History

Friday, December 30, 2005 1:18 AM CST

Tammy has finished the 8 week course of anti-biotics and the Doctors at Hines VA have removed her PIC line. She is drug free and able to sleep through the entire night with no interruptions for IV drugs. Hallelujah!

Hopefully the infection in her arm is completely resolved, though we will continue to watch her condition closely for years to come. The Infectious Disease Doc at Hines told me he had seen First World War vets who had still had recurrent infections from shrapnel they had been carrying around for 70 years. We know Vietnam era vets who had blades of grass removed from their limbs in the 1990s. Periodic infections may well just be a fact of life for the rest of our lives.

We have been concentrating our efforts on obtaining vehicles and constructing ramps and other devices which will enable Tammy to begin to conduct her day to day business in a self sufficient manner. We will purchase a Ford Escape Hybrid SUV with a device that will help her load a manual wheel chair either in the rear hatch, or behind the driver’s seat. She will have to wear at least her left prosthetic leg in order to drive and both legs in order to load the wheel chair by herself. The only way to set up a vehicle that she could use by herself on days when she cant wear both legs, (due to fatigue, or blisters etc.), would be to buy a minivan with a lift, so she could transfer to the driver’s seat, and then lift the chair in behind her. Tammy aint havin’ none o’ that. No minivans. I barely talked her into the automatic transmission in the Escape, but since it is a continuously variable automatic I was able to convince her it is almost as good as a stick. It was either that, or I bored her into submission with technical specs.

We had our first Christmas with some sense of normalcy in three years. Tammy can get around the house, cook whatever she likes, enjoy our Christmas tree with our ornaments, and just relax to an extant that was not possible in any place other than our home. We have collected an ornament from each place that we have traveled together, and putting up the tree is a walk down memory lane. There are ornaments from Hong Kong, Singapore, the UK, Oahu, Maui, the big island, Seattle, San Francisco, LA, Nebraska, Hannibal, my hometown in MD, and one from nearly every year at Oshkosh. During our next trip back to Walter Reed we will pick up an ornament from the Walter Reed Ladies. You might not think we would want to remember the time at Walter Reed, but that was a year I got with her that I wouldn’t trade for anything. There were circumstances that were not very pleasant, but every morning she woke up alive, I was keenly thankful. We also made some very good friends in such a stressful situation. In the years to come we will remember those things every time we put that ornament on the tree.

Friday, December 23, 2005 12:05 AM CST

Tammy has been released from active duty. She has been permitted to stay in the Army National Guard under a program called Continuation on Active Reserve, (COAR). We have returned home to Hoffman Estates to begin the next phase in life together.

Tammy has decided to run for office, and we do not feel that it would be apropriate to annotate any information pertaining to that effort on this site, which is run by a charitable organization specifically for sick and injured patients. If you would like to know about that please email me at bbowlsbey@yahoo.com and I will direct you to another site.

We will keep this site up for at least a couple of months more and detail Tammy's return to live in the house full time, her return to work with her injuries, and her current medical status.

Tammy is still receiving anti-biotics every 6 hours to ensure that the infection in her arm goes away. The scheduled meds do make it difficult to get in normal work/life activities without keeping a constant eye on the clock.

She has also received an additional set of legs, (the latest generation of the Walter Reed's Prosthetists efforts). The new legs are a little different than the ones we received in Florida, and are a little more comfortable. Unfortunately they are a little bit of a tradeoff, since they offer proportionally less support relative to the additional comfort.

Sunday, November 27, 2005 1:15 PM CST

This is a cool story about Tammy from the Daily Herald, one of our local papers in Chicagoland.

We had an excellent Thanksgiving dinner at my brother’s house including all of my immediate family, Tammy’s brother, my dear cousin, and our boston terrier. Last thanksgiving Tammy was still in the ICU, this one was wonderful, and gave us a chance to look back at all the improvements to our lives in the past year. Tammy walked in, and up the stairs, and we had a nearly normal holiday dinner.

The day after Thanksgiving we drove back to our house in IL for a brief 10 day respite. This is a 12-14 hour trip, and unfortunately, 10 minutes away from our house we got into a traffic accident. While we didn’t have any injuries, Tammy was slammed against the seatbelt as I braked hard to avoid the accident, and actually hit the bottom of her left leg against the dashboard. She was achey and sore all day Saturday, but is feeling much better now.

It has been a long tradition of ours to gather with some friends of many years to have an after Thanksgiving day dinner the weekend after the holiday. Part of the tradition is the years first viewing of “The Grinch”, not the abominable recent Jim Carrey movie, or the revised "less scary" version of the cartoon, but the original Boris Karlof version. We also generally watch “Rudolph the Red Nosed Reindeer” and/or “Santa Claus is Coming to Town”. Our group of friends used to take in all of these, and play some games and socialize for hours, but alas, we are not as young as we used to be, and many of our friends are parents. After a belly full of dinner, and one movie, almost all of us seem to be right on the verge of nodding off. Still, the sense of returning to normalcy is wonderful.

We will be in Illinois until 07 DEC, with me administering the anti-biotic drip five times each day, and Tammy attending some errands in IL. She may try to get her drivers license back, since her old one was blown up in Iraq. It is wonderful to be back in the house, very relaxing. We are looking forward to bidding farewell to Walter Reed and getting home.

Friday, November 18, 2005 7:04 AM CST

We received a plastic model of Tammy’s right femur and it really gave me pause. There is much less bone than we had thought. I had thought that the bone extended down and outward from the ball joint to the first journal, (or jog where a normal femur changes direction and continues straight downward), and then continued downward for about 3 inches. Even that would have been pretty minimal to walk on, but she does not even have that much bone there. The bone goes from the ball joint out about 2” to that first turn, and then turns into a jagged mass of HO, (bone material growing in all directions). Some of the HO has apparently grown outward into the muscle. I am not sure where there is enough room for the glute muscles or the hip flexors to attach to that little piece of bone, but they are still attached.

How she has been able to walk on it I can not imagine, but she has done so. She has proven that fitting a prosthetic to a bone that short can work. Had we been able to see how little femur was left, we probably wouldn’t have been so vocal about keeping it, and allowed the doctors to remove it. Thankfully, we didn’t know, and Tammy didn’t realize how difficult a task walking on that leg actually is before she strengthened the muscles enough to be able to do it.

The trip to Gettysburg is coming together for our friend. It was at his request that I started to work toward this, and I have been able to make a lot more headway once it was clear to all involved that he was really motivated to go. Many people don’t understand his reasons for wanting to make this trip, but it is a visit to hallowed ground where some 55,000 Americans died for their convictions in a short period in time. For a man who has been a Soldier all of his short adult life, and who shares those convictions, and is facing a life and death struggle himself, that place has very deep and even spiritual significance. So much so, that he would expend some very, very precious hours to go.

Our buddy is opting for some “second line” cancer drugs which may give him some more time, or could kill him. The alternative would be to accept defeat and go home to die, but that would not be in keeping with the Creed. He and his wife are living every moment; a lesson for Tammy and me. We had begun to be quite comfortable with the idea that we have another 50 years or so. The fact is we just don’t know, none of us are privy to that part of the plan.

Friday, November 18, 2005 7:04 AM CST

Wednesday, November 16, 2005 8:44 AM CST

Alive day was great, and the pictures are currently scattered to the four winds, as my digital was broken. I am scanning some polaroids, and trying to get digital copies of all the rest. More to come.

I am trying to arrange a trip to the Gettysburg battlefield for our friend with cancer. The bureaucrats involved dont seem to understand that if they let this sit on their desk for a few days it will be too late. Or maybe they understand that if they put it off for a few days they wont need to do anything, and that angers me even more. Either way, when I get a green light from the Oncologist I am going to make this happen.

Sometimes I start to lose perspective on our situation. Tammy has it pretty good. Her life will be changed, and she has paid, (and will continue to pay), a price for our convictions. But our convictions are not diminished, and our lives together will be a long and happy. Keep the faith.

Wednesday, November 16, 2005 8:44 AM CST

Friday, November 11, 2005 0:55 AM CST

A good friend, and young sergeant who lived with us at Fisher house is about to be discharged to hospice. The cancer has come back with a vengeance and he will not live to see his wife give birth to their second child next month. He called us from the Ward to say goodbye. His wife will need some help in the next few months.

Tuesday, November 8th, 2005 09:00 AM CST
Alive Day – because life is good.
Alive Day is Saturday 12 November between 1700 and 2100 hrs, (or 5 PM and 9 PM for the militarily challenged). Please shoot me an email at bbowlsbey@yahoo.com if you can possibly stop by. If you are coming out from points west let us know, and we might be able to pull off some sightseeing to any of the monuments, or the Air and Space Museum, the Tomb of the Unkowns, or Mt. Vernon/Monticello. We are currently looking into acquiring a mini bus type vehicle for the weekend. Shoot me a line if we have any takers.

Tammy has been chomping at the bit; anxious to get back to therapy. Sitting on her butt doing nothing is just not in her nature. Her demeanor is about like any one of the kids in our Fisher House family when their parents give them a “time out”, and she seems to enjoy the inactivity just about as much they do. The operation was on her right arm, and it is still in a cast, so she can’t write, or touch type. She has a PICC line, (semi-permanent Intra-Venous tube), in the other arm, so using the other hand for anything can be problematic also. Much of her treasured mobility and self sufficiency is hampered by her current situation, and that is a great source of frustration.

Tammy had a pain block in her right shoulder which looks very similar to an “epidural” type contraption. The pain control team kept reducing the amount of pain medication, while checking for side effects of the drug each day. They tell me that one of the possible side effects is emotional or profane outbursts at inappropriate times. So apparently that is not “normal”. Who knew? Since Tammy spent three years in command of a certain company at Chicago Midway, nearly a year in the desert with a bunch of Army Aviators, and has been living at Fisher house for a year with some Infantry types, I suggested that the doctors might need to find another indicator to use. The pain block has been removed, and she feels very little discomfort in her right arm.

Thursday, November 3, 2005 11:26 PM CST
I am headed out again this weekend for some Army duty. While I love going to drill, (National Guard Duty back in IL), I hate having to leave Tammy in the hospital. So, we have begun our usual negotiations over me trying to find her a playmate, (she calls them "babysitters"), to keep her company over the weekend while I am gone. Tammy's opinion, (of course), is that she is a big girl and will be perfectly fine. That is generally so, though now that she has tubes in both arms again, and one arm is immobilized in a cast, a helping hand can be a good thing occasionally.

The Infectious Disease doctors have determined that Tammy has a bone infection with the same bacteria she had back in January. She will be on a long term course of IV anti-biotics, though she should be able to get out of the hospital in a week or so. It should be the same deal as before where I administer the anti-biotic twice each day, and the infusion clinic in the hospital handles the third. Tammy dislikes tubes in her arms intensely, but it will not interfere with her Physical Therapy once she is back on an outpatient status.

Wednesday, November 2, 2005 7:54 PM CST
The news from yesterday just could not have been better. Essentially, what the doctor found inside her arm was nearly the “best case” scenario we had anticipated. We are still waiting on cultures to come back from the lab. I believe the infectious disease team takes the bugs they found in Tammy’s arm and determines which combination of anti-biotics will kill them most effectively. That will determine how long she will remain on anti-biotics, and how long she will be in the hospital.

I have great faith in the infectious disease doctors here as well, as they are heirs to a long tradition. The historical person Walter Reed, (as opposed to the hospital, or the institution of that name), was an Army Major that conducted research and eradicated yellow fever during the Spanish American war. Two Army Surgeons allowed themselves to be infected with yellow fever, one directly from serum, and one by allowing himself to be bitten by the mosquito that the Walter Reed Commission believed to be the carrier of the disease. The fatality rate for yellow fever was 30 per cent at the time, and one of the surgeons died. Armed with proof, the Medical Corps was able to prevent countless deaths due to this disease within the Army’s ranks. Yellow fever had stopped several french attempts to build a canal across Panama. The new understanding of the fever allowed the US Army Corps of Engineers to defeat yellow fever in Panama and complete the canal. In 1909 the Army Medical School, (which would later become the Walter Reed Army Institute of Research), developed a killed bacillus vaccine which dramatically reduced instances of Typhoid fever. In the 1st World War the British and French adopted the US Army’s vaccine, and saved many lives.

While we both have begun to long to go home, this is the best place for Tammy to be right now. Experience with the particular strains of bacteria, and viruses that wounded veterans are bringing back to the states exists only at the military treatment facilities like Walter Reed and the medical center at Ft. Sam Houston in Texas. This is one of the core competencies that military treatment facilities maintain, (thankfully). Two years into this war Walter Reed knows more about the little nasties inside her arm than any other hospital in the world.

Tammy’s arm doctor visited her on the ward after he got off shift and brought her a momento; the pieces of metal that have held her ulna arm bone together for the past year.

We did not succeed in our quest to get Tammy back onto ward 58, so I will be staking a tent for the night in her room until I get a sense that standard of her care will be somewhat equivalent to what we had become accustomed to previously.

Tuesday, November 1, 2005 11:29 AM CST
Tammy is out of surgery and resting comfortably. The surgery went well, and the doctor found that her radius bone was ok. Her ulna bone had a coating of brown slime on it which he was able to clean off. He removed the hardware that had been holding that bone together, and was pleased to find that the bone was actually knitting back together better than had been apparent from the X-rays.

He seeded the area with anti-biotic beads and cement and closed her up. We dont know exactly how long she will be on the wards again, but she is already anticipating getting out of the hospital.

We are hoping to see as many friends as possible at the "Alive Day" celebration on the evening of 12 NOV. Please shoot me an email at bbowlsbey@yahoo.com if you are going to attend, so I can get an idea of how much food to lay on, and how big a room we will need.

Keep the faith.

Monday, October 31, 2005 10:09 AM CST
Well Tammy’s picture is in Soldier of Fortune Magazine, and there is a juvenile part of me that really enjoys that. She is also featured in a new book, A Day in the Life of the American Woman., which is probably a bit less dubious an honor than Soldier of Fortune.

Tammy spent a relaxing weekend before the surgery; not going anywhere, doing anything, or seeing anyone. I hope the rest will help.

Tomorrow is the day of the operation; the wait is almost over. I think in some ways it will be a relief when they actually get to the operation. At least we will know with what what we have to deal. Not knowing is very bad.

She will be back on the wards for some days after the operation, and we have requested to return to Ward 58, since we know most of the people who work there from Tammy's previous stay, and have confidence in the leadership of the head nurse on that Ward. She is a 'Margaret Houlihan' type in the very best sense, holding civilians and Soldiers to the standards and allowing no caos, or confusion in her fiefdom. I say requested since somewhere in the hospital there is apparently a mythical "Bed Master" who will decide where she goes. As near as we have been able to determine so far; no one has ever seen this person, knows his or her name or gender, or even the place where he/she conjures up "The List". If we are succesful in our quest to find this wizard and influence his decision about where to send Tammy, she should be back amongst familiar faces when I head off to drill this weekend.

I will update this web page immediately after hearing from the doctor tomorrow. We continue to apreciate all of the prayers and well wishes.

Thursday, October 27, 2005 7:25 AM CDT
01 NOV looms before us. Tammy has been through worse, but the idea that she could lose the arm is daunting. I have no desire to have her operated on again, but it is necessary for our friend the orthopedic arm surgeon to go in and see if all the parts of her ulna bone are still alive, or if other measures are required. We will have to compartmentalize that anxiety and put it away for a while.

I am quite sure that all of the aspects of this operation that Tammy and I can have any impact on are exactly as they should be. I have great confidence in the operating room staff here at Walter Reed, as well as the orthopedic surgeon. If we have to accept risk against her arm, (or her life), then the experience and training of the medical staff here are the best control measures for which we could ask. I am not, however, as confident about the bureacracy in a hospital this large. While Tammy is unconscious and incapacitated, I will be listening closely to everything for discrepancies and disconnects between the various departments. Believe it or not, in the past we have been able to head off some problems by listening closely and insisting one doctor speak to another who had a different understanding of Tammy's situation, or ask the nurse to consult with one of the Departments before implementing something that was still on her paperwork, but no longer required. We have no medical training, but I believe it is very important, (physically and psychologically), for a patient to take an active part in their own recovery.

Tammy's arm has not healed since they drained it several weeks ago. The small hole in her skin will shrink and begin to look as if it is about to scab and heal over, only to open back up again. This usually occurs once every couple of weeks, and when it does she is uncharacteristically lethargic. Usually she gets up and rolls herself in to Physical Therapy to work out, but on those days when the infection seems to be increasing, she will sleep for 18 hours, and can barely move herself out to the kitchen to eat.

We traveled to New York city two days ago, in order to present an award from the Avon foundation to Arnold Fisher of the Fisher House foundation. The Fisher House has been very good to us, and we believe it is important to promote the foundation. Much as we would wish that the mission could be accomplished, and this war be over tomorrow; it will not be. There will be many more families of military members who will need the Fisher houses at military hospitals in DC, Texas and Germany, as well as at VA hospitals all over the states.

Thursday, October 20, 2005 11:50 PM CDT
We are very concerned about Tammy’s arm. The orthopedic arm specialist will operate on her 01 NOV. The operation will give the doctor a chance to see what is going on with the arm bones, and implant anti-biotic beads. The beads allow the doctor to apply a lower volume of anti-biotics, but in a much more localized way, and over a long period of time. He will also check to see if parts of her lower arm bones, (radius and ulna), have actually died, and may opt to perform a bone graft from her hip at that time.

Tammy has not had an operation in a long time, and we are not looking forward to this one. She may be back in the hospital, (as opposed to outpatient living at Fisher House), for two weeks.

We are moving forward with plans for the “Alive Day” celebration on 12 NOV at Mologne House here at Walter Reed. We think we may have some folks travel in from as far away as Missouri and Illinois for this event. We would love to see all friends who can attend, old and new, and will have food and drink. Many of the medical personnel that helped to save her life will also attend.

Monday, October 17, 2005 10:13 AM CDT
Tammy had a busy weekend with a trip to the National Italian American Foundation’s, (NIAF), awards ceremony Saturday night, and dinner with my family on Sunday. She is able to wear the legs for longer and longer times, and within the month I think it will be routine for her to stay in them for an entire work day without difficulties.

We have had no resolution on the bacteria in Tammy’s right arm. The small hole that the doctors created to drain the arm had begun to heal, but now seems to have gotten a little bit larger. Tammy currently has very good use in the arm, but the constant uncertainty caused by the bacteria inside it is unnerving. We can’t ignore the fact that the infection could come raging back with a vengeance, and cause her to lose the arm. I haven’t forgotten what the MDs in the ICU told me either; infection is still a threat to her very life.

She won’t allow fear to run her life. Tammy has been much worse off than she currently is. There are many others struggling with bigger issues than currently occupy her.

We were very happy to see General Pace receive an award for military service from the NIAF. Many of you know that the General is Chairman of the Joint Chiefs, but I don’t think it is possible to perceive the man’s true character on the TV screen. We have encountered him twice before, once at a dinner for a former for a Malaysian government official, and at the Spring USO formal, and I believe we may have seen at least a hint of who this guy is. In all cases the General has shown himself to be deeply committed, intelligent, articulate, and passionately concerned with the welfare of the young men and women he must send into harm’s way. Our faith in the senior leadership of our own small part of the military, (the Illinois Army Guard), has been restored, and re-affirmed repeatedly over the last several years. We can see the effect that good examples of leadership have had within our state. It is heartwarming to see a similar thing on the national level. The wounded have taken some changes to their lives for the sake of the mission, and it is important for them to see such men in the most senior leadership roles.

Tuesday, October 11, 2005 9:53 AM CDT
Tammy and went back to our home in Hoffman Estates to watch my sister run in the Chicago Marathon. Domestic airline travel is becoming pretty easy for Tammy, though we learned a great deal about the pitfalls of handicaped access on public transportation while trying to use the CTA to get around town and see my sister at the various viewing areas. Not all of the stations are even listed as “handicapped accessible”, and the ones that officially are "accesible", may not be accessible for all train lines, and generally have elevators which are out of service and indifferent CTA employees. So it was an adventure.

Our other task in Chicagoland was to check out the Hines VA hospital, which could handle Tammy’s rehab once she leaves Walter Reed. Those folks seem eager to work with Tammy, and very well intentioned. However, the vast majority of the patients that they see are elderly, and their goals are much less ambitious than Tammy’s. If the VA Physical Therapists and Prosthetists can get a patient to stand up and hobble down to the cantina for food, they can consider that a major accomplishment. Tammy, of course, is going to fly, swim, and run. I think it would be exciting for those folks at the VA to work with Tammy, and she would probably get consistent and enthusiastic attention, (which is half the battle), but their experience with younger more active patients is very limited. Apparently only one prosthetist at Hines is trained to work on a C-Leg, and of course, he doesn’t see C-legs very often. The VA seems to be very focused on meeting the needs of older veterans. They apparently learned the lesson of PTSD, (Post Traumatic Stress Disorder), from the Vietnam era and are very prepared to handle that ailment. I think that a much smaller percentage of OIF/OEF vets are experiencing PTSD. I am not sure that the VA is completely ready to take care of this latest generation. I find it very difficult to understand how some politicians claim that the VA is adequately funded, if they don’t have people trained in the latest prosthetic technologies, (we have a higher percentage of amputees from this war), and they don’t have infectious disease Docs who are very familiar with Iraqi strains of acinetobacter bacteria, (most OIF wounded have this). On the bright side, Hines does have a brand new spinal chord center, and apparently an excellent rehab center for the blind.

