the nerves outside the spinal cord and brain and is also referred to as peripheral neuropathy.
However, cases like Nese’s are more complicated because medical experts have to deal with the other injuries and make timing decisions for surgery for neuropathy. That being said, Dr. Rose points out that although one has to wait for other injuries to improve before working on the nerves, for the best surgical result for neuropathy, “the sooner, the better in most cases.”
On February 17, 2012, Nese underwent surgery with Dr. Rose, who did a tendon transfer on his toes, allowing his right big toe–which was completely hanging limp–to be connected and work with the rest of his toes. Dr. Rose also repaired the nerve in his ankle and on top of his foot.
Relief was immediate. “I experienced a huge result. It is so much better than it was,” says Nese. Of his overall recovery, Nese reports, “I’m able to sleep more comfortably and not on constant painkillers. I’m looking forward to more future progress.”
In his 22 years working in construction, Paul Nese had never had an accident prior to an event that so radically altered his life. But for those like Nese, who experience such life-altering events, medical experts such as Dr. Michael Rose can return part of the normalcy that was taken away.
