Burn Patient stories Rehab Sunnybrook Magazine - Fall 2020

One man’s journey after a battle with ‘flesh-eating disease’

A harrowing experience with ‘flesh-eating disease’ nearly killed Mark Opauszky. The team at Sunnybrook, and Mark’s positive mindset, helped him recover and get his spark back.


Mark OpauszkyMark Opauszky exercising on the streets of Toronto (photograph by Kevin Van Paassen)

In February 2019, Mark Opauszky flew down to New York for what he thought would be a quick business trip. The Toronto-based CEO and founder of a rapidly growing marketing automation company was scheduled to present at a conference and take in a few sales meetings.

Two days in, Mark fell suddenly, severely ill. With a fever spiking and on the brink of losing consciousness, his business partner rushed him to a Manhattan hospital. Mark emerged several weeks later from a medically induced coma to discover he had developed necrotizing fasciitis, more commonly known as “flesh-eating disease,” and it had brought him to the brink of death.

“I found out later that my probability rate of survival had been in the 5 per cent range,” says Mark, now 51.

The full extent of Mark’s ordeal reads like the plot of a horror movie. Necrotizing fasciitis is a disease in which bacteria infects the connective tissue, or fascia, under the skin. The disease rapidly kills the tissue, causing it to peel, blister and turn black as it dies. Most often caused by Group A streptococcus bacteria (the same bacteria that causes strep throat), it usually enters the body through a break in the skin like a cut or scrape.

Mark’s strain of necrotizing fasciitis resulted in septic shock, a worst-case scenario where the major internal organs begin to shut down and blood pressure dips dangerously low. In order to save his life, surgeons were forced to cut away a vast quantity of Mark’s muscle and flesh to remove damaged tissue, exposing some limbs down to the bone.

The New York team had saved Mark’s life. But by the time he arrived via air ambulance at Sunnybrook’s Ross Tilley Burn Centre four weeks later, Mark says he was in extremely rough shape.

“They did what they did [in New York] and then they sort of shipped me back to Toronto in pieces,” he says.

Mark in his room at Sunnybrook

Mark in his room at Sunnybrook’s Ross Tilley Burn Centre, a few days after his arrival.

THE JOURNEY BEGINS

Mark’s arrival at Sunnybrook was the beginning of a long healing process that would involve multiple surgeries on his limbs, extensive rehabilitation and an extreme level of determination. Mark went through eight surgeries over four weeks at the Ross Tilley Burn Centre, including the amputation of several fingers and toes. He was then transferred to Sunnybrook’s St. John’s Rehab to begin the next phase of recovery.

St. John’s Rehab is renowned in Canada for its personally tailored programs that incorporate multidisciplinary teams to treat complex medical traumas, such as burns, falls, limb loss and vehicular accidents.

Multidisciplinary teams at St. John’s Rehab include physicians, nurses, physical and occupational therapists, prosthetists, speech-language pathologists and dietitians to support patients back to previous daily functioning. Equally important are psychologists, social workers and spiritual care providers to support the mental and emotional aspects of recovery.

“We use a holistic approach to care that focuses on the mind, body and spirit of each person,” says Dr. Amanda Mayo, physiatrist (rehab specialist) at St. John’s Rehab. “It’s one thing to save a life, and it’s another to rebuild that life in a way that is meaningful for that person.”

Mark’s program involved a rigorous schedule of cardio and calisthenics designed to rebuild atrophied muscle. Physiotherapy and occupational therapy helped him start walking again and learn how to use his injured hands. He also required regular massage and stretching for his limbs due to the volume of skin grafts he’d received – an extremely painful procedure.

For the entire duration of his stay at Sunnybrook, Mark says he didn’t once turn on his phone or watch TV. A tech entrepreneur who had previously been perpetually plugged in, Mark transitioned to a near meditative state that allowed him to focus on healing.

“It was me and my brain and my time, and that’s all I did,” he says. “I would spend hours just picking one body part at a time to concentrate on. Or I would open and close my fist because I was trying to get my fingers to work again.”

