After retirement, Tom Keck became a hobby craftsman, making upgrades and repairs around his home. In 2017, while working on a home project, Tom fell off his ladder.

Unfortunately, the fall was severe, resulting in several crushed ribs that impacted his spleen. He had to have his spleen removed. The years went by, and Tom recovered well, not realizing the perilous situation he was in following the removal of his spleen — an organ responsible for fighting invading germs in the bloodstream and controlling blood cell levels.

A Playful Cat Bite

In August 2022, Tom was engaging with his cat when the cat bit him. Tom thought nothing of it since he’d long since settled on the fact that cat fur-parenting involved an occasional scratch or bite.

Later that day, however, Tom felt unwell. He’d previously heard that it was important to check for or receive an updated tetanus shot after an animal bite, but he shook off the thought because he knew that he and his wife kept their cat’s vaccinations updated.

The next day, Tom headed outside to mow the lawn since he had some energy though he was still fatigued.

Tom recalls, “When I came in from mowing, my wife told me I was as white as a sheet. I told her I wasn’t feeling too well and that I probably needed a little rest.”

That night, August, 12, 2022, Tom went to bed at his usual time, but his wife awoke in the middle of the night to Tom sweating profusely and thrashing around in a state of delirium. She immediately called 911.

A Deadly Infection

Within moments, emergency medical services (EMS) arrived on the scene and rushed Tom to WakeMed Raleigh Campus Emergency Department. Based on Tom’s symptoms, the providers performed blood tests which revealed that he was fighting a life-threatening bacterial infection. In time, he went into septic shock.

Sepsis happens when an infection unleashes a deadly domino effect within the body. For Tom, this meant his feet, fingertips and nose turned black.

Medical providers determined that the only way to save Tom’s life was to amputate his feet. Orthopaedic surgeon, Corey Thompson, MD, of Wake Orthopaedics, performed the operation on November 10, 2022.

“I was out of it for much of the time I spent in the hospital. I do remember that I was in pain before they took my feet. All I really knew is that I didn’t want to die,” says Tom.

Dr. Thompson also reflects on this time.

He explains, “Mr. Keck had an extremely rare and unfortunate situation occur in his life, something that most people would never even consider possible from such a seemingly minor injury. While he survived a medical event that could have potentially been fatal, he and his family did have to make the very difficult decision to amputate both of his feet, and that is an extremely difficult decision to make. That decision is instantly life-changing. Fortunately, he is very determined and has a terrific support network. This will help him in his long recovery, and ultimately he should expect to walk again and return to those things that he enjoys in life, even without his feet.”

Tom remained in the hospital for four months as medical providers worked around the clock to clear the infection and save Tom’s life. In December 2022, they transferred him to a nursing care facility, so he could continue his recovery after the infection had abated.

During this time, Tom began to notice the middle finger on his right hand was, again, showing telltale signs of infection. He asked to be taken back to the emergency department. Providers performed testing and realized immediately that the infection had resurfaced in Tom’s fingers. They discussed finger amputation.

Tom shares, “My fingers definitely had been getting better before I left the hospital, but then the middle finger reversed itself and started going backwards.

“At the thought of having my fingers amputated though, I told them ‘I gotta have my fingers. I don’t have any feet. I need, at least, one hand, or how will I be able to make it?'”

Providers collaborated and determined it would be possible to spare Tom’s life by partially amputating each finger to the first or second joint — leaving some of his fine motor skills in tact. Wake Orthopaedics hand surgeon Okechukwu Nwoko, MD, performed this procedure on December 15, 2022.

Tom remained in the hospital for a few weeks to recover. He was also fitted with prosthetics for his feet.

Dr. Nwoko explains, “When we evaluated Mr. Keck, he had already begun to progressively lose his fingers. This was an unfortunate consequence of his condition and the infection his body was fighting. After our discussions, we amputated the necrotic portions to prevent any further infection or loss of his hand. After undergoing healing and rehabilitation, Mr. Keck has done quite well in regaining functional use of his hands.”

A Step Forward in Tom’s Health Journey

On March 21, 2023, Tom returned to WakeMed to participate in the StepForward Program within the Rehabilitation Hospital. This structured program for recent amputees supports patients in regaining their independence and mobility through physical therapy.

Dr. Thompson is highly complimentary of the specialists involved in this stage of a patient’s recovery.

