?WASHINGTON (USA TODAY) Army 1st Sgt. William "Mike" Leonard found himself mourning the left leg that he had agonized for months about keeping. It was in December, just weeks before he would have doctors cut it off.
"There were a couple of nights," the company sergeant recalls, "where I sat in the shower and just kind of had some tears about losing it."
But the bomb blast in Afghanistan that had taken his right leg on March 22, 2010, had so damaged the left one that bones stubbornly resisted mending. Standing on the left limb was excruciating. Leonard could see other amputees at Walter Reed Army Medical Center up and running on new,
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Doctors amputated Leonard’s remaining leg on Jan. 10. Within weeks, he was standing on gleaming new artificial limbs, balancing on bright green Nike Air Max running shoes, and sweating over a hip exercise machine.
"It’s nice to get up and get going finally," says Leonard,
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Wounded soldiers and Marines are making choices about arms and legs that predecessors from earlier wars never had: whether to trade poorly functioning flesh and blood for microprocessor driven substitutes. Advanced prosthetics created to replace limbs lost in battle now are being sought by troops with legs or arms that survived combat,
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What doctors call delayed amputations defined as when limbs are removed three months after an injury now make up 15% of all combat related amputations, according to research in Military Medicine published in December. That’s up from a 5% military rate cited in a 2008 analysis in the Journal of Orthopedic Trauma, and far higher than the civilian rate of 3.9%.
Since the wars in Iraq and Afghanistan began, 134 troops 101 soldiers, 23 Marines,
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The vast majority involve removing legs rather then arms, the doctors say. The largest number of these surgeries occur here at Walter Reed,
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To avoid giving up too soon on limbs that could be salvaged with time and effort, doctors here have developed an informal protocol for handling such cases, says Army Maj. Benjamin Kyle Potter, an orthopedic surgeon who performs most of these elective amputations.
They encourage patients contemplating amputation to have a lengthy period of reflection and consultation with doctors,
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"It’s something that we struggle with consciously and transparently in order to make sure that patients who are considering delayed amputation are doing so for the right reasons," Potter says. "These kids are 20,
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Leonard doesn’t remember the blast.
He vaguely recalls a medic grabbing him by his body armor and urging him to lay down after Leonard apparently was trying to stand on a shattered right leg and damaged left one.
His wife, Cheryl Leonard, back home near Fort Lewis, Wash., recalls it like it was yesterday: the phone call with a curious preamble of questions "When was the last time you heard from your husband? before the news was delivered. She furiously scribbled every word into a notebook.
Her husband had survived combat tours to Baghdad and Ramadi in Iraq. Now a company sergeant, he was not supposed to be going out on routine patrols, Cheryl thought. "I’m thinking, ‘This can’t be happening,’ " she recalls.
It was their third separation caused by war since the two had married in 2003 after by military standards a storybook romance.
In 2002,
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A year later, Mike was so eager to marry her before going to Iraq that they exchanged vows in a phone call he in Germany and she in an Oregon courthouse,
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He was haunted by one possible outcome, Mike says: "I didn’t want to be a double amputee."
Cheryl knew this too well when she caught up with her husband in the intensive care ward at Walter Reed after the blast.
She was told that Mike had nearly died. Doctors twice had revived him at an Army hospital in Germany during his transit from Afghanistan. His right leg below the knee was gone. He was unconscious. And doctors were urging her to let them remove Mike’s surviving,
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The blast had shattered or even obliterated bones in the left heel and foot. What was left would likely not mend and the pain would be intense if Mike eventually tried walking on it,
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But aware of her husband’s worst fear of losing both legs, Cheryl declined. "I told them that he has a high tolerance for pain and I think he needs to be the one to decide," she recalls.
In a heavily medicated state, Mike was dimly aware of his broken body, Cheryl recalls. At one point,
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He also had suffered a traumatic brain injury from the blast. But his head was clearing by late April and early May of last year. "I came out of the haze and fog and started really realizing what was going on,
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Depression set in for a few weeks. Mike met with an Army psychologist. And there were infections and more operations on his left foot.
Soldiers in previous wars had the option of amputation for a damaged leg that was not getting any better. But they didn’t have the array of advanced artificial limbs available today: bionic feet fueled by lithium batteries,
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