Reclaiming life step by step

Paul F. Gero/The Arizona Republic

Quadriplegic Ken Paulson is back on his feet with the aid of a walker. He has an experimental electronic device in his back that stimulates his spinal cord.

Kerry Fehr-Snyder
The Arizona Republic
Dec. 31, 2001 12:00:00

Ken Paulson has made medical history by walking again. So what does he have left to wish for in the New Year?


Paulson doesn't hesitate with the answer. What he wants, he says, is control over an electric stimulator implanted in his back.

Paulson became a quadriplegic four years ago after snapping his spine in a car accident. Doctors told him he would never walk again.

But Paulson, 44, heard about a medical experiment at Good Samaritan Regional Medical Center in Phoenix. Dr. Richard Herman, working with bioengineer Jiping He at Arizona State University, had theorized that he could help patients with spinal cord injuries walk again by first training them and then implanting an electronic device in their backs.

The strategy had worked in animals by activating something called the locomotion pattern generator, a group of neurons in the spinal cord that allow vertebrates to walk without thinking about it.

First, Paulson began training to walk again on a treadmill with a harness that supported part of his weight. The exhaustive, five-month, five-day-a-week training allowed him to re-learn the mechanics of picking up one foot, kicking it forward, rolling off his heel to his toes and following with his other foot.

Then, three days before Christmas last year, Paulson did the impossible: He walked again with the aid of a walker. It was a Christmas present he had wanted for years, promising his mother that one holiday, he would walk again.

The feat made Paulson a celebrity in spinal cord injury circles nationally and prompted hundreds of calls from patients who wanted to become the next subject for the experiment.

More than 250,000 Americans are paralyzed by an injury or disease in the spinal cord, although researchers caution that their work likely won't help the most severely damaged patients, such as actor Christopher Reeve.

Paulson recently walked for a crowd at the Arizona Science Center, bringing a rush of tears to many spinal cord injured patients. He also spoke at the National Spinal Cord Injury Association conference with Herman, principal investigator of the research project and a physician at Good Samaritan.

And in June, Paulson walked from his Phoenix apartment to the car and then through Fry's Food Store to shop for groceries. He hasn't been back since because, as he puts it, "That was a long time to be without a wheelchair."

While he's thrilled with his progress, Paulson says he's ready for the next step.

He wants to ditch his walker and start walking with the type of crutches that strap onto a patient's forearms.

And he wants to control the device that sends electrical impulses to the stimulator imbedded near his spinal cord.

At present, Paulson goes to Good Samaritan's rehabilitation center nearly every weekday, where doctors activate the device so he can practice walking.

Although he is able to walk outside the hospital, he can walk farther and with much less fatigue if his spine has been stimulated.

Approval to take the controls home must come from the federal Food and Drug Administration, which monitors the use of medical devices. Researchers must show at which distance Paulson can safely walk without becoming unstable or falling before the FDA will allow him the controls to the electrical stimulator.

"It's going to come," he said. "I just have to be patient."

Researchers recently picked their second research subject, 47-year-old Cave Creek resident Bill Dotson. He was injured 8 1/2 years ago after he fell asleep while driving.

Although Dotson is only a paraplegic, he must contend with steel rods in his back and a weakened left side. The FDA made three exceptions to the research protocol to include Dotson because of his age, how long ago he was injured and the location of his injury.

Doctors don't know when Dotson will attempt to walk. They recently had to move the electrical stimulator in his back because of surrounding scar tissue.

"We had planned on being farther along by now, but this is research," Dotson said. "A lot of things you don't have any control of."

When he finally gets the chance, Dotson hopes to follow in Paulson's footsteps.

Paulson's longest walk to date has been 1,040 feet, but doctors are more interested in seeing him walk shorter distances with less fatigue.

"The key is that he's walking with less energy expenditure," Herman said.

"It's not necessary to walk 1,000 feet. We want him to function, to walk into a restaurant and know how far it is. We want him to be a homebound and community walker."

Paulson calls it "finding my safety net."

As for being able to ditch the walker and use the crutches alone, Herman said, "that's going to require another set of experiments."

"But this young man has a lot of will, and I don't doubt he will do it."

"If the wind could blow my troubles away. I'd stand in front of a hurricane."