He says, “As surgeons in this situation, we perform the initial technical work and help the patients through a very difficult decision-making process. But, by far, the most challenging aspects are what follows. That success lies in the efforts of the nurses and therapists (who are instrumental in helping the patient learn to adapt, move forward and return to a functional life again), the prosthetists (who spend a great deal of time with the patient fitting and designing a prosthesis that works for them while considering all their future ambitions) and, most importantly, the effort, motivation and resiliency that is required on the part of the patient during the recovery process.”

Physical therapist April Gallons, PT, served as his primary therapist. His rehabilitation team also included physical therapist assistant Christina Johnston, PTA; physical therapist Leanna M. Warsaw, PT; and occupational therapists Emily Lupin, OT; Whitney C. Whitmore, OT; and Karen L. Ambrose, OT.

Gallons shares, “Tom has incredible strength, resilience and perseverance. He has been through so much, and he completely credits the medical team for saving his life — which is incredibly humble. He continues to fight as he strives to regain his independence. He has never said no to therapy and always has a smile on his face. He is a model patient. I can’t imagine what it would be like to have bilateral limb loss, and he has completely embraced who he is today. He has never complained and is such an inspiration to me.”

Tom enjoyed his time in the program and made friends with other amputees.

“I met a couple of guys with amputations. One was a roommate for a little while. They both encouraged me and said that I’d be fine with my prosthetics once I got used to them. I learned it was a lot like learning how to ride a bike. At first, I was wobbly, but then I got the hang of it and figured out how to balance myself.”

Tom’s Life Today

Tom graduated from the StepForward program on April 10, 2023 and was discharged home. He hopes to continue physical therapy through WakeMed Outpatient Physical Therapy. In the meantime, he is, again, enjoying lawncare and hobby woodworking.

Regarding his time at WakeMed, Tom says, “Honestly, it was positive. Everyone cared about me. I appreciate how they took care of me even when I was sick and not really responsive. I’m alive today because of WakeMed.”

---

About WakeMed Emergency Services

The WakeMed system of emergency departments is one of the largest and busiest in North Carolina. As a result, we’ve pretty much seen it all. Our doctors are board certified in emergency medicine, are backed by the highest designated Trauma Center available and bring with them the depth of experience that you would expect from the area’s leader in emergency care.

So, rest assured that no matter where it hurts we’ve got you covered.

About Wake Orthopaedics

For 20 years, Wake Orthopaedics has been serving the Triangle community with comprehensive orthopaedic care to help their patients regain their mobility and restore their quality of life. With specialties and expertise in conditions of the bones, muscles and joints, our team of board-certified and fellowship-trained specialists utilize progressive treatments and state-of-the-art technology to care for everything from hip fractures to ACL injuries to arthritis. In addition to traditional orthopaedic services, Wake Orthopaedics provides trauma services, rehabilitation services and care for pediatric injuries. Wake Orthopaedics is a WakeMed Physician Practice.

About the WakeMed Rehabilitation Hospital

Our flagship Rehab Hospital is a 103-bed inpatient rehab facility (IRF) with dedicated units and gyms for children’s/pediatric rehab, spinal cord injury and brain injury. These units are equipped with highly advanced technology to address the specific needs of adults and children in recovery.

About the WakeMed StepForward Program

It’s time to look ahead

The healing phase after surgery is the time to start thinking about relearning how to do the things you enjoy with your new prosthetic limb.

WakeMed StepForward – a comprehensive, structured program for people who have had amputations – will help you:

• Safely and confidently use your new limb


• Use your prosthesis to its fullest potential


• Care for yourself and your prosthesis


• Troubleshoot issues and who to call for assistance

How StepForward Works

Learning the right way to use your prosthesis with a structured program will help you reach your full potential with your new limb. There are three ways to complete StepForward:

• Inpatient – As an admitted patient in WakeMed Rehabilitation Hospital


• Outpatient – At one of WakeMed Rehab’s participating outpatient practices in Wake County and Clayton


• Home Health – In your home

Which way is best for you? An evaluation with a WakeMed physical therapist and occupational therapist as well as an insurance plan review will determine which StepForward option you qualify for.

When to schedule your evaluation

Your physician can schedule your evaluation when you receive your prosthesis. You will need to bring your prosthesis to your evaluation appointment. Call WakeMed Rehabilitation at 919-350-7876 to get started!

You will need a physician referral for your evaluation, so call your physician and ask for a referral for a StepForward Evaluation. Referrals can be entered into Epic or faxed to 919-350-8791.