- Associated Press - Sunday, December 6, 2015

NORTH CANTON, Ohio (AP) - Dr. Ajay Seth climbed through an open scissor-style door on his 2015 BMW i8 sports coupe, then strode into the sweat-stenched North Canton Middle School gym for a glimpse of his son’s eighth-grade basketball practice.

At about 5-foot-7, with salt-and-pepper black hair, Seth is shorter than many of these two dozen boys, some of whom he’d coached in youth basketball and baseball dating back to third grade.

It was 7 p.m. on a Tuesday. The day began with a one-on-one game against his 13-year-old son, Jaideep, at 5:45 in the morning on the Seths’ indoor basketball court inside their spacious home at St. James Place allotment in Lake Township. Then came his workout at Powerhouse Gym. From there, it was on to his office at palatial Spectrum Orthopaedics in Jackson Township, where the 43-year-old has made a name for himself as an orthopaedic surgeon, specializing in hands, arms and elbows.

“Wrist doctor to the stars,” one new patient called him. He saw 85 patients that day, before scurrying home. He ate a few chips, hugged his wife, Kim, who’s a physician, too, and his 8-year-old daughter, Trinity, before going to watch his son.

Long days are normal. Seth is a busy guy. Driven to success. He’s always been that way.

“In the fifth grade, this student was telling me he wanted to be a doctor,” recalled Steven Dick, a retired Jackson Local Schools teacher.

A son of Indian immigrants, Seth graduated from Jackson High in 1990 with a 4.19 grade-point average. As a senior, he was a Repository Teen of the Month, then Teen of the Year. He even told the newspaper then he wanted to be an orthopaedic surgeon. He made good on that pledge after graduation from Medical College of Wisconsin and Ohio State University.

Seth has treated and fixed thousands of patients over the years. Some, he knows by name. Others, he can place their face. This summer, he met one, Melissa Loomis, whom he’ll remember forever. He made her a promise that he couldn’t keep. He told her he would save her infected arm.

But he didn’t.

He failed.

Now, together, they’re on a journey of redemption.

It was 6 in the morning on July 25, a Saturday. A sleepy and bleary-eyed Loomis stumbled through the kitchen-dining area of her three-bedroom ranch home on Orchard Dale Drive NW in Plain Township to let her dogs outside. Vincent, a beagle, and Vivian, a mixed breed, stormed into the fenced-in backyard.

The 42-year-old Loomis loves her dogs. All dogs for that matter. For a year, she’d volunteered at the Stark County Dog Pound when she wasn’t working at Canton Regency, her employer since her high school days. She’d started there as a waitress, before advancing to director of food service at the retirement home.

So, there she stood inside her house, fiddling with her cellphone - the one with a barking dog ringtone - waiting for the dogs to finish their business. She was a few feet away from a bulletin board that holds her winning ribbons from a workplace dog show, and around the corner from the living room, where a framed “Loomis Est. 2011” sign hangs on a wall. Her husband, Neil, slept in their bedroom.

“I heard this loud hissing sound … hissss, hissss,” Loomis recalled.

Vincent and Vivian went bonkers.

Loomis ran outside.

Her dogs had cornered a raccoon. It sat atop the chain-link fence. Vivian, the mixed breed, had the animal’s tail in her mouth. She dragged it off the fence. Loomis intervened. She grabbed the raccoon and flung it over the fence. It scurried up a tree.

But not before it had bitten and scratched Loomis’ lower right arm.

“I’m sure I screamed; it all happened so fast that maybe I was in shock,” Loomis said.

Her husband took her to the emergency room at Mercy Medical Center. Loomis was given a rabies vaccine, just in case. Those horror stories about giant needles into the stomach proved to be false, she added.

“Just a regular shot in the arm,” she said.

They cleaned and bandaged Loomis, gave her antibiotics and sent her home.

No big deal.

No one yet had a clue her arm would never be the same.

Loomis is a contradiction. She’s an insulin-dependent diabetic. She stands only about 5-foot-2 and weighs a smidgen more than 105 pounds. However, she’s much tougher than her waifish build, pixie-like hairdo and horn-rimmed eyeglasses would lead you to believe.

Two days after Loomis was bitten, her arm hurt even worse. It was red and swollen. She bounced from urgent care to her family physician, the emergency room again, then on a referral to Spectrum Orthopaedics for surgery.

“We were going to do it before church on a Sunday …. I figured it would take about 10 minutes,” Seth said.

Seth planned to cut open her infected arm, then clean it out so she could heal. Except the surgery wound up lasting 10 times longer than he thought. Loomis’ arm was a mess.

“The worst thing I’d ever seen … pus everywhere,” Seth said.

Loomis spent much of the next month in the hospital. She saw 20 doctors. They ran 19 cultures to determine what type of infection was destroying her arm. No one identified the culprit. She had so many surgeries, she lost count. Along the way, she was pumped full of multiple antibiotics and infused with 12 pints of blood.

“I can save your arm,” Seth told her early on.

He doesn’t take such promises lightly. Not when it comes to his specialty. He batted .190 at Cleveland Indians’ fantasy camp three years ago. He carries a 20-handicap on the golf course. He no longer can beat his son in basketball.

But hands and arms and elbows? Seth knows what he and modern medicine can do.

