Hunter VanBrocklin is a kid on the go. The fearless fourth grader loves to hike on his family’s 20-acre property in Alfred, Maine, with his constant canine companion Wendy by his side. He trekked through national parks in the U.S. and Canada with his parents and sister in the summer of 2015. He’s even developed his own version of four-wheeling.
Hunter is exceedingly mobile for a child who shouldn’t be walking, according to the experts.
“When Hunter was a baby, he was slow to roll over and crawl and wasn’t walking,” recalls his mother Kelly VanBrocklin. His pediatrician referred Hunter to Dr. Gregory Melkonian, an orthopedist in the Boston Children’s Hospital Orthopedic Center and Cerebral Palsy Program, who diagnosed Hunter with cerebral palsy, just shy of his second birthday.
Melkonian performed botulinum toxin (Botox) injections and serial casting to reduce the spasticity in Hunter’s ankles and improve his walking and balance. Hunter also was fitted with lower leg braces.
As a toddler, Hunter started using a walker to get around. He jokes, “That walker didn’t stand a chance. Walkers are good for going at slow speeds, but they aren’t meant for kids on the go.” Hunter broke his second walker in less than a year.
Over the next five years, Hunter had a series of Botox and phenol injections. His cerebral palsy team expanded to include physiatrist Dr. Donna Nimec and orthopedic surgeon Dr. Benjamin Shore, an orthopedic surgeon in Boston Children’s Child and Young Adult Hip Preservation Program.
After each injection, Hunter’s doctors worked together to determine how to improve his gait and walking mechanics.
Cerebral palsy can cause muscle tone to be too high (spasticity) or too low (which causes problems with balance).
“Managing tone is kind of like cooking. Every kid has his own recipe,” explains Shore.
Keeping Hunter on the go
Despite Hunter’s determination, walking became increasingly more challenging between ages five and seven. His balance issues worsened, and the effects of his hip dysplasia became more apparent. As a result, Hunter needed a lot of energy to walk.
“He’s a precarious walker and struggles with balance on a good day,” explains Shore.
Andy and Kelly needed to figure out a way to keep their son mobile and active.
They started researching service dogs and connected with Service Dog Project in Ipswich, Massachusetts.
When Kelly first called, she was told Hunter was too small and too young for a service dog. The VanBrocklins decided to attend an open house anyway, knowing the research might be helpful in the future.
Hunter charmed the founder of the organization, and after demonstrating his walking prowess, the organization decided to pair the boy with a mobility dog. The VanBrocklins were cautioned that matching Hunter with a dog could take two to five years.
A few months later, Service Dog Project invited the VanBrocklins to return so Hunter could try walking with a few dogs.
Everyone knew right away — Hunter and Wendy, a 108-pound Great Dane puppy, were a match. “It took two people to drag Wendy away from the car when we left that day,” recalls Hunter.
Hunter and Wendy on the go
Three days after bringing Wendy home, Hunter had an appointment with Shore and Nimec. The doctors were amazed at the progress he had made in such a short time with Wendy. Hunter made sure to do everything else his doctors recommended.
“He wore his braces and knee immobilizers every night and worked hard in therapy. He could have lost range of motion,” says Kelly.
Adds Andy, “We treat him like an athlete.”
Over the next few months, Hunter and Wendy trained together, and Hunter learned how to walk with Wendy supporting him on the left side, rather than a walker as support for both sides.
Hunter gradually gained strength, and Wendy adapted to family life. Every day after school, Wendy greeted Hunter with a puppy-level excitement. “I had to brace myself for a hug from a Great Dane,” says Hunter.
That first summer, the pair became inseparable. “I can take her out in the woods and look at what I want to look at without getting stuck.”
Hunter developed muscles in his legs for the first time and even started walking independently for short distances.
Hunter’s next steps: hip dysplasia surgery
Unfortunately, the dynamic duo of Hunter and Wendy could not overcome the effects of his condition. By age 9, his muscles had become tighter, and at their combined visit, Shore and Nimec told his parents surgery was Hunter’s next best option.
“There were tears in the room. Mom and Dad had known surgery was on the horizon for Hunter, but it’s never an easy conversation or decision,” says Shore. Without surgery, Hunter’s condition would continue to deteriorate, and he would ultimately need a wheelchair.
Hip dysplasia surgery changes the alignment of the hip and femur. The goal is to improve Hunter’s walking mechanics, so he uses less energy and will walk even better down the road, explains Shore.
The VanBrocklins decided to go ahead and scheduled the surgery for January 2016. While most families prefer to have elective procedures early in the summer, Kelly and Andy knew Hunter would want to be as mobile and active as possible during the summer.
Two months after his surgery, Hunter is ready to start the hard work of rehabilitation, which will begin with range-of-motion exercises, gait retraining and pool therapy. Rehabilitation is a slow process that can take 12 to 18 months.
Hunter, Wendy and family have their eyes on the prize — long hours lost in the woods, afternoons of sunshine and swimming and countless years of active companionship.
Call 617-355-5870 or fill out this form to request an appointment with a provider in the Boston Children’s Cerebral Palsy Program.
Learn more about the Boston Children’s Child and Young Adult Hip Preservation Program.