Standing on your feet is the name of the game when you’re a butcher. Just ask Gary Eraas. He enjoyed owning his own shop in the Ozarks, but it didn’t come without some physical problems.

“Standing on concrete all the time started to cause problems with my foot,” he said. “I put up with the pain as long as I could, but there came a point where it was just time for me to be done.”

Eraas sold his shop and eventually moved to Lawrence to live with his sister and began doing maintenance jobs. All the while, his foot continued to get worse but he chalked it up to having gout.

“I wasn’t ever sick and didn’t have any broken bones. If I cut myself, I patched it up and moved on,” he said. “My sister convinced me to go to Haskell Indian Health Services, made me an appointment and went with me.”

That visit in September 2023 revealed that Eraas didn’t have gout, but something much more serious. The swelling in his foot that had begun to affect his leg and hip was due to a blood clot. The doctor told him to go to the Emergency Department at LMH Health immediately.

When he got to LMH Health, Eraas was whisked away and treatment began quickly. The damage was enough that surgery was needed to save his life. Dr. Kara Hessel, a surgeon with Lawrence Vascular Surgery, had to operate immediately.

“The surgery to remove the blood clot (thrombus) was initially successful, but he had scarring of the vessels and progressive arterial disease. Those eventually led to failure and a need for amputation,” Hessel said. “This was the only option at that point because Gary didn’t have the means to further improve the blood flow to his foot and he was having intolerable pain.”

The road to recovery doesn’t always follow a straight path, and Eraas had more twists and turns ahead. He had chronic pain in the amputation and a wound that didn’t heal well. Hessel managed it with dressings for some time, but the pain and wound care became too much to tolerate. She had to operate again in December, this time to amputate the leg above the knee.

“We’re closely monitoring his arterial health and hope to prevent the need for additional surgery, but arterial disease affects the whole body. There is always a possibility of needing to have more done,” she said.

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You don’t just bounce back after having a lower limb amputation. There’s a lot of work that goes into recovery. That’s where the team at LMH Health Therapy Services can help. Jarred Salmans is a physical therapist who works with patients with limb loss.

“One of the first things we do is work on range of motion,” he said. “When the patient first comes in after surgery, they usually have a contracture or other tightness since they’ve been in bed or sitting in a chair and haven’t been able to stand or extend their leg. They also often have weakness, so we start working on trying to get them moving again.”

What does that look like? Salmans said it includes doing stretches on a mat and standing with the sound limb. Once the patient gets a prosthetic leg, the team works to get them up and standing. It’s a work in progress, especially early on.

“There’s a lot of work going into learning where the new foot is and getting used to putting weight on that side of the body again,” he said. “Then we transition to walking, starting with a harness system and parallel bars in our gym before transitioning to a walker and eventually a cane or no assistive device.”

Eraas turned to Corban Myers, a certified prostheist orthotist with Hanger Clinic, to create his first prosthetic leg with a mechanical knee in mid-2024. He continued to work hard in therapy with Salmans and in October, Eraas’ progress led to a new leg — one with more bells and whistles.

“Gary’s new leg has hydraulic function and sensors to tell if he’s putting weight on it,” Salmans said. “If the leg isn’t extended all the way and he tries to put weight on it, the knee component will stiffen and keep him from collapsing to the floor.”

Salmans anticipates that Eraas will spend a total of eight to twelve months in therapy and will likely need to use a cane when he’s out, though he may be able to go without at home. Eraas couldn’t be more thrilled with the care he’s received at LMH Health.

“The therapists at LMH care — every one of them. They ask questions, listen and help me get better every time I’m here,” he said. “If you need help, they’ll be here for you.”

Helping patients improve and return to their daily lives is what Salmans hopes to achieve.

“The work isn’t to figure out how to work with the new prosthetic, it’s about how it can help them,” he said. “Our job is to help patients get stronger and improve balance, but the ultimate goal is working together as a team so they can live life as independently as possible.”

— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a sponsor of the Lawrence Journal-World’s health section.