OPAF PSA: O&P IN NY TIMES

OPAF PSA: O&P IN NY TIMES

Jeffrey S. Reznick

6/21/2004

The Orthotic and Prosthetic Assistance Fund (OPAF) offers the following
New York Times article as a public service announcement (PSA) that helps
to fulfill OPAF's official representation of O&P in community and
philanthropic circles. OPAF aims primarily to enable individuals with
physical disabilities - especially those served by members of the U.S.
orthotics and prosthetics community - to enjoy the rewards of personal
achievement, physical fitness, and social interaction. Complete
information about OPAF is available at <URL Redacted>.

This article will be of particular interest to members of the O&P
community who, like OPAF, are engaged in promoting greater public
awareness of the past, present, and future of O&P.

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Redefining the Front Lines in Reversing War's Toll

The New York Times
June 21, 2004
By MICHAEL JANOFSKY

WASHINGTON, June 20 - With sensors attached to his body and with eight
high-speed, infrared cameras recording his movements, Sgt. Luke Wilson
walked back and forth inside the gait and motion laboratory at the
Walter Reed Army Medical Center. Reading the data, a computer turned him
into a mobile stick figure on the screen, instantly measuring how his
body is accommodating the prosthetic device that now serves as his left
leg.

Sergeant Wilson, 24, an Army Ranger from Hermiston, Ore.,
was caught in an ambush two months ago just outside
Baghdad. A rocket-powered grenade struck his leg and blew
it off. He was taken to a local hospital, then to another
in Germany, and then to Walter Reed, in Washington, in what
has become a routine itinerary for American soldiers
seriously injured while fighting overseas.

Now far removed from the front lines of military action, Sergeant Wilson
and a growing number of other soldiers have shifted to the front lines
of prosthetic medicine. By virtue of an unusually large population of
young men and women in peak physical form who have suddenly lost a limb,
in many cases more than one, Walter Reed has become one of the nation's
leading hospitals in rebuilding bodies violently torn apart. Of 675
soldiers injured in Iraq since the war began last year, about 100 have
been fitted with artificial arms and legs. In any given week, about 20
of them are at the hospital in some stage of rehabilitation.

The large number of young military patients with lost
limbs, combined with a generous budget for their needs, has enabled
Walter Reed to set a rather lofty goal - to restore them to a physical
condition that approximates what they once had. Doctors at the hospital
say some soldiers have returned to active duty but that many more are
returning to an active life.

These are unique young adults who we regard as tactical athletes, said
Dr. Jeffrey Gambel, chief of Walter Reed's amputee clinic. They are
otherwise healthy young people who have suffered devastating injuries.
We use all of our energies to help them recover to whatever they want to
do.

It is not an inexpensive proposition, reflecting a cost of
war that is less apparent than money spent for supplies and ammunition.
Since late 2001, when hostilities began in Afghanistan, Congress has
given Walter Reed an additional $6.6 million for costs associated with
amputee patients, an amount that accommodates anything a patient needs
or requests, including state-of-the-art artificial limbs that can cost
as much as $150,000 each and are not yet available to the public. Some
of the devices that are available to civilians are not covered by
conventional medical insurance.

The prosthetics ward at Walter Reed is a full-service
operation that provides outpatient services for months,
years if necessary, after a soldier has returned home or
back to duty. It includes areas for physical
rehabilitation, occupational rehabilitation, a cluttered workshop where
technicians assemble and adjust the devices, and the motion lab, which
helps assess data to identify problems interrupting a smooth transition
to use of an artificial limb. The overall workload has increased to such
a degree that Congress is expected to approve $10 million for a new
advanced care amputee center at the hospital.

Sergeant Wilson is, in some ways, typical of soldiers who
have lost a leg above the knee. As part of his adjustment
to a titanium, computer-chip driven device known as a C-leg
- which costs on average about $50,000, he is trying to
return to a highly active life, if not to the Army. I'm on
the fence about that, he said about a future in the
military. My wife and I are looking at a lot of options.

Dr. Gambel said that in the early days of rehabilitation,
many soldiers say they want to return to active duty, and
some do, although usually not in combat roles. But as
therapy continues, a process that can take months, they
often begin considering other pursuits. In any case, he
said, doctors and hospital technicians provide them
whatever they want - from physical and psychological
therapy to new devices - to regain the active life they
lost.

Sergeant Wilson talked about returning to pretty much
anything I did before.

Maybe not contact football, he said. But flag football.
I figure I've lost a couple of inches on my vertical leap,
but I plan to play basketball again. I was always a point guard, so I
should stay on the outside anyway. My dad was not so concerned about my
losing a leg. He just wanted to know how I was going to be for elk
season.

Sgt. David Sterling, 23, of Placerville, Calif., lost his
right hand and forearm to a rocket-propelled grenade near Falluja. He
was on a mission to rescue a group of marines when his unit was
ambushed. He now wears an $85,000 myoelectric forearm, powered by a
lithium battery, that approximates hand movements through electrical
impulses when he flexes the remaining muscles in his arm.

For routine tasks, like shaking hands and holding a glass,
he snaps an artificial hand onto the end of the device. For other
challenges, he removes the hand and snaps in the hook or the pliers-like
grip - It's great for changing an oil filter - that he carries in his
backpack. At home, he has snap-on kitchen devices, work tools and
separate hands that help him write, play golf, shoot pool, even cast a
fishing rod.

I've got a hundred of them, he said leafing through a brochure that
offers a range of items, some that cost up to $800 each. If I wanted, I
could have a hundred more. Anything I want. There's no limit to the
rehabilitation.

Many of the prosthetic devices given to soldiers are manufactured by
European companies. But tailoring them to fit comfortably and work
efficiently, a painstaking job of tinkering, falls to technicians like
Ralph Urgolites and Joe Miller.

They are Walter Reed's mad scientists, lab-coated experts
who use computer programs and magnetic-resonance imaging to
fit each prosthetic devise to the remainder of the limb
lost. In some cases, it takes weeks of trial-and-error
testing and intense physical therapy before the soldier has
a new arm or leg that works painlessly and effectively.

Mr. Urgolites, director of the hospital's orthotics and prosthetics lab,
said civilians would rarely have access to the level of technology that
Walter Reed has available for soldiers. In the civilian world, he
said, you get an X-ray.

Services at Walter Reed for amputee patients will only get
more sophisticated, Mr. Urgolites said. He and other technicians are
working with the Defense Advanced Research Projects Agency, the chief
research and development branch of the Defense Department. It creates
things like clothing that changes with the terrain and advanced weapons
systems
- and, if Mr. Urgolites has his way, artificial limbs that would no
longer require batteries or conventional computer chips.

We want them to develop thought-control prosthetics, he
said. They're at the beginning stages of them now.

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