When Tammy leaves active duty she will be able to return to Walter Reed for treatment if absolutely necessary. This will hold true if Walter Reed is located at its present locale, or if it has moved to Bethesda, MD. The other option, should Walter Reed be to far, or Hines not be able to meet her needs, is Rehab Institute of Chicago. By all accounts, RIC is even better than Walter Reed.

Tammy is already in need of a new right leg, so we will be making another trip to Orlando sometime soon. The right leg works, but her residual leg has shrunk enough that it is a little loose.

The house is very relaxing for Tammy, and she is really looking forward to getting home.

Sunday, October 2, 2005 11:53 PM CDT
Tammy goes back to the grind early tomorrow, (Monday), morning. Her cold is on its last legs and she is eager to get back to therapy. Her right Quad-S socket was revised this past Thursday to relieve the pain that wearing the leg all day was causing along the scar line on that leg. The modification seems to have been successful, and she is able to she is able to wear the legs for 8 to 10 hours each day now. On Friday the right Quad-S socket, was further modified to allow her to attain full stop to stop motion on the simulator rudder pedals. The current generation of the Quad-S was constructed by the prosthetist in Florida, and bears very little resemblance to the original Quad-S. It is working very well, but already the new liner she received in Hawaii has begun to show signs of wear. We may need to continue working on durability issues for the liner even after it is completely optimized for fit and function.

The next generation of the other right socket will completely abandon the Harmony vacuum system and go back to a pin and socket system with a much more finely crafted socket, and a liner that borrows heavily from the new liner from Florida. The new liner will fasten on her left side, simplifying taking the leg on and off, and greatly easing rest room operations. The whole socket and leg will be much easier to sit and fly in.

We will make a whirlwind trip back to Chicagoland this weekend in order to meet with the Hines VA center there and take a look at the facilities at that location, and the Rehab Institute of Chicago. Tammy hopes to be able to return to our home in Hoffman Estates within a few months to complete her rehabilitation. She will still be able to go back to Walter Reed for operations and follow up care.

Friday, September 30, 2005 10:34 AM CDT
Tammy has returned to Walter Reed and is continuing to rehabilitate. She had a very good day Monday, as she was able to ride the wheel chair into the hospital, and then abandon it for the entire day in favor of walking around on her legs. It's still a lot of physical effort to go the whole work day, and it kicked her butt.

She has caught the virus that is making the rounds, and spent the Tuesday and Wednesday in bed with a high fever, sore throat and nasty cough.

Thursday she went back in to Physical Therapy, and met a teenage triple amputee who is just amazing. He has lost both legs above the knee, and one arm just below the shoulder. This guy runs, (pretty fast, too), and has swim legs which he uses to scuba dive, which is something Tammy used to do. This kid has just refused to believe that he can’t do anything, (hmm…, “…will not accept defeat”), and swims like a fish with less remaining muscles than Tammy has. He flutter kicks without any quadriceps, or hamstring muscles, (using only his hip flexors and glutes like Tammy has on her right side).

Tammy really loved getting back in the water when she was in Hawaii, though we have not been sure that she would be able to get a swim leg for her right, (AK, or above knee), side. Unlike the young amputee she saw yesterday, Tammy still has the important parts of her left leg, and will be able to engage her left quad and hamstring. The added muscle on her left side would give her more power, but an asymmetric thrust from a standard flutter kick. I am thinking of a setup including a swim leg with a simple mechanical knee on her right side, and a big monofin to which both feet would attach, like free divers use. Free divers kick with these things like a whale, or dolphin uses its tail. Tammy should be able to use her core muscles in her torso, as well as her remaining glutes, hip flexors, and leg muscles.

She continues to increase her wearing time in the legs, but her endurance is not increasing as quickly as she would like. The liners for her right leg are also likely to tear after long usage, and we need to have a couple on the shelf, in case of a break down. Charlie Mike.

Tuesday, September 20, 2005 12:48 AM CDT
Tammy has not been as mobile during this trip as she would have liked. The liner for the right prosthetic leg has broken down, and she has been confined to the wheelchair for most of the trip. Through creative use of 100-mile-an-hour tape, (Duct tape), we have been able to get a few more hours of use out of the liner. She had to speak at Governor Lingle’s International Women’s Leadership Conference and attend the National Guard Association convention in the wheel chair. This is all very frustrating to us, but we have learned that once we get the prosthetics optimized we must insist on having two of everything for just such a contingency.

Tammy attended a dear old friend’s wedding here in Hawaii. It was a wonderful ceremony, and gave me time to reflect on weddings, and marriage. The bride is ethnically Phillipina, the groom is from an Albanian family that immigrated to Italy 500 years ago, and they are both Canadian. The ceremony was in Hawaii, and contained elements of all those ethnic groups and places, as well as some unique Hawaiian touches. Looks like the bride held out for the right guy. It was good to see our friend happy, and playfully interacting with her groom. Aloha nui loa.

Seems rather fitting that every wedding should be unique, as each couple is comprised of two individuals with different characteristics who each are opting to give up some of their individual selves, and form, to some extent a new composite identity. At least, that is the way our marriage seems to work. Though it has been the most rewarding thing I have ever done, I haven’t been able to come to an actual, all encompassing, definition of my own marriage for twelve years. It is still a fascinating, dynamic thing. The only things I know for sure about marriage is that it is not easy, it requires continuous nurturing and the return on investment of that effort is very good.

I was attending my brother’s wedding last November when DA casualty called to tell me my own wife had been wounded. It did not make any sense to tell my brother and new sister about Tammy’s injuries, as she was already enroute to Walter Reed, and would arrive the day after the ceremony. There was no benefit to sharing the news at that time and casting a pall over their day. There was nothing for me to do to help my wife until she arrived, so standing up for my siblings gave me some time to reflect on marriage, which helped to remind me of those things that are really important, and solidify my resolve. Hearing their vows helped to refresh and relive our vows, and gave me an intense desire to resume the vibrant relationship with my wife, which had been in limbo during the eight months she was deployed before being shot down. Some days later, when Tammy woke up, and her eyes focused on mine, that interaction of a split second confirmed for me that she was still the same person, still the woman I married. I knew in that brief second that we were going to make it, and the rest of our lives would not be a matter of simply keeping our word and fulfilling the verbal contract of the wedding vows, but we would be able to nurture this thing and keep it healthy. That was the happiest day of my life so far, though I am sure there will be others during the next forty or fifty years.

Thursday, September 15, 2005 2:08 PM CDT
Aloha

Tammy has been cleared to travel, and we have made the 12 hour flight to Hawaii. Tammy has a childhood friend who is getting married here this weekend, the Governor of HI has asked her to speak at a Women's Leadership Conference, and the National Guard Association of the United States is meeting here at the same time.

The arm is still worrisome, and we change the dressing on it every day. The MDs have decided to give it another look on the Monday after we return from the islands.

The flight over was brutal, and the custom silicone liner for her right leg broke after being subjected to the long 15 hour flight. That is currently the only one she has, and we will be putting it back together with that magical material that American Soldiers have used to fix everything for at least 25 years; hundred mile-an-hour tape. This is roughly like OD green duct tape. It has been used to temporarily hold body panels on aircraft, and build bridges, and engineer all manner of things. It will work pretty well on that high tech, computer controlled, carbon graphite prosthetic leg, as well. We have already called Florida, and another liner is being made as I write this.

There will be new pictures up very soon.

Tuesday, September 13, 2005 11:28 AM CDT
Tammy does have an infection in her right arm. There are a variety of possible outcomes, and nothing to indicate anything particularly dire at this stage. The infection may be in the radius and ulna bones in her arm, it may be hiding out on one of the surfaces of the metal plates in her arm, and it may, at some point degrade both bones. The orthopedic surgeon, (the friend and comrade who spent some time with us at Oshkosh), may need to go back in and remove the plates holding her right arm bones together, and he may, at some point need to rebuild the radius and ulna from a bone graft taken from Tammy’s pelvis. Tammy has faced more daunting situations before, and we will take no counsel from our fears. This is the place to be, and that is the guy to do it, if it turns out that she needs the operation.

Not being able to weight bear on that arm would have a big impact on Tammy’s ability to get around, and her ability to continue with therapy at the level she would like.

In the best case scenario the infection would remain “sub-clinical”, and not represent a serious threat to the arm bones.

Monday, September 5, 2005 9:34 PM CDT
Tammy continues to work out hard everyday, and she is gaining a great deal of upper body strength. She will happily show off the newly developing “guns,” (bicep muscles) in her upper arms. Despite the progress, she is very tired of being here, but she must Soldier on. Her last trip to the flight simulator was somewhat disappointing to her, as she still must work hard to do the most basic piloting tasks. “It’s like day one of flight school all over again,” she says. Things that have been easy for so long now require a great deal of effort. There is improvement, of course, but not the huge amount that she would like. We’ve known this will be a long process, but her pride is a little hurt sometimes at her new awkwardness.

Occasionally Tammy still dreams that she is still in Iraq, doing her job. They are not bad dreams. She just wakes up exhausted, as if she has just worked a full shift in the Tactical Operations Center, (TOC). The dreams are usually triggered by her watching some news reports on Iraq or doing something that reminds her of what she was in the middle of doing when she was injured. Trips to the flight simulator or to climb into the cockpit of a Blackhawk always bring on the dreams later the same night. She isn’t really bothered by them. Sometimes she says they just let her remember what it was like to have her legs and be doing what she loved to do. Mostly, they just leave her tired in the mornings but she still heads into therapy. We think that the dreams will fade over time, maybe once she gets to finally go home. Unlike the rest of her unit, she never really got to go through the winding down process where she could feel like she was able to accomplish her mission in Iraq.

She is walking very well on the new legs. Each day I meet her at Physical Therapy for a lunch date, and to catch a few minutes of her walking. She is walking a quarter mile in 9 minutes, as opposed to the 16 minutes it was taking her with the older legs. Her pace has picked up to the point that I walk comfortably with her at nearly a normal pace. The alignment on these legs is superb, and the fit is very tight. She is much more confident when she places each foot. She can now walk awkwardly a short distance with no support devices although she usually uses just one cane.

The new legs do bring a new set of problems and concerns. She is only able to wear them for about 2 hours right now. The skin on her right leg develops blisters, scabs and bruising in the area along her scar line. She may have “H.O.”, (unwanted bone growths common in blast injuries), just under the skin on that leg, which contribute to the pain and discomfort when wearing the legs.

The doctors X-rayed her limbs to determine if she had HO in the problem areas, and if she will need another operation to remove the HO. This is very scary for us as an operation raises the long dormant specter of infection. I have not forgotten the doctors in the ICU telling me that the only thing that could take her from me now would be infection. An operation also may result in her losing even more of her very, very short right femur.

She has also developed what looks like a blood blister the size of a nickel on the scar line of her right arm. She accidentally bumped it on a corner a few days ago and the bruise has recently started to fill with fluid. We don’t believe that this swelling is a sign of infection, like she previously had in that arm. However, Tammy is very concerned with losing that arm, and the threat is not far from her mind. This is not a likely occurrence, but if it crops up the Infectious disease team here at WRAMC will swing into action quickly. I know the lead doctor on that team by name, and have reconnoitered the location of his office. Walter Reed is the best place to be right now.

Friday, August 26, 2005 0:00 AM CDT
Tammy has spent the week walking on the new legs. She and her physical therapist are concerned about skin breakdown on her residual limbs since the new sockets fit so closely. The close fit is really helpful because she does not have any “wiggle room” inside the sockets, and she should be able to develop more power in order to actuate the helicopter’s toe brakes. Unfortunately, the close fit will probably cause a bit more irritation on the skin of her residual limbs. We also won’t know to what extent the HO on her right leg will interfere with this good close fitting socket for several weeks or a month.

This past weekend we were able to visit with the aircrews from Missouri with whom Tammy was flying when they were shotdown. These are great guys, and it was a pretty emotional meeting for Tammy. I thank the One who made us for the professionalism of these Soldiers, and every NCO, IP, and mentor that ever trained them. Each one of them made direct contributions to getting her to medical care in time to save her life. A delay of just a few minutes at any step of the trip to the hospital in Baghdad would probably have resulted in her not coming home to me.

I have been in Illinois for the past week with the Army. Putting Tammy on that airplane in St. Louis to travel back to DC alone was very hard for me. We had the details worked out pretty well. I got her to the gate, with all of her bags checked, (except for a big, odd shaped bag that contained a spare right leg), and made sure the airline would get her onto the plane and seated. My brother was waiting on the other end to pick her up and get her back to Walter Reed. It still bothered me badly until I got the message that she was safely back in the company of my family.

Thursday, August 18, 2005 1:09 PM CDT
Tammy walked late last night for the first time on the new legs. (These guys made her a new carbon fiber socket for left leg as well.) She walked, (shakily), without canes, or supports for the first time since she was shotdown. The alignment on these legs is different, and Tammy is learning new techniques to walk on them, but I can already see the improvement in her gait. She stands upright, with her shoulders square and walks, as opposed to the semi-hunched hobbling kind of walk that she was doing until last night. Don’t get me wrong, all the efforts of the many different individuals that went into getting her to the type of walking that she was doing before she came to Orlando were necessary for progression, but it does my heart good to see her be able to take the next step. These legs are a lot simpler, and they paid a great deal more attention to getting the fit exactly right on the socket than ever before. There is some technical innovation involved in the vacuum system, but nothing very high tech. I believe that at least 50 percent of the benefit of this system is realized because of this particular prosthetist’s coaching on how to walk on the legs he made. Seems there is no substitute for consistent and close interaction with a good prosthetist.

This morning Tammy was able to walk on the legs again, but she had some sore spots on her right residual leg right over some of the bone growth on her short right femur, (thigh bone). This bone growth, (called HO), is a result of the blast, and makes it difficult to fit an amputee's leg since the femur bone is not smooth. This socket fits so closely that she is bearing weight on the area of her HO, and that irritates her flesh badly. There are several things that can be tried to resolve this, and ultimately she could probably have another operation to remove the HO on her femur. Another operation is not Tammy’s first choice, as neither one of us would like to see her go under the knife again unless absolutely necessary. This morning it was difficult to achieve the same vacuum fit she had last night. The prosthetists are still revising the liner, and the final one should be easier to put on, and use. One other drawback to this system that we can see is that the silicone liner material covers a lot of her body and may be a bit hot to wear, but they are still tweaking the liner, and may cut away enough of it that she won't be so hot.

To my great embarrassment Tammy has found a T-Shirt which says, "Lucky for me he's an @$$ man." She snuck this on this morning and since I was busy loading legs, and wheel chairs and other accessories, she got all the way to the prosthetist's office before I realized she was wearing the darn thing in public. I blame the influence of the Aviator/Crewchief friends we were able to spend some time with this past weekend.

Wednesday, August 17, 2005 11:20 AM CDT
We attended the annual block party on our cul-de-sac in Hoffman Estates and met up with all of our neighbors, and many old friends from Tammy’s unit. It was good to get in one more summer weekend, and spend a little more time at our house.

The very next day, (Sunday), the Army had Tammy on orders to visit a very good prosthetist in Orlando, Florida to be fitted for a new right leg. It took all day Monday to construct a new liner, which is unlike any liner we have seen to date. This liner covers Tammy’s right leg, incorporates an attachment for the socket, and extends across her body over to the left hip. It is kind of like wearing one legged silicone pair of shorts. The liner is very comfortable and secure, and does not look like it will sweat off ever. This could be the innovation that will allow Tammy to wear the leg for 16-18 hours like she needs. The new socket will pull a vacuum between itself and this liner, and appears to be much lighter than the Harmony setup. The prosthetist and his staff are fabricating the new socket today, and Tammy will probably be walking on it tonight. The socket/liner design is very different, and only vaguely resembles the older Quad-S system. We will be here in Orlando for the whole week, and we hope that Tammy will be walking much better by Friday

Thursday, August 11, 2005 10:59 AM CDT
Tammy has not been able to make any great leaps forward in some time. She is able to keep her leg on and walk for a few hours, but has not been able to increase the duration of her wear time for the last couple of months.

She has been working nearly every morning with the prosthetists since we have returned from Oshkosh. Her right leg Harmony socket is still the major area of concern, and her current setup will not allow her to keep the leg on and maintain good suction for more than a few hours. It also presents a problem when she sits down, as the socket contacts the chair and breaks the seal on her leg. The prosthetists have been fashioning a smaller socket, which will not interfere with her sitting down, and should allow her to achieve more suction on her leg. Ultimately they would like to be able to pull more than 20 lbs. of suction, (and by their definition, they would then have “vacuum”).

This whole effort is frustrating for Tammy since she and the prosthetists have been “close” to achieving vacuum for about a week and a half. The difference between her current frustrations, and those in the first 4 to 5 months of trying to find the optimal solution for her right leg is this; consistent work by the prosthetists every day. We are not waiting for weeks for disinterested third parties who are not within our sight to finally come through with a new socket for her. Nearly every day Tammy is in the prosthetic lab for 3-4 hours, as the prosthetists fit, and shape and refit sockets trying to craft one that will provide the long duration fit that she needs to be able to work 16 hour days. This is important to both her drive to stay in the Army, and her ability to work without hindrance in the civilian world. The prosthetists have ordered a new smaller socket from Otto Bock, and they believe it will be in on Friday. (I love these prosthetists, but we are getting wise in the ways of ordering things from that company, and won’t be particularly surprised if it takes them 13 weeks again).

We go home to Chicagoland for a short respite and to attend the annual block party in our cul-de-sac this weekend. After that the Army will send us to Florida next week in order to visit another prosthetist, and produce the next generation of Quad-S socket. The Quad-S, though it always offered better alignment, has fallen by the wayside for a month or so, while the Harmony socket offered slightly better performance through the few pounds of suction it was able to develop. Hopefully this next generation of the Quad-S will develop “vacuum” on her limb, and combined with the superior alignment will allow her to continue to improve her gait. Hopefully it will also be less complex, and maintain the “vacuum” for a longer period of time.

We will then fly from Florida to Missouri to attend the Missouri Army National Guard’s Safety Stand Down Day next weekend. Tammy was flying with C Co. boys from Missouri when she was hit, and they were the ones who landed the aircraft, drug her body to the second aircraft and got her to the Medevac bird. She hasn’t seen the pilot in command of her flight, or the other crew since just before the RPG exploded, and this will be an emotional meeting for her.

Tammy will then return to Walter Reed and I will stay in the Midwest for a Company Commander’s conference. It will be a busy couple of weeks.

Tuesday, August 2, 2005 11:51 AM CDT
Oshkosh, (specifically the Experimental Aircraft Association's annual gathering in that town), was, as usual, a massive display of all things aviation. Tammy and I have gone each year for about 6 years straight, and before that pretty regularly except when the Army, or civilian employers required our presence elsewhere. Tammy was pretty insistent that we sleep on the ground as usual, despite the added challenges this year. The EAA volunteers went out of their way to ensure that we had a campsite close to a handicapped accessible Porto let, and showers.

It was my normal procedure in years past to lead the charge to the flight line early every morning, and walk Tammy's legs off all day. We would stop only briefly to eat, attend an airplane building workshop, or listen to the sage words of Tex Hill, Robert Johnson, Bob Hoover, Chuck Yeager, Francis Gabreski, or the like. Generally, we would get back to the campsite after dark, eat again, and get ready for the next full day of fun. Luckily, I married an Army chick, whose expectations of comfort are low, so we were able to pitch a tent close to the show, and revel in the relative luxury of a campfire, a daily shower, and a futon to sleep on inside the tent. Generally, when Oshkosh rolls around, each of us has just come back from a couple weeks in the field with the Army, so our accommodations at OSH seem like the Taj Mahal.

This year presented some new challenges. We slowed down the pace, bought a new handicapped accessible tent, rented an electric vehicle for Tammy to drive around rather than walk, and tried to target only activities that we really wanted to do.

We have been so caught up in the pace of life recently with me just getting back from Annual Training, and a bunch of other things going on, that we weren’t able to co-ordinate with friends as well as we would have liked. We didn’t manage to hook up with some friends from Illinois that we intended to, though we ran into two Soldiers from Tammy's unit that we didn’t anticipate. These two have been previously mentioned on this blog as, "the Soldier who flew to Germany to be with Tammy", and the father half of one of the father/son teams who deployed with Tammy. (The son was one of the guys in the back of Tammy's Hawk who was also wounded that day). (As usual, we try not to use real names to avoid any unanticipated consequences of posting a friend's name on the public internet, and to protect the guilty.)

We also managed to hook up with the orthopedic surgeon who worked on Tammy's right arm. He told me that, back in the day, he didn’t have the eyesight to go through Army flight training, so he became an orthopedic surgeon to support his flying habit. I am quite thankful he chose that path, the only example I have of his work is a masterpiece. Tammy's quest to return to flight status has relied on Soldiers such as this one. I don’t want to think about what the skills of a civilian surgeon similar to this guy would have cost us. While I know that there are civilian MDs who are mission driven and care deeply for their patients, (I am related to some), I personally draw an extra measure of comfort from the fact that the guy cutting on my wife shares and understands our unique culture, and values.

Tuesday, July 26, 2005 7:26 AM CDT
The flight simulator trip went well despite a system computer crash that disabled some of the functionality of the device. The group was able to look at most of the things that Tammy needed the prosthetist’ and therapist’ help to resolve. All of the physical leg clearance problems were solved through experimentation with seat positioning. Once the aircraft seat was in the optimal place, her right socket was actually lower, which enabled her to grip the cyclic stick firmly with her right hand.

The right leg socket is still not quite the socket it needs to be, but the prosthetist is working on it, and Walter Reed is sending Tammy to Florida to complete the next generation of the “Quad-S” which will incorporate a vacuum fit similar to that which she has enjoyed with the Otto Bock Harmony sockets.

