Best Foot Forward

Paul Kocher, 46, says doctors told him he’s lucky to be alive after a battle with flesh-eating disease that caused him to lose five toes. Photos by Omar Mosleh.

After a battle with flesh-eating disease that caused him to lose all the toes on his left foot, Paul Kocher ran 2.5 km during a fundraiser for St. John’s Rehab.

Paul Kocher is a man who doesn’t like to use his disability as a crutch.

In fact, when he lost five of his toes to necrotizing fasciitis, more commonly known as flesh-eating disease, he preferred not to use a crutch at all.

To be fair, the 46-year-old father of three briefly walked with a cane upon leaving the hospital, but considering doctors told the Leasider he’s lucky to be alive, it wasn’t such a bad trade off.

“I’d venture to say if I could have held out on the pain one more day, I would have died,” Kocher said. “This certainly would have killed me … In fact, the surgeon told me he never thought I was going to leave the hospital.”

That same surgeon might be surprised to hear Kocher was back at his job working full time as an IBM executive just six months after having his toes amputated.

Or, better yet, that he recently managed to take part in a 5-kilometre run/walk to raise money for the hospital that helped him rebuild his life.

“I’m still recovering,” Kocher quips with a grin.

“I went into it not sure if I could walk it or not … because beyond what you see here, there’s a lot of sensation and pain in this foot, just walking without my orthotic is painful.”

But, never one to play it safe, Kocher did better than walk the full 5 kilometres. He actually jogged the second half of the race.

“Admittedly I’m quite sore, and needless to say this wasn’t the brightest decision I’ve made,” he said. “But I ended up finishing it in about 39 minutes.”

Compare that to the average of 32–34 minutes, and Kocher did pretty well considering he has a disfigured foot and is legally disabled. While he’s experiencing some residual pain from the race, it’s likely it was worth the look on his wife’s face at the finish line.

“When I came around the corner, I could just see her thinking ‘Are you crazy?’ ” Kocher says with a chuckle.

One could say if Kocher isn’t crazy, he’s certainly lucky.

It all started in March 2008 when Kocher woke up feeling a little under the weather. At first, he dismissed the weariness and muscle aches as flu symptoms.

Over the course of the next few days, Kocher’s condition would worsen to the point where he couldn’t get out of bed. He also noticed an odd pain in his leg.

To make a long story short, Kocher contracted the disease from the same bacteria that causes strep throat, which his wife had at the time.

Typically, the bacteria enter the body through a cut or blunt force trauma, but in Kocher’s case, the bacteria were already present in his bloodstream and were trying to work their way out.

“The doctor said the way I got it, the chances are probably one in two million,” he recalled. “It wasn’t quite the lottery I was hoping for.”

Within 24 hours, doctors were operating on Kocher’s legs and injecting high levels of antibiotics into his body.

He was diagnosed with flesh-eating disease, a rare infection that can cause death within 12–24 hours if left untreated.

The condition causes the destruction of skin and muscle due to the release of toxins. As a result, the dead material needs to be removed. This is actually where most of Kocher’s scars originate from, as they had to cut open his leg and remove skin from the other leg to close the wound.

Another side effect of the treatment is that blood pressure drops very low, which leaves the vital organs at risk of failing. To combat this, the doctors use compressors that keep the blood pressure up in the core but also starve the rest of the appendages, such as feet and hands, of oxygen.

“On this side, I had been deprived of oxygen for so long that the toes actually died and turned black,” Kocher explained.

But it was still a surprise when he heard a doctor casually remark he was doing well despite the fact he was losing his toes.

“I said ‘Wait a minute, what?’ And then I could tell that he didn’t realize nobody had told me,” he said. “He just told me in a very nonchalant fashion.”

Kocher eventually had his toes amputated one by one over a course of six months. He even remained conscious for the operations, as the doctors just gave him a general anesthetic.

“They’d put a needle in my foot every once in a while, but quite frankly they’d just get something out and start cutting through it,” he said. “I’m not going to lie, it’s not fun.”

But Kocher is not one to lose his sense of humour, even in the midst of his toes getting chopped off. Having people guess when his last toe would be amputated, he started a betting pool, with the proceeds going to Sunnybrook Hospital.

“The range of emotion went from absolute horror and disgust and shock, to, you know, good laughs,” he said.

While it’s easy for him to poke fun at the experience now, there’s not a day that goes by where he isn’t happy to be alive.

And he realizes the tremendous impact the disease has left on his family.

“Arguably, it’s been harder on my family than it’s been on me,” Kocher said. “I could tell my son was really proud of me when I finished that race.”

While Kocher survived his fight with flesh-eating disease, the exposed bone in his foot led him to contract osteomyelitis, a chronic bone infection.

“I have some things that I’ll have to deal with for the rest of my life,” he said. “At the end of the day, if I just have to take some pills for the rest of my life, I can probably manage that.”

Today, Kocher is tremendously thankful to Sunnybrook Hospital, which he says saved his life, and to St. John’s Rehab, which he says rebuilt it.

But in what may come as a surprise to some, one of the hardest parts of overcoming his affliction was leaving the hospital.

“There’s lots of folks I saw in the hospital that are never going home, so it’s tough leaving,” he said. “It’s a sad feeling.”

Paul Kocher still has the toes he lost as a result of flesh-eating disease.

In particular, it’s hard for him to forget a terminally ill patient who had his pelvis reconstructed.

“Just for him to get out of bed was a victory for him, but he knew he was fighting a losing battle,” he remembered. “He knew he wasn’t leaving that hospital.”

It’s experiences like those that have prompted Kocher to call his battle with flesh-eating disease a gift.

“I must admit I turn red every once in a while because that’s not who I am, but I recognized that this story has an impact for people and it does inspire them,” he acknowledged. “And that’s why I call it a gift … It’s a gift of perspective, it’s a gift of life when people thought you would die.”

That perspective is something Kocher carries with him every day.

“It’s not like I’m a completely changed person with this big halo over my head, but every once in a while I realize I’m working too much or not paying attention to the stuff that matters,” he said. “And it just takes me a millisecond to what I call ‘go on the other side of the sheets again.’ ”

The renewed outlook on life is not the only thing he’s kept from his ordeal.

He still has his dismembered toes — for sentimental reasons.

“They were hard to let go of.”

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