I cannot get out of my mind, the many pictures that we’ve seen, of the trauma that wreaked havoc at the Boston Marathon bombings. In particular, I’ve been concerned for the people who lost limbs in these bombings. We know the bomb that was put in the pressure cooker, apparently had BB’s and other metal loaded in it, creating more damage to the victims. This show is about what it’s like for people who’ve lost lower legs and limbs.
This blog is taken from “The Joan Jerkovich Show” radio transcript and edited for easier reading. Listen to the Podcast and post your COMMENTS at -THIS LINK-
In the Boston Marathon bombing, most of the trauma was to the lower extremities or the legs, yet people who’ve also had some sort of illness or injury or war injury that’s taken the arms as well, are often so much more challenged with getting back to normal life than someone who lost a leg. When we look at those people, who have successfully accomplished and achieved working with a prosthesis, like the Olympian that ran in the first Olympics with a prosthetic leg, we can’t quite fully grasp the unique and individual struggles that have been met to do so.
I wanted to share with my listeners this morning some of what it really takes for these people to go through this process. I found an interesting article written by Oren Dorell, for USA Today, that was talking about how many of the veterans who lost their limbs in the Iraq and Afghanistan wars, went on a trip to Boston to provide support and information to those who were injured in the Boston bombings. As we know, at least 15 people have lost their lower limbs in this bombing to date. This added up to the highest number of civilians who’ve had this kind of multiple traumatic injuries in our country. The article said that these veterans showed up in Boston to talk to these patients and they found them all just sitting there, looking so dejected, and feeling like their whole world, their whole lives, had been turned upside down; but within a half an hour later, many of them were laughing and didn’t want the veterans to leave. They were there to give the kind of support you can only get from those who’ve been through exactly what they’re (the Boston bombing amputees) experiencing right now?
The Veterans said that some common questions these patients had were, “How do you shower? How are you able to get back to doing the things that you love or like doing? How are we going to go on the beach or ride a bicycle? How about driving a car or going to work?” Their biggest concerns are always going to be about not being able to live their life the way they want after this traumatic injury. One of the servicemen was quoted as saying, “Accepting the injury and moving on is crucial. You figure out what you need to do to get back to a normal life and you do it.”
These war veterans traveled to Boston representing the Semper Fi fund, which is raising money for these victims. They want to help them with these prosthetic devices, which I was shocked to hear, can run as high as $100,000 dollars. What you need to realize is that the prosthetic devices are unique to the types of activities you do. You may need one to go back to being a jogger. You may need a different one for something related to your specific work. There are specialized prosthetics for swimming and all types of activities. If just one of those costs $100,000 dollars, you can imagine the challenges these amputees have ahead of them, not to mention the emotional trauma they’re going through.
You know, while these victims of the Boston bombings come to mind, these 15 victims, we cannot turn our backs on the numbers of amputees coming back from war in Iraq and Afghanistan, which total almost 600. But where those numbers seem astronomical to me, there is a much smaller group of our war veterans that fall into the categories that they call, “the quadruple amputee.” There are only five of those. Then they also have the “triple amputees” and there are 40 of those. Of course, quadruple amputees are the ones who’ve lost both arms and both legs. Can you imagine?
An article by CNN writer, Steve Almasy, in October 2012, which of course was before the Boston bombings, talked about the actor, Gary Sinise. We all remember Gary’s character from “Forrest Gump” as the double amputee. In real life, Gary Sinise is involved with helping amputees raise money for the very specialized homes that they need to function fully in their lives. In this article, the point was made, that years ago, in wars, these amputees would not have survived on the battlefield. No one that had their arms and legs blown off would have ever survived the loss of blood. Advances in the battlefield medical treatment and the immediate treatment of the soldiers, has helped prolong their lives. Also, they say the body armor that they wear today on the battlefield, has quite a bit to do with the survival rate.
The serviceman pictured with Gary Sinise, in this article, was Todd Nicely. He was in Afghanistan when an explosion from a pressure plate on a roadside bomb was triggered. He didn’t even realize at the time that he had lost his legs and needed to have amputations, even of his arms. It seems that they (the soldiers) can have such adrenaline flowing during wartime, that they don’t even recognize that they’ve had this traumatic injury until after the fact. I’m sure this is a similar scenario with the Boston marathon bombings that happened with those people on the sidelines and the runners who were taken by surprise. Corporal Nicely talked about how, in another wartime, he would’ve died on the battlefield. But once again, the body armor we talked about, the helicopter arriving in just six minutes to pick him up, and the quick reactions he credited to his fellow Marines, all helped him to live and become just the second quadruple amputee to ever survive battlefield injury wounds.
The first quadruple amputee that was wounded and survived was Brendan Marrocco, 22 years old. Thanks to the efforts of actor Gary Sinise, and a foundation called “Tunnel to Towers,” Brendan lives in a specially equipped home that has special features like stoves and sinks that move up and down. The home has elevators in areas that most of us wouldn’t think of and a heated outdoor wheelchair ramp, because he needs to melt the snow so he can get around. It also has appliances that are all controlled by computers. Keep this foundation in mind. It’s called, “Tunnel to Towers” and they’ve agreed to build 11 more homes, hopefully in this year for other quadruple amputees or even for the triple amputees.
