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W.V. man holds on to hope

Device will allow him some use of one hand

Ted Loosli can't hold a sandwich. Or pick up a phone. Or scratch his ear very well.

But unlike many of the motions he lost when he severed his spinal cord in a three-wheeler accident 13 years ago, he thinks he'll be able to do those things — and a few others — again in the very near future.

Tuesday, University Hospital hand surgeon Dr. Douglas T. Hutchinson will implant an upper-extremity device called a Freehand in hopes of stimulating paralyzed muscles enough that Loosli, 58, can do simple tasks with his right hand. Right now, he can only shrug his shoulders and lift his right arm a bit. He has no dexterity in his hands.

Loosli wants to be able to brush his own teeth and maybe even comb his hair. But it will likely be weeks before Loosli, his wife, Jean, and the doctors learn whether the device will work as well for him as it has for others around the country.

So far, the Freehand has been implanted about 100 times. This is the first implant of its kind in the Intermountain West.

The device uses a very small stimulator-receiver that is placed in the chest. Electrodes on leads that run from it are sewn or punched into certain muscles of the arm, wrist and hand that are

to be stimulated. It's tricky, Hutchinson said, because there's an eight-lead limit. So doctors have to choose carefully which eight of the 50 muscles will give the patient the most benefit.

The device connects to an internal shoulder control unit. And it's all connected to an 8-pound cassette-recorder-size external processor whose programming can be tailored to meet the patient's needs.

A few years ago, when the device was new, Loosli, of West Valley City, looked into it but found his insurance wouldn't pay. This time, he wasn't even thinking about the device. He went to Hutchinson to see if he could have the tendons in his fingers cut so his fingers would quit curling. But one thing led to another, the insurance company approved it, and next week he will have what could be a nine-hour surgery.

The Cleveland surgeon who invented the device will assist Hutchinson, an associate professor of medicine at the U. School of Medicine. Together, the two doctors will stimulate different muscles to determine which ones will do Loosli the most good. They may end up fusing the bones in his wrist together to make it more rigid, since they can't intervene with more than eight muscles. They just don't know yet, Hutchinson said.

The device provides two motions: gripping and pinching. The doctors will definitely stimulate a muscle that allows Loosli's thumb to close down on his finger in a pinching motion. And they know they'll want to stimulate a tricep muscle, because his is too weak. The rest is kind of up in the air.

The computer-processor passes a message like this to the electrodes, Hutchinson said: "Fire muscle number three at such a rate, with such force." As Loosli begins to work with hand therapist Kathy DeTemple, they can determine together whether the strength level should be changed in the unit.

To operate the device, Loosli will have to shrug his opposite (left) shoulder in certain ways. One motion might tell the device to grasp, another to pinch. An entirely different motion will tell it to stop.

Until the muscles heal where the electrodes are attached, Loosli's arm will have to be immobilized, probably up to four weeks. Then he'll start therapy with DeTemple to figure out how to use the device.