Patient Profile: Queen Still Loves to Travel

Patricia Queen has type one diabetes, but that isn’t why she lost her leg below the knee last year. Nineteen years ago she ruptured a disk in her back that nearly severed her sciatic nerve, leaving her paralyzed below her left knee. Still, Pat was able to remain healthy and active, wearing an orthotic brace and flying all over the country for her employer, the United States Postal Service.

It wasn’t until a trip to Las Vegas October 4, 2006, that things started to go terribly wrong. Suddenly, a bone stuck out the bottom of her foot. Pat couldn’t feel the pain, but she did see the blood and went immediately to the emergency room.

Pat was diagnosed with osteomyelitis in her left foot, which is a dangerous infection of the bone, and they treated her with antibiotics. Still, after returning to St. Louis, Ms. Queen’s temperature spiked and she ended up at Missouri Baptist Hospital being seen by vascular surgeon Dr. Ricardo Rao. He removed the dead tissue, but she failed to begin healing properly. So one day he came into her room and said, “I’m going to talk to you just like I would talk to my mother or my sister. You need to have an amputation. We can heal this, but it will take time, and it’s not an issue of when the infection will come back, but when.” Later, a plastic surgeon working with the hospital’s wound care center gave her an even graver assessment. Pat says she saw his face change from concern to horror before he said, “I just pushed a cue tip through a bone in your foot. There is no way we can ever heal this.”

On November 3, 2006, Pat Queen lost her left leg below the knee. But her amputation site began to develop gangrene because of her diabetes, and on January 3, 2007, she had a second amputation, this time just two-and-a-half inches below her knee. With such a short residual limb, it was a challenge for Manny Rivera, her prosthetist with P&O Care, to create a prosthesis that would protect her tibia or shin bone. A short limb is a short lever and so requires more force to do the same amount of work, so when Pat told her therapists she wanted to walk out of the hospital unassisted, they said, “We’re going to have to work you’re butt off to do it.”

On February 22, 2007, Pat stood on both legs for the first time. After four weeks of therapy, she was able to walk on even ground without a cane or walker. Since leaving the hospital, Pat has gained even more strength and has been able to move into a new prosthetic socket that allows her to bend her knee more than at first. Nothing is slowing her down. She has traveled over 30,000 miles, crisscrossing the United States in her car from Maine to the Grand Canyon and many other destinations.

Pat says the initial shock of amputation hit hard, and she definitely had to morn her loss. At 58 years old, she retired last June after 34 with the Postal Service. But it was the long healing process was the most difficult for Pat emotionally: “Getting used to not being able to do everything I wanted to do was the hardest,” she says. “Talking with other amputees online at [the social networking site] Less Than Four has helped more than anything else, and I love reading inMotion” a bi-monthly magazine just for amputees. Recently, Pat has even been able to talk on the phone and encourage some of Manny’s patients struggling with depression.

Pat’s strangest experience since becoming an amputee has been her phantom limb pain. “I hadn’t felt my foot for nineteen years,” she says, “but all of a sudden after the first amputation, I started feeling it itch or cramp. It was really weird, and the doctors couldn’t tell me why the feeling came back even through my leg and foot had been paralyzed.”

That pain has gone down some, but it’s still there a little. What Ms. Queen doesn’t have to deal with is pain from her prosthesis: “Manny’s work has just been amazing. Never ever have I had pain with that leg.” Besides having a prosthesis that fits well, Pat says managing her socks is most important. “I start the day with 6 socks and move up to 7 or more. I met another amputee who complained so much about his leg hurting, but he hadn’t been taught how to manage his socks.”

Pat has her health insurance through the Government Employee Health Association (GEHA), who covered her prosthesis and replacement socket. But Pat has been in touch with other amputees who have been denied coverage because of hidden caps in their group or private policies. So, Pat is supporting the efforts of the Missouri Coalition for People with Limb Loss and talking about the importance of prosthetic parity legislation in Missouri on her profile at http://www.lessthanfour.org/. Just search for Pat Queen.

Prosthetic Parity: Saving Money, Saving Lives

Prosthetic Parity: Saving Money Saving Lives

Introduction to P&O Care

Introduction to P&O Care - Upload a Document to Scribd

Read this document on Scribd: Introduction to P&O Care

CNN: Marine Walks with Bluetooth Technology

CNN has a good story on its front page right now about a Marine walking with Ossur's Power Knee on both sides. The two motorized and computerized legs communicate with each other using Bluetooth technology, just like our cell phones and ear buds. There is also a great video to go with the story.

