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Back on her feet

Juvenile rheumatoid arthritis was robbing Nairy Markarian of her mobility. Then she landed at St. Michael’s Hospital.

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Leah Engel, Nairy Markarian and Dr. Tim Daniels

Leah Engel, Nairy Markarian and Dr. Tim Daniels

I went 45 years without knowing what it’s like to stand up barefoot, feeling the ground beneath my feet. I do now. And it is wonderful. I have Dr. Tim Daniels, head of orthopaedic surgery and the Chair in Foot and Ankle Fracture Research at St. Michael’s Hospital, along with his team, to thank. This is my story.

I was born in Jordan. At the age of two, doctors knew something was wrong, but they didn’t know what. What I knew was that I was always in pain. Ankles, feet, knees, elbows, fingers, wrists, neck, spinal cord, jaws–they all hurt. Over time, I was able to use them less and less. My ankles were the worst. It became harder for my parents to find shoes I could wear, but I couldn’t walk without shoes. I spent most of my time in hospital.

When I was eight or nine, they finally diagnosed me with juvenile rheumatoid arthritis. Since they didn’t know what to do about it, it wasn’t a huge comfort. And the deterioration continued. Over the years, I underwent many surgeries. My knees and elbows have been replaced, but doctors said they could not replace my ankles–that my only choice was to have them fused. I wouldn’t let them do it. The cost in mobility would be too great, and somehow I knew that one day, I would find someone who could replace my ankles and literally get me back on my feet again.

I moved to Canada in 2017. A year later, a rheumatologist referred me to Dr. Daniels. That was when my life changed. Dr. Daniels told me he might be able to replace my ankles with a prosthesis that he’d developed, but he made it clear there were no guarantees. My ankles and feet were in terrible shape. He laid it all out and then left it up to me. I said, yes. Very much, yes.

Because of COVID-19, the surgery would not take place for nearly four years. But this past June, I got the call. I was excited and terrified. My parents had always been with me during surgeries and procedures. But they were back in Jordan. I was alone. I was afraid to tell the nurses that I would need help with going to the bathroom. I was nervous that they would put a needle in my right arm where I have nerve damage. Basically, I was terrified of everything. I felt like I was going to my own execution.

But it wasn’t like that. It wasn’t like anything I had ever known. They were so nice to me, it made me cry. As I expected, I had to go to the bathroom just as they were about to take me in for surgery. Nobody got mad. They just helped me. They were careful of my arm. They asked me if I wanted to be awake or asleep during the surgery. I said asleep, and the doctor said, well okay, but no snoring. It made me laugh.

After the surgery, they were even kinder and more compassionate. They took such good care of me. They wouldn’t let me go home until they knew my place was properly equipped for someone recovering from surgery. And once I was home, they kept checking in to make sure I was okay. I have never received treatment and care like this before. I didn’t know it existed.

I now work for St. Michael’s Foundation.

St. Michael’s Hospital and Providence Healthcare want to create a healthcare experience that’s built around patients. Where things are easy to understand. Appointments are easy to book. Problems are looked at in new ways. And humans and their health always matter most. In other words, they want to make sure all patients get exactly the kind of care I did. As you can imagine, I love my new job.

Today I am looking to the future with real optimism. They only replaced one of my ankles; the other will be done in a few years. I can already tell that I’ll be walking almost like the average person. I’ll even be able to do it barefoot. Can you even imagine what a gift that is?

I want to express my deep, deep thanks to Dr. Daniels and the other doctors, nurses and staff. For the first time in my life, a medical team made me feel strong.

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