Listening to God, Leveraging Positive Motivation and Interaction to Make a Tough Decision
Written by William B. Reynolds III, CPT(R)
On November 7th 2004, I was near gravely wounded by the shrapnel from an IED on a dismounted patrol in Southwest Baghdad while serving as a Chief of Reconnaissance and Sniper Employment Officer for the 10th Mountain Division. After the blast, finding my foot on the front of my hip, and audibly/visibly losing a lot of blood, my self-prognosis was that I would not survive, and I told the combat life-savers in my platoon to attend to other casualties. However, the well trained soldiers that Henry Adames and Joey Collier are, they did not listen (a welcomed insubordination!). They saved my life, reassured me, and called in the MEDEVAC.
After a life-saving, day long surgery at the Baghdad Combined Arms Service Hospital, I was on my way home via Balad and Landstuhl AFBs and hospitals. By the time I reached Walter Reed Army Medical Center (WRAMC) on November 13th 2004, I was only 4 surgeries into my treatment, but stable. The next 7 surgeries were complex as they further stabilized me, rid me of infections , and started the left arm and leg “limb salvage” process. My pre-op consults for all the surgeries were the same: “we’re going to conduct an irrigation and debridement and other limb saving procedures, and if they do not go well, you could wake up without your leg.” Some would find that disconcerting, but I was optimistic—I was alive, I was with family (Medical Research Partner William Reynolds—my father, Nurse Evelyn Reynolds—my mother, Dr. Evelyn Reynolds, Suzzanne Anicette and Robin Wilt—my sisters). I was so optimistic, I told those from my unit calling via Satellite Phone from Iraq and good West Point friends who were stateside like Matt Sunderland, Jeremy Edge, Dan Hofstra, as well as a great childhood Friend Dave McGuire, that I would be out of the hospital in a week or two.
However 5 weeks and 13 surgeries later, I was still in the hospital when I finally got to the point where Doctors were more confident that I would be able to keep my limbs for the foreseeable future, but the prognosis was uncertain. Again, I was less concerned with prognosis, and happy that after 6 weeks of hospitalization in this early stage of treatment, I would be discharged for the first time to go home with family just before Christmas! For the next 5 months, every month I would be admitted to the hospital for another procedure to revise or improve upon my external fixation devices, facilitate more bone growth etc., so that I could reach my max therapeutic potential beyond limb salvage. Unfortunately, that potential was limited by continued bouts with infection necessitating emergent surgeries, so I would not infect the joint and lose it. Ultimately, my leg was internally fixated and fusion set-in salvaging only 10 degrees range of motion in my knee and 30 degrees range of motion in my ankle.
Therefore, after 22 surgeries, over 100 days of hospitalization and over 1,000 hours of physical therapy I was forced to go in another direction. While undergoing treatment, I finished out my last couple years in service as the Deputy Operation Chief for the Joint Improvised Explosive Device Defeat Organization (JIEDDO). After serving in JIEDDO, I was medically retired. In 2007 I began my graduate pursuit where I not only re-tooled myself vocationally, but emotionally, spiritually and physically. I married Cassandra Bryan Reynolds, and we started a family in 2008. I started volunteering and served on my first board—an ecumenically based poverty outreach center, and started my foray into athletics again—this time adaptively. During this period I met Johnny Fahner Vihtelic, an amputee special forces veteran who after hearing my story and how I could no longer run introduced me to handcycling. A former marathon runner and cyclist, I immediately took to the opportunity to be on the road again exercising and connecting with people—sound like a similar modus operandi? Months later, I completed my first long ride—the Face of America 110-mile weekend ride, and 2 years later finished 3rd in the handcycle category of the Boston Marathon. Concurrently, a lifelong skier, I got back into the sport seated on a monoski, which I did for several years.
Several years later, as I became more knowledgeable and proficient at adaptive athletics, I made the transition to one-leg upright cycling as introduced by Chris Joyce, and three-track skiing (one leg upright skiing). It was then I was introduced to and joined a second board becoming a charter member, Outdoor Adventures for Sacrifice in Service (OASIS) Adaptive Sports, which helps veterans and service members in the upstate NY streamline their journeys to gain proficiency in several different sports. Around this time, I also saw a Facebook post from Mike Erwin with his initial thoughts of starting Team RWB. I still remember where I was when I reconnected with an old friend on the phone in April of 2010, and enthusiastically presented my desire to take part. Knowing we were just about to have our first child, and were moving to DC, Mike’s response was “I tend to gravitate, and work with those that have a full-plate!” In May of 2010 when the board first convened I was finishing my graduate degrees and moving down to Washington, D.C. for full-time employment. As soon as we touched down, I started one of the organizations first chapters which I oversaw for a little over a year before taking on another role with the Team RWB national foot print.
