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Amputees driving innovation

As war continues, treatment of those who have lost limbs is a growing concern at Naval Medical Center San Diego.

March 26, 2007|Tony Perry | Times Staff Writer

SAN DIEGO — Army Staff Sgt. Travis Strong, whose legs were blown off above the knee by a roadside bomb in Baghdad, was trying a few steps on his new, man-made pair, constructed out of aluminum and carbon fiber.

Using his muscular arms and steely determination, he steadied himself on the parallel bars as he walked gingerly along the mat at Naval Medical Center San Diego. "If I stand straight, this leg is good," said Strong, nodding to his left, "but the other leg buckles."

Peter Harsch, the center's newly hired prosthetist, listened and made adjustments.

"Prosthetics are like a car," Harsch said. "If a car's tires aren't aligned, the car won't drive right."

Harsch is the center's first full-time prosthetist. Before the Iraq war, the center had little need for his particular skill -- designing artificial arms and legs and helping patients adjust to life as amputees.

Now, as the war enters its fifth year, the treatment of service personnel who have lost limbs has become a major concern for the center, already the busiest Navy hospital in the country.

As of March 1, 520 personnel have lost a limb in Iraq -- 371 soldiers, 130 Marines, 14 sailors and five Air Force personnel -- and 101 of them have lost more than one limb. Nearly 300 others have lost a finger or toe or part of a hand or foot.

Strong, 29, was in the middle of his second tour in Iraq when the Stryker armored combat vehicle he was patrolling in was hit by a roadside bomb called an explosively formed penetrator.

The military believes such bombs, built to penetrate thick armor, are smuggled into Iraq from Iran and are responsible for the fact that a higher percentage of the recently wounded are losing more than one limb.

A second after the blast rocked the 20-ton vehicle, Strong looked down and saw that his legs were bloody stumps. He tried to crawl out the back hatch but passed out.

When he was rushed to the Army medical station, doctors could not find a pulse, but they revived him and gave him massive transfusions.

Within days of his Nov. 27 injury, he was at Walter Reed Army Medical Center in Washington, where he remained until he was transferred to San Diego in mid-January.

His wife, Misty, 27, drives him to his Monday through Friday therapy sessions and appointments with wound care specialists.

The military relocated the family from Ft. Lewis in Washington state and provided an apartment in off-base military housing in San Diego for the Strongs and their children, Sean, 5, and Brianna, 7.

Misty Strong provided encouragement as her husband worked on his walking. "You're looking good, Babe," she said, her voice upbeat despite the months of therapy ahead.

"He had flat-lined [in Iraq] and they brought him back alive," she said. "We have so much to be thankful for."

It is one of the grisly facts of history that war provides the laboratory for medical advances. With the Iraq war, the advances have come in prosthetics. The patients, young and accustomed to being active, are demanding consumers.

"They're driving the technology," said Army Maj. Jacqueline Coley, Strong's physical therapist. "They're asking for better and stronger prosthetics, and the industry is responding."

Coley, 35, was stationed at Walter Reed but transferred to San Diego to be part of the medical center's push to provide more services for amputees and other severely wounded. Later this month, Coley will marry retired Army Capt. Lonnie Moore.

The pair met at Walter Reed, where Moore was being treated after losing a leg in Iraq.

When the war started, Harsch, 36, who studied prosthetics at Cal State Dominguez Hills, was working for Ossur North America Inc., a company that makes prosthetics in Aliso Viejo.

As the number of amputees increased, he acted as a consultant for the Department of Defense.

When he was offered the job at the medical center in late October, with the chance to design his own prosthetics lab, he did not hesitate. "This is the best job in prosthetics," he said.

In July the center plans to open a 23,000 square-foot facility that will include Harsch's lab and several therapy rooms.

The expansion of the amputee program at Naval Medical Center allows patients from the West Coast to be closer to their families and reduce the time they spend at Walter Reed or Brooke Army Medical Center in San Antonio, the military's major amputee facilities. In February, Brooke opened a $50-million rehabilitation complex.

Before being wounded, Strong enjoyed dirt-biking and other sports. He may need Harsch to outfit him with different legs for different activities.

"There are walking legs, jogging legs, legs for sports," Harsch said. "I'm making a surfing leg right now. I have a bilateral (double amputee) patient who is a rock climber, so I'm making legs with stubbies on the end so he can grip the rocks."

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