Not mentioned in the CNN story: The Power Knee is still too heavy for most individuals to walk with successfully, but as the technology shrinks, there is hope that it might enable amputees with limited energy to walk greater distances than traditional prosthetics.

Activists Visit Senators

Bill McLellan, Jeff Dameral (Chairman), Jean Freeman (Secretary), Jim Weber.

Last Tuesday, activists from the Missouri Coalition for People with Limb Loss visited Jefferson City for appointments with two Republican Senators. Senator Kevin Engler, Majority Whip, and Senator Scott Rupp both expressed sincere support for prosthetic parity. They did not know and could not believe that insurance companies in Missouri claim to cover prosthetic limbs while capping coverage at less than a fourth of what they actually cost.

While Republicans generally have a hard time with insurance mandates, they agreed that prosthetic parity is not a traditional mandate. It simply requires insurance companies to cover what they claim to cover and stop taking advantage of employers and individuals who have no idea how much a prosthesis costs. Senators Rupp and Engler, as well as other Representatives we met with in the hallways of the State Capitol, want working Missourians who tragically and suddenly loose limbs to be able to return to work instead of becoming dependent on Medicaid.

It looks like prosthetic parity has broad bi-paritisan support in Missouri, but we are still looking for a Republican Senator and Representative who has the time and dedication to sponsor our bill in their houses of Congress. It takes more than sincere support; we need to become a priority on the 2008 legislative agenda, and for that to happen, individuals across the state need to contact their Senators and Representatives and write letters to the editors of their local newspapers in support of prosthetic parity legislation.

Most persuasive are the personal stories of working Missourians like Jeff and Jean who lead the Missouri Coalition, real people who have suffered from hidden caps on prosthetic coverage.

Arm Amputee offers Inside Look at Life without His Limb

Here is an excellent blogger who has posted stories about his experience loosing his arm, waiting on it to heal, and then getting fit with an upper-extremity prosthesis. You can even watch a slide show of his arm through the healing process, but I warn you: it is not for the squeamish.

Below you can read his own welcome:

Welcome to my blog, here you can read about my life after I lost my left hand in a near fatal accident whilst paragliding in Colombia, (South America), back in February 2006. You can read about the accident in one of my first posts here, and see how I've recovered by checking out the posts under the recovery category. As is normal for blogs everything is in reverse chronological order, so go the bottom if you want to read in time order.

I try and post about once a week on things I experience in life, some related to being an amputee and others not. I've also started to do some product reviews of things I've found useful when you only have one hand. You can see details of my coverage in the media, something that started with an article in the San Francisco Chronicle. I hope you find your reading enjoyable, interesting and perhaps informative. Please leave a comment on a post or two, it's always nice to hear from people that have come to visit.

PeerClip: Online tool for Doctors

Social bookmarking has become very popular in the past few months. Sites like Digg and del.icio.us are popular with a wide audience, but now there's a special option just for doctors. Social bookmarking basically works like the "Favorites" tool on your browser, except that you can allow your friends or colleagues to see which sites you have marked. When you select a website, you improve it's performance on search engines like Google. On the bookmarking site's home page, you can also view which pages on the web are most popular with the community.

From PeerClip website:

A simple online tool that enables physicians to organize, share, discuss and discover relevant medical information.

Using PeerClip’s “research assistant” tool that integrates easily into any Web browser, physicians can “bookmark” any type content, including journal articles, blogs, podcasts and videos. Bookmarks are conveniently stored online for easy access in a central location, creating a personal homepage of relevant medical information. Physicians also can organize, keyword tag, rate and share bookmarks.

The PeerClip “research assistant” also provides physicians with at-a-glance information on articles that their peers have tagged and rated as useful. The combined ratings and tagging of all physicians helps the PeerClip member quickly find the information he or she is looking for. Additionally, the PeerClip “research assistant” also recommends other relevant information based on the member’s profile and interests. The simple act of member participation guides the recommendations as well as the member’s discovery while browsing.

Physicians also can invite peers to join the network as well as create personal online peer networks in order to track future bookmarks and comments by peers or Key
Opinion Leaders across the PeerClip community.

Here is a quick snapshot of how PeerClip works:

1) Using PeerClip, physicians can click a button in their browser tool bar to store their favorite online articles, blog postings, podcasts and videos on a personal
home page for easy future reference.

2) Physicians can also view bookmarks, comments and ratings on content their peers have bookmarked in PeerClip.

