Volume 18 · Issue 7 · November/December 2008 | Download PDF
by Rick Bowers
Bilateral above-knee amputee gets help from others to regain his independence and joy
October 9, 2004 – Near Baghdad, Iraq
It was a day just like those before it – one day closer to going home. Then my unit got the go-ahead on a mission that had been called off several times.
As we drove down the road that night, the area suddenly lit up like a camera flash as an IED (improvised explosive device) blew up under our vehicle! BOOM!
The soldier behind me yelled,“My legs! My legs!” I then looked down at my own and saw that they were both split open from ankle to midthigh all the way down to the bone. I cried out, “Why me? My wife … my kids!”
When I woke up almost a month later at Walter Reed Army Medical Center (WRAMC) from a medically induced coma, I was one leg less and had many other injuries, but at least I was still here for my family.
– Sgt. Ramon Guitard
Unfortunately, this sort of thing happens way too often. A person gets knocked off his or her feet in an instant with little or no warning. Perhaps a woman sees the headlights of a car being driven by a drunk driver racing toward her, but she can’t get away. Or perhaps a man doesn’t know that deadly bacteria are multiplying in his bloodstream after he has a seemingly “minor” operation. Or perhaps, like Ramon Guitard, he or she hears an explosion but can do absolutely nothing to change what is happening.
One second, Ramon was a healthy young soldier looking forward to going home; a second later, he was facing years of pain and struggle – if he survived at all.
Facing a new enemy
After his devastating injuries in Iraq, Ramon would spend 18 difficult months recovering at WRAMC. Though the young soldier had lost most of his right leg, his left leg had somehow been salvaged. Unfortunately, this didn’t turn out to be the blessing it at first seemed to be. For more than 3 years after being airlifted out of the war zone in Baghdad, Ramon had to fight a new war at home against another unrelenting enemy: recurring, painful infections in the salvaged leg. The “good” leg had turned into a nightmare.
During this time, Ramon had been medically discharged from the Army and was attending Midlands Technical College with plans to attend the University of South Carolina to earn a Master’s Degree in Business Administration. In addition, in November 2007, he and his wife learned that they were going to have their third child.
Ramon knew that he needed to make a difficult decision: Keep fighting the infection or have the “good” leg amputated so that he could start anew?
“I needed to decide immediately so that I could be more mobile and help my wife and family more,” he explains. “I realized that the best thing that I could do was get rid of my left leg.”
He allowed doctors to amputate on February 12, 2008.
From one leg to no legs
Unfortunately, even after this surgery, Ramon still found it difficult to spend a lot of time walking. As a result, instead of being able to take full advantage of his two computerized prosthetic legs, which cost many thousands of dollars, he regularly used a wheelchair and canes to help him get around. Fortunately, he was willing to strive to get to where he wanted to be with his rehabilitation, and he knew where to go for help.
In 2007, Ramon had attended the Amputee Coalition’s (Amputee Coalition’s) National Conference as a single-leg amputee and felt that he might be able to benefit from returning as a bilateral above-knee amputee in 2008. He decided to go.
It was a decision that would change his life.
That’s what friends are for
When the 25-year-old arrived at the Amputee Coalition National Conference on Thursday, June 19, he was lugging a wheelchair, two canes, and two computerized prosthetic legs, all of which he depended on in various combinations to help him get around on a daily basis. He was definitely not traveling light.
Fortunately, a few amputee friends and a few sessions led by renowned prosthetists and physical therapists would quickly help him lighten his load. When Ramon attended the 2007 Amputee Coalition National Conference, he had met trilateral amputee Cameron Clapp and bilateral amputee Heath Calhoun and had told them that he would probably eventually be a bilateral amputee himself. At that time, they gave him the answer he needed: “Whenever you are,” Ramon quotes them as saying, “we’ll be here to help you out.”
At the 2008 conference, Ramon took them up on their offer.
“Cameron and Heath showed me how to do the things I wanted to do, and I just kept doing them,” Ramon says. “They said, ‘Can you use one cane?’ and I said, ‘Yeah,’ so I gave them one of my canes. I have good balance, and they showed me that I didn’t need both of my canes – that I was using them as ‘crutches.’
” Ramon used only one cane for all of Thursday afternoon and Friday morning, and then he attended a bilateral workshop led by renowned prosthetist Kevin Carroll, MS, CP. During that workshop, Ramon said, “You know what? I don’t need my other cane either.” So he gave them his other cane too.
Less than 2 full days into the conference, Ramon was already walking on his prostheses unassisted. “Since that time,” he says, “I haven’t used my canes at all! I use my computerized prosthetic legs all the time now.”
