Determined mum and surgeon help teen Nathan Fernandes get back on his feet
When her son collapsed on the soccer field and couldn’t walk for 18 months, a desperate Ferntree Gully mum took matters into her own hands to solve the medical mystery.
Victoria
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It was a mother’s determination and a surgeon’s willingness to take a leap of faith that got teen Nathan Fernandes back on his feet.
When a slew of medical tests failed to find what was wrong, his mum Queenie turned sleuth to solve a medical mystery that for almost two years had brought the Ferntree Gully family’s lives to a halt.
“I do not have a medical background. I have been asked that every single time by every single doctor,” Mrs Fernandes said.
“I was just a desperate mum trying to find answers for something we couldn’t understand.”
Mrs Fernandes said the nightmare began when Nathan, now 16, was at soccer training on a cold May night in 2022.
“Nathan suddenly dropped to the ground,” she said. “He couldn’t walk. It was the start of everything.”
Nathan said he felt fine. “Then I went to kick the ball and I just collapsed on the field from the pain.”
Much later the family would learn he had suffered a compressed tibial nerve in the calf of both legs. This is the nerve that connects to 21 muscles allowing movement of the leg, foot and toes.
“I was on the internet all the time,” Mrs Fernandes said. “In the absence of getting any answers from doctors and trained professionals I just didn’t know what else to do. I was desperately looking at websites, reading medical journals, talking to people online.”
Mrs Fernandes and husband Kenny had moved to Australia from Dubai when Nathan was one.
He was a healthy, energetic toddler who started playing soccer at the age of three. By 14 Nathan was playing for his school, Mazenod College in Mulgrave, as well as the local soccer club.
He was super fit, and academically super smart.
In the lead up to that horror night at soccer training Nathan had noticed a bit of calf soreness.
The family put it down to soccer training that may have caused a muscle strain or an injury.
When he still couldn’t walk the next morning, describing symptoms like having a brick attached to his ankles that felt so heavy he couldn’t lift them, his worried parents took Nathan to a GP.
“The doctor ran a whole bunch of tests and all they could find was that his vitamin D was low, but the GP said that wouldn’t be a reason for this to happen,” Mrs Fernandes said.
“She sent us to specialists including two rheumatologists and three neurologists. They did MRIs, X-rays, scans; they did muscle tests, we even went so far as to do genetic testing which was sent to the US.
“It was an absolute nightmare and every single test came back negative.”
It was also an expensive exercise that saw the family exceed their Medicare levy twice, two years in a row.
“But what do you do?” Mrs Fernandes said. “We needed answers.”
So she turned to the internet, keying in Nathan’s symptoms that now also included tingling and numbness in his legs.
Mrs Fernandes said while she did the ground work of organising medical appointments, it was very much a team effort with Mr Fernandes always there for every medical appointment.
“We all worked together,” she said.
The eureka moment finally came when Mrs Fernandes read an American medical journal article online that included a case study describing symptoms similar to Nathan’s. The patient had been helped with surgery to release the compressed nerve.
Next, the family needed to find a doctor who agreed that Nathan’s pain may be nerve-related.
Step in pediatric neurologist Manoj Kanhangad and the head of Paediatric Plastic Surgery at Monash Children’s Hospital Dr Nelson Low.
“I took the study to my GP, she discounted it. I took it to the rheumatologist, he discounted it.” Mrs Fernandes said.
“I took it to my neurologist and he knew it was nerve-related so he read through it and said he knew of a surgeon, ‘let’s see what he has to say’.”
It proved pivotal.
Dr Kanhangad introduced the family to Dr Low at Monash Children’s Hospital who offered hope in the form of experimental surgery, but warned the family there was no guarantee of success.
Also involved in Nathan’s care was the Victorian Paediatric Rehabilitation Service at Monash Children’s Hospital that caters for children and adolescents needing specialist interdisciplinary rehabilitation.
Dr Low explained that to have compression of the tibial nerve in one calf was uncommon. In both legs, at the same time, he said, was almost unheard of.
“It was the first time in my career that I had seen this in both calves,” he said. “It is rare because it is not picked up if you don’t go looking for it and have an understanding of the anatomy.”
Dr Low said the cause of the condition remains unknown.
“It is what we call compression neuropathy where the nerve gets compressed, or squeezed,” he said.
“It can happen in the wrist, which is called carpel tunnel syndrome. You can also get it in the elbow, which is also fairly common. Anywhere you have a nerve there is the potential for it to get compressed.”
Dr Low said Mrs Fernandes was understandably determined because she wanted to find an answer for her son who was missing a lot of school, couldn’t walk, go upstairs, was in a lot of pain and couldn’t play soccer anymore.
“We worked together with Nathan and met multiple times to talk through the surgery which would be done in two stages: the right leg first and then three months later the left. Then it was question of whether they were prepared to take the risk surgery might not work.”
The surgery did work, with Nathan’s right leg successfully operated on to relieve the compression in August and the left leg in December.
He is now back walking, and has returned to school,
“Nathan has always been optimistic that we would find the cause,” Mrs Fernandes said.
“It is such a relief, although I secretly hope he never goes running or plays soccer again, but that’s just a crazy mum speaking.
“My husband keeps reminding me he is a teenager and he has to get back and live his life like he was before and Dr Nelson is determined that is what he does.”
As for Nathan, he says it is good to be back at Mazenod College, which he said been incredibly supportive.
Will he return to playing soccer? “I’ll definitely be back on the soccer pitch at some time,” he said.
As for his mum and dad: “I couldn’t have done it without them.”
At a glance:
• The tibial nerve sends messages from the brain to the lower leg
• It helps extend your hip, flex your knee and ankle and rotate your knee
• Untreated it can result in persistent pain and weakness
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Originally published as Determined mum and surgeon help teen Nathan Fernandes get back on his feet
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