Mike Brewer gives his surgeon Zac Moaveni the thumbs up for salvaging his hand. Photo / Brett Phibbs
Mike Brewer gives his surgeon Zac Moaveni the thumbs up for salvaging his hand. Photo / Brett Phibbs
Every day, lives are saved through surgery. This week the Herald takes a look at some of our country's most extraordinary operations - from a thumb being replaced with part of a toe, to part of a bike being removed from young girl's groin. Health reporter Emma Russell reports onsome of the remarkable stories.
When Mike Brewer wants to send a text message, he gets out his phone and starts writing with part of his toe.
He also uses his toe - at least part of it - when he waves, holds a drink or gives the thumbs up.
That's because the pad of his toe was transplanted onto his thumb after it was torn off in an accident earlier this year.
The experienced kitesurfer had been skidding along Muriwai beach in May and was about to catch his last ride for the day when his gear got tangled.
"It all happened in a split second. I remember thinking I've got to let go and I did but it basically tightened this noose around my thumb and pulled it off like a knife had just sliced it off."
The 54-year-old said he couldn't believe his eyes when he looked down and saw the majority of his thumb was gone.
Instead of the usual pad on the back of his thumb there was just a gap and blood was streaming from the remaining flesh.
He was initially given two options by doctors: a skin graft, which would mean he'd keep what was left of his thumb but it "would be pretty ugly", or an amputation.
That's until Counties Manukau District Health Board plastic surgeon Zac Moaveni examined his thumb and offered him a third option - a toe transplant.
"I jumped at it. For me, any option that's going to let me keep my thumb is a good one."
Mike's new thumb just days after surgery. Photo / Supplied
It was a procedure Moaveni had never done before, and to his knowledge no surgeon in New Zealand had done, but he was confident it would work.
"It was a very unusual injury because he had lost his entire thumb pad but the bones and tendons were okay so he was perfect for this kind of technique," Moaveni said.
Within 24 hours of the accident, Brewer was rushed into the operating room for a six-hour microsurgery.
Moaveni told the Herald they had two teams; one was working on the thumb and the other was exploring the toe to make sure the blood vessels and nerves were all where they should be.
Mike happy as Larry after waking up from his unique surgery. Photo / Supplied
The first step was dissecting the blood vessels, veins and nerves out of the side of his left big toe before sewing it back up. Then, using a microscope, Moaveni had to rejoin the material to the thumb.
To put it in perspective, the vessels were less than 1mm in diameter, making it a "highly complex" procedure.
A skin graft was also taken from his arm to fill the gaps and help close the thumb.
There was no guarantee it was going to work, but luckily it was completed without any complications.
Two months later, his thumb had completely healed, leaving only small scars.
Part of Mike's big toe in the place of his thumb pad. Photo / Supplied
Moaveni said he remembers seeing him text with his new "toe thumb", and thinking "wow that's incredible."
Showing off, Brewer said he could even use his special thumb to open up his phone with a print ID.
However, his toe took a little longer to heal because of an infection.
"I couldn't walk properly for a couple of months. I was using a knee scooter. In hindsight, I didn't appreciate how much I should [have] kept my foot up."
Now, just six months since his accident, Brewer has already been back in the water for a kite surf.
"I had a few butterflies driving out there, and it's definitely made me more aware, but I'll never give it up."
