Publication: Telegram & Gazette

By: Geraldine A. Collier

Lynnette McIntire has worked several different jobs in her lifetime, but her passion has always been reserved for tap dancing and passing on that artful skill to youngsters who are willing to invest their time and effort to learn.

“Teaching tap dance is what I have been put on this earth to do,” said the 57-year-old dance instructor, who has herself taken classes with the best of the best, the legendary Gregory Hines and Broadway star Savion Glover.

But a small sore on Ms. McIntire’s right foot that refused to heal over a four-year period threatened to keep those patent-leather tap shoes in her closet forever more.

“It was about the size of an eraser (on a pencil),” said Ms. McIntire, who, as one of the 29 million Americans who are diabetic, knew that a foot injury could lead her down the path toward an amputation.

That’s the fate of about 73,000 diabetics in the U.S. each year, making diabetes the leading nontrauma cause for people losing toes, feet or limbs, according to Dr. Samir Malkani, director of diabetes services at UMass Memorial Affiliate and
Member Hospitals.

While better diabetes management and better foot and wound care have reduced lower limb amputations by half over the past 20 years, about one out of every 400 diabetics still undergoes amputations. The trouble starts with a break in the skin that can sometimes go unnoticed because of numbing nerve damage. That break then get infected with bacteria that feast on high blood sugars, leading to an ulcer exposing the layers of tissue underneath. “It’s like a hole boring into your foot,” said Dr. Malkani.

Healing can be difficult.

Diabetes can lead to a narrowing of blood vessels that reduces the flow of oxygenated blood to the feet, slowing down the healing of a wound or ulcer and making the body less effective at fighting infection. “A wound or ulcer that doesn’t heal can lead to gangrene,” explained Dr. Malkani. Ms. McIntire was determined to do battle. Initially, a podiatrist fitted her with a boot that would take the pressure off Ms. McIntire’s right foot. “While I wore the boot the ulcer would heal, but once we took the boot off and I was going about my business, the ulcer would come back.”

Over four years, Ms. McIntire was prescribed several different kinds of antibiotics. Eventually, she underwent treatment five days a week for about six weeks in a hyperbaric chamber at St. Vincent Hospital in hopes that a higher-than-normal concentration of oxygen delivered at higher-than-normal pressure would stimulate healing. The treatment was not ultimately successful; neither was a debridement, the cutting away of layers of tissue down to the bone.

Instead of being vanquished, the infection spread, first up to her ankle, then up to just below her knee. Her surgeon told her there was just no way to save her lower limb. “If I had waited much longer it would have just kept spreading and I probably wouldn’t be alive today,” said Ms. McIntire.

Going ahead with the amputation was a decision that Ms. McIntire was comfortable with. “I put up a good fight. I am not winning this fight, but I am not losing this fight, either,” she said. Decision made, Ms. McIntire made an immediate phone call to Melissa Dube, owner of Aspire Dance Center in Oxford, where she taught tap to girls 10 to 18. Her message: You’ll have to find someone else to teach tap. Ms. Dube’s reply: No, if you want to come back, the job is yours.

“I knew she could still teach; after all, I had seen her teach in a boot,” said Ms. Dube, whose dance center offers both recreational and competitive classes for youngsters 2 to 18. “She’s a strong teacher; she has a lot of love and passion for tap. I didn’t feel that you needed to have two legs to be a good teacher.”

Ms. McIntire’s amputation took place on July 8, 2016, at St. Vincent Hospital. Transferred to Fairlawn Rehabilitation Hospital, she began inpatient therapy with both a physical and an occupational therapist.

Ms. McIntire’s inpatient physical therapist at Fairlawn worked with her to improve the strength in both of her legs. Since she had not yet been fitted with a prosthesis because her stump had not healed, Ms. McIntire learned to move with a rolling walker. And she was taught how to climb stairs and get in and out of a car.

Michelle Pfannenstiel, a Fairlawn occupational therapist, focused on improving Ms. McIntire’s balance, showing her how she could wash up and get dressed as well as perform other activities of daily living, so she could go home.

“She had the most positive outlook; she was the hardest-working person. She had her goal in sight and she wasn’t going to let anything stop her,” said Ms. Pfannenstiel.

After Ms. McIntire was fitted with a prosthesis at New England Orthotic and Prosthetics Systems LLC, she returned as an outpatient at Fairlawn to work with Pablo Maldonado Pinuer, a physical therapist, who saw her from October to December
last year.

“I am far from being a decent dancer,” said Mr. Maldonado Pinuer, “but I had to learn a few steps in order to work with Lynnette.” In order for Ms. McIntire to still being able to dance, she had to compensate with her hips and knees. “During therapy, we focused on hip flexibility and strengthening.”

For most people, therapy focuses on gait and even and uneven surfaces. “However, for Lynnette, I included activities that required higher level coordination, balance on one leg, being able to walk in different directions and make quick turns, while maintaining good balance,” he said.

“Lynnette was always up for any challenge I would come up with, never afraid to take any risk. Basically, every session she would come and tell me she had conquered something new,” he added.

In the fall of 2016, while still undergoing therapy, Ms. McIntire returned to the Aspire Dance Center to teach tap, initially without a prosthesis. A young woman initially assisted, demonstrating steps for the right foot, but once Ms. McIntire was fitted with a prosthetic limb, she didn’t need any further assistance.
Ms. McIntire also had to fulfill one request Ms. Dube had made of her, that she be upfront with the Aspire students about her surgery, and answer any questions they might have about that or her prosthesis rather than try to ignore the situation.

“I didn’t want the children to feel scared. I didn’t want them to feel nervous or unsure,” said Ms. Dube. “I didn’t want them to get crazy ideas in their heads about what ‘Miss Lynnette’s’ foot might actually look like. In our opinion it’s better to just nip the subject in the bud and talk about it rather than let rumors circulate.”

Once Lynnette was on board with the idea, Ms. Dube emailed all the parents, explaining how the matter would be handled and asking them to get in touch “if they weren’t comfortable with ‘Miss Lynnette’ talking to the children.” No one registered an objection.

How much information Ms. McIntire would provide depended on the age of the students, with the younger ones at the dance center simply told that Ms. McIntire had had a “boo-boo.” However, for the older tap students, it was “show-and-tell.”

Sitting in a chair, while her tap students sat on the floor around her, Lynnette showed them how the prosthetic leg goes on and off, how the different parts go together and — answering the burning question of the day — how does it attach to the rest of your leg? Their biggest reaction to all they saw and heard: “Wow.” Then they got back to their dance lesson.

Looking ahead, Ms. McIntire hopes her students have learned a lesson that will serve them well in helping them persevere in the future no matter what obstacle they might encounter. “I hope that when they look back on that dance teacher they had, it will make them think ‘even though she lost half her leg, it didn’t stop her from doing what she wanted to.’””