Transitioning to life on a prosthetic leg
By MEREDITH FORREST
He was calm and quiet as the details of his new prosthetic leg were explained. He wasn’t noticeably excited or fearful, but instead seemed to take this as just another step in the process of recovery.
Eugene Frederick, who lost his leg in an accident in August, is starting to walk with a cane after only a little more than two weeks on his prosthetic leg.
(Photo by MEREDITH FOREST for the Observer)
Before the appointment, Eugene Frederick said he was afraid that he would not be able to walk in the new prosthetic leg.”I don’t want to go up there, stand up and fall flat on my face with the first step,” Frederick said. And that is not what happened.
Frederick, 57, lost his left leg in an accident involving his 2005 Honda VTX 1300 motorcycle and a Chevy S10 pickup truck. The truck was entering traffic on Midcounty Highway in Montgomery County, Md., and turned into Frederick. The bike was knocked sideways by the impact of the collision and his leg dragged beneath it as he slid on the asphalt.
Frederick said he was awake and coherent for most of the accident and can recount many of the details and his thoughts as things were happening. “I looked down at my leg and thought, ‘This isn’t good. I’m going to bleed to death here,'” Frederick said.
Learning to walk again
“Can he still play games with me on the floor? Can he still read stories to me?,” Gail Frederick, his wife, said their 4-year-old granddaughter asked when she heard of Frederick’s injury. Their grandson, 16 months, was just learning to walk at the time. According to Gail, he went “on strike” and refused to walk for three weeks.
Before the accident, Frederick said he had been very active. His job as a master electrician sign mechanic required him to be on high ladders and walking from end to end of large shopping center parking lots. Around the house, he was a do-it-yourselfer; installing a shower and doing his own mechanical work.
Now he is learning to walk again. He won’t be able to drive his work truck because he can’t operate the manual transmission. He said he is anxious to be able to lift his grandson again. He bought a snowplow for his small John Deer tractor because he knew shoveling would be too difficult for him this winter. Even the smaller units where one walks behind the machine would be difficult to turn for Frederick, because he was still learning to maneuver with his leg on flat, dry ground in the early winter season.
At the hospital, Gail and their two adult children, Jennifer and David, waited for news of his condition. They made every medical decision about Frederick together, but when it came to the amputation, they had little choice.
“If you want him to live, there is no discussion,” said Gail, recalling the doctor’s advice to her after Frederick’s accident. Within 10 days, he had three amputations on his left leg as the doctors tried to save as much as they could. The result was an amputation a few inches above his knee.
“They kept telling us, ‘you made the right decision’,” David said.
The weeks in the hospital were difficult for Frederick and his family. His wife only missed two days in a month of visits while he was in shock trauma intensive care at R. Adams Cowley Shock Trauma Center in Baltimore. She also called every morning and night just to check on his progress.
Frederick said he remembers some wild, vivid dreams, including one in which the doctors amputated part of his right leg, which had been unaffected by the accident. Another dream of two angels looking over him brought Frederick some comfort.
Frederick had been running a fever and, because his blood pressure would not stabilize, he was connected to a crash cart for the better part of the day. It was clear something was wrong, but the source could not be found. In the middle of the night, a nurse found an infection oozing from his leg wound and was able to get Frederick into surgery quickly. Gail said this likely saved his life. The infection was identified as a strand of staph infection called methicillin-resistant staph aureus (MRSA), and Frederick took the proper antibiotics as treatment.
Experiences like this one in the recovery, Frederick said, have helped bring his family even closer.
Adjusting to a new life
Frederick said he has relied on his children and especially his wife when he has tough days. Jennifer located the prosthetist who made Frederick’s first prosthetic leg. David is helping him at home with exercises to strengthen his body after the accident.
“I’m still here. I don’t have my leg, but I’m still alive,” said Frederick. This is his mini-mantra to stay positive during his recovery.
Slowly, the family has modified their split-level home in Walkersville, a suburb of Frederick, Md. They have installed hand railings for the numerous stairs and replaced the showerhead with a hand-held device. They plan to install a railing at the front door to help Frederick navigate the two stairs into his home.
On Nov. 3, three months to the day of his accident, Frederick had his final fitting on a prosthetic leg. It consists of a bucket made of black carbon fiber to fit his limb, a hydraulic knee and an aluminum pylon for his lower leg. Although several adjustments will be made over the coming months, Frederick took his first steps with a walker within minutes of receiving the prosthetic limb.