Doctors anticipated Mark’s in-patient stay at St. John’s Rehab would take eight weeks. He walked out the front door two weeks later. Mark says his quick recovery time was a combination of the outstanding care he received and the extreme discipline he had maintained in his previous life as a high-functioning CEO.

“I would get up in the middle of the night, get my walker and do laps around the nurses’ station at 2 a.m.,” Mark says of his time in rehab, noting that he was motivated by his desire to get back home to his wife, Danielle, and his two children.

ONE MORE STEP

In October, Mark returned to the Ross Tilley Burn Centre for a final amputation of his lower left leg. He had a bone infection, his left foot wounds weren’t healing and despite a top-of-the-line orthotic to offload his painful foot, he was in constant pain.

Dr. Mayo says she recognized that Mark’s left leg below the knee might need to be amputated due to the extensive damage back when he first arrived at the Ross Tilley Burn Centre. But she also understood how important it was to his emotional recovery to give him the opportunity to make that decision on his own time.

“Limb loss is a life-changing event. A lot of patients with chronic infections have to go through this journey and they go through multiple treatments or surgeries that can become quite draining,” says Dr. Mayo, who led Mark’s limb-loss rehabilitation team. “And then they realize, ‘I’m actually better off not having the foot. The foot is painful. This foot has wounds. I can’t walk on this foot.’ And Mark came to that decision.”

The left below-knee amputation surgery, led by plastic surgeon Dr. Alan Rogers, proved successful and has improved his quality of life, Mark says.

He began outpatient rehab at St. John’s Rehab to learn how to use his new prosthesis. Esther Chung, Mark’s physiotherapist, says that Mark’s dedication was a key factor in his specific recovery.

Mark and familyMark with his wife, Danielle, and children Racquel and Max

“Mark is very strong mentally, and I think it helped him progress,” she says. “He also had a strong support network of family and friends, which is important to maintain motivation over the long run.”

Dr. Mayo agrees that mindset and attitude are crucial aspects of the rehab process at St. John’s Rehab.

“A patient’s perseverance is very important,” she says. “Somebody who’s very active and doesn’t have any other medical comorbidities should be going back to most of the activities they did before, [only now] wearing a prosthesis or maybe [using] some adaptive equipment.”

Today, Mark is thriving. He is adjusting to a new normal that seems much closer to his previous life than he had initially imagined.

“I lift weights. I have a treadmill. I started [martial art] Muay Thai again. I’ve been learning to be a bit more agile on my limb,” he says. “I don’t even walk with a limp anymore. Some people can’t even tell that I’ve lost a leg.”

Feeling immense gratitude to his Sunnybrook team, Mark says he is inspired to give back.

“I would very much like to transition from just being a patient to being somebody who can contribute to the [organization] in some way, shape or form,” he says.


HEALING THROUGH MINDFULNESS

How much does your state of mind dictate how well you heal?

At his Sunnybrook lab, physiatrist and researcher Dr. Robert Simpson develops mindfulness and yoga programs for patients with disabling long-term conditions, including multiple sclerosis, stroke and amputations.

“There’s now robust, high-quality evidence for mindfulness improving mental health outcomes – mainly stress, anxiety and depression. There’s also fairly robust evidence that it leads to beneficial changes in cognitive function and probably pain,” says Dr. Simpson, who is trained to teach both mindfulness and Hatha yoga.

Mindfulness can be defined as the act of paying attention to the present moment, non-judgementally. It is often taught through guided meditation practices that focus on the breath and sensations within the body.

The concept hit the North American mainstream in the late 1970’s when a program called Mindfulness-Based Stress Reduction (MBSR) began to infiltrate medical and wellness circles as a treatment for chronic pain and stress. The program had been adapted from Buddhist and Yogic principles by U.S. medical professor Jon Kabat-Zinn.

Dr. Simpson says he considers a host of factors when deciding who might benefit from a mindfulnessbased intervention (MBI). For example, someone with an amputation who also has conditions like diabetes, high blood pressure and depression may face more challenges with rehab than someone without these conditions.

That’s why a combination of personalization, education and support are key to improved results, he says.

“Humanistic factors like encouragement, empathy, compassion, understanding – I think these are all really important factors, and different people likely need different ‘doses’ of these things.”