I will drop more comments as and when I receive the beta invitation.

Posted by Dr.Subrahmanyam Karuturi at Thursday, September 20, 2007

How Media Shapes the Way the World Sees Amputees

Jeniffer Hoydicz has an excellent article in the newest issue of O&P Business News that looks at images of amputation in the media, particularly Hollywood. Here are some of her fascinating conclusions, interacting with Raphael Raphael, MA, a professor of film studies at the University of Oregon, and David Serlin, PhD, associate professor of communication and science studies at the University of California at San Diego.

This will hopefully pique your interest in the whole article.

“The disabled body seems to be perceived as a challenge to … independence and self-sufficiency, especially challenging our – largely mythological – notions of masculinity,” he said.

To overcome these perceptions, the public needs to be challenged to evaluate its own prejudices and value systems, Serlin explained. Additionally, more attention needs to be paid to “ordinary” people with amputations rather than individuals who are often identified critically as “super crips” by the disability rights advocates.

“Why does someone have to exhibit super abilities in order to be recognized as productive or ‘normal’? That I think is frustrating,” Serlin said. “Part of the goal for those within the disability rights community or people who work with orthotics or prosthetics organizations should be able to make non-disabled people aware that disability can be an ordinary phenomenon that does not define who a person is. People who use prosthetic devices or deal with amputation should not have to be superheroes in order to get respect.”

It's Official: Oscar Pistorius Barred from Olympic Games

Today, the IAAF has issued its official ruling that Oscar Pistorius' two carbon fiber prosthetic feet give him an unfair advantage over able-bodied athletes. It has barred him from the 2008 Beijing Olympics and any other track meet it sanctions.

As reported by the news agency Reuters, the official report issued by Professor Peter Bruggeman at the German Sport University in Cologne concludes that "Pistorius was able to run with his prosthetic blades at the same speed as the able-bodied sprinters with about 25 percent less energy expenditure." The same data, however, could also be interpreted to show that with his cardiovascular strength, he could run faster than those guys if he had their legs.

Nevertheless, Oscar Pistorius has done so much to raise awareness around the world about amputation, prosthetics, disabled sport and disability in general. His is a truely heroic sport story!

NY Times Says Pistorius Probably Will Not Run in 2008 Beijing Olympics

The New York Times is reporting today that in the the IAAF will soon announce that Oscar Pistorius, the double amputee sprinter from South Africa, will not be allowed to run in the 2008 Beijing Olympics because his two prosthetic legs give him an unfair advantage. An editorial in today's Times argues that this is the best decision, but an interactive slideshow gives the other perspective, from the University of Miami and Ossur, who manufactures Pistorius' feet.

On the one hand, Pistorius is unable to produce the energy an able-bodied athlete produces with his or her calves, and he must exert almost twice as much energy with his thighs. On the other hand, it seems that his prosthetic feet lengthen his stride. His J-shaped feet, called Cheetahs, conserve 90% of the energy they receive on impact, much higher than the human foot by itself, but much lower than the 200% return the foot gets with the aid of the calf muscel. It seems that the determining factor against Pistorius may be that in closely monitored trials, he used less oxygen than able-bodied runners at the same speed.

Scotland joins arms race with superhuman strength

By Kate Foster

A TEAM of Scottish scientists has produced an artificial arm that is more powerful than the real thing. The superhuman arm, for patients who need an artificial limb, can lift heavier weights than the average person is capable of and will only fatigue when its batteries run out.

The i-Limb System arm has been developed by researchers at prosthetics firm Touch Bionics, which last year launched the most advanced artificial hand in the world. The Livingston-based firm specialises in hi-tech limbs for patients who have undergone amputations or were born with limbs missing. The researchers say their new arm is capable of repeatedly lifting a weight of 10kg up above head height and could do so all day, compared with the average human being who would tire within minutes. The wrists could rotate 360° and anyone using it could perform hundreds of push-ups.

However, the sheer power of the limb means its creators are faced with the problem of deciding which patients could be trusted to use it safely, as it has the potential to be used as a weapon.The arm was developed by David Gow, director of rehabilitation engineering services at NHS Lothian, who has worked with hundreds of patients at the South-east Mobility and Rehabilitation Technology Centre at the Astley Ainslie Hospital in Edinburgh.Gow is also the director of technology for Touch Bionics, which researches and develops state-of-the-art technology.