The upper body workouts have really paid off, and Tammy was able to haul herself into the real aircraft cockpit with much less effort. She also had no problem climbing up into the seat of the prosthetist’ SUV which they used for the trip. Both our new friend, the prosthetist, and our ‘old’ friend of many months, the therapist worked an extra long day to travel to Ft. Indian Town Gap with Tammy. They laughed and joked about misrepresenting the trip as arduous so no one would know they had an easy “vacation” day of it, but they still spent a great many hours away from their families on Tammy’s behalf. We have become very aware of every minute we spend apart, and the time we cause others to be apart from their loved ones. A Soldier places the mission first, and accepts the time away. We deeply appreciate the dedication of these civilians.

My wife has signed us up for the New York City Marathon. She will hand bike the course, and I will motivate my buttocks across the 26.2 miles on foot. I had been trying to talk her into the Chicago Marathon, but thought that she was resistant to the idea. I guess I will be stretching out my runs, and possibly jogging beside her on the handbike down Rock Creek Parkway into the center of the city in preparation for the event.

Monday, July 25, 2005 7:28 AM CDT
Tammy goes back to the flight simulator today. She will take her therapist, and prosthetist with her. After today she should have the programming for the C-leg optimized, so the knee action on that leg will be as good as it can get with current technology. The prosthetist will be able to see with his own eyes how the legs must be adjusted to fit past the instrument panel. She also needs a lower profile right leg socket so she can firmly grip the cyclic stick with her right hand.

The therapist will get a first hand look at what activities in the cockpit Tammy needs more strength to accomplish. Essentially, she needs more strength in her right, (shorter), leg to control the aircraft during hydraulic failures, and actuate the brakes when the aircraft is on the ground.

She received the next generation of Harmony socket while I was gone with my Army unit. For about three days she did not have a working right leg prosthetic, but this latest socket fits her leg and gives her an acceptable working solution for the time being.

During my convoy back to Carbondale, IL from Ft. McCoy WI, this past Thursday and Friday, I had a lot of time to think. The only reason that the short, (two week), separation from Tammy was bearable was because I was with my Soldiers. It occured to me that I did not adequately explain the emotional impact of Tammy's trip back to Illinois to visit with her Soldiers. While I feel a very strong bond to my Soldiers, I have never been to combat with them, and that bond has not been strengthened and solidified by exposure to stress. Some of my Soldiers who have deployed talked to me about the people with whom they deployed as "family", others said, "I'd lay down in traffic for those guys". This is the same type of bond that Tammy feels for some of the people with whom she deployed. In both cases, (my wife, and my Soldiers who are veterans of OIF), the bond doesnt seem to necessarily extend to everyone in the Company, or Battalion, but only to a group of people that the individual came to rely upon. It was that group of people that Tammy was most anxious to go visit during our recent trip to Illinois.

Friday, July 22, 2005 3:58 PM CDT
Tammy has been having some expected difficulties with her Harmony sockets. As her limbs continue to change shape, the sockets become looser, and need to be remade. In the past doctors typically waited longer to start fitting patients with prosthetics, and the changes in volume for the limbs were much less of a problem. With this population of patients, and especially my wife, waiting is not an acceptable alternative.

She received another generation of the Harmony socket today, and Walter Reed is working out a trip to Florida in order to fit her with another vacuum type of socket that is the next generation of the "Quad-S". This latest socket is the culmination of our trip to Iowa, and should be a little less complex than the Harmony system.

As always her spirits are high. I did not marry a fragile woman, and in the environment of Walter Reed, she has been able to fare quite well without me for these past two weeks.

At the end of this month we will make the annual pilgrimmage to Oshkosh for the Experimental Aircraft Association air show there. This is an event we have attended each year for the past six years. We will test Tammy's ability to climb into several different types of aircraft, one of which we will probably start building in the near future. Pulling rivets should help to increase her grip strength, and will give her a form of workout that will vary from the monotony of lifting weights daily, and is a little more productive.

Friday, July 15, 2005 11:28 PM CDT
Tammy is working out very hard now. Her grip strength in her weaker right hand has doubled, and her "pinch" strength has tripled in a few short weeks. The therapist are pushing her very hard on a weight training machine called a "Gravitron", which strengthens her Lats and biceps, and gives her the strength she will need to climb on aircraft and overcome hydraulic failures.

She is also walking with one cane and learning how to fall. She tells me that getting back up is a huge effort right now.

I am currently in the field at Ft. McCoy, WI with my Army unit and will only be able to offer the short updates that I am able to get from Tammy over the cell phone. If I climb a 300 foot hill behind my area of operations I am able to get line of sight on a cell phone tower and speak to her, and I do this each night that I am able to steal away for half an hour or so. The Air Force satellite link that I am using to access the web is tenuous, and not really capable of uploading any pictures, so I wont be able to change any of the photos for another week.

This separation is the hardest thing about being a Soldier. The physical challenges really just require effort, and a Soldier just becomes used to more discomfort than you would believe; but being apart hasnt gotten any easier in the 12 years we have been married.

Thursday, July 7, 2005 9:27 PM CDT
Tammy flew the full motion flight simulator this past Tuesday at Fort Indiantown Gap. Even though we are still sorting out the prosthetics for walking, she walked into the building, up two flights of stairs, and hauled herself into the cockpit with relative ease. I thought I would strain my face muscles when the IP told her, “You are cleared up”, and she nonchalantly picked the aircraft up and flew a few traffic patterns.

The simulator did uncover some mechanical difficulties that she will need to work out with the prosthetics. Just sitting in the aircraft out on the tarmac had not revealed that her left leg prosthetic rubs against the lower edge of the instrument panel. Even when she had both legs, the clearance between her shins and the panel was minimal, (we suspect that during the shootdown, the explosion from the RPG actually drove her left leg into the panel, shearing off the shin.) The outside diameter of the left prosthetic socket is larger than her leg, of course, reducing the clearance between her “shin” and the panel to zero. The answer to this difficulty may be to lengthen her lower legs, thus moving the wider part of her legs further away from the panel.

Additionally, Tammy’s right arm will need much more strength, and she will need to work out a method to get her hand fully on the cyclic stick. Previously she flew with her right elbow resting on the inside of her right thigh, and she was able to comfortably reach the stick and manipulate it in all axis and quadrants, for extended periods of time. Now, however, her right leg prosthetic socket is where her right thigh used to be, and it is a different shape than her thigh was. It is difficult for Tammy to press her forearm down on the prosthetic socket far enough to get her hand fully on the stick. It is also more difficult for her to move the stick to the right. The next generation of the Quad-S socket should be softer plastic, and may alleviate this problem, but the Harmony sockets will forever be the current hard carbon fiber. The Harmony has been the first socket so far to develop a vacuum on her leg, and is the best so far for walking, but it may not be the best solution for flying.

I am very confident that with some more tweaking of the prosthetics and a few more months of therapy and trips to the simulator she will be able to easily fly under normal conditions. The standard she will have to meet in the end, however, is to be able to fly during a couple of different types of hydraulic system failure. This will be kind of like driving a large automobile with the power steering and brakes failing, and she will have to generate enough force in her remaining muscles to control the aircraft under those conditions. Luckily, she will not have to deal with something called a “hard over” in the cyclic stick, which she controls with the weaker right arm.

She will also have to be able to exert more force on the right rudder pedal than she can currently produce. This will come into play in the event of a hydraulic failure, and also for actuating the toe brakes when the aircraft is on the ground. The answer for this problem is simply more strength training for her residual right leg.

Tammy does not waver. She continues to address each challenge as it comes up, works on the components of the problem for which solutions are immediately apparent, and waits for solutions to present themselves for those components that have not been resolved. Simply by refusing to quit, and not accepting defeat she has come further in these past eight months than I would have believed was possible.

Tuesday, July 5, 2005 7:37 AM CDT
Tammy had a nice 4th of July weekend. We went to a breakfast up in Frederick, MD which was hosted by some folks from Army Materiel Command, who are working on some specific difficulties that Soldiers will have with prosthetic legs and arms. We made the acquaintance of some of the researchers from Ft. Detrick who are developing specialized equipment for amputee Soldiers, and enjoyed a patriotic program. Later that day we went down to Ft. McNair for a picnic and to watch the fireworks over the mall.

Tammy goes to the flight simulator today for the first time. We have added a second program to her C-leg especially for flying, and today she will test out the parameters of that program and see if it will permit her to manipulate the rudder pedals and fly the aircraft.

I leave in a few days to take my company to Annual Training for two weeks. This will be the longest time that I have been away from Tammy since she was wounded, and I am not looking forward to being apart from her. She is functioning better and better each week, and I believe she will be able to take care of herself with minimal help. I will have emergency numbers programmed into her phone, and the room laid out so she can reach everything she will need. She can shower and cook, and get into the hospital for therapy. If she needs it, she can revert to the powered wheel chair in order to get back and forth to the hospital, which is the longest distance she will have to cover during my absence.

Tuesday, June 28, 2005 8:41 PM CDT
The hospital staff wants us to get out more and start dealing with the conditions that are encountered in the normal world, so we went out and spent a relaxing weekend with some good friends. There is a Korean War veteran double amputee and his wife who are peer visitors and have been monitoring and talking to us since before Tammy was conscious, and of whom we are very fond. They invited us to spend a weekend with them at Lake Anna, in Virginia. Tammy was able to walk down to the dock, take off her legs, and swim in the lake with minimal effort. (We don’t have swim legs yet, and the C-Leg’s computer doesn’t do well under water). She still needs my help to get off the dock and into the water, (Perhaps, to be more accurate, I wanted to be right there in order to help and preclude her getting the idea to just jump).

Swimming is getting easier as her right arm gets stronger, and she got a good workout swimming back and forth between the dock and a small beach. I think she will be able to flutter kick quite well, even with her short right leg, since that requires mostly glutes and hip flexor muscles, and she still has both of those. With swim legs for right and left, she will probably be more mobile in the water than on land. She is already Scuba certified, and I suppose now would be a good time for me to get up to speed with Scuba so we can do that activity together. We are already planning to go snorkeling around her old haunts in Hawaii, during September when we attend a good friend’s wedding there.

After getting out of the water she found that it was not possible to get a good vacuum seal on the new Harmony leg for her right side while her bathing suit was still wet. Upon returning to Walter Reed we found that the Harmony socket had developed a small tear in one part that was allowing air in. In fact, though the Harmony / C-leg combination had been the best leg to walk on so far, after she sits down for a few hours the vacuum seal is lost. This requires her to stand up, and pump on the leg for a few minutes before continuing on. The prosthetist are not sure that the Harmony is the system to use, but I think we can conclude that whatever we wind up with, a vacuum socket of some sort will be part of the optimal solution.

Since our good friend Dennis returned to his long neglected family and practice in Iowa, we have had a succession of prosthetists. Some of these guys seem to not have the necessary interpersonal experience specific to this situation. They will answer a direct question evasively, or with a “pat” or “dumbed down” answer which does not serve to either answer the question, or give confidence in their command of the situation. We have a lot riding on the outcome here, so we’ll keep forging ahead.

Friday, June 24, 2005 2:18 PM CDT
Tammy got her two new Harmony system legs adjusted today. She went for a long walk, about a quarter mile, to test out the right leg and so far so good. Previously her leg would sweat out of the socket attaching it to the prosthetic leg after just a short time. It seems that today even though she was sweating, the Harmony suction system was still able to keep the leg on. This is great. We will see this weekend if she has any difficulties as she moves around for different activities. One of the issues that amputees often develop is increased sweating or ’glistening’ as Tammy calls it. Your body cools itself by sweating through all its pores. When a limb is removed, the pores on that limb are no longer available to help cool the body, consequently, amputees often find that they overheat and sweat more than they used to. Tammy just says that she’s glistening like a pig a lot lately!

Today Walter Reed officially opened its new Fire Arms Training System, (FATS), facility. This is a video weapons firing range. It uses real rifles and pistols equipped with lasers that are shot at a video screen. It’s a fairly sophisticated system and will allow injured Soldiers to continue practicing their marksmanship skills. Tammy tried it out yesterday and did very well. She was pleased to find that she has developed enough strength in her injured arm to hold up both the rifle and pistol to fire. Although she normally qualifies at the expert level she was happy just to get a passing score yesterday. It seems she has to make some more progress with her manual dexterity so she can change the magazine to reload more quickly. Yesterday she kept dropping the magazine and lost a lot of time during reload. She is planning to go back and practice wearing her legs to fire from all the required positions, standing, squatting, and prone.

Wednesday, June 22, 2005 3:18 PM CDT
Tammy had an EMG test on her right arm and hand on Monday morning to determine the condition of her nerves. This is the very painful test that she previously had on her left hand and arm that consists of the doctors sticking needles into her hand and sending electrical impulses through them to note the reaction of her muscles. The nerves are regenerating, but they were unable to get a response from the muscles in her wrist. This doesn’t mean that she won’t get a response, in time, but only that the muscles are extremely weak still.

She was also scheduled for a prosthetics appointment to fit the Otto Bock Harmony sockets for both legs. Unfortunately, no one in prosthetics remembered her appointment, (despite me calling last week to quell their confusion and set up the specific date and time), or had made any progress over the past two weeks to assemble the sockets and legs which we had been promised would be received and assembled so she could take them to Illinois with her. The only guy who is supposed to work on her legs left at lunch on Monday to attend a conference on patient care provided to amputees, and he wouldn’t be in until some indeterminate time on Thursday. Needless to say, we were not happy.

After some diplomatic but pointed discussions, another prosthetist assembled the pieces and parts and fitted them for her today. The results are very impressive and encouraging, and she walked more naturally on the new sockets and legs than ever before. The right socket, (Tammy’s shorter residual limb), pulls a very good vacuum on her leg and is very secure, which was a primary concern of ours. This leg incorporates some offset like the Quad-S socket, and the prosthetist has ordered another part to increase the offset tomorrow. This may or may not be necessary as she becomes more accustomed to walking on the new leg. The left leg Harmony socket is slightly too large. Fortunately, it is very easy to add another layer of “sock” under the Harmony liner and keep her leg from “bottoming out” in the socket. The left socket may actually solve the recent problems she has had with bruising on that leg.

The next generation double wall, Quad-S socket is also in the works, and will probably provide another viable and, possibly, less complex solution. Once again, there are mutiple plausible solutions to the remaining hurdles that lie in Tammy’s path. She continues to get stronger and be more and more mobile every day.

Monday, June 20, 2005 0:13 AM CDT
We have returned to Walter Reed to continue therapy and keep refining Tammy’s prosthetic legs. It is disappointing to leave our home to go back to Fisher House. As beautiful as Fisher House is, it just isn’t home. At Fisher house it is a constant struggle to keep control of the huge amount of stuff each of the families here have packed into their one bedroom. The room is chock full of furniture, wheelchairs, and all manner of gifts sent by well meaning folks. Tammy can barely get in the door at times. Our house in Hoffman Estates is, in contrast, much more relaxing for her.

Walter Reed is, however,the best place to continue her recovery. During our stay in Chicago Tammy’s left leg shrunk enough that it began to “bottom out” in its socket. This bruises the end of her leg, and the best fix will be to get her into a new vacuum socket, which the prosthetist here should have ready for her this morning, (Monday). She is also ready to get back to therapy and continue strengthening her arms and legs.

Tammy visited her workmates at Rotary International before we left Chicago. Imagine my surprise to learn that I am a Tim Tam rustler. Tim Tams are a peculiar chocolate covered, chocolate graham cracker cookie with a chocolate fudge filling, which are made in Australia. Apparently when Tammy deployed, her Australian co-workers had sent a supply of cookies which, Tammy reported to them, had been intercepted and eaten by me. Sounds to me like a plot by the no-legged girl to get more Tim Tams. Apparently, Tammy is a fan of “Tim Tam blasts”, wherein she drinks a cup of coffee using the cookie as a straw. (Note: the best address to send Tim Tams is still c/o Bryan Bowlsbey. Ok, so maybe I sampled a few from the first batch, but purely for quality control purposes.)

She greatly enjoyed seeing her friends at Rotary again, and is eager to progress in therapy and return to work there.

Wednesday, June 15, 2005 11:10 AM CDT
Tammy spent a leisurely summer weekend with me in our house in Hoffman Estates, IL. There have been very few of these weekends in our lives. We are usually doing so much work with our different Army units that we get at most 2 or 3 weekends together each summer. In the past we have always been willing to expend our vacation leave at our civilian jobs in order to go to a second Annual Training period, or an Army school, and just haven’t spent the time together that we should have. From this time forward we resolve to set aside, and protect, at least a two week vacation period together each year.

Now with the house looking as wonderful as it does Tammy really enjoys every day. We set up a hammock on our new back deck, and spend a few daylight hours out there each day. It has been quite restful for her once we got the trip to Iowa done, and got through the initial round of dealing with the media. The house has been very easy for Tammy to navigate in the wheel chair for the last couple of days. The modifications done to the house have already been a blessing.

Tammy was a bit to ambitious during the visit to her unit and actually bruised her left leg by walking a bit too much. I believe that she actually bruises herself by standing up and sitting down. She has to drive herself up with her left leg only, and that forces her left stump into the bottom of the prosthetic leg socket with her entire body weight, plus whatever force she generates with that leg. Doing this repeatedly when getting into and out of the car, or an aircraft, and even sitting down and standing up from chairs, bruises the end of her left leg. The liner and socket for that leg are of the older style mechanical pin and receiver type, and they have worked adequately until now. Generally Tammy has walked for short periods in the hospital environment, and the right leg generally has been the limiting factor and given her problems before the left leg began to hurt. Consequently we have focused on modifying the right leg socket up until this point, but the prosthetists at Walter Reed are working on a Harmony vacuum socket for her left leg as well. I believe that vacuum socket will distribute the force of her standing up across the entire surface area of her left stump and alleviate this problem.

Someone said to me a few weeks ago that they found it remarkable that I didn’t think that Tammy’s belief that she can fly for the United States again is odd. I guess I understand how the general public would come to that idea, after watching movies like The Right Stuff, where one is led to believe that only the most physically perfect specimens can possibly fly, but the idea just doesn’t seem outlandish to me since most of my boyhood heroes flew airplanes during the Second World War with disabilities.

Claire Lee Chenault flew for the Army Air Corps, reformed Nationalist China’s airforce, apparently engaged in undocumented combat against the Japanese, founded the American Volunteer Group, (aka the Flying Tigers), and was inducted back into the US Army Air Corps as a General Officer; all while being as deaf as a doorknob. Sakai Saburo was blinded in one eye, and wounded in his right hand while attacking an American Avenger bomber. He dead reckoned his battered fighter back across thousands of miles of open ocean, found his tiny island base, and landed. After a suitable recovery period he began teaching student pilots, and then returned to combat with one eye. How the man could even land a high performance aircraft without depth perception, I don’t know. Sakai continued to engage American fighters and, occasionally, beat them, despite his disability and the ever increasing technical superiority of American aircraft.

Tammy’s challenges are not as great as if she had the injuries of either of those men. She could not function in the modern airspace environment without being able to hear her radios, or be able to act as member the highly interdependent aircrew without being able to hear and respond to the other crew members. While I have seen Army Aviators fly with “coke bottle bottom” glasses to correct their vision, they always had, and needed both eyes. All nations have been more accepting of pilots with disabilities during times of war. The US is no exception, and we have learned of more, and more cases of amputees and others with disabilities who have continued to hear the call to the colors and fly for the US. Judgement, knowledge and experience play at least as big a part in piloting ability as the physical acts of moving the controls. She still has all of those components as well as all her senses, and I have seen the prosthetic legs that will enable her to move the flight controls. The only remaining problems associated with continuing to fly with her injuries are easy to define; she needs to be able to climb on top of the aircraft for her pre-flight inspection, and she needs to be able to handle a failure of the hydraulic system that powers the flight controls. Both of these tasks require muscle strength in her existing limbs, and she has some top notch therapists who are working with her on these very things.

Saturday, June 11, 2005 5:04 PM CDT
As previously reported we made a trip to see a good friend and prosthetist in Waterloo, IA. It was a three and a half hour drive across the cornfields and through the small towns of the heartland on a pleasant spring day. We crossed the Mississippi river, that mythical artery of the nation, at Dubuque. Somehow it is very reassuring to see “Old Man River” still rolling along. The Mississippi lends perspective and shows us that the events that shape our lives, and seem so momentous to us personally are just simply insignificant in the grand scheme of things.

The many small towns along the way still had all of their flags and bunting out for the recent memorial day holiday. Thankfully the American way of life is alive and well in rural America despite those who would threaten it. May it always be so.

The advantage of actually going to the manufacturing site like we have done this past week is simple: the prosthetist is able to produce and modify, refit, test run, and produce and modify sockets repeatedly until he shapes a piece of plastic that exactly conforms to Tammy’s residual limb allowing for a good vacuum seal, while allowing her the range of motion she needs. She can put on a test socket, walk around, sit down, stand up, and then give the prosthetist the feedback he needs to modify the piece while she waits. Sometimes you may have a socket that provides for a good vacuum seal on her leg, but has a shape to it that is uncomfortable to sit in. The prosthetist can rectify any problems like that immediately. It can be a source of great frustration for Tammy to wait even a few weeks for even a small change to be made. We probably jumped two versions ahead in the Quad-S socket by making a run out to Waterloo.

Being male I found the manufacturing process interesting. The prosthetist first takes a picture of Tammy’s limb with a special “ring camera” device, which allows the computer to construct a three dimensional model of the limb. A CNC* machine then shapes a piece of plaster into nearly the exact shape of the limb. The technicians then place the plaster in a vacuum forming device. They heat up a sheet of plastic in a large oven, and then stretch the melting plastic over the plaster model while applying a vacuum to “suck” the plastic down to the contours of the plaster. The result is a very close fitting socket which they can then fit to her leg. Of course the leg changes shape slightly as Tammy walks and the various muscles flex, so during this fitting they mark any areas which may need to be taken in, or “relieved” to allow her to move, and still maintain suction. If need be, they can modify the plaster model, and vacuum form another socket very quickly.

