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March 9, 2005 – Rare surgery lets young city man breathe on own

By: Alexandra Paul

A young quadriplegic Winnipeg man is breathing on his own for the first time in his memory, thanks to an innovative surgical procedure that helped Hollywood actor Christopher Reeve get off a ventilator.

Reeve's surgeon, Grand Forks, N.D. native Dr. Raymond Onders, operated on Kelvin Sinclair, 19, on Feb. 23 at the University Hospitals of Cleveland. Sinclair is recovering there before coming home this weekend. "The first time I took a breath was really neat. It feels weird, the breath going in and out," Sinclair said in an e-mail from Cleveland, Ohio, yesterday. The Cleveland centre is the only hospital that does this experimental surgery. To date, only 16 such procedures have been done. Reeve, the star of the Superman movies, was only the third person to have the surgery. An operation in 2003 let Reeve return to directing and even acting before he died in November.

Four months after Reeve's death, Sinclair became the third Canadian, and the first aboriginal person in North America, to have the surgery.

The laptop-size ventilator he has been using to breathe until now pushed air in. Now he has to learn how to breathe with his new pacemaker, which pulls air in.

When he was 20 months old, Sinclair ran into the street and was hit by a car. The accident severed his spinal cord from the neck down, and he spent nearly a year in hospital.

During last month's surgery, tiny electrodes were implanted near the
diaphragm's phrenic nerves, a procedure called mapping, and hooked up to a small battery pacemaker the size of a Walkman.

Electrical charges can now be used to move the muscle in a rhythm that
replicates natural breathing. The diaphragm stops working naturally when the spinal cord is severed the way it was for Reeve and Sinclair.
The system was developed in partnership with Case Western Reserve
University. Once hooked up, patients go through rehabilitation to strengthen the diaphragm for normal breathing.

Sinclair will switch between the laptop and the pacemaker until he learnshow to breathe. But it's likely the ventilator will always be his backup, attached to his powered wheelchair. The surgeon and Sinclair's mother both said that first breath was a little scary because the sensation was so different for Sinclair, and he was nervous about letting go of a machine that's kept him alive. Sinclair was so used to feeling air pushed into him, he didn't know how to draw it in through his nose or mouth. "I had to talk him through it," said the surgeon in an interview from Cleveland. "I'd never done anyone who never remembered breathing before." Not only can Sinclair breathe, he now also has a sense of smell. "It's something we take for granted. (But) he's never smelled anything," said Sinclair's mother, Donna Hauser. She said nurses were pumped up about the recovery of his sense of smell, and they made him a special treat for the occasion.

"They made him a cup of hot chocolate to smell. He thought it was weird," his mother said. But Sinclair said he's getting the hang of it.

"Hot chocolate... was kind of exciting. I didn't know what to expect. It's going to be really interesting to smell things," he added.

Sinclair's family is ecstatic because the surgery gives the teen a measure of independence he's never had in his life.

Being on a ventilator means he's never been alone, because nurses attended to him around the clock. He did go to school -- he graduated from Glenlawn Collegiate in 2003 and has a year of college under his belt -- but it was always with a nurse in tow. Now, being able to breathe independently means freedom. One of the first calls Sinclair made after the surgery was to his best friend, Reed Tomlinson.

"He called me the other day from Cleveland, and from what I hear it will make it a lot easier for him," Tomlinson said from his St. Vital home yesterday. "We'll be about to go out and he'll be like a regular person." For Sinclair's parents, the surgery was a smashing success.

"It's been a dream of ours since the day we brought him home from the
hospital," his father, Laurence Hauser, said from Winnipeg yesterday.
After the accident, Sinclair was so badly injured and his disabilities were so severe that his natural parents couldn't look after him anymore. His nurse in intensive care was the woman who became his adoptive mother. The Hausers fell in love with the youngster and they adopted him straight out of the hospital. Onders and his mentor, Dr. Tom Mortimer, pioneered the surgery, adapting it from a riskier operation in which the abdomen was opened up by a scalpel.
The two used key-hole surgery to turn it into a procedure with few
side-effects. On Monday, Onders will perform the surgery for the first time ever on a patient with Lou Gehrig's disease, a fatal neurological condition.

Alexandra Paul
Reporter
Winnipeg Free Press
1355 Mountain Ave.
Wpg. Mb. R2X 3B6
office telephone: 204-697-7249.
fax: 204-697-7412.
cell: 204-781-6056.
e-mail: alexandra.paul@freepress.mb.ca