BANGOR, Maine — Brandon Morris is a cheerful, energetic 11-year-old and an avid Steelers fan.
Like a lot of Maine kids his age, he would like to have been be outside playing in the fresh snow last Thursday morning. Instead, he was flat on his back on a gurney at Eastern Maine Medical Center, waiting to be rolled into a nearby operating suite for a critical adjustment to a pricey, implanted device that has saved his left leg and quite possibly his life.
He was draped in an oversize hospital johnny. He had a battered Red Sox cap pulled low over his eyes, under the flimsy blue tissue-paper bonnet required of all surgical patients. He fidgeted with his IV tubing as he bantered nervously with the nurses. His mother, Tammy Morris, sat quietly nearby, waiting for her youngest child to be wheeled away.
Brandon enjoys roughhousing with his friends and siblings, Tammy Morris said after he was out of earshot. He also plays hockey, baseball and backyard football.
“Oh, he’s very active,” she said, chuckling. But it was not always clear that her energetic boy would be able to maintain his busy, athletic lifestyle.
Diagnosed when he was 7 years old with Ewing’s sarcoma, a rare bone cancer that targets children, Brandon easily could have lost his leg.
Amputation is common with Ewing’s sarcoma, said his doctor, Ian Dickey, an orthopedic oncologist at the Bangor hospital. But instead of removing Brandon’s leg, doctors here opted to take just the top 9 inches of his immature thighbone, which had been invaded by the malignant tumor.
In place of the diseased bone, they implanted an innovative, spring-loaded metal rod. The expandable prosthetic device is the only one of its kind in use in Maine, according to Dickey, and only the second one in the country to be placed in a heavy-use hip joint. It has been in Brandon’s leg for about three years now.
It’s not terribly unusual for children with cancer or other bone disorders to have expandable metal rods or other prosthetics in their legs, Dickey said. But as children grow, the implants must be mechanically lengthened to accommodate natural growth. Every time the surgical site is reopened to allow doctors access to the device, it’s an invitation for infection and other potentially serious complications, he said.
Often, it is the complication of maintaining the implants, rather than the re-emergence of cancer, that triggers a medical crisis, he said.
That’s why Brandon’s “Repiphysis” implant is so important. With Brandon comfortably asleep under a light anesthetic, Dickey and his surgical team slide a magnetic ring over the boy’s slender leg. Using live imaging technology to position it over the implant site, they deliver a microwave blast to soften temporarily the hard plastic casing of the spring-loaded device, which responds by expanding gently and lengthening the upper segment of Brandon’s leg.
Dickey monitors the adjustment minutely, measuring and eyeballing the changing length of the limb, ensuring it lines up with Brandon’s right leg.
It takes only a few seconds to add about an inch to the boy’s lanky frame. The microwaves stop, and the implant hardens in place until the next time Brandon’s left leg needs to catch up with his right — probably just a few months from now, since Brandon, like most 11-year-old boys, is growing fast.
Dickey exhales loudly with relief.
“Every time I do this, my coronary artery pressure goes up, because I don’t know if the spring is going to work or break or what,” he said, although so far he never has encountered a problem. The benefits far outweigh the risks, he said, although “that implant costs more than a Humvee.”
Brandon Morris has been cancer-free for two years, although the possibility of it re-emerging is real. The cost of his care at EMMC is partially borne by MaineCare, Maine’s Medicaid program for low-income residents and those with disabilities. But the hospital also depends on fundraising programs such as the Children’s Miracle Network and a charity event planned at the Sugarloaf ski resort to offset the cost of managing complicated cases such as Brandon’s.
Dickey said Brandon and his family are fortunate to live in Bangor, where there is a convergence of high-level clinical expertise, biomedical research capacity and other services. Otherwise, he said, the Morris family likely would have had to make frequent trips to Boston for Brandon’s care, which has included months of chemotherapy and other treatment besides the specialized prosthetic implant.
Tammy Morris waited in a family area near the operating room for her son to wake up from the anesthesia
“His leg will be a little achy,” she said, “but he’s not one to let that keep him down. He’ll be up and walking around on it tonight.”
Brandon called the Bangor Daily News on Friday to confirm his full recovery from the leg-lengthening procedure. He planned to be rooting for the Steelers with his family on Sunday.