Another unanticipated but happy result of the trip to Waterloo is the discovery that International House of Pancakes there has not removed boysenberry syrup from their tables, as have the criminal IHOPs on the east coast. Boysenberry is uniquely American and delicious. To celebrate I had an order of pancakes, with a side of pancakes, (and it was worth every step of the extra five miles I ran the next day).

*Computer Numeric Controlled machine – a programmable computer controlled automatic milling machine.

Thursday, June 9, 2005 7:19 PM CDT
Our first couple of days back in Illinois were spent apart; each of us with our respective Army unit. My unit is far to the south, (about 5 hours by car), in Carbondale, IL, and I was not able to accompany Tammy as she met up with her unit again. I was certain that she was in good hands, however. She went on Saturday to the welcome home ceremony for the Headquarters and Headquarters Company, (HHC), of the 1-106th Aviation Battalion of which she was a part while stationed in Iraq. A unit member that lives near us picked her up and took her to Chicago Midway to board a Blackhawk, (as a passenger), with Brigadier General Fleming and fly to Peoria, the Battalion Headquarters. This was her first time flying in a ‘Hawk since she had been shot down, and she regretted not being able to fly it down there herself yet.

While at Peoria, Tammy was able to reconnect with a member of her aircrew on the day she was shot down. He is the second generation of his family with which Tammy has had the pleasure of serving. This young Soldier was returned to duty with a bullet in his butt, (where the surgeons have decided to leave it), a Purple Heart, and the ability to offer to show an unsuspecting audience where he was wounded. Me thinks the boy should make a fine Army Aviator.

After some accommodations, Tammy was able to stand in formation with the company. This is a seemingly simple ritual which we both took for granted before, but which, in the face of not being able do it ever again, has become deeply meaningful to her. As she continues to gain strength and become steadier on her legs, she will be able to fall in with the unit like every other Soldier.

Previous to her assignment with HHC, she commanded B Company of that same Battalion for the lengthy time of three years. On Sunday Soldiers of B Co. picked her up from our house and took her to Midway where B Company resides, for that unit’s welcome home. It was heartwarming for her to see all of the unit members, retirees, and spouses. Despite the fact she is currently assigned to the Joint Staff at the State Headquarters, (and no longer assigned to B Co.), the current commander invited her to sit with the unit during the ceremony with the comment “Once a Mad Dog, always a Mad Dog”. Whatever assignments or commands lie in her future, I believe nothing will ever replace the fondness with which she remembers her time at B Co.

Tuesday, June 7, 2005 6:25 AM CDT
We have traveled back to Illinois so that both of us could attend drill weekends with our respective units, see our completely refurbished house, and work with a prosthetist in Iowa. The TSA crew met us at the plane at Chicago Midway, and escorted us through the airport, to claim our baggage and out to the rental car. These folks really go out of their way to help wounded veterans in any way they can.

Our 1970s vintage house has been completely refurbished. Old “Guys” Construction Co. has done a beautiful job. The kitchen was completely gutted, down to the floor joists and redone with new cabinets, sink, and counter tops. The bathrooms have been completely redone; the walls throughout the house have been moved to allow for wider hallways and larger turning radii around each corner. All of the closets and bathrooms are wheelchair accessible. All of the carpets have been replaced with materials that will be easier to roll over with a wheel chair, and the wooden floors have been replaced, and refinished. There are no longer any thresholds between rooms which would impede a wheel chair, and two new french doors have been added to ease exterior access. A new deck was built on the back of the house overlooking a small lake. All of the walls have been repainted and all of the trim replaced. We are the proud owners of a whirl pool tub, which is fed by a new water heater. The place looks incredible, and I am having a difficult time taking pictures that do it justice.

Tammy has been spending the better part of the day, every day, perambulatin’ ‘round on her legs, (as opposed to using the wheel chair). She walked on her own feet to go visit her unit at their welcome home ceremony on Saturday. She got a ride in a Blackhawk from Chicago down to Peoria for the event, (first time flying in a ‘hawk since she was shot down). She also walked on her own during a visit to her old unit this past Sunday. We packed her wheel chair in the car yesterday morning for a visit to a prosthetist and friend in Waterloo, IA, but she walked into the office on her own, and continued to walk for the rest of the evening; going out to dinner and shopping later on. She is pushing herself hard to adapt to wearing the prosthetic legs as much as possible and continues to gain strength every day.

Tammy is deeply humbled by everything that her friends have done for her. We always say that the members of a unit are a “family” but our house now provides a graphic, and tangible depiction of this idea. We would like to thank everyone who donated money and time toward the effort to rebuild our house. Though Tammy was initially were very embarrassed about allowing people to donate money and effort to benefit us; this effort will make her life immeasurably easier in the years to come.

Despite the joy of being home and getting to see all of her comrades and friends there is still a small hole in Tammy's heart. She misses her friend SFC Bill Chaney who passed away during the deployment. The celebration couldnt be entirely complete without him, and he is sorely missed. Godspeed Bill.

This is a good newspaper article with some pictures of our arrival at the house.

There is another great article by Mary Ann Fergus about the homecoming on the Chicago Tribune web page, (www.chicagotribune.com) you can go to that website and search for "Duckworth". I can link to their content directly but if I do that the Tribune web page would require you "log in" by giving your email address and some demographic info, and I dont want to assist any marketing guys in their efforts to spam my friends.

This is a music video showing the lighter side of duty in Iraq courteousy of the Royal Dragoon Guards. Comrades become family by sweating together, bleeding together, and very often being really goofy together. We love the Brits.

Monday, May 30, 2005 10:57 PM CDT
Tammy has been spending as much time with her legs on as possible. She has pretty much abandoned the electric wheelchair in favor of the manual one, and even started to abandon the manual chair in favor of wearing her legs for as many activities as possible. She still begins to sweat out of the right leg socket after an hour and a half of straight exercise, or several hours of light activity. She is walking with crutches that loop over her forearms for the time being, but she may soon go to two standard canes. She is able to walk to, and get into and out of, the car with minimal assistance.

The major issues before her still are trying to get a practical and comfortable socket for her right leg. We are working with the prosthetists here at Walter Reed, and will be very insistent that they continue to refine the fit of both the Harmony Socket, and the Quad S. Alignment on the Harmony is still a major issue, and we will press the prosthetist for a plan of action tomorrow.

We attended a small gathering this weekend with some new Army friends, and used the occasion as a “legs only” test run. I stashed the manual wheel chair in the trunk, just in case, but Tammy negotiated a few stairs and slightly uneven terrain very well. Walking on the prosthetics in the real world is a bit different than walking in the hospital. There are different surface textures, and uneven flooring, and Tammy is learning how to “load the toe” and make the computer controlled right knee work under all conditions.

Today, Memorial Day, we went down to Tammy’s father’s gravesite in Arlington. The cemetery workers have not finished laying sod around the grave yet, but Tammy was able to dismount from the car and walk up the muddy, gravel strewn embankment to see her dad’s headstone. Her father had wanted to live long enough to see her walk again. There were three small stones placed on top of the headstone, as is the custom when someone visits a grave there. Several Soldiers from Tammy’s unit have stopped by to visit there during their visit to see her here in DC.

Thursday, May 26, 2005 12:59 AM CDT
Tammy received the new Otto Bock Harmony socket, and it stays on her leg quite well even without belts. The suction pump in the socket pulls a vacuum on her leg, and it is quite secure. However, while the socket offers the best level of retention she has had to date, she looks a little ungainly walking on it. This socket has not had the months of refinement that the Quad-S socket has gone through, and as a result her gait is not nearly as smooth with it as it is with the Quad-S. We hope that with continual tweaking over the couple months she will be able to have all of the best features of both sockets in one.

We will then have a good basis for setting up a low tech mechanical leg with no computers which will not require batteries, or electrical power, and which will be usable in wet weather. Tammy will need a leg like that in order to be retained in the Army. The design of mechanical knees has come a long way, and the Soldiers who I see walking around on them do nearly as well as they do with their computer legs. Their gait is not as smooth, and they seem to "limp" a bit, but they are able to walk functionally, and, in some cases run.

Both of Tammy's legs now have 'pivot plates', (my term here), incorporated into the leg so she can hit a release and turn each foot sideways, or completely backwards for that matter. These should prove quite useful in allowing her to get into and out of the cockpit. She has taken to sitting down and pivoting her right leg at the knee until the sole of her shoe is facing upward. She then rests a drink on it. Too bad she cant drink alcohol, I'm sure that would be a good bar trick.

In addition, the prosthetist have taken off her training feet and gone to higher tech feet on both sides which will provide some spring and allow her to preserve her energy and walk farther.

Her outlook hasn’t wavered since she woke up those many months ago in the ICU. However young and dumb I might have been 12 years ago, I clearly made the right choice and married well.

Tuesday, May 24, 2005 7:12 AM CDT
Long time between updates. We have been very busy. I am in the usual 'ramp up to Annual Training' period of the year, and have had some additional training requirements to fulfill. My military duties have taken me away most weekends for the last couple of months. Tammy has appeared before a house commitee on Veterans affairs, attended a bunch of promotions and retirements and been working her butt off at therapy.

The current plan is for Tammy to travel with me to IL on 03 JUN, in order to see the house, and meet up with her Battalion during their drill weekend. That is also my drill weekend, so we are working out the details of how she will get around. We hope to get Tammy back out to the aircraft to work out some difficulties with the prosthetics and capture some programming parameters for the computerized leg after she gets back from IL.

It looks like the prosthetists here at Walter Reed, (as opposed to the factory guys), are going to be working on her newer Harmony socket for her right leg this week. They may not be the technical experts the factory guys are, but I feel much better about that since we can have a little more assurance that progress is actually being made on a day to day basis. I know that I can hunt them down and show them my smiling face every day until someone decides the only way to get rid of me is get Tammy's prosthetic working in a practical manner.

The Quad-S socket continues to work well for period of an hour and a half, or so. I have never seen her walk as well on any other system. The improvement in her posture and gait are dramatic each time I return from a three day session with the Army. If we could get this socket to stay on her leg for 12 or 14 hours without sweating off it would be nearly optimal.

The therapists are still working on her arm strength, but they think it is going to take a quite a while to get her upper body ready to climb on top of the helicopter for pre-flight.

Wednesday, May 18, 2005 4:52 PM CDT
Tammy is making progress by walking with canes more frequently. With each new assistive device that Tammy learns to use for walking her body weight and alignment shift slightly and she must adapt to the way in which she “loads the toe” and makes the leg work for her. The measure of her progress is her therapists increasing confidence in her ability to walk by herself with less stable devices.

Shrapnel continues to work its way out of her skin. Her body is slowly expelling chunks of metal in her arms. Her skin will bulge slightly around a small hunk of metal before it actually breaks through the skin and she can get rid of it.

The latest Quad-S socket incorporates an offset to the side and rear, (see the picture above). It is the easiest socket for walking that Tammy has yet used, due to more natural alignment of the prosthetic leg. The vacuum system in the right Quad-S socket still doesn’t work, so the socket still gets sweaty and begins to slip off after an hour or so of steady walking. This socket continues to demonstrate the most usefulness. Tammy may choose to try to use Botox to suppress her sweat glands in her right residual limb to aid with this socket.

We still await Otto-Bock’s Harmony socket. I hope that we can get some type of Harmony double wall socket which incorporates the shape of the current Quad-S, and the Harmony pump. Getting these guys to make adjustments and follow through is like pulling teeth, and I have begun to wonder if they are still committed to the effort, though Tammy is demonstrating the patience of a saint. They are not very forthcoming with any type of plan of action to resolve the remaining problems. We have to play twenty questions with them each time we see them in order to keep the effort active. They are very anxious to conclude each time that “we are making progress”, yet over the course of some 10 weeks we have yet to see a Harmony socket that will stay on her leg for a practical period of time. So far we have followed the “win more flies with sugar, than with vinegar” approach, but the Soldier within increasingly counsels to identify a specific target that is the cause of most of the problem, and call for fire. No doubt that would allow us to vent a great deal of our frustrations, but our primary concern is to secure the resources which will enable Tammy to continue the mission. Going negative before it is necessary may actually cause people to lock their heels and be less helpful than they can be. We have not quite concluded that such an action would get her a practical and functional leg more quickly.

Thursday, May 12, 2005 9:26 AM CDT
There was a good article in the Thursday, (12 May), Chicago Tribune in the Tempo section. We feel we know the author, and believe she wrote a pretty good article, though it does make me wince a little when she says Tammy is 'counting on the Army to deny her' to stay in initially.

As it did with racial integration in the late 1940s, the Army is leading the American public in the integration of the "handicapped" into the workforce. (Dont quite have my arms around the word "handicapped" yet. "Disabled" is right out.) Of course she will have to prove that she can still accomplish the mission. It is a mission focused organization, but one in which not leaving a fallen comrade is valued.

The article also refers to the Pilot in Command as Tammy's "co-pilot", which is a minor thing and only slightly frustrating. I believe that is a case of the general public not attaching the specific meanings to those titles that pilots and military folks do. Since becoming aware that even well intentioned people have a tendency to mythologize and build her into some sort of romantic hero, Tammy has become hyper sensitive to even slight inaccuracies regarding the shootdown.

We have spent some time this week with the prosthetists revising a brand new Quad-S socket for her right leg. They have been able to offset the leg attachment slightly to the outside, and it has had a very positive effect on Tammy's gait. By Monday they will have a new version of the Quad-S socket with both the sideways offset, and a rearward offset which will align the prosthetic leg even better. The newest socket fits better than all the previous versions, but we still cant achieve any vacuum on the right side. Hopefully the socket due in Monday will allow for a good seal. This is important because the current legs "sweat off" after about an hour. The vacuum will help resolve that difficulty.

Otto Bock is revising her right leg Harmony socket in Minneapolis still. It should be in early next week also, though apparently the Otto Bock company reps are so confident that this revision will be the cure all that they will not be coming out with it. I wish I could share their confidence, but I havent seen their socket really work for more than a few steps yet.

Tammy goes to speak before the House Veteran's Affairs Commitee on Thursday, (19 May). Much of her statement will be similar to the one she presented before the Senate committee, though we have now had some time to refine the message. We will post her statement toward the end of a future journal so that those who are interested have access, but other readers can get the current update first without having to dig through 4 pages of text.

Monday, May 9, 2005 9:52 AM CDT
A quick rundown of the events of the past week:

We left Wednesday to go with a group of about 10 wounded Soldiers and spouses to New York to support an auction for the benefit of the Fisher House Foundation, and the Intrepid Fallen Heroes Fund. We flew up, so we learned that getting through security with metal legs and shrapnel embedded in the body is pretty easy when you call ahead and let the Transportation Security Administration, (TSA), folks know that you are coming. TSA people met us at both airports and were very helpful, as were the airlines. This is good to know, since we eagerly anticipate being able to take at least a short trip back to Illinois in the near future.

We also learned a lot about transferring into an out of various vans and busses with the prosthetic legs on, and a lot about just plain walking in the real world outside of the hospital environment. Walking is still a shaky affair for Tammy. We see the bright beam of light at the end of the tunnel, but it will be slow plodding progress for some time, before we get there. Just putting on the legs in the real world environment is different, and the real world practice was quite helpful.

The itinerary for the trip was jam packed. While Tammy’s real mission and reason for taking the time off from PT and OT was to support the Fisher House Foundation, the folks from the foundation went to great lengths to come up with other interesting activities to fill the time while we were there. The first evening they took us to the play Julius Caesar starring Denzel Washington, and arranged for Denzel to come speak with our group and sign some autographs. Mr. Washington recently donated some $1.4 million to build another Fisher House.

The next morning we went to the Today Show to see Neil Diamond play, and had seats right next to the stage. (Before they deployed we went to a Neil Diamond concert in Chicago with another officer in Tammy’s Battalion.) At one point the cameras started to pan toward us while Neil was singing “...every time that flag’s unfurled, they’re coming to America”, which for me is very powerful imagery. I thought, “Great, I’m going to lose my composure on national television”. I managed to keep it together, however.

We spent the remainder of that day touring the USS Intrepid, an aircraft carrier that served for the thirty years encompassing the Second World War, Korea and Vietnam. Intrepid is now a museum, and houses a pretty fair collection of aircraft and other artifacts. We also met up again with the guys from OCC who were the major contributors of items to the auction.

The next day we spent touring New York City on a bus. We stopped for lunch at Tavern on the Green, and went back to Intrepid for the charity auction that was the reason for the entire trip. Tammy really enjoyed spending a little time with Paul, Paulie, and Mikey Tuttle of OCC, as well as Steven Tyler, (lead singer for the band Aerosmith). Aerosmith pretty much wrote the soundtrack of our lives from the time we could drive to the present. Mr. Tyler donated a guitar to the auction signed by the entire band, and the Tuttles, and spoke to us at length.

Today brings a change of mission as we return to the business of recovery. I packed Tammy up, and sent her off “to school” (as she calls it), in the manual, (or haole boy powered), wheel chair. We will be using the electric chair less and less in order to build up Tammy’s arm strength. She will need a lot of strength in order to enable her to pre-flight the helicopter. Of course, in those areas where there are no steep hills, we will have to make as light use of the “haole boy” power as possible, and let her wheel herself around.

Tuesday, May 3, 2005 7:23 PM CDT
We went out to the flight line at Ft. Belvoir today to work with a Blackhawk on techniques that Tammy can use to conduct preflight inspections on the aircraft, and determine if she would be able to manipulate the flight controls with her prosthetics and injured right arm. Despite the progress Tammy has been making, she was concerned that she might have some difficulties with the flight controls. However, once she climbed into the aircraft, (not the easy task it once was), she demonstrated that she could indeed operate all of the hand and foot controls to include the toe brakes. You could see the apprehension lift from her as she realized that she would physically be able to fly the aircraft, and flashed us an ear to ear grin.

She must also be able to climb on top of the helicopter and examine the rotorhead as part of her preflight. This task is currently a little beyond her reach as simply climbing into the pilot seats was very taxing. She will need to develop new techniques for getting into, and on top of the helicopter which use only her left leg’s power, and her arms. She will have to strengthen her arm, shoulder and left leg muscles which have atrophied over the past five months, and in fact will probably need more strength in her remaining muscles than she had before.

It is a testament to Walter Reed that the head of the Occupational Therapy department, a Colonel, went out to the flight line with us. He climbed up on tail of the aircraft to see for himself and when he came down he said to me, “This isn’t going to be easy, we are gonna’ have to kick her @$$.” By “we” it was clear to me that he meant to be personally involved in devising a challenging program for Tammy to follow, and supervising its execution.

Tammy’s physical therapist also went with us and showed absolutely no hesitation about climbing on top of the aircraft to determine what type of therapy and training would best enable Tammy to do the same. Tammy’s one goal for today was to be able to climb back into the cockpit, and this wonderful lady, (the therapist), figured it out on the spot. She then put Tammy to work climbing into each side of the aircraft.

As I write this Tammy is racked out beside me on the bed, exhausted from a long day. We had another small victory today; transferring into and out of the car with the prosthetic legs, (as opposed to the wheelchair). We also spent the early morning in the prosthetics lab helping Otto Bock revise her right leg Harmony socket, and the late afternoon back in the prosthetics lab making further revisions on the Super Secret Socket System, (aka the S⁴, or Quad-S socket). Neither socket is optimized yet, but both will probably be functional legs in the future. The Quad-S will probably be the first one to be completely optimized and provide a leg which is passably usable for day to day activities.

Monday, May 2, 2005 7:58 PM CDT
We spent most of the day speaking to the orthopedic doctors and getting a new X-ray of Tammy's arm. Her Ulna bone which was showing no significant bone growth has begun to heal. 6 weeks ago there were huge gaps between the many separate pieces of bone which were held together by metal plates. Now, the X-ray shows bone growth in all the areas that it should. The bone is not healed yet, but the Doc has cleared her to bear some weight on the arm. Her range of motion is getting better in the right arm also.

Tammy taped a short presentation for LTG Schultze to incorporate into a speech at the Army Aviation Association of America convention. Tammy considered it a great honor to talk about the Soldier's Creed, and was delighted to have the opportunity to comment on the effectiveness of her body armor, and her Aviation Life Support Equipment both of which played important part in her survival.

This link tells about the mission for which Mr. Novosel was awarded the Medal of honor and will explain a small part of why Tammy found him to be a fascinating guy.

Friday, April 29, 2005 10:15 PM CDT
Tammy went to a farewell luncheon for Assistant Sec Def Wolfowitz on Friday. Since I have to be away for the Army this weekend, and she wants to be as self sufficient as possible right now, I set her up so that everything she needed was within close reach, her uniforms prepped and the bathroom configured for her to shower and use the other facilities, delayed until the last possible moment, and drove to the airport. She is a hardy woman, and we keep her cell phone charged and on her person for emergencies, and my family is close by and would drop whatever they where doing and run to help her if needed, but it bothers me to leave her. Tammy seems to need to fend for herself a little bit, it’s just in her nature. It also helps to better define the areas where she actually, physically needs my help, and those activities of daily life where we need to engage the occupational therapist and develop strategies and techniques that will enable her to be as self sufficient as she wants to be.

We have seen a pretty good cross section of the available prosthetics and socket systems currently available, and I am increasingly confident that we will find the leg, socket and prosthetist that will enable Tammy to continue to serve, and to fly. I am not sure which combination of these things will be the right solution, but she and the technicians will just keep adjusting and tweeking and re-fitting until they get her up to speed.

