BTK amputations in hopes to RTD

[dzhitshard]

Caveat, I'm not a med guy. I know what little terms I have picked up from my extensive wading through the recovery process. I'm just a grunt trying to put this into the most accurate terms I can in hopes that those can possibly assist me.

FEB07 I sustained shrapnel injuries that severed the bulk of my sciatic bundle in my L ass cheek loosing the function of my L leg. In MAR07 I requested a BTK amputation in hopes to RTD in the quickest possible time.
I was denied & strongly urged to cooperate with the treatment plan.
I have & I have busted my ass trying to recover as fully as possible.

I was originally told that with the measurement between my point of injury & my L foot that nerve regen would reach max potential in 12-18 months. I'm well past 2 years into that & results of my last 2 EMGs showed no further conductivity or improvement.

I currently have weak anterior & interior pronation that greatly limits stability under even moderate activity.
I have weakened plantarflexion compounded by the pronation issues above.
I can do the requisite 15 toe raises while supported by my arms on a solid object. They are unstable unsupported.
I have limited & weak dorsiflexion to approximately 20degrees bellow neutral.

I have had several models of AFO's ranging from base COTS moldings, to custom fitted carbon fiber with articulating joints & spring assist, to a Bioness L300(?) Estem device.
I've been on a plethora of meds since the injury date. Initially it was a narcotic coctail & 600mg gabapentin x3 daily. For well over the last 18 months it's been premagablin 100mg x3 daily. The meds in itself are an issue. Weight gain & being tired etc.

None of the above AFOs or med combos are conducive to active daily use.
I need more than a trip to the mail box leg.
I need some advice in what I view as the next step in my recovery.
I need this for more than service. I was an active, hiking, hunting, mountain climbing mother fucker before this. The couch is wounding my heart as much as any shrapnel injured me.

Since I left the MTF & WTU I don't have a lot of the resources I'd like to use to get this point across to a CIV doc or VA 3rd year resident who controls my fate with their vast life experience

If someone could put me in contact with individuals who have BTK amputations & prosthesis that would be a great help.
If someone with insight in the medical aspects as well as that of an Infantryman's background would feel like offering suggestion that would be appreciated as well.

Thanks
DZ

Εἷς οἰωνὸς ἄριστος, ἀμύνεσθαι περὶ πάτρης

[swatsurgeon]

Try contacting the rehab center at Walter Reed.....they comprehend the issues you have.

Good luck......thank you for your service.

ss

[dzhitshard]

It's embarrassing after spending all that time there but I've lost all the info for my therapists there & a lot of the paper work/business cards.

If anyone can put me in comms with a current POC there it'd be appreciated.

I'm hoping once I sell my point to the civ/va I'll be returned to active duty & the procedure would be done @ an MTF. I know there are provisions for this but being I'm a wave maker unlike most, the procedure isn't exactly science in my state's org.

I've also got a shot out to WWP.

Thanks for the input.

[The Reaper]

DZ:

Sometimes, the physician really does know best. I do not think you will be RTD, regardless of the outcome, nor treated at an MTF. Regardless, I hope that you get the resolution you desire.

Best of luck to you.

Thank you for your service.

TR

[Red Flag 1]

DZ,

Thank you for your service and sacrifice!

I am sorry to learn of your injury. Your injury is severe and a life changing event. Poeple say all kinds of things about military medicine. Two things the military medical community excell in are burn treatment, and innovative prosthetic treatment for war injuries. The Burn center is at Brooke Army Medical Center in San Antiono, TX. The Prosthetic facility is Forest Glen north of Walter Reed Army MC at 9801 Georgia Ave, MD 20902. As SS suggests, if there is a workable solution for you, the folks at Forest Glen will have it.

What I gather fom your post is that you are seeking an elective BKA to help manage your post injury rehab? If that is the case, you may have trouble finding someone. The surgery will not change the extent of the nerve damage from your injury, IMMHO. It could well be a second life altering event that can't be reversed. I expect the risk benefit ratio may be stacked against elective BKA.

If you would like, I could pm you a name of a doc in N. Virginia that may be able to offer some additional insight.

A final thought, IMHO you will be best served by a multi-disciplinary approach. There are really many problems you are dealing with, and multiple specalists confering together on your behalf is likely in your best intrest. I would expect to see ortho, neuro, anesthesia, internal med, pt, pharm, and psych in the mix. Psych generally causes folks to recoil a bit, does not mean you are loco, far from it; the psych folks can provide input to best help you out in dealing with this from a non-physical point of view. As you pointed out a "third year resident" does not have the big picture. That having been said, all docs on this board were residents.....do not sell them short!