He told Scotland on Sunday that the arm is at the prototype stage and is undergoing further fine-tuning in order to make it available to patients.He said: "The i-Limb system is better than a human arm. It is faster and can lift heavier weights than a human arm. It also looks good, has smooth movement, and operates with less noise than existing prosthetic arms. The technology is new and evolving. "However, we might have to scale the power down to make it suitable for everyone. With something that has a better than human performance, our challenge is ethical. "A patient would have the potential to hurt themselves or other people with it as it is actually better than a human arm. It could do damage. "We have got to take safety very seriously. You have to attach it to the patient's body and that could cause damage if the weight is too heavy. It could snap their ribs. And it could be pretty scary flapping about."

Scientists have spent years researching how to create robots that can surpass human performance. The i–Limb System is the latest in a long line of bionic body parts to have been created in laboratories just two or three decades after they were merely the stuff of science fiction.

The arm, which is worn in a harness, is controlled by electrical signals that come from the user's own body. Electrodes are placed on the skin on the user's chest which pick up minute signals from the muscles. The user is taught how to move these muscles to send electrical signals which control motors inside the arm such as wrist rotation and elbow movement. It is powered by lithium-ion batteries which can be recharged overnight. The i-Limb System will be covered in a realistic cosmetic skin.

Promoting Your Allied Healthcare Practice: Tip #7

Don’t ever treat people like they owe you. Inexpensive items like pens or tape measures with your logo and phone number are actually mini-billboards your contacts can hold in their hands. They don’t obligate anyone to use your services. If you bring in lunch so you can get more time with a group of doctors, you are simply buying time, not their business. It would be grossly unethical for a practice to refer to you because you brought them a candy jar or fed their employees, so don’t think that way or use any other pressure techniques. Even if it works, it will create resentment and never get you more than the one patient they might feel obligated to hand over. You’re in this for the long haul, and you could never afford to repay a truly loyal source of referrals.

Morgan Sheets: Letter about State and Federal Prosthetic Parity Bills

Dear Editor: Currently, due to archaic insurance regulations, prosthetic care is being put out of reach for many amputees in Wisconsin. Insurance plans are restricting or even eliminating coverage for prostheses. This is a matter that Congress must address.

In return for premiums paid for private health insurance, consumers expect to be covered for catastrophic illness or injury. They expect that their monthly premiums will provide them with the most basic of care, including prostheses.

Policy reports regarding prosthetic parity laws from Colorado, Massachusetts, California, New Jersey and Virginia suggest that the costs are minimal -- anywhere from 12 to 25 cents per member per month.

If amputees are prevented from accessing prosthetic care, this increases state Medicaid costs due to complications. The subsequent cost to the health care system far exceeds that of providing prosthetic care, while the lack of productivity places a huge burden on society.

Prosthetic parity bills have been launched all over the country, including in the state of Wisconsin. A federal prosthetic parity bill is going to be introduced next year. This bill would ensure that prostheses are treated the same as other basic, essential care.Please urge your member of Congress to co-sponsor the federal parity bill when it is introduced. We must give people with limb loss the care they need to fully participate in society!

Morgan Sheets, national advocacy director, Amputee Coalition of America, Washington, D.C.A letter to the editor.

Disaboom.com brings web-based educational material together for disabled people

There is a new website that aims to bring together information for people with disabilities. The pages for adult and pediatric amputation are especially good, explaining topics like disease, trauma, recovery, rehab, prosthetics, and lifestyle. The site also has some very excellent videos. We are adding a link on our sidebar for future reference.

Ford Commercial with Amputee Athlete Sarah Reinertsen

bmclellan@pandocare.com has sent you the following article. Comment: We're so excited for Sarah! I like this commercial because it communicates that disabled people do not have to perform at any particular level to be considered remarkable.

Ford Commercial with Amputee Athlete Sarah Reinertsen Cool commercial looks like a normal car commercial until the door opens and Sarah steps out. Author: Disaboom Keywords: ford amputee disability disaboommedia sarah reinertsen commercial Added: December 10, 2007

Learning to cope with lifelong scars

BAGHDAD: For generations to come, Iraqis will have to cope with the physical and mental scars of tens of thousands of people severely injured in the violence of the past four years.

They include thousands of amputees, many of them children.

The date, time and place that changed Ali Abdullah's life is etched in his memory.

It was November 24, 2005. A Thursday morning. He was 13.
Ali's father runs a parking lot south of Baghdad. On that day, he had agreed to let his only son open the business by himself for the first time. It was a proud moment.