The Harmony socket is working, though it concerned me that it fell off after her very first step, and again on the second attempt, after two steps. The Otto Bock company guys continue to work on it, and it does stay on her leg for most activites now. The Harmony relies on the vacuum developed by its integral pump to keep the socket on her residual leg. There is no mechanical pin to engage, and on Tammy’s current Harmony socket, there is no belt that loops over her opposite hip to hold it on should the vacuum seal break. I suppose the lack of any other retention method is an indication of Otto Bock’s faith in the vacuum mechanism. I am, as yet, unsure that the Harmony will provide 100 percent retention reliability at all times. That kind of reliability is pretty important when you are driving a 20,000 lb. helicopter 50 feet above the ground at 120 kts, (aprox. 138 mph). Having the leg you depend on to step on the rudder pedal just fall off would be bad.

The vacuum pump itself is located where her femur used to be, and when she places her weight on the socket with each step, the pump sort of acts like a shock absorber on your car and collapses about one quarter of an inch. The pump is not meant to cushion her step, but rather as the air is “squished” out of it, it uses that action to “suck” air of the the socket and make the socket cling to her residual leg. This is great for walking, but flying will involve sitting for several hours, and no matter how good a seal she is able to attain with the socket, air will seep in over time. She may need to carry a small hand pump in the calf pocket of her flight suit with which to add to the vacuum at each fuel stop.

Thursday, April 28, 2005 9:28 AM CDT
Well, we got our fill of attention from Otto Bock yesterday. Tammy worked with those guys for 5 hours to get the Harmony socket up to speed. Her left leg became sore and swollen from having to stand on it so long while they worked on the right. There is a lot of promise, but this is a complex socket system. She will have to work with it a while, and continue to get slight tweeks from the technicians in the quest to make it secure on her leg.

Tammy is generally not in favor of any venue that differentiates between Soldiers on the basis of gender. That being said: USA Today did a reasonably good job of reporting the facts in this flash presentation and article on Tammy and two other female Soldiers. The article however, has a bit of a slant to it, and it seems to concentrate on some odd civilian pre-occupation with women in combat. (In my opinion; a nation that relies on an all volunteer Armed Force can ill afford to look askance at half of the potential volunteers because of their gender. This issue was decided thirty years ago, it is time to get over it and get on with the mission.) The article also seems to be critical of the Army for offering too much equal opportunity, which is baffling to me. You can read the full text at this link: USA Today article

I have made a grievous mistake in stating previously that the Black Knight on Tammy's T-shirt was from Monty Pyton's, "Life of Bryan". Several Python enthusiasts have quickly informed me that I mispelled "Brian", and the Black Knight was actually from a different movie, namely, "The Holy Grail". I dont know what I was thinking.

Wednesday, April 27, 2005 10:03 AM CDT
The guys from Orange County Choppers, (from the TV show “American Chopper”), have fabricated a custom motorcycle for the Fisher House Foundation, the charitable organization that built and runs the house where we live, and many others like it at US military hospitals all across the states and overseas. The bike will be auctioned off next week in New York, and the foundation has asked Tammy to go up for the event. It is a good cause, and Tammy is a big fan of the TV show, so she will enjoy meeting those folks again and getting away from the hospital for a bit.

Tammy will get to meet the legendary Army Aviator Mike Novocell, (Medal of Honor Recipient), and JT Travers this weekend. Mr. Novocell was flying a Dustoff, (meaning Medevac), mission during the action for which he received the Medal of Honor. You can imagine that has some special meaning for Tammy.

Monday, April 25, 2005 8:48 AM CDT
Tammy continues to walk, at therapy, and back at the Fisher House with me. She would like to walk with crutches, or canes all the time as she can stand more upright with them and her gait is more natural. However, that method is a little less stable than walking with the walker. Ultimately, she will be able to walk with no support of any kind and a fairly natural gait.

Tammy's endurance is getting better, and a short term goal of her's is to abandon the wheel chair once she gets to the hospital each morning, and walk to her various appointments at PT, OT, the pharmacy, lunch and the other clinics.

She will talk to the Physical Therapist this week, and see if we can find methods for Tammy to get into and out of the passenger seat of the car with the prosthetic legs on. Currently she transfers from the wheel chair to the car, and is tied to the wheel chair when we are out anywhere.

Next week we will be working on the physical requirements of pre-flighting a Blackhawk. The therapist will be able tailor her therapy to strengthen the muscles she needs to climb on top of the aircraft and examine the rotorhead. We believe that pre-flighting may be more difficult for her than flying. For both tasks, however, we have located some bi-lateral amputees who do very similar things, and we will be able to get a lot of pointers from those folks. Keep the faith.

Wednesday, April 20, 2005 8:27 PM CDT
We attended a Press Club luncheon today with Secretary Nicholson of the Veterans Administration. It was a wonderful occasion, and was televised.

This latest event, along with the media attention that Tammy has received from her testimony to the Senate VA committee has made us realize that people often make simple mistakes when reporting or recounting events. Typically, these are subtle mistakes made by people who are not familiar with aviation. Additionally, there are some, with the best of intentions, who would like to make Tammy's role more heroic than it was. She is deeply troubled that people may under apreciate her comrades' truly heroic efforts on that day. It is important to both of us to reiterate these points:

1. The pilot in command of Tammy's aircraft landed the aircraft after it was hit with the RPG. This gentleman is a good friend and we are forever grateful to him for his actions and leadership that saved Tammy's life.

2. The crew and passenger of the chalk two aircraft were pivotal in calling for support and for getting everyone from Tammy's aircraft into theirs and onto Taji.

3. We are sure that the two B CO aircraft that flew cover were a significant factor in keeping the insurgents away, allowing the rescue to be successful.

4. While Tammy remembers trying with everything in her power to land the aircraft, she was operating on instinct and training. She did not land the aircraft. It is likely that the aircraft controls on her side were so severly damaged that she was probably making no significant flight inputs. We are sufficiently proud of her instinct to get on the controls and land and do not feel the need to make her role any more than what it was, a pilot disabled by enemy fire.

5. What we are most proud of is the professionalism of all involved, acting as a team with no hesitation. The quick reaction of her crew, chalk 2, and the cover aircraft are what kept Tammy alive until she could receive the medical care that she needed so desperately.

On a personal note: Tammy has nearly forgiven me for asking my cousin the Pediatrician to look after her while I went back for drill this past weekend. She loves my cousin to death, but had some suspicions that I might be making some subtle insult by implying that a Pediatrician may be exactly the right type of MD to take care of an Army Aviator. I am certain that I dont know what she means.

Tuesday, April 19, 2005 8:12 AM CDT
The socket and liner fit have been adequate to allow Tammy to walk twice a day, and she has begun to have pain from muscle fatigue. That is a good pain.

Her longer left leg continues to change shape and shrink, so the liner and socket which fit so well last week are beginning to get loose on that leg. She may be able to wear a "sock", (an inner liner), inside the Super Secret Socket System. Incidentally we have created two codemane acronyms for the Super Secret Socket System, the liner/socket system which we are not allowed to name yet; S4, or Quad-S. I am leaning toward Quad-S. (Yes, I know I should find a twelve step program to help me with my worsening Army-geekitude).

There are updated versions of both left and right Quad-S liners on the way, and of course, the Otto Bock socket and Harmony pump for her right leg is still due in. The volume change on her left leg which has given her difficulty this week is the very type of thing for which the Harmony setup is designed.

A little of the morbid humor to which Tammy and the other amputees cheerily subscribe:

Tammy has a pink girly looking T shirt which says, "Dude, where's my leg?"

Another of her T shirts features the Black Knight from Monty Python's Life of Bryan after King Arthur has cut off both of his legs and both of his arms in a fight. He is saying, "It's just a flesh wound. Come back here, I'll bite your knee caps!!"

Another popular T shirt, especially amongst the Special Forces amputees who have lost a leg, says "One foot in the grave."

Overheard an amputee at a particularly frustrating civilian bureaucrat's desk in the hospital as he was saying, "Dont make me take off my leg and beat you with it."

Overheard at Physical Therapy; "If you are more concerned about losing your favorite Tattoo than the limb on which it was drawn.....Ya' might be a redneck" Somebody tell Jeff Foxworthy.

Thursday, April 14, 2005 1:28 PM CDT
Long time since the last update, but there havent been any large changes.

The socket saga continues. Otto Bock representatives were here Monday with a Harmony vacuum pump and socket system. Their system consists of an inner hard plastic or carbon fiber socket that fits over the residual limb, and an outer socket that attaches to the leg. The Harmony pump pulls a vacuum between her residual limb and the inner socket, and every time she rests her weight on that leg it will actuate the pump and pull more vacuum on the leg. Of course, since they cast her leg 7 weeks ago it has changed shape and the inner socket no longer fits. They claim they will revise the socket and be back again in "maybe two weeks". Last time two weeks turned into seven weeks, so we will see.

The other socket system which she has actually been able to use, (hereafter known as the "Super Secret socket system"), is working OK, and she has been able to walk outside the building with it. The pins engage in both prosthetic legs, but the shorter right leg still becomes loose after she walks for about a half hour, and the sweat builds up on that leg. There are a few more tweeks the prosthetists can try to optimize the right leg "Super Secret" liner and socket. The left leg "Super Secret system" is sweet. It is already dialed in very well and is very close to being as good as a socket and liner can currently be.

Thursday, April 7, 2005 1:03 PM CDT
We have had a busy few days. Tammy went out to visit a USAF Helicopter squadron at Andrews AFB Tuesday morning. They were flying Hueys, (November models), and the whop-whop of the familiar and beloved old aircraft did her heart good. Later that evening we attended a formal thrown by the USO. Tammy and one patient from each of the other branches, where asked by the USO to represent their respective branch at a ceremony for Walter Reed and Bethesda Naval Hospital.

Tammy looked pretty good in her blues, but unfortunately, "Ladies' Hairstylist", is a job function for which I have no apparent talent. Poor girl must endure with the only hairstyle I can manage; hair pulled back in a Pony Tail and folded over with rubber bands. Thankfully her hair is now long enough that I can manage that. For the past month or so it has been just long enough to threaten to make her "out of uniform", but not quite long enough that my big male fingers where able to put it up for her. We can usually get some help from the female Occupational Therapists or Physical Therapists, but as soon as she plops down on the matt to work out, her hair falls out again. We have also been taking some liberties with the IPFU uniform that she wears to PT each day. She has difficulty fitting her prosthetics with the standard PT shorts, and we have substituted some black "Walter Reed" shorts of a different material, and with no inner liner. A lady stopped in from the Red Cross who may be able to help us modify a few pairs of standard shorts to fit better with the prosthetic legs.

She walked on the new liners, and two brand new sockets today. While the suction valves on these new sockets are not working completely yet, the pins on each liner are now engaging in the sockets, and her legs are very secure. The prosthetists will get the suction on these sockets working for an even better fit.

Tammy will go for a test walk on the high tech Otto Bock sockets and liners on Monday. These may be even better than this last new set. I believe the biggest issues before her now are getting her right arm healed, and strengthening and conditioning her glutes and hip flexors so she can walk longer distances.

Tuesday, April 5, 2005 7:38 AM CDT
Tammy had a great day. She was fitted with prototype custom liners for both legs. It is kind of a cloak and dagger deal since the liners are a proprietary design and we are not supposed to show them off for now. I will publish some photos of them in a couple months when the company that made them finishes the marketing package for them and makes them available to the general public. These liners are not very “high tech”, but they use an innovative new method to seal the liner to the socket, and keep both on the leg. Her initial test run on the new liners was very successful. Each liner has a metal pin at its base which is intended to fit into a receiver in the socket and hold the prosthetic leg onto Tammy’s residual limb. For the past six weeks she has had a terrible time getting this pin to engage in her right socket. She has been walking with only straps around her waist holding the leg on. Needless to say, this is not an optimal fit, and we have had to re-adjust the straps every few steps.

Today, both liners fit her limbs precisely, allowed both pins to engage in the sockets, and took about 100 lbs. of force to pull them off her legs. These results are with the old sub-optimal sockets. The liners alone are a breakthrough; probably half of the battle. The prosthetists here are working on a new low tech plastic socket for use with these liners. They made a new cast over the new liners today, so the socket will fit precisely over the liners. Between the combination of new liner and new custom socket, I think we will have at least one viable solution for walking/flying and most of the other aspects of life on dry land. (We haven’t begun to talk swim legs yet, but we will).

The OttoBock high tech sockets are also still due in, and will have their own high tech liners and may represent another viable solution. Either way, we are increasingly confident that Tammy will be able to transition to the prosthetic legs as her primary means of locomotion in the next few months.

Tammy and I were enjoying some sandwiches outside the hospital by the post flag pole when a Sergeant First Class who had been the Non Commissioned Officer In Charge of the emergency room in Baghdad when she was brought in recognized her. He had actually been there when she was brought in, and he remembered her clearly because it was so unusual that when she came through the doors of the emergency room she was awake and talking. He said she was propped up on her good arm, telling the emergency room personnel, “I’m ok,” (despite missing both legs, and having the back of one arm shot off), “just take care of my guys,” (meaning the crew chiefs). He said he couldn’t understand why she was conscious, given her wounds, and asked “Are you in pain?”. She responded, “No, please just take care of my crew.” It’s likely that she didn’t feel any pain from adrenaline or from starting to go into shock. The NCO said they had to put her under fairly quickly because of her blood loss, and even remembered that they put her in bed number two. We thanked him for the efforts of the emergency room staff which saved her life.

Tammy doesn’t remember any of this. She was apparently unconscious from shortly after her aircraft landed through the flight on the Chalk 2 aircraft, and until sometime during the 10 minute flight on the MEDEVAC bird to the emergency room at the CSH hospital. It has been interesting to receive bits of information from various people who saw her that day, and try to reconstruct the events. We don’t know if, over time, Tammy will recover any memory of these happenings on her own.

Wednesday, March 30, 2005 3:47 PM CST
Otto Bock now says they wont be back until the eighth of next month, so the prosthetists here have found another avenue to get Tammy a new right socket, (this time with a custom liner), in order to keep her moving forward. I would really like to see the new technology of the Harmony socket, but if we need to wait two months to get it, it might not fit all that well by the time it shows up. The other option in the future is to go with a local prosthetist and vendor who can purchase Otto Bock parts and components, but not rely on Otto Bock to do the lower tech, and more artful parts of the liner and socket construction and fabrication. The corporate guys seem to lack any sense of urgency. (Of course, we haven’t cancelled the Otto Bock stuff, so if and when it comes in we’ll give it a try also).

Today Tammy was fitted for another right socket by the same prosthetist that got an army pilot back on flight status with an amputation. This gentleman is from Ohio, and is also a pilot, and apparently a civilian flight instructor. He and his engineer placed Tammy's residual limb in a "T-ring" apparatus that contains four precisely located digital cameras which create a composite image from four different angles, and allow a computer program to instantly construct a 3-D model of Tammy's limb.

Through computer-aided design and manufacturing, they will construct a custom liner and socket for her leg. The liner will have varying thicknesses of silicone; thicker where she needs more cushioning, and thinner in areas like behind the knee where she needs flexibility. Rather than her current "off the rack" type of liners where the prosthetist selected a size of cylinder shaped material which was closest to her leg, and then cut and modified it for her; this liner will be constructed to fit the individual curves and hollows of her leg exactly. These gentlemen impressed me with their appreciation for the soft, artistic aspects of their profession, as well as their integration of the available computer technology.

I have been re-reading "Reach for the Sky", the biography of Douglas Bader, the bilateral amputee RAF fighter pilot who fought in the Battle of Britain. His return to flight status was a matter of seven or eight years of healing and learning to control his prosthetics. With our current technologies, I expect Tammy's trip back to be much shorter, (though we are aware that we may not completely win this fight for another couple of years).

In many ways the trial and error methods of getting these prosthetics to work optimally have not changed much in 50 years. The legs are better, of course, and we can now use plastics and metal alloys which make them lighter. However, the art of forming sockets from leather, plaster, metal and wood described in the book is very similar to the process that Tammy is currently undergoing. The computer manufactured products that we will have back this week will probably be much closer to optimal at the initial fitting, but there is still no substitute for a good prosthetist plying his art, fitting and modifying and fitting again, repeatedly. There is also no substitute for a motivated amputee, like Bader, or Tammy, who is personally involved and invested in the process.

The Army has set up a Disabled Soldier Support Network with the job of helping those who wish to remain in the Army, as well as those who wish to take a medical retirement. Apparently the entire process of staying in the reserve components is known as COAR, (Continuation on Active Reserve). There is also a COAD for those who wish to remain on Active Duty, but Tammy would prefer to return to her Guard unit.

Monday, March 28, 2005 9:51 PM CST
We are still waiting for the new socket from Otto Bock. That company now tells us they will not be bringing the socket back for another two weeks. Needless to say, our frustration level with this situation is pretty high.

Unfortunately, Tammy’s next leap forward is pretty dependent on being able to resolve the difficulties with her right socket. If we can transition to the prosthetics as her main mode of transportation, she will be much more mobile and able to attend events, and possibly work outside of the hospital environment one day each week.

Her right arm continues to get stronger, but we are wrapping it each night, and have begun to put it in a splint which keeps “stretched out” overnight. Her scar tissue and muscle tighten down each night. It is generally a good thing that scar tissue tries to shrink, as it is through that process that scars get smaller as they heal. In this case, however, the shrinking scar tissue on her arm serves to limit her range of motion. We will continue to massage her scars and keep her stretched for the next 9 months or so, and she will be good to go.

Thursday, March 24, 2005 9:32 PM CST
This is a neat video report in windows media format from TV Station KATU in Portland Oregon. You can read the story here.

This is a cool article from the Chicago Sun Times. Although, as opposed to what is implied in the article, there are absolutely no real indications to date that I will be taking my company to Iraq in November.

This morning started extra early with a trip to the orthopedic doctor leading the hand team. We looked at the latest X-rays of Tammy’s right arm. One of the bones in her lower arm is healing nicely, though it is held together by plates and many pins that will never come out.

The other lower arm bone still has a significant fracture which has not yet healed. This doesn’t really concern the orthopedic doctors much yet. Until just last week, Tammy was taking a drug called etidronate which inhibited unwanted bone growth called “HO”, unfortunately, this also inhibits the good bone growth which would help heal this fracture. Amputees sometimes develop odd bone growths which interfere with the wearing of prosthetics and cause other problems. HO represented the bigger problem at the time the drug was prescribed. Many of the decisions the doctors have had to make have been a tradeoff, or a matter of prioritization similar to this.

It appears that Tammy may actually regain some ability to turn her hand palm up through the healing process alone. We had thought that she would not be able to rotate her hand past the normal “handshake” position. There are also some procedures that the surgeons may be able to do later on which would free up her hand even more, though the procedures themselves are tradeoffs since they would involve detaching some muscles and could make her hand and arm weaker. Tammy could opt for those procedures if needed.

I had previously reported that the bone in Tammy’s upper arm was broken. As of this morning we know that to be incorrect; the only injuries to her upper arm were the flesh wound to the back of the arm, which included her detached triceps muscle, and a small incision through which the doctors had inserted the top end of the external fixator, and secured it to her upper arm bone.

The X-rays also showed a great deal of shrapnel in Tammy’s arm. Additionally, small pieces of shrapnel have begun to work their way out of the part of her right eyebrow just next to her nose.

Yesterday was the “final fitting” of Tammy’s harmony socket, and it does look promising. The socket should be back at Otto Bock’s US headquarters today to be fitted to a Harmony pump, and a new C-leg. We are eagerly anticipating the return of the whole apparatus. She has been walking each day and getting incrementally stronger, but we pause every few steps to readjust her right leg.

Today she walked up and down a short flight of stairs. She will be able to negotiate stairs by stepping up with her left leg, and then bringing her right leg even with the left. With currently available technology Tammy wont be able to walk foot over foot upstairs, as she does not have quadriceps muscles to lift her right knee. Today's exercise gives us a strategy for those few steps which she will encounter in day to day life and absolutely must negotiate.

Tuesday, March 22, 2005 1:58 AM CST
Tammy fell yesterday morning and scared me badly. She was making a transfer from the wheel chair to a chair that she has made repeatedly over the past month, and with which she is very familiar. The seat of the chair to which she was transferring broke off and that side of the chair collapsed on her, dumping her on the floor. I got her back onto the wheelchair and took her into Physical Therapy to have them check her legs. She had some bruising, but most of the other amputees acted as if this was no big deal. Apparently they have all fallen, and don’t worry about it very much. However, Tammy has a mending arm, and I really don’t like the idea of any falls that we can prevent.

The docs indicated that her arm was not re-injured this morning, but it still has not healed completely in the areas where she recently had the infection. The hand docs are more concerned with that, and they will continue to see her each week to check up on it.

She has begun to handwrite thank you notes as part of Occupational Therapy. It takes some time to write each one, but she will try to write one each day. With the long list of folks we need to thank, this will provide some therapy for her for quite a while.

We still continue to wait on the “Harmony” socket from the boys from Otto Bock. It has been three weeks since they fitted her for this socket and we haven’t seen anything of them since. They seemed very confident that if any socket would work for her right leg, this vacuum type socket would. We are very impatient to see if this will cure most of her current walking difficulties.

Sunday, March 20, 2005 7:59 PM CST
It has been a quiet weekend. For Tammy it has been glorious to have nothing to do, for a while. I, on the other hand, was sick as a dog for two days.