“I sure like how that feels,” Frederick said as he stood on his prosthetic leg for the first time. “I’m glad I can walk again.” He didn’t fall once in the two hours it took to work out the first basic adjustments needed.
This type of prosthetic limb, an above-the-knee limb with a non-computerized knee, costs between $12,000 and $40,000, according to Jennifer Aloi, a certified prosthetist at Prosthetic Solutions, a division of Orthotic Solutions. Aloi made Frederick’s limb.
“I want to make sure we get a really nice tight fit,” Aloi said before delivering the limb to Frederick. She said the goal is to get a snug fit, but not so snug that it is uncomfortable. “That’s the key.”
To do this, Aloi made a liner for Frederick with a rubber band that runs all the way around his lower thigh. He fits this into a bucket that covers his leg up to his hip. The fit is generally snug and there is not supposed to be pressure on any single spot. Aloi has cut two clear plastic windows into the carbon fiber socket to allow for changes in Frederick’s weight (such as water weight) and to help him identify when the prosthetic limb is on correctly.
“This is completely customized,” Aloi said. She will continue to make adjustments to get the right feel for Frederick. There are 12 adjustments for this unit, including the swing of the knee, the height of the leg and the positioning of the foot. All of these are likely to change as Frederick becomes more comfortable with the technology.
The prosthetic limb makes up the bulk of Frederick’s expenses from the accident. In total, he will pay around $17,000 out of pocket for the limb, insurance deductibles and physical therapy sessions. Insurance has been able to pick up the remaining part of the bill, which totals more than $500,000, Frederick said.
The police report said the driver of the truck that hit Frederick was found at fault for failure to yield the right of way, said Public Information Office Melanie Hadley of the Montgomery County Police Department. But for unknown reasons, the officer who filed the report did not write any citations, Hadley said, so the driver has not yet been charged with any crimes related to the accident. Although the officer can still charge the at-fault party for up to a year and a day later, Hadley said, it would be unlikely.
“It would be at the officer’s discretion.”
“He’s living out of his car basically,” Richard P. Bricken, Frederick’s lawyer, said of the other driver. At the time of the accident, the driver of the truck was not insured. Frederick does have the option of filing a civil suit against the other driver within the next three years. Bricken said that they would monitor the other driver to see if the expenses of such a suit would be worth it.
Even if the other driver had been charged with failure to yield, the penalty would have been about a $500 fine, Bricken said.
The path ahead
The next phase of the process for Frederick is to become comfortable walking in his prosthetic leg. He is going to physical therapy at the Glade Valley Nursing and Rehabilitation Center just two miles from home. He has one-hour appointments, three times a week until the end of the year.
“I’m hoping by spring he can do whatever he wants to do without a device (walker or cane),” said Debra Capella. She is Frederick’s principal physical therapist and will work in close contact with Aloi to have his prosthetic leg adjusted to meet his needs.
At their second session since Frederick received his prosthetic limb, Capella led him around the facility to identify ways to improve his walking. In some steps, Frederick would swing his leg around with his hip, instead of lifting his knee. Other times, he would lock the knee too soon and give his step a bit of a limp. While he practiced on the stairs, the knee buckled a bit as he learned how to negotiate it.
“He’s doing very well,” Capella said toward the end of the session. She credits his active lifestyle before the accident for his ability to recover quickly and said that, as an amputee, Frederick will be using about 30 percent more energy to move than a non-amputee. Adjustments made to his prosthetic leg about a week after he received it “made a world of difference” in his ability to walk, Frederick said. By the last week in November, he was walking with a cane, although he was not always completely steady.
In December, Frederick said he was hoping to return to work two days a week at Lighting Maintenance Inc. in Gaithersburg, Md. By then, he hoped to be walking with a cane. When Frederick returns, he will be in a new position. He will be working on safety and training with Lighting Maintenance, said Myrna Creek, director of accounting and human resources. The position, although it was created with Frederick in mind, is a big help to the company as well. They have expanded very quickly and need someone to look after safety concerns. Frederick, Creek said, was a perfect pick for the job.
His employer and co-workers have been supportive during his absence. His co-workers have donated their vacation and overtime pay to help the Frederick family meet expenses, Gail said.
“Probably the worst thing, and the thing I hate more than anything, is the fact that I like a nice hot shower beating down on my back,” Frederick said. Now he has to sit on a bench and use a hand-held showerhead. “I don’t like that. I want to be able to stand up and feel that hot water on my back again.”