In the middle of the morning he stepped out for breakfast just as a car bomb exploded nearby. Shrapnel destroyed one of his legs and an eye, and peppered his chest with wounds.

Ali told his story while waiting for a new artificial leg to be fitted at the Baghdad Artificial Limbs Centre, one of the Iraqi capital's two main prosthetics clinics.

"I came here to replace the old one because it became too small and I limp when I walk," he said.

The Baghdad centre alone has registered 2,700 amputees since 2003. The cost of looking after them is high - especially in the case of children, who will need to replace prosthetic limbs regularly as they grow.

"We mostly care for children. We try to provide them with the limb as soon as possible. We like to help them to return to school, to regain a normal life," said Qassim Mohammed, the centre's deputy director.
Besides the physical cost, there is a huge psychological toll.

"Some of them come here in despair, but we try to plant hope in them, because 50 percent of therapy is psychological," said Hussein Majeed, one of about 20 technicians in the centre's workshop, where the prosthetics are built using old machine tools, plaster casts, plastic and glue.

Saad Al Shaboutt, 65, said he now felt able to cope, two years after losing his leg to a bomb at Baghdad's Shorja market.

"I reached the point when I wanted to commit suicide, but I am better now," he said in the centre's waiting room.

"I am a manager at Iraqi Airways. I was about to be transferred to be the head of our office in Cairo, but I cancelled the transfer. Without a leg, how could I go?" he said.

Even doctors become emotionally involved. Sadiq Ali, a psychotherapist at the centre who helps counsel victims to cope with a future of disability, recalled a young man he treated two months ago who had lost all four limbs.

Wounded victims often need advanced reconstructive surgery. Yet Iraq has experienced a brain drain of medical specialists fleeing in fear after doctors were targeted by insurgents or kidnap and extortion gangs.

"I used to have 10 anaesthesiologists, now I have four," said one of Baghdad's leading reconstructive surgeons. His hospital is able to perform only about 10 operations a week, down from 14-15 a week before the war, he said.

"Oscar Pistorius should be out of the running"

Despite these results, the man has no calves. Able bodied runners rely not only on the energy storing properties of the foot, but the energy producing properties of muscle, which Pistorius does not have. I say, let him run! What do you think?

From the Times of London:

Oscar Pistorius, the double amputee world record-holder at 100 metres, 200 metres and 400 metres, is almost certain to have his dream of competing at the Beijing Olympic Games shattered in the next few days. Professor Peter Brüggemann, the scientist in Cologne who has conducted tests on the South African at the behest of the IAAF, told a German newspaper two weeks ago that Pistorius’s curved carbon fibre blades give him a “considerable advantage” over his able-bodied rivals.

According to the report in Die Welt, the German newspaper, Brüggemann confessed to being surprised by the unequivocal nature of the results. “The difference is several percentage points and I did not think the findings would be so clear,” he said. “The prosthetics return 90 per cent of the impact energy compared to the 60 per cent of the human foot.”

The IAAF, which stated at the outset that it would not sanction Pistorius’s participation in able-bodied events if the tests showed that his blades gave him a material advantage, is expected to make its ruling on January 10.

Many of Pistorius’s fans and a surprising number of pundits have responded to Brüggemann’s comments by urging the IAAF to ignore its own criteria and allow Pistorius to compete regardless. They claim that Pistorius has achieved a miracle by getting this far with amputated legs and that any bar on his participation in the Olympics would be mean-spirited. They argue that their stance has humanity, empathy and even morality on its side. In doing so they confuse these noble sentiments with something both demeaning and pernicious.

Giving the South African the green light under such circumstances would not only be an insult to Pistorius but an assault on the principles of Paralympism. Disability sport came into existence precisely so that men and women with handicaps could compete with each other on a level playing field.

Categories of disability were created to safeguard this philosophy. So, how can it be argued that Pistorius should be allowed to compete despite having a measurable anatomical advantage over his able-bodied competitors? The ramifications hardly need stating. Why not allow wheelchair athletes to compete and win - as they undoubtedly would - in able-bodied marathon events? Why not allow amputees with motorised limbs into the Olympic Games? We would quickly end up with a technological free-for-all no less damaging to the integrity of sport than if we allowed carte blanche in the use of performance-enhancing narcotics.