Tammy is concerned about the scar tissue on her right arm. It tightens down each night and limits her range of motion. At some point the scar tissue will also knit to the underlying tissues and further immobilize that arm. She stretches the arm every day, but it will be a long painful process to retain her range of motion, and even increase it a bit more. Each night we wrap the arm and place some silicon "silly putty" kind of stuff on the scars. This silicon stuff actually reduces the size of the scars. We also massage the scarring each day.

We have received several tiaras which Tammy will wear on non-duty days. In the civilian offices where she has worked, Tammy has always maintained that every day would better if a girl could put on a tiara. She kept several tiaras in her desk in order to pass out to co-workers who needed a little boost.

Thursday, March 17, 2005 5:22 PM CST
It was a long day for Tammy. Below is the statement that we drafted, and Tammy delivered to the Senate Committee on Veterans Affairs, after which we were hosted for lunch by Senator Akaka from Hawai’i and his staff:

Mr. Chairman and distinguished members of the Committee, thank you for the opportunity to come before you today to discuss the care of wounded service members injured in Operations Enduring Freedom(OEF) and Iraqi Freedom (OIF) and our efforts to facilitate the transition between the Military and Veteran Affairs (VA) Health Care Facilities, and between military and veteran status.

The medical efforts of Walter Reed Army Medical Center, as well as the medical team at Landstuhl, the Combat Area Surgical Hospital and the in-theater MEDEVAC helicopter crew have been extraordinary. In any previous conflict I would not be alive today. It is a testament to the superior protective equipment that I was wearing and to the medical care pipeline from the front lines to Walter Reed that I can be here.

I would like to take a moment to stress the unique nature of the military healthcare system. While civilian professionals are an important component in that system, there is no substitute to being treated by, and recovering with fellow Soldiers. Only a fellow service member can understand the stresses and wounds of combat. The CASH in Baghdad is the target of frequent rocket attacks. I have met physicians and nurses at Walter Reed who were there. They know on a personal level what the foot soldier faces. Additionally, I doubt that doctors at a stateside civilian hospital would be as familiar with the damage caused by a rocket propelled grenades, improvised explosive devices, or the dangers of theater-specific bacterial infections. Soldiers, whether they are physicians or other wounded Soldiers understand the warrior ethos that drives my recovery.

As disabled Soldiers transition to veteran status, we will look to the VA to provide continued access to healthcare, health technology, assisted living devices and social services. The VA will have to face the challenge of providing care at the high level set by the military healthcare facilities. This is a challenge that the VA can meet if it is given enough resources and if it listens to disabled service members and puts forth the effort to meet our needs.

The first, most easily identified need that the VA will have to support is continued access to technology. Disabled veterans will require access to different devices as they age and as the available technology undergoes innovation. The VA will need to track ongoing changes in medical technology such as in prosthetics research and inform the veteran of the availability of this new technology.

I am certain that while the American people are focused on injured Soldiers from the Global War on Terrorism, the funds to aid those Soldiers will continue to be forthcoming. I am concerned that during peacetime, funds for research such as in the field of prosthetics will be reduced. The VA needs to continue to support the cutting edge research that is underway as a result of the current conflict's wounded. In order to do so, the VA itself will need continued funding earmarked for this purpose.

Second, as I look around at the other wounded Soldiers, it is clear that the majority of them are young with long lives ahead of them. Whether we will continue to have the honor of serving in uniform, or return to productive civilian lives, we will require continued access to high quality VA services as we age. The VA will need to support this need over the long term as currently wounded Soldiers will be accessing its programs over a lifetime.

Third, in order to provide ongoing care to veterans, the VA will have to identify and develop specific programs and cultivate professionals to implement them. Experience is, as we say in combat terms, a force multiplier. The technologies that make recovery possible from such severe wounds require experienced professionals to assess and apply them to the veteran. Patients benefit from long-term relationships with highly trained and experienced specialists. This is especially true of the therapists that specialize in amputee care who grow to know the peculiarities of residual limbs and the use of prosthetics. The level of care provided by the VA will be enhanced by a commitment to the programs and professionals who will interact with the patient.

Fourth, disabled soldiers will need access to assisted living devices such as:
1- High tech prosthetic care.
2- Orthopedic care and rehabilitation.
3- Home modifications e.g. ramps, thresholds, lifts and wide doors.
4- Vehicle modifications/hand controls.
5- Specialty equipment such as wheelchairs, bathroom equipment, hand cycle, adaptive sports equipment.
6- Specialty equipment for blinded soldiers such as talking appliances or computers.
7-Smart home technology.

Fifth, the VA will need to provide access to social services such as job counseling and psychological support. Many of the young wounded Soldiers today need advice on which jobs or educational programs will be most suited to them. Such career counseling will allow the Soldier to maximize the educational and job training benefits provided by the VA. Additionally, those that sustained brain injury as well as those that develop psychological trauma will need long term counseling and support.

Finally, it does the disabled veteran no good if he or she is unable to access the various programs provided by the VA. While still assigned to Walter Reed I have immediate access to the prosthetics care that is part of my recovery process. This access will continue for me through the new amputee center. However, for disabled veterans living in areas far from VA Hospitals and facilities, travel itself is a significant obstacle to their continued care. These disabled veterans will need regular, easy transportation support from the VA.

I applaud the VA and Department of Defense (DOD) partnership that assists military service members who have served in combat and aims to provide them with a seamless transition to civilian life and veteran status.

Those select individuals from amongst the American people who would willingly serve in the armed services are a limited resource. Our warriors are expensive, and indispensable. I believe we must jealously guard this resource, retaining as many as possible in the service, and sparing little in the effort to return one of them to service. For example, the cost to "make" another Military Police Captain in order to replace a wounded one is prohibitive when compared to the medical costs to fix wounded Soldiers and return them to duty.

I would urge you to think of the efforts of the Army Medical Department (AMMED) and the VA as a force multiplier for two reasons. First, these organizations can help us retain good Soldiers, Marines, Airmen and Sailors who would have otherwise not been able to continue to physically accomplish their missions and remain in the service of the United States. These wounded have already been trained at great expense, as well as been tested and gained invaluable experience in the crucible of combat.

Further, I believe we want to ensure that our warriors are secure in the knowledge that, when and if their comrades are hurt we will take care of them. The frontline Soldier should not expend a moment of time to worry about a fallen comrade. We must ensure that he knows, 'my buddy made to Walter Reed, he will be ok, they have the best doctors, and cutting edge technology there'. We will maintain the optimal morale and performance from our Soldiers through ensuring that these medical facilities are adequately funded.

I have experienced first hand the excellence of the Army's medical system for the combat wounded. Because of the type of injuries, and the geographical location of my home, I have been treated at Walter Reed. Had I been burned badly I would have been sent to a different facility. For example, an amputee center has been opened at Ft. Sam Houston's Brooke Army Medical Center. I believe it is just as important to fund all of those facilities. I can only hope and implore that the VA steps up to receive disabled veterans as we transition into its care from the military medical system. In order to continue to provide care at the level provided by the military health care system these programs will have to be funded into the future.

On behalf of our injured, wounded or ill service members and their families, I thank members of this great institution for providing us with the funding and resources to take care of some of the finest citizens of this nation. These are the men and women in uniform who have committed their lives and well being to the defense and protection of this great nation. Thank you for the funding that provides invitational travel orders for family members, allowing my husband and mother to be at Walter Reed. They are an important part of my rehabilitation team. The AMEDD, with WRAMC on the cutting edge, has provided world class health care to injured and wounded members of all the Services. A strong partnership between the military healthcare system and the Department of Veterans Affairs will provide the optimal care for the needs of our service members and their families.

The following is a pretty cool article on Tammy.

This is a pretty neat flash presentation on The Soldiers Creed.

Thursday, March 17, 2005 6:09 AM CST
Tammy goes to testify this morning before the Senate Committee on Veteran's affairs. We have been occupied by drafting her statement for the committee, and I will post the final draft later today.

Senator Obama from our home state of Illinois, has indicated that he would like to meet her today. Also Senator Akaka from Tammy's childhood home of Hawaii, will host her for lunch at the Senate Dining Room.

We also received a visit some distinguished folks from Sikorsky aircraft who make the Blackhawk helicopter Tammy was flying when she was hit. One of the reasons that Tammy is alive today is that the aircraft continued to fly after being hit by an RPG, (Rocket Propelled Grenade), which is essentially an anti-tank round. Except for the most recent new additions to the ranks, nearly all of this nation's military helicopter pilots have a deep emotional attachment with the Huey, which was the Blackhawk's workhorse predecessor. Tammy is no exception, having learned to fly in Hueys during flight school, and operating that aircraft for several years in the Army Reserves. While she was talking to the guys from Sikorsky about the Hawk it was apparent that her attachment to that aircraft is nearly as strong. We certainly have more wood or plastic Blackhawk models in our room at Fisher House, and at our house in Illinois, than Huey models now. It is odd that Soldiers develop such attachments to inanimate hunks of metal.

Monday, March 14, 2005 8:32 PM CST
Life is good.

Each morning for the three months Tammy was in the hospital I woke up in a fold out chair across the room from her bed. I could look over and see her there, the woman I married, and that was good, and I would thank the One who made us that I had her back alive. But, when I would lean in to give her a kiss she smelled of antiseptics, and dried blood, and the peculiar smell of healing skin grafts. Her consciousness was there, hanging on determinedly, if only by a thread at times, but the depth and textures of all the things that define her were impossible to re-assume in the hospital environment.

Now, at Fisher House, life courses through her with renewed vigor. All of those properties that define her personality have returned. I wake up with her in my arms and smell her hair and the scent of her skin and experience all the other sensory nuances that tell me I am in very close proximity to the woman who has fascinated me and been imprinted on my senses for 14 years. She is much more herself now, and it just feels a thousand times healthier and better for her here. As I say my morning thankyous now, I add one for this place.

We are not worry free here, however. Tammy is concerned about her right arm. It hurts, as should probably be expected of a limb which was completely shredded internally. The muscles had been detached; the bones and connecting tissues have been shattered and torn. As she works at her strength and range of motion, her arm hurts inside in many places, and this causes her to worry. She needs that arm to fly, and attain her goals, and she worries that she will lose it still.

The saga of her right leg socket causes me to ride the emotional roller coaster more than her arm. I was very elated when I saw the first socket they made for her that used the shape of her hip, but as her limb changed and that socket began to fit more loosely, and she had more difficulties walking on it, the doubts and fears begin to creep in for me. The prosthetists scanned her leg two weeks ago, and began to fabricate a new vacuum socket for her. That device will incorporate a vacuum pump and a one way valve into the socket and again I have begun to feel some cautious optimism based on this “hard” technical solution. While the existence of the technology re-enforces for me all of the possibilities, she will require a combination of the “hard” technology and some of the “soft” artful work of the technicians and physical therapists. Will the team be able to find some optimal solution in the end that will fit securely to her right leg? Well of course they/we will, we just need to maintain our composure and the solutions will continue to present themselves. We can not take counsel of our fears. There is work to be done.

We celebrated the eighth anniversary of Tammy’s 29th Birthday this past Saturday. Family and friends descended on Fisher House 3 with a full buffet in tow. It was a great day and we heard from friends in Illinois, Canada and beyond. It was hands down better than her last birthday which was spent riding in the back of a Blackhawk into Iraq for the first time. We are so incredibly grateful to her comrades and to all the health professionals who have made it possible for her to be here for this birthday.

Saturday, March 12, 2005 10:11 AM CST
We have had a great many administrative and managerial tasks recently. I went back to IL to attend drill for a weekend and drive one of our vehicles back to Walter Reed. We will begin experimenting with transferring from the wheel chair into our Honda CRV.

We also buried Tammy’s Dad this past Wednesday. The Old Guard provided full military honors, to include the burial detail, military band, firing party, bugler, and military chaplain. It was a beautiful ceremony.

The Soldier who flew to Germany to be with Tammy during her stay there came to visit her here, and attend Mr. Duckworth’s funeral. Another Soldier who worked with Tammy at her Battalion Tactical Operation Center in Balad, and just happened to be Tammy’s swim buddy visited just as Tammy was climbing out of the pool on her first swim. She was so happy to see both of them, and appreciates the extra time they took out of their vacation to come see her. Both of these Soldiers drove here from IL to see her. That is a long drive of at least 12 hours, and usually a few hours more.

Tammy also received a call from the Pilot in Command of her helicopter on the day they were shot. It was a pretty emotional event for her, and we were able to get a much clearer picture of events that occurred while Tammy was unconscious. Every eyewitness that we have spoken to attributes the short period of time between the ambush, and the injured crew member’s arrival at the hospital to that Soldier’s leadership on the scene.

Tammy has been cleared to start swimming, and I think that will help strengthen her right arm considerably. She has some adjustments to make since her body no longer works the same way, exactly, in the water. She should begin to do a crawl stroke very soon, and that will help with her strength, aerobic fitness, and her range of motion. The arms do most of the work when doing the crawl, so Tammy’s leg injuries should not have a large impact on her ability to do that stroke. We will also obtain some web fingered gloves to increase the resistance and allow her to swim faster. We also believe she will be able to use a kick similar to the one used with the butterfly stroke. That kick could use her core muscles, and her remaining muscles in her left leg, and we would have to work out some kind of prosthetic to attach a limb to right side and possibly a big mono-fin. Hopefully such an activity would not be too hard on her back.

The doctors have given us the ok to alter Tammy's dosage of Methadone as needed with the goal of weaning her from the drug while minimizing withdrawal effects. For the past week we have had her on half a pill, or 2.5 mg each day, (as opposed to the 10 mg/day she had for the past three months). Yesterday we began cutting the pills into quarters, but they crumble when cut that way. We may go to half a pill every other day, but I dont think that would let us lower the concentration of the drug in her system smoothly. We hope that in another week she will be able to just stop taking the drug all together and deal with whatever, (hopefully), slight withdraw symptoms she will have.

We are anxiously awaiting a new vacuum socket for Tammy’s right prosthetic. Hopefully that will eliminate a lot of the constant adjustments as she walks, and allow her a more secure fit on that side. Otto Bock, the company that makes the C-leg is currently making this socket for her. We believe it will offer the best fit currently available.

Sunday, February 27, 2005 7:49 AM CST
Tammy’s Preventative Medicine and Rehabilitation, (PM&R), doctor reduced her dosage of methadone, (a synthetic morphine type drug), by half last Thursday, and then on Friday had me remove it from her daily oral meds completely. She has some aches and pains in her legs and burning sensations in her hands, and we are not sure if those symptoms are as a result of slight withdrawal from the drug, or if the feelings are the outcome of her daily workouts which have been masked by the drug until now. Either way, she has more feeling in her right hand, including her right “pinkie” finger which seems to indicate some healing in her ulnar nerve on that side.

I hung Tammy's last IV bag of anti-biotics on Friday night, though the doctors will leave the PIC line in her arm until next week just in case. Her blood was drawn yesterday in order to measure her levels of anti-coagulants, and by next week I may be able to stop giving her Lovenox blood thinner shots also. She has been getting these shots in the belly twice a day for more than three months. I think she hates getting them as much as I dislike sticking her.

We received a visit today from Tammy’s Battalion Chaplain, who drove all the way here from IL with his family to see her, and a friend from Tammy’s days at NIU Army ROTC who now lives here in Laurel, MD. Chaplain Bob was deployed for the past year with Tammy’s unit in Iraq, (if ever any flock needed a shepherd, it would be a battalion of Army Aviators), and he was able to fill in some of the pieces of the puzzle and tell us about some of the actions taken by individuals immediately following Tammy’s ambush. She is grateful to her Battalion Commander for sending a fellow pilot from her unit to accompany her from Balad to Germany so that, on the off chance that she would wake up, there would be a familiar and friendly face. She is also grateful to that pilot for making what must have been an emotionally difficult trip.

On a somewhat lighter note; we learned that when her Commander and a group of key personnel from the unit visited her in Baghdad while she was undergoing the first emergency surgeries that amputated her leg, the hospital staff ran out of her blood type. Some 4 of the 6 Soldiers visiting had her same blood type and immediately rolled up their sleeves and donated blood on the spot. We knew that Tammy had taken 40 units of blood at the hospital in Baghdad, but had no idea that some of that blood came from her friends. She can only hope that the blood donated by the Commander and Chaplain offset the blood of the Battalion Flight Surgeon, as we surely wouldn’t want her to exhibit any tendencies to flirt outrageously with the nurses, or sew patches everywhere on her clothing.

Through the graces of Deputy Secretary Wolfowitz, Tammy was invited by former Secretary of Defense Cohen to attend a dinner at the Willard Intercontinental Hotel in honor of former Deputy Prime Minister of Malaysia Anwar Ibrahim. Mr. Ibrahim was recently released from prison in Kuala Lumpur, and Tammy was honored to meet him as she has followed his plight closely for several years. It was an additional treat to get to see and speak to Mrs Cohen again. She is a favorite of the wounded Soldiers at Walter Reed and she visits the wards at the hospital often and without fanfare or an entourage. She brightens the outlook of a great many of the patients who would not be old enough to have any idea who the pretty lady's husband is, even if she told them.

The Willard Hotel has been a Washington fixture since 1850, and being a US history buff I was very interested in the location of the dinner also. A great many affairs of State and events from U.S. history in general occurred on the premises. U.S. Grant liked to lounge in the hotel lobby and puff on a stogie during his tenure as President, and people would approach him there in order to talk to him about pet projects. Grant coined the term "lobbyist" in reference to this activity. Most Presidents have stayed overnight in the hotel, which is odd since it is only a couple of blocks from the White House. Countless foreign delegations have stayed there as well and the hotel is more richly appointed than most of our government's public buildings, which seems satisfyingly appropriate.

Wednesday, February 23, 2005 6:57 AM CST
Tammy is typing slowly and painfully now, and the activity helps to strengthen her right hand and fingers.

I thought I would share an incident that she wrote about to some friends as I believe it illustrates her every day attitude and aproach to whatever obstacles we face. I would have preferred some other action rather than the one she took here, since her right arm is still healing. Tammy, however, will not be deterred sometimes. The italics in the following paragraph are mine. Here is what she wrote:

A couple of evenings ago Bryan accidently locked himself out of our room. I was inside the room hooked up to an IV (which Bryan has to give me every 8 hours). He had also moved my wheelchair away from bedside in order to plug it into the outlet for recharging. I ended up using my teeth to unhook myself from the IV, (there is a quick disconnect on the tubing which is semi-permanently in her arm), dropped a couple of pillows on the floor next to the bed and attempted to slide of the bed, (and drop on to the pillows) to scoot myself across the floor to unlock the door for Bryan, who was trying to break in with a credit card. The pillows here at Fisher house are top quality and I actually bounced off them like a ball when I slid off the bed and ended up doing a drop and roll onto the floor. It was definitely an unplanned adventure but I am now a little wiser and will hopefully have a better plan for the next time I have to climb out of bed.

Tuesday, February 22, 2005 7:18 AM CST
Tammy has mastered the transfer from the wheel chair to a car, so we have been going out to lunch, and dinner, and shopping. The manual wheel chair folds and stows in the car trunk. As it turns out, I am a very poor shopper and this provided some motivation for Tammy to begin to roll herself around in the manual wheel chair on Saturday. (Though I maintain that I shop quite well for important things like computers, and airplanes and such, it is only when shopping for bedsheets and housewares, etc that my failings as a shopper are evident. After all, I am a heterosexual male and she knew that when she married me.) Once we actually get to the stores Tammy slowly wheels around between the isles and look at the items on the shelves by herself. Her right hand continues to get stronger, but we still need to limit the amount of stress to that limb.

Since my very own First Sergeant checked my last APFT, (*), and ratted me out to the wife about the top speed she can expect from the haole boy powered wheel chair; I would like to inform any Army IP who is planning to visit, that our friends from the EAATS at Ft. Indiantown Gap dropped off a UH-60 -10 manual, (**), complete through change 1, and a copy of the relevant checklist. I would think that any quiz questions on topics from those documents would be fair to ask Tammy.

* APFT, Army Physical Fitness Test - .an annual event conducted at the unit level for every Soldier. APFT currently consist of sit ups, push ups, and a two mile run.
** UH-60 -10 manual. The “owner’s manual” for the helicopter Tammy flies. It prescribes operating limitations and emergency procedures and other things that Instructor Pilots, (IPs), can quiz the other, mere mortal pilots over.

Friday, February 18, 2005 9:42 PM CST
Tammy walked for her longest distance and time to date, 100 meters. (And yes, I know I am an Army geek for having measured it out with my pace count). She is walking with a platform built into a walker so she can rest her right arm on the walker without stressing the two mending bones in her lower arm. Her gait is getting smoother, and she is able to “load the toe” and make the artificial knee bend naturally on almost every step. In order to do this though, she is using some hip movements that are not conducive to a natural gait. At this stage we are not very concerned with the extra hip movements as she may be able to smooth them out with more practice, and there may be another advanced leg which would not require her to “load the toe” in the same manner.

It really is a challenge to control the long lever of the artificial leg with her very short residual right limb. Her femur is about 5 inches long; although, due to the shape of the female hip, it only extends about 2 inches below crotch level. All of her gluteus muscles and hip flexors are still attached to the short leg, however and she is able to position the prosthetic well with what she has. She has been able to keep her right leg stretched out, and it has not shown the tendency to be pulled into a horizontal position, (as seen while standing), by her remaining muscles. That was one of the doctors’ concerns and reasons that they suggested removing what was left of her residual leg. The orthopedic doctors were also doubtful that she would be able to move, position or control the artificial leg very much with her own leg. With the innovative socket that the prosthetists have built for her; I believe this concern has also been disproved.