I’d like to bring this closer to home and put out some information on the realities of what it’s like to have an amputation and to rehabilitate from that. Right after being carted off the streets of Boston from this bombing these victims probably very soon woke up after having surgery to amputate their legs, and most of these, again, were lower leg amputations. They’d wake up and have a big bandage on, they’d have a cast on, and they’d have a drainage tube in. When you read stories about people who’ve had this and they just wake up to that realization that, “I don’t have my leg anymore” or “I don’t have my legs anymore…” I can’t even imagine what that would be like. Then it takes a good 3 to 4 weeks for the actual wounds from the surgery to heal.
I’d watched one of the surgeons interviewed right after this and he said, “We weren’t really amputating. We were just finishing what the bombs started…” meaning that the amputations were pretty much there. They were just cleaning them up and making the limb more usable to fit with a prosthetic later on…but it takes about 3 to 4 weeks for these wounds to actually heal. They heal with a scar and then the internal healing takes another year to a year and a half.
So what do these victims have to look forward to in that time? First of all, they do have a lot of trouble with pain, as we can imagine, from any surgery or any traumatic injury. They’re going to have a lot of trouble with swelling, so they have to wear a compression bandage to keep the swelling down. In this situation too, it helps to mold their limb so that it will fit better into the prosthesis. That’s a very big part of the immediately postoperative weeks after this traumatic amputation.
In this time the wound is going to feel really weird… not to just say hey, I don’t have a leg anymore or I don’t have an arm anymore, but it’s going to feel really odd. They say it can really feel supersensitive and we’ve also heard of that thing called, “phantom pain”, where they can sort of feel a residual pain from the fresh wound. There’s been immense trauma to the bones and the nerves, so they are going to have a phantom pain sometimes where, even though the foot is gone, they may feel like they’re having pain there.
It takes a good 10 days before the wound is ready for them to try, what they call, an “interim prosthetic.” This prosthetic is just what it means. It’s just kind of a temporary one that can help them begin to get back on their feet.
Think about it… you lose a leg above the knee or even below the knee and you’ve lost a lot of tissue, a lot of muscle, a lot of weight. You’re going to have a lot of balance problems. One other thing that people talk about is how you’re going to have to put almost 80% of the workload on your surviving leg, if you have a surviving leg, to make up for the one that you lost. The prosthetic will come in and gets to feeling like it at least gives you that initial balance, because of the weight of the prosthetic. But you have to first learn to stand… you have to learn how to walk. You have to learn how to sit and how to get back up again. You have to learn how to do stairs. You have to learn how to go up a ramp, down the ramp… things that we don’t even think about it.
I want you to think about this, not just for our Boston victims, but also for our war victims that have to live with amputations. Think about when you get out of your car, what they have to do differently. When you walk into your home, up those few steps, what they have to do differently with their prosthetic limb. They can go back to swimming and jogging, even mountain climbing. With a special type of prosthesis, they can do almost unlimited things. But, the truth of it is, this doesn’t happen overnight and it takes many, many months and sometimes, even years for them to get comfortable enough with their prosthetic to where they can get back to that full life. The rule of thumb is that it’s going to take these amputees about six months to become really independent, not only with caring for their prosthesis, but of course with all the mobility that they need to be trained, once again, to do. Getting back to work is their priority and getting back to their normal lives is their priority. For those of us that have not been victims of these very vicious terrorist attacks, we should all be mindful of the challenges that lay ahead for these people as we go about our normal daily lives.
The emotional component is a huge piece of recovering from this kind of traumatic accident or amputation. As you can imagine, there’s a huge grieving process that goes on. They grieve the loss of life as they knew it, they grieve the loss of independence. Imagine needing to ask someone for help to take a shower or get dressed or all those little things that we take for granted. Then there are the feelings that would come along with feeling inadequate, feeling like you’re not the wife you used to be or the partner you used to be. Then, sometimes, I’m sure these people worry about if they’re in a relationship, will they be rejected for this? How will they be treated? How will the people on the streets look at them? Will they be treated differently at work?
I was reading about a doctor who wrote about this and said that the first thing that people typically experience is “shock” from the sudden, traumatic amputations from like the bombing, or from a war situation (of course a sudden amputation can also be from a health problem). I’m not talking about those amputations that happen because they have complications of diabetes or peripheral vascular disease (those are the higher percentage), but of the traumatic amputations which are only about 15% of all amputations. These traumatic amputations are the ones where their first feelings might be shock. Then, as you can imagine, there’d be the “why me”, “why me”?
One thing I will leave you with is what some of the people writing about this have to say about what carries them through; this can speak to all of us as they mention their faith, the hope they have, and the caring and loving people they surround themselves with. Most especially, they say, when they had this traumatic amputation they decided that they need to go on and find their life purpose, so that they can live the life they are meant to live.