I wish you well!

RF 1

[dzhitshard]

Thanks for sharing the opinions & the contact.


The Reaper,
No disscrespect intended Sir,
"Never give in--never, never, never, never, in nothing great or small, large or petty, never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.


I've been worshiping this creed for well over 2 years. I'd done my best to live by it previously. I've been excedingly fortunate that men such as yourself have trained me & mentored me for a quarter of my life.

I actually have RTD as a RC Soldier. I faced down the MRB & fought through every objective they put in front of me. There are provisions in place to pull troops back to AD for further treatment of combat related injuries. My case is going to be a hard sell but I know I can be a far more productive Soldier, Father, & man with this procedure.

Redflag
"The surgery will not change the extent of the nerve damage from your injury, IMMHO. It could well be a second life altering event that can't be reversed"

I understand that it cannot be reversed. I'm trying to articulate to the right ears that neither will the damage I currently have.

The nerve damage I have is exacerbated by activity. The more the ankle articulates & the foot & toes are splayed (? right term) during activity the more intense the pain is. Often with an active day the pain is enough to prohibit sleep. It being addressed with chemical cocktails for the rest of my life is as equally unsettling an issue as attempting to minimize pain through activity restriction.

Additionally, (and this is the part where I am admitedly not as objective in my reasoning as I'd like to be) with the falls etc I've had, it's not a matter of IF someday I may re-injure the leg but WHEN it will be.
These were sustained in controlled environments as well.

My previous resident comment, I don't believe that can apply to any members here with the exception of them possibly smacking their head, chuckling & recalling how in their diligent studies & vibrant youth, they once knew everything too.


Thank you all again.

[CSB]

I see that you were a commo man (31 series MOS). Even if you were able to convince some surgeon somewhere to do the surgery in an effort to get a below the knee prothesis affixed, you would not be able to hump the ruck of an AD commo soldier in the Special Forces.

BUT, this is an excellent opportunity for you to put together two fields you obviously relish: the Army, and Signal Communications.

My recommendation, in the "for what it's worth department" is that you get a degree in electronics, and seek a position in research and development of lightweight, frequency agile, secure analog and digital communications, integrated with GPS/LORAN etc. You can speak with authority about what a soldier needs, and have the experience to back up your positions. Take advantage of your GI Bill and use more brainpower, age alone will sap your physical abilities after an eight year time out even without severe injury. Move into an signal slot in the RC, if you are really good at it, and seek a CO or WO position when you get your degree.

[Irishsquid]

Edit: nevermind.

[dzhitshard]

I am an old man.lol
Commo was 31 series back in the day.

[MiTTMedic]

I sincerely respect you and your position.

The two main centers that deal with amputees (WRAMC & BAMC) have many civilian experts that help out with Soldiers in your condition (in all disciplines). I would actually wander to one of those two sections to get in touch with them. You could probably call them just as easy. I'm fairly certain that you would not be the first to be pushed from the Military system into their practices. If you still cannot find one that suits you, let me know.

Mittmedic

[dzhitshard]

MiTTMedic

Thank you.


Also, one thing that would GREATLY help me is if any of you know, work with anyone with a BTK prosthesis etc that would be willing to communicate directly with me.
Maybe I'm all wet. I saw dozens in my time @ WRAMC that received these & moved on to what I viewed as active lives. Unfortunately, I was wrapped up in my own drama & recovery & didn't get tight with many people.

[dzhitshard]

I was looking for another thread & stumbled across this one while searching my previous posts.

I read through the thread & just wanted to follow up with a little info for those who's guidance helped & inspired me.

I found an option that worked better for me than another trip to the old sawbones.
I ended up with a PHAT Brace, a biometric partial foot prosthesis. Don't ask me what the hell that is because I just stole that shit strait out of the brochure & never looked back.
All I really know is that it allowed me to keep the virtually worthless skin & bone sack bellow my knee but wearing it allows me to do things I needed to do to get back in the saddle and allowed me to go back & leave Iraq on my terms after 11months of foot patrols, guard duty, & leading Soldiers one last time (away from the mega FOBs & flag pole to boot.)

It was a fun ride while it lasted. I never made it as far as I set my expectations but I did what I could & then I did a little more. I've started down the medboard path again things being what they are & have no inclination to fight it. You guys go motivate & mentor some new kids