He also learned how to walk on foreshortened prostheses, or “stubbies.” These short prostheses do not have a knee joint and function like very short stilts. They provide bilateral above-knee amputees a lower center of gravity, which makes it easier for them to balance, and since the devices don’t have knee joints, users don’t have to worry about the knees buckling.
“I never knew what stubbies were until I got to the conference,” Ramon says. “At first, I used the very small stubbies, and I was falling all over the place. But then I got used to them, and I stood up and did pretty well. Cameron helped hold me up, and I used his shoulder to balance. And then that night, they let me try the wider stubbies, and I walked all over the hotel!”
Today, Ramon uses stubbies a lot, especially for certain types of activities. “They’re good around the yard, and I use them a lot when I’m working outside,” he says. “They’re also good inside the house if I want to clean the floors or load the laundry. I also use them occasionally when I go to the beach or if I get in the pool.”
“The Big Day”
In a mobility clinic that Ramon attended on Saturday, led by renowned physical therapist Robert Gailey, PhD, other amputees were learning to walk better and run, but Ramon hesitated a little at first.
“I didn’t think I could learn to move so quickly,” he recalls. “Someone somewhere had told me that I wouldn’t be able to do it because I was a new bilateral amputee.”
Ramon, however, went against the naysayer and gave it a shot. He was thrilled with the results.
“I used to love to run,” he says excitedly. “To be able to move so quickly at the conference was just amazing!”
During the clinic, he learned to better control his prostheses to increase his speed.
“I had to activate the leg to bend it, and it worked,” he says enthusiastically. “I kid you not! It worked, and I was moving at a rate of speed that was definitely not walking!”
“In the beginning, you really have to think about it,” he says. “It’s a technique that must be learned and ingrained. It takes a lot of energy to use the prosthetic legs and to think about it so much, but if I set my mind to do something, I have to do it.”
As Ramon tried to increase his speed at the conference for the first time, he struggled to keep his computerized legs moving in the proper rhythm as the surrounding crowd applauded and yelled encouragement. They too were mostly amputees trying to learn to walk and run better, and they shared in Ramon’s joy at improving his speed.
As Ramon rested from his efforts, he beamed with happiness. Learning that he could move so quickly again and learning how were the most gratifying things Ramon learned at the conference, and his amazingly rapid progress quickly became the “talk of the event.”
“Did you hear about this young bilateral above-knee amputee who gave up his wheelchair and canes after only a few days at the conference?” attendees asked their friends. It
was that amazing!
“There is no other venue where someone like Ramon will receive such encouragement from his peers, see other people do what he wants to, and find the inner strength to do it himself,” explains Robert Gailey, who is also a member of the Amputee Coalition’s Medical Advisory Committee. “Every year, we see one person after another exceed their expectations because of the overwhelming support from their peers.”
These amazing experiences also have a great impact on the healthcare professionals at the conference, Gailey notes. “When we witness a person like Ramon get out of a wheelchair and walk for the first time and improve so quickly, that is something very special. When we see the joy and excitement in his face, it makes every clinician in the room want to go home and do the same thing for every patient we see. Though it was Ramon who actually made the progress there, hundreds of other people with limb loss throughout the country have benefited because he motivated the clinicians at the conference to go home and do more and expect more from their patients.”
Continuing to move forward
Since those days of learning to walk better and move more quickly at the conference, Ramon has improved dramatically and it’s become much easier and natural for him.
“I put my artificial legs on now, and it’s like I have my real legs again,” he says. “It feels good.”
Ramon encourages other bilateral amputees to attend the conference.
“First,” he says, “you’ll see other bilaterals, and second, you might have the opportunity to work with professionals who’ve worked with bilaterals many times. It’s amazing to see others who are just like you doing things that you want to do.”
Seeing others and learning from them is essential, he points out, but that doesn’t mean you don’t have to put forth your own effort as well.
“Keep doing things and just don’t give up,” Ramon tells other amputees. “The possibilities are endless; only you can determine how far you go.”
Ramon believes that the conference made a big difference in his life, and he is very thankful to the Achilles Track Club of New York, the Amputee Coalition, and the physical therapists, prosthetists and prosthetic companies that helped him at the conference.
“Without them helping me,” he says, “I might still be walking with my canes.”
And, for Ramon, the joy of “throwing away” his wheelchair and canes is not just about walking again. It’s much more, he explains. “My hands are free to help with anything around the house, my quality of life is so much better, and I am much more independent without assistive devices.”
Still, the real joy is even greater, he continues. “I can now walk while holding the hands of my wife and kids, and that alone makes it all worthwhile.”
“Something special always happens at the Amputee Coalition National Conference,” says Gailey. “Sometimes it’s a big event, and sometimes it’s a quiet difference in a single person’s life. But if people don’t attend, they’ll never have the chance to be a part of the magic.”