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Occupational Therapy, Determination Get Amputees Through the Day

By Fred W. Baker III
American Forces Press Service

WASHINGTON, June 5, 2007 – Army Sgt. Dennis Cline never was the kind of child who put together plastic models.

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Army Sgt. Dennis Cline puts together a model in Walter Reed Army Medical Center’s occupation therapy room. Working with the small pieces of the model helps Cline develop fine motor skills using his prosthetic hand. Defense Dept. photo by Fred W. Baker III
  

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More of an outdoor kid, he preferred doing anything outside -- biking, hiking, hunting, fishing -- to putting together a model.

Still, here he sat one recent day, as an adult, with his instructions and wheels and gears and rubber belts scattered about, putting together a racecar model. And he considers himself lucky to be doing it.

Cline’s left hand was claimed by a rocket-propelled grenade while on a patrol “outside the wire” in Afghanistan in 2006.

“I know I’m lucky,” he said. “That RPG penetrated through the truck, through my hand, through the backpack with three 60 mm HE (high explosive) rounds and into a can of 40 mm HE rounds and didn’t detonate any of it.

“That truck could have easily been a pink mess,” he said.

Pulled up to a table in the bustling occupational therapy room of Walter Reed Army Medical Center here, Cline put the model together piece by piece, working on his fine motor skills with his prosthetic hand.

The room is white, square, filled with small weights, ropes and puzzles. Off to one side is a room set up like an apartment with a kitchen.

Amputees work individually and with therapists to regain skills they had before their injuries. Tasks as simple as brushing their teeth can be frustrating and cumbersome.

“We take it for granted, our fine motor coordination -- to be able to grab a tooth brush and squeeze the tube of toothpaste just hard enough to get enough toothpaste on your brush. Or to have your arms and be able to pick up a shirt and be able to stick your arms through, … to be able to put it over your head.” said Harvey Naranjo, a certified occupational therapy assistant at the center.

“Those are all tasks that we take for granted. … For someone who has been injured, it can be extremely trying,” he said.

Naranjo said he works with amputees to get them to the point that they can reintegrate as much as possible back into normal life. He teaches them to use their prostheses in simple daily tasks. They learn to cook, clean, make their beds, tie their shoes, dress, and function as they did before their injuries.

“When you’ve been doing it the same way your whole life, and all of the sudden you have your dominant hand gone, … it is sometimes very difficult to relearn,” he said.

Cline has three prosthetic hands, each having different functions, from normal wear to carrying heavy objects. He said it has taken months of hard work to learn to use them without breaking things in his grip.

“It takes a lot of practice and a lot of work to be able to use these,” Cline said. “When you push down on something, it can easily break what you’re trying to hold. It took a lot of time learning how much force to use. I would set there and use my finger and practice how much muscle to use to grab my finger without smashing it.

“I’m to the point now where I can shake somebody’s hand with it and not hurt them,” he said. “It’s got to the point now where it’s pretty much second nature.”

Cline said his love for the outdoors and strong desire for independence drove his recovery.

“To me, I love being outdoors. I love doing stuff. It was very important to me to regain my independence by being able to use my hand. A lot of things I like to do you can’t do with one hand,” he said.

“I made it my goal to try and use this as best as possible to give me back my independence … so I can get around and do things. There are very few things (now) that I can’t do,” he said.

One of the highlights of his recovery was learning to shoot a weapon again. The Fire Arms Training System at the center is a computer-generated weapons-training lab that helped him learn to fire using his prosthetic hand. For an outdoorsman like Cline, the therapy helped restore some normalcy to his life.

“As soon as I was able to get around a little more freely they had me down here shooting,” he said. “As your recovery progresses, it allows you to know that you are a little more independent and you can do things that you used to do before.

“(Originally) I felt out of my comfort zone. I wasn’t able to hold the weapon. I wasn’t able to feel the weapon responding to the trigger squeeze,” he said. “Now I can do it, and it feels as normal as it’s going to get. It’s a second nature again. It’s more comfortable. I’m confident; I know I can hit the target.”

The longtime outdoorsman already is hunting again, he said. Since his recovery, Cline has taken three deer, five ducks and three geese. He’s practicing tying flies with plans to learn fly-fishing. Cline also recently skied for the first time since his injury.

“It just takes time. You’ve got to learn how to do things differently, … so you learn to adapt and overcome,” he said.

Cline said he plans to go to college when he leaves the military. He has served in the Army for seven years and has been away from his wife and three children for nearly half of that time.

He also plans to organize a group of injured combat vets who regularly meet and travel for outdoor activities, he said.

Cline said getting away from the hospital is key in the recovery process. “The biggest thing I’ve noticed is that when I’m able to get out and do something that I like to do, it helps relieve a lot of the stressors that you have on your life,” he said.

Cline offered simple advice for those beginning their recovery.

“If there is something you want to do, don’t give up. There will be a way to do it,” he said. “Yeah, life sucks now; … don’t give up. Never give up. It doesn’t matter what you do in life, you never give up. Once you give up, you’re done.”

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Walter Reed Army Medical Center

Click photo for screen-resolution imageArmy Sgt. Dennis Cline puts together a model in Walter Reed Army Medical Center’s occupational therapy room. Amputees work individually and with therapists to regain skills they had before their injuries. Tasks as simple as brushing their teeth can be frustrating and cumbersome. Defense Dept. photo by Fred W. Baker III  
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