Glyndon woman’s foot restored through hyperbaric therapy

Jean Mahlum was walking across the living room of her Glyndon, Minn., home when her shoe caught on the carpet. She tripped, hyperflexing her right foot so it doubled up beneath her.

That seemingly minor misstep in 2001 would balloon into a foot infection so severe that doctors believed the only option was amputation. But after 14 surgical procedures and 18 casts, Mahlum’s foot was saved by the same therapy used to treat deep-sea divers suffering from the bends.

For five months in 2008, Mahlum received daily treatments in a hyperbaric chamber at Hennepin County Medical Center in downtown Minneapolis. She sat inside a pressurized air chamber and breathed pure oxygen through a mask for two hours at a time.

Today, Mahlum has her life back. After the hyperbaric treatment effectively killed the virulent infection in her system, surgeons at the Mayo Clinic in Rochester, Minn., rebuilt her foot. Mahlum has written about the restoration of her health and spirit in a self-published book, “God Bless You Minneapolis.”

In the meantime, she has become a poster child for hyperbaric treatment, which is gaining renewed respect from medical experts for its success at treating conditions like diabetic foot ulcers and severe infections.

“It can heal. It is life-giving,” Mahlum says from the sunroom of the home she shares with her husband, Wayne. “I have my foot, and I’ve never felt better.”

A long, hard journey

Before hyperbaric therapy helped Mahlum, she experienced six years of pain and frustration. Mahlum repeatedly visited the doctor after her injury, but no fractures could be found on X-rays or with a scope. Still, the pain and swelling continued.

By 2002, Mahlum was on crutches. Over the next seven years, she wore 18 casts and received 14 surgical procedures, including ankle fusions.

Unable to stand for any period of time, Mahlum had to quit her job teaching paralegal classes at Rasmussen College. “I just wanted it to stop hurting,” she says. “People thought it was psychosomatic, but I knew better.”

On Easter morning of 2007, Mahlum again wound up in the hospital. She was so weak she couldn’t walk across a room. The attending physician, Dr. Brent Hella, diagnosed a widespread infection. He ordered a PICC line – a centrally located catheter that allows antibiotics to be delivered into major blood vessels for extended periods. He also recommended she go to Mayo Clinic.

The pain continued to escalate, and she traveled to Mayo a few months later. There, doctors gave a sobering diagnosis. Mahlum had a triple bone infection, including staph and Methicillin-resistant Staphylococcus aureus – a bacterial infection that is highly resistant to antibiotics. Doctors also believed she had broken her ankle back in 2001, but the fracture – undetectable by X-ray – had healed incorrectly.

Over the next couple of months, doctors implanted antibiotic spacers – cement capsules that leach antibiotics into the system over a six-week period – in efforts to subdue the infection. Nothing worked.

In early November, Dr. Harold Kitaoka, a Mayo surgeon, gave her the worst news to date: The stubborn, persistent infection had killed the blood supply to her bone tissue. The talonavicular joint, a major joint between the leg and foot, was completely gone. It would be best to amputate.

Mahlum could not accept the news. An accomplished pianist, she tried to imagine what it would be like to not have a foot to press the damper pedal.

Mahlum called her insurance carrier to check on coverage for the amputation. She asked the nurse on the line if anything else could be done. The nurse suggested hyperbaric treatments, and added that she thought Minneapolis had a chamber.

Mahlum’s research led to the Hennepin County Medical Center’s hyperbaric medicine department. They had one appointment open for Nov. 28 – the same day she was scheduled for a foot amputation at Mayo.

She went to Hennepin instead. The physician there, Dr. Robert Collier, wasn’t optimistic. But he agreed to try.

Five months to wellness

Most people might associate hyperbaric treatment with the bizarre photos of Michael Jackson sleeping in a hyperbaric chamber in 1986.

In fact, hyperbaric treatment is a legitimate, Medicare-approved treatment for conditions such as carbon monoxide poisoning and diver’s decompression sickness. But in the past 10 to 15 years, the medical community has found it can also help nonhealing wounds following radiation treatment, diabetic ulcers, antibiotic-resistant infections and traumatic brain injury.

Diseased or injured tissue can be oxygen-deficient, which can lead to the growth of anaerobic (oxygen-hating) bacteria and a compromised immune system.

“What hyperbaric does is load up the blood that’s going to (diseased/infected) tissues with very high doses of oxygen,” says Dr. Cheryl Adkinson, Hennepin’s medical director for hyperbaric medicine.

The chamber’s increased pressure actually forces the oxygen to be dissolved into the plasma portion of the bloodstream at a higher rate.

In the process, oxygen can super-charge a body’s ability to heal.

From late November 2007 to March 2008, Mahlum made daily treks to the Hennepin chamber. Although the pressurized cabin – the equivalent of 43 feet below sea level – made her ears pop, the overall experience was painless, even relaxing. She would read or nap.

By the time a couple of months passed, she started noticing improvements. She felt stronger, her hair grew thicker, and the migraines she’d battled for years had disappeared.

Initially skeptical that hyperbaric would make any difference, her Mayo doctor, Dr. Kitaoka, announced by the end of December 2007 that he would rebuild the foot he once recommended to amputate.

On Jan. 15, Mahlum underwent a six-hour surgery in which two screws and three rods – including one that ran up to her knee – were planted in her leg and foot. Dr. Kitaoka also performed a major bone graft, using cadaver bone, coral calcium, ceramic and bone from Mahlum’s own knee.

By March, the bone showed growth. Microscopic growth, but progress nonetheless. Mahlum recalls her stoic husband, a man of few words, breaking down at the news.

Life today

Life is good these days. In fact, Mahlum – a glass-is-half-full kind of woman – would say it’s better than ever. She’s returned to a part-time teaching job at the Minnesota School of Business and also does substitute teaching at area schools.

The remnants of her injury are never far away. Because of her life-threatening infections, the 57-year-old must be on antibiotics for the rest of her life. She wears specially modified sandals, as her right leg is now 3 inches shorter than the other. She will never be a power-walker, although she’s thrilled to stroll around the backyard with her toddler-aged granddaughters.

In the meantime, Mahlum has been surprised by her newfound celebrity as a speaker.

Since Mahlum addressed health professionals at a Fargo conference in April, the floodgates have opened. There’s been a demand to hear her story, especially as every stage of her journey was dutifully chronicled by Wayne, an amateur photographer. She has received offers to speak at international health symposiums and the American College of Hyperbaric Medicine convention.

Mahlum says she not only experienced a physical healing, but a spiritual one as well. Her journey, she says, was filled with encounters with unexpected angels, like the Minneapolis street people who helped pick up her crutches and paid for her light-rail pass when she fell in the snow.

That wish to thank her good Samaritans gelled into the book, which will be released in early summer.

“It finally occurred to me that these people were angels,” she says. “This experience has totally changed my perspective. I am still humbled by all those people who were so good to me.”

Readers can reach Forum reporter Tammy Swift at (701) 241-5525

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