The last of the orthopedists concerns which has yet to be surmounted with her right leg is retention. Most amputees have longer residual limbs, with more surface area on their sockets, and this helps them to keep the artificial leg attached to their own leg. Tammy has relatively little surface area to give the socket “purchase” on her residual limb. The socket itself has been built to take advantage of the shape of her hip, and has a strap which goes around her waist to the other hip. So far, for the limited distances and types of things Tammy has done, this has proven adequate. As her right leg continues to change shape, the prosthetists will make different sockets in order to fit her. In the end, when her leg has reached its final shape, and she has an optimal socket to fit it, we are not sure how securely the leg will be attached. So, retention is the variable in the equation that we can not reduce at this point.

Tammy will continue to push on and work on the most immediate difficulties. She has come a long way in these past three months, and spent very little time worrying about questions for which no answers are currently apparent.

Last week walking 10 feet kicked her butt. This week it is 100 meters. For the immediate future she will continue to work on balance and stride, and build her core strength. She also continues to strengthen the glutes and hip flexors on her right side. (By the way, the left leg socket hurts, but she walks on that leg as if it were her own). I don’t know what technologies will be available to us in the near future, but I have great faith that she will keep giving it her all, and some opportunity will present itself when we need it.

The funeral for Tammy’s father will be at Arlington on 09 March at 1500 hr. (3 PM). The family requests that donations be made to Soldier’s Angels in lieu of flowers, as it was through the efforts of that organization that they were able to spend another holiday season together prior to his passing.

Tuesday, February 15, 2005 4:52 PM CST
We have been very busy. There have been a lot of medical improvements and changes and also some appointments with VIPs. Tammy was invited to, and attended, a private lunch with Deputy Secretary of Defense Wolfowitz and two Brigadier Generals at the Pentagon. Deputy Secretary Wolfowitz visited the hospital some time ago to see wounded Soldiers and came to Tammy's ward. Dr. Wolfowitz had been the Ambassador to Indonesia, and knowing this, Tammy spoke to him in Indonesian. After conversing about Tammy's academic background, her language skills, and her experience working for NGOs, (Non Governmental Organizations such as Rotary International), he requested that she come to the Pentagon for a tour and to discuss how she may be able to serve in the Tsunami relief efforts while she recovers at Walter Reed. It was a wonderful lunch, and Tammy seemed to hold her own in the discussion of geopolitical issues which are far beyond the knowledgebase of her bumpkin husband. Army Vice Chief of Staff GEN Cody, (who we had met previously on one of his visits to Walter Reed), also attended briefly. (Although I nearly hurt myself on his arrival, when I heard a rustle to my right whilst sitting at the table and glanced that way to see 4 stars on a background of the new ACU uniform.)

Tammy has been released to outpatient status to live in the Fisher house on a long term basis. I am actually setting up her IV twice a day, and administering all her oral meds. We go into the infusion clinic once each day so they can do one iteration of her IV meds. She continues to attend OT, (Occupational Therapy), and PT, (Physical Therapy), at least once a day, and does a second session of each every day if she can fit them in around all the other appointments. The largest part of our day is still spent in the hospital, but we get to go “home” each night to our own room.

Until Tammy’s IV course of antibiotics is done, I will be tied pretty closely to her side. I was not at all comfortable, initially, handling the medical things; but she really needs and wants to get out of the hospital and begin the next chapter in her recovery. Living in the informal setting also forces her to adapt to a more “normal” daily routine. She will help wash clothes and do the daily househould tasks as she would at home. She has to transfer from her wheelchair to the bed, to the commode, to the couches, and to the shower seat. She accomplishes all these things now with increasing ease.

Her right arm continues to get stronger, and she is able to use her right hand to do more things all the time. The hand doctors have reviewed her latest X-rays and determined that she can bear weight on the upper arm, but still should not stress the lower arm too much just yet.

We go to PT every day so Tammy can walk on her prosthetic legs. She puts on both legs and stands with the help of a platform crutch, (a crutch with a device attached so she can rest her elbow on ‘the platform’ part). She walks between the parallel bars about 10 feet, turns around and walks back. As she brings the right leg forward with the C-leg attached, she has to put pressure on the right toe, which signals the computer knee to allow the knee joint to bend. She is learning the process and is currently able to “load the toe” about 9 times out of every 10. If she does not get the toe loaded, the leg just swings forward rigidly, which still supports her, but doesn’t look natural. The socket for her right residual leg has gotten looser and looser each day as her leg continues to shrink to its permanent shape. At some point the prosthetists will need to revise the sockets on both legs to get a better fit; but for the time being we are making do with thicker socks and sleeves between Tammy and the socket. Right now the whole effort of walking is a shaky affair, but I have come to expect rapid improvement in all that she does. Her balance will probably improve quickly given the amount of time she insists on logging on the legs each day. Today she walked with a great deal less help than any previous time. In the past she had so many hands steadying her, you couldn’t tell if she was actually moving forward, or people were pushing her along. Today I could see her making all the motions, placing the feet for each step, and controlling her own balance. We have not attained her final goals yet, but 94 days into this I can tell you she is going to make it.

Wednesday, February 9, 2005 12:04 AM CST
Tammy stood up at the parallel bars and walked today.
This is a huge leap, and we are very pleased.

Oddly, mine were the only dry eyes in the crowd. I guess I have known that she would reach this point for two months; it is no great surprise to me. I was pretty focused on her walking at the time, and the only other thoughts were to recalculate the time frame to reach her next goals. Gotta' "charlie mike", (continue the mission), through the bad times and the good. I suppose, however, that we should pause briefly, and relish each small victory for bit.

I returned from some Army duties last evening and noticed immediately that Tammy seemed stronger, and even more alive than she was three days ago. Her mom has been massaging her limbs each morning, and that helps a great deal with the aches and pains caused by each days multiple workouts. The doctors have also eased off some of her meds, which has made her much less nauseous, and she is able to take in a lot more calories. She reached up and hugged me with both arms. The right arm and hand continue to improve.

Tammy is standing on the second generation socket for her right leg. She can control it very well, and it is the fulfillment of a late night pact made between her and the prosthetist about a month ago, while she was at the depth of her worries about being able to use the right leg.

Thursday, February 3, 2005 11:49 PM CST
Yesterday Tammy and I, and another wounded Soldier from Illinois, attended the State of the Union Address as the guests of Senator Durbin of Illinois. The Senator and his staff were very gracious, receiving us in his offices in the Capitol Building. We had some time to visit with the Senator, then a brief period with the TV and newspaper reporters from Illinois, and then dinner with many of the Senators in the offices occupied by Lyndon Baines Johnson during his time in the building.

Though I am very focused on my wife right now, I could barely contain the feelings of awe when we were confronted with the grandeur of that hallowed place. Except for the addition of computers and phones, the offices have been maintained in much the same manner that they were since 1859. Where we wheeled and walked last night, Lincoln and Jefferson and John Adams each debated the issues confronting our democracy during their times. We could feel a connection to history as we watched the President make the trip to the hill to address both the other branches of our government, as has happened since George Washington delivered the very first State of the Union Address on 08 January, 1790.

The Capitol at night is beautiful. There was one moment in Senator Durbin’s office, when I could look just past my wounded Soldier wife as she sat in her wheelchair speaking to the Senator, through the window, at National Color, bathed in spotlights, and waving just in front of the Capitol Dome. That was a very emotional moment for me, but I believe I was able to maintain my composure fairly well, with a bare minimum of stuttering and stammering. Neither the Senator, nor his staff seemed to notice.

Tammy, on the other hand, was the very picture of unflappable poise; sitting there in her Class A’s, conversing with Senators and handling the reporters’ questions with ease. She was every bit the professional Army officer, and I am afraid that the pride I felt for her then far outstrips my ability to articulate it.

The other big news in our lives today was Tammy’s first fitting with her right prosthetic leg. The socket looks good and fits very well, giving her less trouble than the left leg which should actually be the easier fit. The prosthetist wanted to get her up on both legs in order to see how the socket fits when bearing weight, and allow her to start getting used to wearing it. Right now the legs are different lengths, and he told us he had set them up that way on purpose so Tammy could live on a hill, with one leg always uphill. We informed him that there are no hills in Illinois, (at least not where we live), so he will add about 6 inches to the length of the right leg pylon. For today we added some blocks underneath her right foot just to get her vertical. The socket works well.

Interestingly, Tammy is one of the first females they have fitted with an above knee amputation that is so short. The prosthetist seems to actually be able to use the rounded shape of her female hip and waist in order to keep the socket in place. There was some discussion that it might be more difficult to fit a male Soldier with that short of a residual leg since the different shape of the male hip, and lack of flare to the waist, would give the socket less to “grab onto”. (Add that to the long list of reasons I am glad Tammy is not male.)

Tuesday, February 1, 2005 5:36 PM CST
Tammy had an exciting afternoon PT session today. The prosthetist constructed a cast, (the prototype for a socket), for her right leg which, to my uneducated eye, looks quite functional. We slipped the cast onto her right leg and checked for fit, stability and her ability to control it. For the first time we have something more tangible than hope, for the rehabilitation of her right leg. I can look at the cast and actually see in my mind's eye how she can make it work bio-mechanically.

We had always hoped that she would be able to retain the short residual limb, and use it in the same manner that amputees with longer limbs do. If this cast results in a successful socket for a C-leg, she will be able to use both her adductor and abductor muscles to position the prosthetic limb, and have a much more natural walk than if she had a hip disarticulation type of amputation. She should also be able to place her foot on a aircraft rudder pedal with her own muscles, and perhaps feel the position of the pedal even in her shorter limb. (Of course both left and right pedals work together in a push-me, pull-you type of motion, and she will be able to feel the position of both pedals quite well with her left leg, regardless).

With this socket on her residual right limb she should also be able to move the C-leg in and out, as well as forward, and to some degree, backward. This degree of control will increase her ability to perform many different physical activities.

We will attend the State of the Union Address as guests of one of the Senators from Illinois tomorrow. It has been the effort of the better part of the day to beg and borrow uniform pieces from the female soldiers here at WRAMC to put together a Class A uniform for Tammy with the proper rank, awards, and name tag. I am very, very proud of my wife, and it will do my heart good to see her don the dress uniform with Major's rank for the first time, in order to attend this ritual of our democracy.

Tuesday, February 1, 2005 9:57 AM CST
Tammy is doing well. Her family had been expecting her dad's passing for many years, and even he had to tried to prep them for it. They also had a chance to say goodbye, and be together for a bit before the end. I believe that things went as well as such an event can possibly go.

Tammy is back in OT and PT, and we have found ways to make her IV tubing, and her right arm stint work with the Army IPFU, (the pysical training uniform). No one really requires her to be in uniform right now, but she is on duty, and drawing pay, so she feels that she should be in uniform.

Old "Guys" construction Co. has begun to modify our house, and we are looking forward to the time several months from now when we can get back home.

Friday, January 28, 2005 1:39 AM CST
We regret to report the passing of Tammy's father.

He was both, a Marine and a Soldier who served the United States through two wars and, in different capacities, for fifty years.

We hope to interr Mr. Duckworth in Arlington. We will inform all interested parties of the funerary details.

Tuesday, January 25, 2005 10:41 PM CST
Word apparently had spread throughout the hospital about the Army Aviator who was frustrated with her incredibly slow electric wheel chair. The vendor was brought in to reprogram the chair and supposedly it will now attain its top speed of 7 mph, (6.09 kts). The courageous technician who hot rodded the chair, (or 'pimped her ride', as the younger soldiers say), actually asked if she thought she could handle the chair in its fastest form. Brave man, he.

We have also tested the haole boy powered wheel chair in the snow, and found that it operates quite well in 2-3" of the white stuff, though I have placarded the unit against flight into known icing, (solely for my benefit, of course). Top speed is still TBD, as Tammy was unable to find a suitable straight away to get up to the redline.

Tammy is still dealing with the IV antibiotics every 8 hours, but is finding ways to continue her PT and OT regimen while not interfering with the Infectious Disease Teams work. She has continued to lose weight, but since she hasnt been back to surgery for a while, her appetite has returned. We are currently plying her with ice cream, tacos, Thai food, and everything else we can think of which may add some calories to her diet, and that problem should be taken care of shortly.

We actually received a state flag today from the office of the Lieutenant Governor of IL which was postmarked on 30 NOV. That should give you some idea of how the mail works here. On the other hand, we get some letters within two working days. Go figure. Electronic communication seems to move a bit faster, and we are making some progress on getting web access from the room for Tammy. She should soon be able to work on her military correspondence courses, and finish up her Doctoral degree, as well as check and respond to her email.

As some folks know, Tammy's dad had a heart attack shortly before she was hit, then another some weeks later. He was released by the doctors in Hawaii to come see her here at Walter Reed, and had a third episode. This past friday he underwent open heart surgery and survived, though he is in critical condition. We have had several post operative scares, and his doctors had told us earlier today that he needed to undergo some surgery immediately. They thought that his chances for surviving that surgery were not very good, and we were braced for the worst case. Once again, his surgery went better than expected and we are happy to report that he has made it through the most immediate danger. Tammy's family is taking everything day by day, but they are very thankful that they have been able to spend another holiday season together. Had Tammy not been hit, her father may have died while she was deployed. Tammy's family is very apreciative for all of the thoughts, prayers, and assistance that they have received during this time.

As you can imagine, the psych types at Walter Reed are a little unsettled by the calm with which Tammy has handled the events of the last couple of months. I think they would be a bit more comfortable if she showed a little more emotional wear and tear. Her attitude is very positive, almost infectiously so. I believe the professional will continue to be baffled as we are now about two months into the recovery, and I think we are just about done with the emotional zoom climb that we got out of the initial euphoria that she had survived. Now we will see the underlying resolve of this woman. As I have been priviledged to make a fourteen year study of the behaviour of this particular subject, I am quite confident in my prediction that she will continue to gain in momentum.

Thursday, January 19, 2005 23:49 AM CST
No surgery today. Tammy continues to get antibiotics every 8 hours and sleep a lot. There are no signs of infection, but the antibiotics will continue for at least another week. The MDs did not see anything but healthy tissue inside her right arm, and the arm hasn’t drained any more fluid into the wound vac that the surgeons had previously attached. They have replaced Tammy’s removable splint on her right arm with a cast-like dressing which immobilizes her arm.

The Physical Medicine and Rehabilitation Service conducted an Electrodiagnostic Report, (EMG, but dont ask me how that contracts to EMG), by connecting electrodes on either side of her left hand and arm and sending electric current into her nerves on that side. They stuck needles into various muscles and measured the output and reaction times. They determined that the blast had caused some nerve damage on her left side, but that all the nerves on that side were healing nicely. The test was moderately painful, especially when they tested each of the nerve endings in Tammy’s left hand. They will conduct the same test on her right arm once it is unwrapped.

The blood pressure in Tammy’s right “pinkie” finger is beginning to rise back to normal levels, and she believes she can feel more tingling sensations in that finger. She can move all of the fingers, and sensation in her pinkie is the only thing keeping us from declaring that she will have full use of her right hand. As I have mentioned before, she may lose some of the extreme range of motion in her right elbow, but should have more than enough range of motion to perform all normal activities without hindrance.

Another Army Aviator came to visit Tammy today. This lady came a long way through the snow, and spent good while talking with Tammy about helicopters, and the challenges of company command. Unfortunately, during her visit we had some unscheduled interruptions as the medical teams surprised us with the afore mentioned EMG test an hour earlier than they had previously told us. This happens a lot when folks come to visit, and Tammy would like to be able to “block off” time to spend with people who have come a long way to see her. Unfortunately, that is not possible, and we often wind up trying to fit in some quality time with guests between appointments. Luckily all the good folks who come to visit seem to understand.

Saturday, January 15, 2005 10:13 AM CST
We have had a small, temporary setback. The surgical routine kicked her butt yesterday, and she slept a lot of the afternoon and night and late into this morning. The tissues and bone in her arm looked healthy when they were in there, but there are two different bacteria present. The infectious disease doctors won’t use the term "infection" at this point, though I am not sure what practical difference it makes if by clinical definitions Tammy has a "colonization" or an infection of these bacteria. Infection would be the worst case, and the doctors are treating her as if that is what she has, just in case.

There are antibiotics which will be effective against both bacteria, and she will be on at least two weeks of an intravenous course of them. This is frustrating for Tammy since she will have an IV, (again), for at least the next two weeks. That impacts her mobility and interferes with her sense of progress, not to mention her workouts.

We were made aware of these bacteria very early, (this past Tuesday), by an alert Occupational Therapist who works with Tammy's right arm twice a day and was very familiar with it. She, (the therapist), noticed the swelling, and was very insistent that the doctors examine Tammy's arm. The MDs, (who have a multitude of patients other than Tammy), did not feel any urgency to do so, since the indicators of infection that they were monitoring remotely, (like white blood cells, and body temp) were not showing anything significant yet. The therapist was very insistent and assertive, and when the MDs looked at Tammy's arm they decided to go in and drain it the next day. In catching this early the therapist may have kept the bacteria from getting into Tammy's arm bones. I am a bit of a techno geek, but I think this is another example that absolutely nothing replaces a thinking, knowledgeable human being who is directly involved in the situation.

We have recently had an opportunity to see a modern civilian hospital. The place was as modern as Heaton Pavilion, (the building where Tammy is at Walter Reed), must have been when they built it thirty years ago. All of the equipment which crowds the tiny rooms at Walter Reed is built into the walls, floor and ceiling in the newer civilian hospitals. That place is not cheap, and a one week stay can easily cost $18,000.

Walter Reed is the best place for Tammy to be, because of the staff. If you could assemble such a staff at a civilian hospital, I can’t imagine what it would cost. I also don’t think you could secure the type of dedication that these folks show at any price.

Friday, January 14, 2005 7:25 AM CST
Back to surgery today. The doctors are treating the fluid in Tammy’s right arm as if it is an infection, just in case. She went in Wednesday to have the fluid drained, and is back in today for a washout of that same area. The doctors are being aggressive and pro-active in working on this since the area in question is very close to her arm bones, and she currently has a lot of foreign material holding her bones together. The cultures taken on Wednesday showed nothing after 24 hours, but at the 48 hour mark were growing something which the doctors have not identified yet.

We hear slightly different things about the cultures from the different doctors. Each doctor interprets the data slightly differently, then translates it into layman’s terms for us. Each of us then interprets what the doctor said. Tammy and I have listened to two different doctors interpreting the same data and come to different conclusions. Tammy believes that they have identified some infection, and will be treating her with anti-biotics. I thought I heard something like, “We don’t know if this is an infection, it could just be normal flora, but we are preparing for the worst case scenario, and will have drug x,y and z ready if we identify something from the cultures.” Either way, I am very confident in the different specialists and teams here, and am sure they will be able to handle whichever contingency arises. This does give me an appreciation for the difficulties doctors have in communicating effectively with patients.

This round of surgery is interfering with PT and OT, and Tammy is anxious to get back to them. They are grueling, but she will only reach her goals by exerting herself in those therapies.

We had to take a trip away from the Walter Reed yesterday. Tammy was out of the hospital environs for about 5 hours, and that is pushing the limits right now. Sitting up, and getting all of that input for that long a period made her nauseous, and very tired. However, after getting her back and letting her rest for a few hours she was back to her usual cheerful self.

Wednesday, January 12, 2005 11:04 PM CST
Tammy’s arm surgery went well today. There was fluid, but no sign of any bone infection in her arm. All the tissues looked healthy but the surgeons took cultures while they were in there. They are also growing the cultures to see which, if any, bacteria are present. We are keeping our fingers crossed and the doctors are going to monitor her progress and take her back into surgery in a couple of days to wash out those areas again.

The whole routine of surgery is not one that we miss at all. She isn’t supposed to eat after midnight the night before the surgery, and if she is not first on the agenda, she misses two meals straight. Even if she is “first case” for surgery they might not return her to the room until after the normal lunch hours sometimes. This plays havoc with our schemes to get more calories into her. She has lost some weight, and has a hard time keeping things down sometimes. We generally get her anything she would like to eat, and thinks that she can keep down.

Surgery makes her sleep schedule difficult also. She will generally sleep off the anesthesia right after the surgery, and then not be able to get back to sleep during her normal sleep hours.

During this last surgery they placed an IV at a very inconvenient place in her left elbow, which keeps her from being able to bend that elbow. I suspect that the doctor who placed it there only intended it to be there for the duration of the surgery plus enough time to give her one bag of fluids. So far tonight, the IV hasn’t been removed. While this seems like a very minor thing; her left hand is currently the one with which she performs all actions from feeding herself, to brushing the hair from her eyes, to the all important transfers in and out of her wheelchair. She is effectively bedridden, and unable to do anything for herself. This situation causes her a great deal of frustration. We discussed this with her primary doctor, and we are hopeful that the IV will be removed sometime tonight, which will be good since she keeps asking me to scratch her nose.

We have managed to fit Tammy’s wedding band, and engagement ring back on her finger. Occupational Therapy would also like for her to start wearing her requisite “big honkin’ aviator watch" in order to build up her biceps on that left arm. Tammy’s version, a Citizen Navihawk, has a built in E-6B slide rule computer which, (I am quite certain), she will absolutely need very soon in order to calculate her fuel burn rate and ground speed in the wheelchair. (Being an aviator she is very concerned that the newer wheel chair is too slow.) The watch survived a rocket propelled grenade blast that went off just inches away without a single scratch. Seems there must be a watch commercial in this somewhere, with a motto like “takes an RPG and keeps on tickin’”. I think we should, however, avoid Tammy starring in such a commercial since I personally would not want to cause a wide audience to wonder for what, exactly, she may be compensating with the big chunk of metal strapped to her wrist.

