Young amputees put prosthetics to work

[Woodmonkey]

NEWARK, Del. — Bob Kislow arrived on a Harley, his high-tech prosthetic leg hidden beneath blue jeans and steel-toed boots.

Turning heads with his Mohawk and tattoos, Kislow strode with an even gait into the prostheticist’s office, a visit he’ll make regularly for the rest of his life.

Just 22, the Army veteran lost his lower right leg in 2005 after being shot five times by a sniper during a 10-hour firefight in Afghanistan.

Three years later, he’s back on his feet in earnest. He’s gone skydiving and rock climbing, played paintball, raced motorcycles and golfed.

He changes artificial legs like most people change socks.

“I jumped out of the Jeep from doing some interior work,” Kislow, an auto-shop worker in Bethlehem, Pa., explained to Newark, Del., prostheticist John Horne, 33, who himself lost a leg to cancer when he was 15. Kislow held up a metal foot that needed repairs. “(It) flipped forward ... the band loosened up. It must have been from riding that motorcycle...”

Adventurous and adaptable, Kislow is one of more than 750 men and women who have lost limbs in Iraq or Afghanistan — a small, but highly visible percentage of the estimated 185,000 people who undergo amputations every year in the U.S.

Studies by the Amputee Coalition of America show that 82 percent of amputees in the U.S. lost limbs because of complications in the vascular system — problems usually associated with aging.

But most 21st-century war amputees are in the prime of their lives. And unlike the wounded returning from Vietnam and World War II, they have access to a rapidly evolving array of high-tech prosthetics, from mechanical knees to myoelectric arms.

“These younger vets want to get back to work, get back to sports,” said Reema Malhotra, physician and director of the Elsmere (Del.) Veterans Affairs Medical Center amputee program.

Ironically, war — the cause of so many amputations — has historically accelerated improvements in prosthetics, with the military leading the way in research and sparing no expense. Last year alone, the Department of Veterans Affairs spent almost $50 million on artificial arms and legs for the 8,400 vets who needed them.

“If there’s one good thing that comes out of this war, there’s going to be a huge advancement in prosthetic componentry,” said Frank Austin, a physical therapist at Christiana Care Rehabilitation Services and Therapy in Delaware.

The latest limbs are “actually powered up, moving toward the bionic stage,” Austin said. “That’s exciting for my generation, who grew up watching the ‘Six-Million Dollar Man.’ ”

But the high-tech limbs aren’t practical for many amputees, regardless of their age. And all the bionics in the world don’t make it easier to lose a limb.

Kislow was 19 and still growing when he got shot in the right heel, right arm, head, back and side during fierce fighting in Paktika province. When Kislow awoke from surgery with his right leg gone below the knee, he was angry, then defiant.

“If you lay in bed and feel like you wish you would have died, you’re going to die,” he said. “If you say, ‘I want to go out there and kick more ass,’ you’re going to go out there and kick more ass.”

Eugene Smallwood felt a little less gung-ho. He watched his foot turn purple a few years ago and knew it couldn’t be saved.

“I was so depressed, it was pitiful,” said Smallwood, now 61, an Army veteran of the Vietnam era. Like all of the 36 patients at Elsmere’s VA medical center who lost limbs last year, he has multiple health problems, including diabetes and peripheral artery disease. “I still get depressed. That’s just part of life, I guess.”

Members of the Amputee Support Group of Delaware try to help people like Kislow and Smallwood adjust. Regardless of how it happens or at what age, losing a limb has the potential to destroy a life, said Rick Hoffman, who lost his leg in a motorcycle accident in North Carolina.

“The emotional aspect of it is rarely talked about,” said Hoffman, who is certified by the Amputee Coalition of America as a “peer group member” and visits with new amputees to offer support. Not everyone is able to adjust. Last spring, one man committed suicide.

“Who knows what pressures build up and from which direction?” said Hoffman. “But the peer group can act as a safety valve. If you’re having a panic attack at 3 in the morning, you can pick up the phone and talk to someone who’s been where you are.”

Until a little more than a decade ago, most prosthetics remained fairly rudimentary.

Though advances in the field have been dramatic, most amputees don’t qualify for the high-tech artificial limbs, which require candidates who are already very active and function well with an ordinary prosthesis.

Other candidates for the latest prosthetic technology can’t afford it. The Proprio foot, which some refer to as “bionic,” costs about $15,000 and isn’t covered by most private insurance policies. Others — veterans who qualify for the technology and can count on the government to pay for it — think the mechanical limbs are more trouble than they’re worth.

“The computer technology is not for everyone,” said Stephanie Beaman, a physical therapist at Elsmere’s VA medical center. “They have to be tech-savvy to use computerized limbs. ... They have to remember to charge their leg.”

And some of the youngest and healthiest war amputees such as Kislow simply push their bodies too hard.

“He’s so active, he would probably break it,” said Horne, who tried the bionic foot himself, but broke it after just a week. “That’s the problem with the new technology — it’s great that it’s out there, but it’s not entirely functional. He would break it. Definitely.”

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