From the outside, it’s hard to see that the nearly 90-degree curve in Chris Arum’s spine is almost gone. More than three months after the 13-year-old African boy received radical spine-straightening surgery in Mesa, much of Chris’ body remains as twisted as it was when his vertebrae began to curl like a snake.
One shoulder arches higher than the other, tilting his head to one side. Without a brace, his right knee bends inward and his foot drags on the ground, rubbing a hole in his sandal. And the farther he walks, the more he hunches forward, toppling over once in a while.
The difference is on the inside.
X-rays once showing a deep Scurve from scoliosis now reveal just a slight bend, pulled into place by 13 hooks and two 10-inch-long titanium rods. Chris’ spine no longer crushes his left lung, which made it difficult to breathe.
And most important, doctors say paralysis spreading through his right arm and leg has been halted with the insertion of a tube to release fluid pressing against his spinal cord.
The donated medical procedures, arranged by the nonprofit Healing the Children group, have given Chris the chance to walk better and live more independently — a chance he would not likely have at home in Kenya.
It will be up to Chris, though, to make his body move more normally again through regular and sometimes painful physical therapy exercises.
The clock is ticking. On Sept. 7, Chris goes home to Nairobi, where it’s unclear how much medical help will be available; he will need to exercise on his own.
"We’re kind of at this crossroads," said Micki Martin, whose family is hosting Chris in their Tempe home. "Everybody has done so much for him. It’s him who’s going to fix himself. This is where he has to invest."
Wearing swimming trunks adorned with the American flag, Chris’ arched back was wet and exposed during a backyard pool gathering last month, but the neighborhood children didn’t seem to notice. Dragging his right foot along the pool edge, Chris lunged into the water, where he stayed hours at a time.
Water supported Chris’s body the way his muscles cannot, allowing him to easily move his arms and legs.
"Now I can swim, I can hold my breath in the water," Chris said proudly. "And I can sit normal. No bending."
A more straightened spine means Chris can sleep on his back and sit without leaning too far to the right. Getting out of the pool, Micki Martin wrapped his thin frame in a towel and scooped him into her arms.
"It’s difficult to stand there and watch him struggle to get from one place to the next," she said.
Just carrying a dinner plate to the kitchen sink can take Chris a long time. Martin said she, her husband and their four children are trying to teach Chris to do things for himself — skills that will help him move better and live more independently. The expectations have at times frustrated Chris, who was helped at home in Africa by his brothers and sisters.
"He got catered to. He used that to his advantage," said Johanna Ricketts, director of Healing the Children’s Arizona chapter. In the Martin home, Chris has chores and schoolwork, as do the Martin kids.
Today, Chris can dress himself, brush his teeth and put on a car seat belt. With a brace, Chris is close to walking better on his own.
FIRST STRAIGHT STEPS
Holding onto rails for physical therapy, Chris takes his first steps with a brace that forces his foot and the rest of his leg forward.
"Chris, you’re not dragging your foot at all!" Martin said, clapping her hands.
The momentous first steps follow months of medical care provided free by a host of health care professionals.
Before Chris arrived in Arizona last September, Dr. Dennis Crandall agreed to do his spinestraightening surgery and Banner Desert Medical Center provided its facilities. But once Crandall evaluated Chris, the orthopedic spine surgeon discovered a bigger medical problem: A pocket of fluid had accumulated along his spinal cord, causing his back to curve dramatically in the past several years.
The fluid, which was paralyzing his right arm and leg, had to be drained. A neurosurgeon agreed to put a shunt in Chris’ back to keep the fluid pocket from reforming.
On March 29, Crandall pulled Chris’ spine as straight as he safely could. Using rods and hooks attached to his spine, Crandall said he had to be careful.
"Because he has not been able to walk normally and play like other kids his age, his bones are soft," Crandall said. Still, the curve was pulled from nearly a right angle to one of about 30 to 35 degrees.
Medical complications unknown before Chris arrived forced Martin to search for specialists who not only would take Chris’ risky case, but provide free services.
"He had to see seven specialists before we could do anything," she said. "Every person we went to wouldn’t see him."
Martin’s friend, Jeff Petersen, who also recently hosted a child through Healing the Children, provided Chris hours of physical therapy at his Mesa practice. For Chris’ brace, Petersen found Joseph Pongratz, a physical therapist Petersen knew had donated prosthetics for clinics in Nogales.
"You just have to look at the big picture of what you do," Pongratz said. Chris needs a brace to improve his mobility, he said. "He certainly has a long way to go to straighten up, but stability and walking will improve drastically."
Chris will outgrow his brace in eight months to a year, as well as the tennis shoes he needs to wear the brace, Pongratz said. He said he hopes Chris will be able to replace both in Africa.
In the meantime, Chris will need to do physical therapy exercises at home — exercises he doesn’t like to do, Martin said.
Despite the pain, Chris said he understands how important it is to continue physical therapy.
"I think it’s going to help me stand stronger," he said.