I spent much of my early table tennis career practising with John Jenkins, the leading wheelchair player of the era. No quarter was asked, none given. When the opportunity arose I would deliberately angle the ball to exploit Jenkins’s lack of reach and, on occasions, he would lean so far to get bat on ball that his chair would topple over, sending him to the ground with a deafening crash. Seconds later he would be up again, face gritted, lips smiling grimly, his eyes dancing with the joy of competition.

One time my father happened to be watching us practise and, seeing my tactics, berated me for a lack of sportsmanship. Jenkins eyed my father closely, put a hand on his elbow and told him that going easy on him would be the most serious violation of sportsmanship and the grossest possible insult. “I would rather not play than experience that,” he said. Jenkins understood, as so many of Pistorius’s apologists do not, that giving an artificial advantage to disabled athletes springs from the misguided pity that is the scourge of their lives.

I spent two days with Pistorius in South Africa this year and, like many who have made his acquaintance, I left with as much admiration for his generous personality as for his athletic prowess. He is a young man with a huge amount to offer the sporting world even if he is “confined” to the disabled events in which he has made his name and growing fortune.

On hearing the comments of Brüggemann, Pistorius vowed to get independent corroboration of the results. He is right to want to ensure that the science governing his future is robust. If it can be shown that Pistorius does not have the advantage Brüggemann claims, then the South African should be allowed to compete against the able-bodied.

If not, he has no business competing at the Olympic Games. And one suspects that, once he has come to terms with his initial disappointment, Pistorius will embrace that verdict wholeheartedly.

West Coast rehab center offers wounded veterans a shorter road to recovery

From PE.com, the Press-Enterprise:

Army infantry Sgt. Wally Fanene's sister calls him "the face of who came back from the Iraq war," a reminder of the savagery confronting American troops daily.

Fanene, while on foot patrol in Kirkuk in September, stepped on a fist-size land mine, heard a pinging noise and temporarily went deaf from an explosion that tore off his right arm and leg and seriously injured his remaining limbs.

The 25-year-old Temecula man's fight today is to rebuild himself as completely as possible, regain as much as he can -- to surf, pick a nickel out of his pocket, change his daughter's diaper, resume his Army career as a weapons instructor. With the assistance of a new rehabilitation center at Naval Hospital-San Diego, it's a war Fanene says he intends to win.

The $4.4 million Comprehensive Combat Casualty Care Center -- C5, for short -- opened in 2006 and provides the latest treatments and prosthetic devices for amputees. The new center means soldiers, sailors, Air Force personnel and Marines who live in the West won't have to move from family and friends to rehabilitate their injuries at Brooke Army Medical Center in San Antonio or Walter Reed Army Medical Center in Washington, D.C.

Fanene's father, Lynn, calls the center a "godsend" and attributes his son's progress to being so close to home.
"We're a hop, skip and a jump away from San Diego," Lynn Fanene said. "We can provide all the emotional help he needs."

In the 15 months since opening, the center has evaluated and treated 34 amputees, fitting many with prosthetic limbs, providing them the physical and mental-health therapy that's part of any successful recovery. It also helps those who can't return to service to forge civilian careers.

All told, about 725 American military personnel have lost limbs in Afghanistan and Iraq.

C-5 staff members say the prosthetics make some amputees resemble 21st century bionic men and women. Jennifer Town, C-5 program director, said the goal is to return the superbly conditioned young military service members to the active lives they led before their injuries. "They don't want people to feel sorry for them," Town said.

Phantom pain persists, like needles being shoved into his missing limbs. He quit taking the powerful painkillers, instead preferring to "gut out" the hurt rather than risk addiction.
Doctors operated in Iraq, Germany and at Walter Reed. On Oct. 1, three weeks after he was wounded, Fanene took his first steps on a prosthetic leg.

His gait has improved since then. Fanene wears his leg up to six hours at a time, far more than the two hours in the weeks after receiving the injuries. He can shave and hold a fork and brush his teeth with his prosthetic arm, all abilities he had to re-acquire. His prosthetic leg includes a "power knee" that can swing freely or provide more resistance, depending on whether Fanene is walking up a hill or running. Sensors in the knee let orthopedic specialists know via computer whether it is operating at maximum efficiency.

Reach Joe Vargo at 951-368-9289 or jvargo@PE.com
San Diego's C-5 Rehab Center
Opened: September 2006
Cost: $4.4 million
Size: 30,000 square feet
Features: Orthopedics, physical rehabilitation, treatment for posttraumatic stress disorder and mild traumatic brain injury.
Amputees treated: 34

Homeless Man Attacked, Loses Leg

Above Knee Amputee Bike Riding