“Emotionally, I was really into this case,” Seth explained.

He grew close to Loomis. Her fighting spirit was unlike any he’d encountered. He became close with her family. Her dad and stepmom. Her sister and brother-in-law. And her husband of four years, Neil, a man she has known for 25 years - a man she used to buy drinks for at BB McLain’s on Tuesday nights because he was too young to buy for himself.

Loomis wasn’t getting better.

“Am I going to die today?” she asked herself more than once.

She sat and prayed with a nurse a few times.

Sepsis set in. Her kidneys stopped working.

“You tried to save my arm; now save my life,” she told Seth.

Out of alternatives, he amputated her arm between the shoulder and elbow.

Seth is a skilled free-hand artist. After he performs surgery on a child, he takes a few moments to draw a picture, usually of a cartoon character such as Mickey Mouse. On the drawing he writes, “You did awesome in surgery!” Then, he delivers the drawing, so the patient can find it while in recovery.

“That’s my stress relief,” he said.

Physicians save. They heal. They make patients feel better. But it doesn’t always work out. At the office with patients like Loomis and even within his own family.

The Seths’ second-born, daughter Jayani, died at the age of 17 months in 2006 after battling a brain tumor for about one year. The license plates on his BMW read “J ARMY 15,” an homage to Jayani’s Army, a nonprofit foundation the Seths organized to help families cope with childhood cancer.

“People don’t bring it up to me, but I say, ‘I think about her every day,’ ” Seth said.

The left-handed Loomis had lost her right arm. She could be fitted with a mechanical prosthetic limb, a standard fix for amputees dating to the Civil War. But that didn’t seem good enough. Not for Loomis, who was so resilient through the grueling month. And not for Seth, who wanted more for her.

“I said I would save her arm … I’ve got to get her the next best thing,” he thought.

Perhaps it was fate that after Seth had amputated her arm, he attended a professional conference in Seattle. He was mesmerized by what he learned about something called Targeted Muscle Reinnervation surgery - TMR for short. The procedure reassigns nerves that once controlled an amputated arm and hand to move their myoelectric prosthetics simply by thinking about the movement. It had been performed a couple hundred times in the U.S. This, he thought, would be ideal for Loomis.

“That one-hour lecture just blew my mind,” Seth said.

And that wasn’t all.

Loomis, he reasoned, could simultaneously undergo Targeted Sensory Reinnervation surgery, known as TSR. It enables amputees to “feel” objects with a prosthesis. And Seth wanted to take that another step forward by tediously splitting the nerves in the arm during surgery. The result would be an even more advanced sensory experience - a process believed to have been completed only a handful of times in Canada and Italy but never in the U.S.

“I want to trick her mind into thinking it’s a normal arm,” Seth said.

Loomis’ trust in Seth is unwavering. The bond between patient and physician has grown stronger. Maybe it was the happy birthday cake he gave her - written in Chinese - when she was still in the hospital. Perhaps she knew that he lies in bed awake many nights, trying to figure out how to save her arm.

She agreed to the surgery early on.

The surgery will begin at 7 a.m. Dec. 10 at Aultman Hospital. It’s expected to take as long as 12 hours. And whether it’s a success won’t be completely known until at least next summer.

Problem is, Seth has never performed the surgery.

So, in the past two months he has immersed himself. He flew to Chicago to witness a similar surgery. He read volumes on the subject. He reached out to experts in the field, such as Dr. Jacqueline Hebert at the University of Alberta, Cleveland Clinic researcher Paul Marasco, Dr. Brian Carlsen at the Mayo Clinic and Dr. Todd Kuiken at the Rehabilitation Institute of Chicago.

Seth is confident he can do the surgery.

“If I didn’t, I wouldn’t even try it … I already do nerves all the time,” he explained.

While Seth studied, Loomis has continued to prepare herself.

Twice a week, she visits Intelligent Fitness to work with owner Danielle Wirick and personal trainer Cassy Daniels. Their mission is to make Loomis stronger so she can recover better after surgery.

“We want to get her a solid base,” Wirick said.

Twice a week, Loomis also goes to occupational therapy at Spectrum. Therapists there, such as Denise Troxell, are trying to strengthen Loomis’ bicep and tricep on what remains of her right arm, again to help with the surgery.

And through it all, she has maintained her sense of humor in the face of tragedy, at times wearing a shirt with a raccoon face print on the front. At work, she has managed to type one-handed. At home, she has used her teeth to tie her shoes.

Last week, Seth brought Loomis and her husband, Neil, into his office, so he could better explain the surgery.

“We’re getting close,” he told them.

They asked questions about prosthetics.

Seth explained that her new arm will be new technology, hopefully enough so to include her in research at the Cleveland Clinic next year.

“OK, bend your elbow,” he told Loomis.

In her mind, she did it, though she no longer has a right elbow.

Immediately after the amputation, Loomis’s mind provided a sensation that her missing right hand was located near her right shoulder. When she was asked to move her hand, she’d move her shoulder instead. Through therapy, she’s been working to visualize that she has a complete arm, and to work on moving independent portions - from the elbow down.

Loomis’ husband is confident in Seth, and in his wife.

“She deserves a win,” he said.

___

Information from: The Repository, http://www.cantonrep.com

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