'Just like Iron Man': Calgary surgeon undergoes experimental spinal surgery

Dr. Richi Gill's life changed in an instant.

The 38-year-old surgeon, who helped develop Calgary's bariatric surgery program, was involved in a freak accident on a boogie board during a family vacation in Hawaii one year ago.

"The wave pushed me down instead of forward in pretty shallow waters. My head hit the ground and ended up breaking my neck," Gill said following a recent physiotherapy session.

"I don't have any movement or sensation below that injury level. I do have some use of my arms but not my hands."

Gill described how he embarked on strenuous rehabilitation at Calgary's Synaptic Spinal Cord Injury and Neuro Rehabilitation Centre, then headed to Thailand in October for experimental surgery.

An epidural stimulation implant was placed in his lower back. With the use of a small device like a remote control, the implant sends electrical currents to Gill's spinal cord to stimulate nerves and move his limbs, bypassing the traditional brain-to-spinal-cord pathways.

The implant can be programmed to stimulate certain nerves mapped out by surgeons and therapists.

Gill said his middle of three children, Akaash, thinks the implant is cool.

"He's very much like, 'This is just like Iron Man! ... We need the suit," Gill said.

"He's only seven so I think he might think there's a suit that's out there somewhere."

The smile doesn't fade from Gill's face as, strapped into a harness, physiotherapists slowly help him walk with the use of a machine on wheels. Gill isn't able to move his legs on his own, but by concentrating he is able to make his hip muscles flex and help himself along.

"Right now, realistically, assisted stepping is where I'm at and being able to stand with assistance. Will I be able to walk on my own? It's a possibility. My main focus is just trying to improve day by day and we'll see where that gets me.

"It's definitely fatiguing because each time you try to take a step you have to really focus and concentrate to get that signal to the right spot."

Second surgery planned

Gill spent $100,000 for the surgery and travel, since they weren't covered by health care or insurance. He plans to return to Thailand later this year to have a second stimulator placed higher up on his spine.

His career as a surgeon is over, he said, but he hopes the operations in Thailand will help him regain some hand function and his overall quality of life.

The spinal surgery is also performed in a few other countries such as the United States and Switzerland, but it's much cheaper in Thailand.

Only a half dozen people in Canada have had it done abroad and the number worldwide is about 30, said Dr. Aaron Phillips with the Cumming School of Medicine at the University of Calgary.

So few procedures having been done makes it harder to get approval from Health Canada or the Food and Drug Administration in the United States, he said.

Phillips has been involved in assessing the procedure for the last nine years.

"I'm just really overcautious about selling these things too early. And, although I am extremely excited about the potential of this therapy, it still needs to pass rigorous tests first," he said.

"We don't know if this will work the same way in everyone. We're still dealing with very small numbers, although the initial findings are promising."

'It's amazing'

Ryan Straschnitzki of Airdrie, Alta., the Humboldt Broncos player who was paralyzed from the chest down when the Saskatchewan team's bus crashed last April, has become friends with Gill through the Synaptic clinic.

Gill has inspired the 19-year-old with his positivity.

"He's able to do things he couldn't do before. It's amazing," said Straschnitzki.

The executive director of Synaptic has seen a marked change in Gill's abilities and has visited the medical facility in Thailand.

"Given the nature of Richi's injury, there was no sensory and no volitional movement below his level injuries. This has allowed Richi to regain some of that function and to be able to command voluntary movement below his level of injury," says Uyen Nguyen.

"This is not a cure. But from what we can see, this appears to be the most promising procedure for people with spinal cord injuries."