However life came at me again, and in December of 2010 I had complications with the internal fixation prosthesis in my salvaged leg that necessitated the removal of the device. A former resident on my primary orthopedic surgeon’s service, Kyle Potter, now a stellar attending at WRNMMC did the surgery. Going under the knife for the 23rd time raised the opportunity to consider other options and strive for more function. However, a seamless removal of the prosthesis that led to no leg instability and a quick return to my normal level of activities of daily living and recreation made me complacent in pursuing other options—If it ain’t broke, don’t fix it! I was not ready to go under the knife for a 24th time to pursue more function—especially when I had learned how to live my personal and recreational life fully with one leg, including kind of chasing after children. Being laid up for a month with one child was not bad, but being laid up for 3 months with multiple children was not something I wanted to consider for “personal” gain. Therefore, I forwent discussions of further options (a distal femur replacement or knee disarticulation—through the joint amputation).
Fast forwarding almost exactly 3 years to the day when my Doctors had provided me with other options after my 23rd surgery, I was in a bike-on-car accident causing unrelated damage to my previously salvaged limb. This landed me back in the operating room and on crutches. It was at this time with the forecast of being laid up for several months, I began to think about the options presented to me during my previous extensive care. Given my history, an additional internal prosthesis which would inevitably fail or need replacement was not desirable. This essentially meant that I was signing up for subsequent surgeries when I needed a new implant.. With the distal femur / knee replacement route there was a high likelihood of chronic pain—another reason why I did not want to pursue the replacement route. All of this caused me to shy away from the distal femur replacement (or total joint on steroids as my Dr. called it). Per my Doctor, if I had went the distal femur replacement route, I would be 1 of 4 patients in the world to undergo such a difficult a joint replacement. Therefore, I pursued what my Doctors and I fought off for nearly 10 years, and most recently presented in 2010—an amputation.
However, the decision criteria was much different at this juncture of my life:
a) I was healthier not dealing with other tangential injuries from the blast, making me able to better recover from and withstand the surgery.
b) I had in essence, been practicing on one leg, strengthening it and refining its balance for 10 years!
c) More importantly, the successful limb salvage I had gone through on my femur and knee allowed Doctors to execute an amputation through the joint. This would make it much easier to articulate a prosthetic than if they had pursued this course of action 6 or more years ago. My femur would have not had the time to heal meaning I would have a transfemoral amputation.
d) And last, I had the life experience of living with a fused leg to know the pros and cons of not being able to articulate joints. This led to a complicated life in terms of activities of daily living and recreation.
So for me, the decision was easy. Although making a decision to lose a part of me, I would be gaining much:
a) The looming threat of needing surgical revisions to my limb salvage decreases.
b) For the first time in over 9 years, I will be able to sit comfortably and walk more normally.
c) I have the potential to horseplay and chase after my children more effectively. All this, while my current recreational activities I participate in with one leg are unaffected; I can just pick up at my previous level of proficiency and fitness.
The fact that I’m a part of an organization like Team RWB to welcome me and see me through this transition at a time when I do not have my service colleagues or a unit to support me, also makes things much easier—and the goal of perhaps doing a run with Team RWB one day. I am greatly inspired by those who had gone this route before me. Staying involved with the Team RWB community and other organizations such as Walter Reed Bethesda Cycling, and Disabled Sports USA, where I am a ride leader and ambassador respectively, helps me to stay motivated throughout my recovery. Being involved with Team RWB fuels my optimism for the road ahead. Also a faithful person, I’m a firm believer I’m sometimes guided to be in the right place at the right time no matter how painful the lesson or consequences.
Therefore, I’m certain the road ahead is bright:
a) I will immediately be able to sit comfortably in every setting—something I have not been able to do for 9.5 years.
b) I project I will be back to work and back on the bike trainer with my stump hanging “free” during the first week in January.
c) As I start to weight bear on my stump in the middle of January, I project I will be walking normally for the first time in 9.5 years by mid-February—my Valentine’s gift to my wife being able to do things around the house again, and being able to carry our children around again!
d) And of course I will be back on the road still cycling as I did before with my one good leg. The only difference is now I will be using a stump holder so I can continue to get out of the saddle when riding. I project I will be at this point by the middle to end of February.
e) One added bonus is that I am shooting to do some runs with Team RWB in the summer / fall!
In closing, all I ask for are no long faces if checking in. Just business as usual! We’ll keep you posted or you will see me out on the road cycling as usual, walking better than I’ve walked in the last 10 years, and subsequently giving up my rights to permanent shotgun or aisle seating! You may also see me running for the first time in 9.5 years. Life is good! Merry Christmas!