Tuesday, January 11, 2005 11:45 PM CST
Tammy is working hard at Physical Therapy. We have posted some photos in the photo section today showing her working on an exercise ball. Currently the physical therapist, (or “physical terrorists” as some of them refer to themselves), are helping Tammy work on balance and core strength. In the future she will also need a great deal of upper body strength to be able to climb on and preflight aircraft, but she wont begin working on upper body strength heavily until her right arm is able to bear some more weight.

Tomorrow, (Wednesday), Tammy will go into minor surgery on her right arm to clean out what could be a small infection around one of the areas that the metal pins of the external fixator had occupied. This is a minor infection, and not as much of a concern as an infection in her wounds before they were closed would have been. The infection area is small and very localized, and the doctors want to clean it out before any infection could possibly reach her bones. It is still surgery though, and there is always some risk in any surgery. No matter how many times we go through this routine we still do not get any more comfortable with it.

I returned to Walter Reed yesterday, and went immediately to see Tammy in Physical Therapy. She looked wonderful, smiling and happy. She was working at some exercises energetically, and then they fitted her left prosthetic leg into its socket and stood her up on a tilting table for a few minutes. She is up to standing for 7 minutes as of today. For the time being, just standing is challenging. It will be much easier when they get her fitted with her right leg. She currently rests all of her body weight on the left socket. When the right leg is fitted she will be able to distribute her body weight over both legs. She also hasn’t been vertical, (except in a chair), for a couple of months. I think it will take a bit longer to get the gyroscopes in her inner ear used to the idea of standing. She will also have to adapt to keeping her balance on the artificial legs.

Odd as it may sound, she looks a lot more like her self when wearing the prosthetic leg. Somehow her body just looks about the right length, and her shape just seems to be more normally proportioned with the leg on, and a foot in about the same place I am used to seeing one. The legs themselves don’t look any thing at all like human legs, but somehow she still looks more “whole” with it on.

Catfish 6 came to see Tammy today and stayed for a good long visit. She really enjoys speaking to Soldiers with whom she served, and we are very hopeful that she will be able to get leave to go back to the demobilization site to meet up with her Battalion when they come home. If that time comes very soon, she may not be able to walk very far or well, but I believe she'd be happy to meet the planes in a wheelchair if it meant them coming home any sooner.

Friday, January 7, 2005 4:09 PM CST
Sorry for the long delay in updates. Tammy is doing well, though she has had some bouts with nausea from day to day. She is very tired of being tired and bedridden. Her wounds are continuing to heal well, and she will probably be fitted with the initial prosthesis for her left leg today or very soon. The prosthetists have "casted" her residual right leg in order to fabricate a "socket" for it, and they should have that completed very soon also. (The socket is a plastic, or carbon fiber device which attaches to the residual limb with straps, or suction, or vacuum, (there is a difference between suction and vacuum, apparently), or a combination of methods.)

Tammy's right socket will be attached to a "C-Leg" which has a computer controlled knee joint that will be programmed to match her gait. The C-Leg is one of the most technologically advanced artificial limbs available right now, though it is still an unpowered leg. Tammy will have to move it forward through a combination of her hip flexors, and her hip movements.

The left leg prosthesis will be much simpler since her left leg is much longer and retains its knee joint. Both legs will be fitted with ankle joints which will help Tammy walk with stability, while preserving as much energy as possible to make walking easier. The ankle joints have some "spring" effect which will help Tammy move forward into her next stride. Amputees typically expend more energy to walk than they did previously with both legs. Depending on her ability to adapt and use her remaining muscles, Tammy may need to expend between 50 and 100 percent more energy to walk a given distance now.

Initially they will stand Tammy up on a tilt table. Her right arm is still healing and is pretty weak, so the usual method of having the patient walk between two hand rails which are set up like "parallel bars" wouldn't be practical right now.

We are moving forward with the modifications to the house, and I now have several sketches to show the boss on my return to the hospital. We will sort out the best arrangement for bathrooms, and kitchens, and get moving on the project pretty soon. I will have to spend at least a week in IL each month working on the house and taking care of Army business. We have had a lot of folks offer their services and labor to help in this project, and we will have to do some scheduling to get the optimal number of folks on each sub project. There will probably be some parts of this that will require a lot of hands at one time, and I will put out a "net call" to all the folks who have contacted us to help.

Though it is the dead of winter now, spring time will be here very soon, (literally and metaphorically, I guess). We'd like to finish the house modifications before the weather gets very warm, as recent events have reminded us that "family time" is a finite commodity, and needs to be a high priority. We don't know how much of it any of us will have, and Tammy and I do not want to cut into the time our friends have with their families. Many of our friends are Soldiers, who have even less time with their loved ones, and they need each summer weekend, and evening that they can set aside for their wives, and husbands and kids.

Sunday, January 2, 2005 3:58 PM CST
Tammy had a red letter day two days ago; her first day in underwear since the ambush. She also spent the night with me at Mologne house for the last two nights, her first overnights away from the hospital. The change of venue is good for her, but, for now at least, the adjustable hospital bed is more comfortable than a normal bed.

Each day she gets a little more mobile, but she is stiff and sore from the previous day’s workouts. Her right hand swells up a bit overnight, and the swelling doesn’t recede until after her first session of Occupational Therapy, (OT), in the morning. Today was a day free of workouts. Her only appointment was a dressing change on her right arm. Tammy’s skin donor site on her right abdomen is healing, but is presently very sensitive to pressure. She still has a “colonization” of an Iraqi bacteria living on the skin of her right arm, but it is not an infection. Her right arm is healing nicely, and the skin graft is doing well also, though it is a little numb right now. We don’t know if she will get more feeling in the skin transplanted from her side, to the back of her arm.

We are beginning to think about how she will get around and accomplish the mundane tasks of daily life such as driving to work. The VA will assist us in buying and adapting a car to her needs. At this point, I don’t know if she will be wearing prosthetics legs for the entire workday, (say 12 hours straight), or employing a combination of wheelchair and prosthetics to get through the work day. She may need to drive to work with the wheelchair. It is relatively easy to fit off-the-shelf products to production cars which allow the bucket seats to swivel sideways for entry. That would help her get behind the wheel. There are also devices which would hoist her wheelchair into the trunk, so she could drive to work with prosthetics, unlimber the wheelchair and ride it into the building. Tammy likes to drive a stick, but there are now cars available with continuously variable automatic transmissions which are nearly as efficient as a stick and would keep her from having to shift. I don’t know if I will be able to talk her into a CVAT transmission, but at least the option is there in production cars. It wouldn’t be as deep an insult to her pride if she has to drive a CVAT as a car with the older type of automatic. We may also switch the pedals out so she can drive with her longer left leg. I believe Tammy will probably attempt to drive with as few modifications/adaptations to a standard car as absolutely necessary, but she is very pragmatic when it comes to safety. I am sure she will accept whatever type of vehicle she needs in order to be safe.

At this point the family and I need to step back and allow her to struggle with things. She needs to work at getting around and accomplishing every day tasks for herself, but it is very difficult to stop myself from just reaching in and doing each task for her.

I will also be leaving the hospital for a short while to fulfill some obligations I have to some of my Soldiers who are going downrange. I need to speak to them, and to their families.

Though I have full confidence in the medical staff here, and her family as well as mine will be here to look after her, it is very difficult to leave her side. I know that this reluctance to leave her here is ridiculous; after all this is a woman who was navigating and taking care of herself on international trips throughout southeast asia at age 15. Though she is now down a limb and a half, she is tough and talented. Since the narcotic pain drugs have been out of her system, she has been mentally sharp as a tack, and emotionally very stable, and more than capable to co-ordinate her recovery and run her affairs all by herself. After all this rationalization, I still have no desire to be away from her. However, we made commitments a long time ago and we must think of our Soldiers and do whatever small things we can for them.

Thursday, December 30, 2004 10:31 PM CST
Tammy received a new rental powered wheel chair today that is a bit cooler, and a bit more maneuverable. She is getting much better at transferring herself into the wheelchair, and as her right hand and arm continue to improve her mobility will continue to increase.

Her daily routine is becoming more and more like the movie Groundhogs day. She gets up, goes to occupational therapy, (OT), goes to Physical therapy, (PT), goes back to the room for lunch and a nap, gets up and goes back to OT, goes back to her room for dinner and a nap, visits with her folks for a while, and racks out for the night. She pushes hard at each work out; if the therapist says “Do three sets of 10 repetitions”, she’ll do four. If the weight she is working with seems tolerable, she asks for heavier weights. That schedule will define her life for the next several months, and I will get some pictures up of her doing OT and PT as soon as possible.

The workouts have had good effect on her right arm. She is more flexible and getting better use out of that hand each day. Unfortunately, her right leg has begun to tighten up, and she is concentrating on keeping the hip flexors, and what is left of her quadriceps stretched, while strengthening her glutes. She will need to concentrate hard in these areas in order to have good use of the short residual right leg.

Many of you have asked if there is any way in which you could help Tammy and me, and until recently we have not been able to conceive of anything that we really need. We would like to announce the formation of “Old Guys Construction Company” which will help us modify our house and make it more accessible for wheelchair and prosthetic users. The “company” consists of a bunch of our friends, military and civilian, who have graciously volunteered some time. (Note: the group prefers a name that is rather more colorful than old “guys” construction, but we don’t want to test the limit on how much “color” our web host will tolerate, and at just for the purposes of presentation here decided to use a PG-13 rated name).

I know that some of you will question the wisdom of allowing a group that includes aviators and other officers to run amuck with power tools. Fear not, gentle reader; a suitable number of NCOs *, and other enlisted folk, have volunteered to provide adult supervision and run the more dangerous machines.

We are trying to arrange a walk through to evaluate the house with a few key personnel on the evening of 05 JAN, or sometime during 06 JAN. We may be able to do some work inside during the cold winter months, like widening door ways, or re-arranging the bathroom layouts to allow better access. We may also co-ordinate one or more days to do large bits of outside construction later in the spring. We could possibly need some help with these projects. I will post the details when we get a bit more organized.

* NCO is short for “Non-Commissioned Officer”, like Sergeants and Corporals.

Wednesday, December 29, 2004 6:17 AM CST
I print off the messages in the guest book each day and give them to Tammy to read. The guest book on the web page mangles the characters of notes written in anything but English, but I can retrieve the document with the proper characters if they are sent to me in an email, as an attached document with an intro telling me in which language the text is written, (bryan.w.bowlsbey@us.army.mil).

Tammy is now attending Physical Therapy once, and Occupational Therapy twice each day. She drives the electric wheel chair and goes to all of her appointments by herself. The therapists are working on her core body strength and stretching and strengthening her hip flexors and glutes, as well as loosening up all the muscles in her right arm and hand.

The doctors have removed the hard cast on Tammy’s left leg, and taken all the stitches out. With that done, she is really looking forward to her first shower in a month and a half. Within the next week the Occupational Therapists will start working with her on learning to transfer herself into a shower chair from the wheelchair. This will take some time as her right arm is still in a stint, and is very, very weak.

She is currently wearing a compression sock on her left leg to help shape the leg for a prosthetic socket. She may be up on her initial prosthetic for her left leg this week. We have also discovered some different options available currently which may allow them to fit her right leg with a vacuum socket made from carbon fiber.

PT and OT are inspiring for her as there are many Soldiers in all stages of recovery in the same large room. Some are just beginning and are still being pushed to the sessions in large reclining wheelchairs, while others are mastering the finer points of walking on prosthetics, or performing fine motor skills with their prosthetic hands.

The wounded Soldiers share a camaraderie that is heartwarming. They also keep up a steady banter; encouraging when needed, but more often playfully chiding each other. If it weren’t for the sometimes macabre humor, I could close my eyes and imagine myself back in the squad bay in basic training; listening to the good natured verbal jousting of young Americans with a common group identity. The missing limbs, the scarred bodies and the adversities they face with courage, haven’t changed the personalities or the essence of the vast majority the patients here. They are still, as American Soldiers have ever been.

Friday, December 24, 2004 9:56 PM CST
We would like to wish a very Merry Christmas to all of our deployed warriors. Of all the days of the year to be deployed this is the most difficult. There are places you would rather be, and absent friends and family whose company you would like to keep.

Soldier on. Your efforts to engage those who endanger our loved ones and who would impose their own theocracy upon us are deeply appreciated. Because of you the nation is safe and all Americans can look forward to many a white Christmas in peace.

Though violent activities seem at variance with the spirit of the day, you continue a long tradition of noble and gallant American warriors who have engaged the enemies of the United States in adverse conditions on Christmas. In 1776 Washington marched his ragged Army all Christmas night to surprise and destroy 3 regiments of Hessians at Trenton. On Christmas day of 1944, George Patton’s Third Army engaged in a furious counter-attack against the Nazis in the Ardennes during the Battle of the Bulge. The next day Third Army established contact with 101st Airborne defending Bastogne and broke the last serious threat to allied victory. Your efforts do them proud. We look forward to spending next Christmas with you.

We have secured a short 4 hour pass for Tammy to leave the hospital for today, (the 24th), and one for tomorrow. We wont be going far tonight, only about 600 meters to the Mologne House, (which is still on post), but I think she will enjoy being out of the hospital. Tammy’s folks and brother will be here for Christmas with her, and my family will come down and visit tomorrow at my new room in the Fisher house. Eventually Tammy will be released from in-patient care at the hospital, and we will both live at the Fisher house for a few months during her convalescence. The Fisher house foundation has built “Fisher houses” at several different Army hospitals, and they operate somewhat akin to a Ronald McDonald house for the families of wounded Soldiers. The rooms are very physically accessible, and close to the hospital so the convalescing Soldier can attend appointments at the various clinics while re-establishing a sense of a normal life.

Tammy and I, as well as both our families, would like to thank you for all of your love and support. We wish you and your loved ones a merry and peaceful Christmas.

Wednesday, December 22, 2004 7:45 AM CST
Medically Tammy is doing very well, though she is now experiencing some infrequent nausea. Her wounds are all healing, and her right arm is in a hinged splint so she can work on her range of movement in that elbow. She is completely free of IVs, catheters, and any other tubes or wires hooked into her body, and is venturing out into the hospital on short excursions to the dining facility, and the various medical clinics that need to see her. The powered wheel chair really gives her a sense of mobility, and she will continue to use it while her right hand and arm heal. She hopes to get up on prosthetic legs as soon as she can.

The current plan is to try and fit her residual right leg with a prosthetic if at all possible. Apparently there is a tendency for an amputee’s muscles to pull a short thigh bone, (such as Tammy has), out of its vertical position, (when standing), and into a horizontal position. She will have to stretch her hip flexors a lot, and try to strengthen her glutes in order to prevent this. It looks like she will have a long row to hoe in physical therapy, and many hours working with a prosthetist trying to fit a socket to her right residual leg. I have no doubts that she will be equal to the task. If anything she is gaining momentum now that she is up and mobile. She is more alive and vivacious and full of fire every day.

Lieutenant General Schultz, (Director of the National Guard Bureau), Major General Thomas, (The Adjutant General for Illinois), Tammy’s entire chain of command from Illinois, and many senior Officers and Enlisted men from Guard Bureau promoted Tammy yesterday to the rank of Major. LTC Allen, her Battalion commander, attended the ceremony while on leave from Iraq, expending precious hours that he could have spent with his family. In addition, she was awarded the Air Medal, and an Army Commendation Medal.

Tammy’s folks arrived today to spend Christmas and New Year’s with her. Soldier’s Angels purchased the airline tickets for Mr. and Mrs. Duckworth, and took them to the airport in Honolulu. Good friends from HI picked them up on this end and brought them to Walter Reed.

Tammy is deeply grateful to all the foundations, Family Readiness Groups, Army units, and private individuals who have sent us funds. We have decided to use some of the funds to modify our house and make it more wheel chair accessible. We will hold the rest in reserve until such time that we can determine that she won’t need them, and then put them back into the FRGs, or the three organizations for which we have web links on this page.

I had replaced the image of the Soldier's Creed with some other photos since we are limited to three pictures on this web page. Several folks have asked about the wording of the Creed. In order to have it permanently on this page I will read it into the record in this journal.

Soldier’s Creed

I am an American Soldier.

I am a Warrior and a member of a team.

I serve the people of the United States and live the Army Values.

I will always place the mission first.

I will never accept defeat.

I will never quit.

I will never leave a fallen comrade.

I am disciplined, physically and mentally tough, trained and proficient in my warrior tasks and drills. I always maintain my arms, my equipment and myself.

I am an expert and I am a professional.

I stand ready to deploy, engage, and destroy the enemies of the United States of America in close combat.

I am a guardian of freedom and the American way of life.

I am an American Soldier.

Saturday, December 18, 2004 3:18 PM CST
Two days ago we saddled Tammy up in an electric wheel chair and let her drive around the hospital. She handled the contraption pretty well, though I had to ground guide and provide the hand signals which were necessary for her to ignore in order get through the tighter spaces. (Aviators will understand the need to ignore at least one ground guide in difficult spots).

Occupational Therapy and Physical Therapy have really bumped up the amount of time they are working with her each day. With her right arm free, they can now start to work on a whole new set of muscles, (in her shoulder), as well as do even more work with her right hand. Only her right elbow is still immobile as it is still in a splint. They also work with her left leg, and her right leg as much as possible. These sessions really take a lot out or her, and she usually takes a two hour nap after each one.

Our main concern presently is how, or whether, the staff will be able to attach a prosthesis to her right leg. That limb is very short, and the doctors have mentioned the benefit of completely removing it, so as not to interfere with a hip disarticulation type of prosthetic. Logically Tammy understands the immediate benefits of removing the limb as described by the doctors, however, emotionally she is not ready to lose what is left of the leg. As Tammy and I have discussed this difficult decision, it occurs to us that the downside of this would be that she will lose any benefit of her hip flexors and glutes which are currently attached to her short femur. The prosthetic leg on that side would just be free swinging, with none of Tammy's muscles, or nerves attached. It would also be difficult to get any feedback, or feel from that leg, and may make it difficult to fly or continue to serve the United States in any capacity. It seems to me, that she would also be married to current technology, and may not be able to take advantage of any breakthroughs, (like a myoelectric leg), that might be available in the future.

This seems potentially like a huge blow, but we keep in mind the Blackhawk which went down a couple of weeks ago near Ft. Hood, TX. Seven Soldiers died in that crash. They wont be going home to their loved ones, in any condition, ever. Our present problem seems much less significant when viewed from the proper frame of reference.

Wednesday, December 15, 2004 9:11 PM CST
Surgery went well today. The doctors cut her arm loose from her side, and stitched up both the arm, and the abdomen. They also removed the stitches from her right leg. All of her skin graft donor sites are healing very well, and she has no more open wounds.

They did not repair the one blocked artery in her arm. They will go back to the OR sometime during January and make two small incisions in her arm, as well as harvest an artery from her left leg, and then graft the artery into her arm.

She hasnt run any fever tonight, though she normally does so right after surgery. Her white blood cell count looks good, indicating that she is still infection free, and she will get her last dosage of anti-biotics tomorrow.

Surgery really tired her out today, and she is sleeping soundly. I have taken to guarding the door and staring down anyone who wants to un-necessarily wake her up to empty her trash, take her vitals every half hour, give her a bath at 0100 in the morning, and many other trivial things that interfere with the prolonged sleep that she needs. The hospital is not a good place to rest, and that is aparently what she needs right now in spades. The doctors have been a great help in this effort by revising and rescinding a lot of the "orders" that had been written along the way and never reviewed. As it turned out, some of the original procedures, ( which were necessary while she was in ICU), were still being carried out faithfully by the staff because no one thought to stop the orders when they were no longer needed. The rest really seams to do her good.

Tammy's largest concern right now, is that they may not be able to fit her resdiual right leg with a socket for a prosthetic leg because it is so short. She doesnt want to lose what is left of that limb, because she still has the use of her gluteus muscles, and her hip flexors to position the limb. If they had to remove her residual limb, she might lose some functionality. She will probably spend a great deal of time working with the prosthetists in the lab on a socket for that limb.

The medical team here have done an incredible job of fixing Tammy so far. For the next several weeks her focus will be healing and physical therapy.

Sunday, December 12, 2004 8:04 PM CST
Tammy is adapting well to life without intraveneous pain meds. She is still getting some oral pain medication, and has some occasional small pains which cause her some stress and tire her out. The physical therapy and ocupational therapy teams have upped their game a bit, and she is getting a real work out every day, even though she is still in her bed. On the upside, without the epidural and arm pain blocker Tammy has more sensation in her residual limbs, and her right arm. She is getting a lot of rest, which helps her heal, and looks even stronger and more vivacious each day.

She is showing no further signs of infection, and all of her numbers, (white blood cells, body temps, etc), are very boring. The infectious disease docs believe they will stop tracking her altogether in a few days, as she appears to be all closed up and doing fine. The skin graft closure operation on her arm this coming Wednesday will signal an end to this phase of Tammy's recovery. After that, hopefully, she will have a lot of healing to do, and many months of physical therapy, but no more surgeries.

An introduction to Army mail for any who may be unfamiliar: Regular US postal service mail seems to be taking about 11 days on average to reach us here. If you would like to pay extra, (like $14), for "Express mail", your package will receive an extra two week, all inclusive spa treatment from the mail delivery types once it arrives here at Walter Reed. Both of the express mail packages we have received have taken over 21 days to be delivered to the room, (though they arrived here at Walter Reed the day after they were sent). Aparently this holds true for FedEx packages as well. I believe you will get the fastest delivery with standard USPS postage, but check the address listed below on this website for the current room and ward, as the hospital staff may need to move her again as her condition improves.

My wife is very apreciative of all the gifts we have received. While she may have some needs in the future, all of our current needs and wants have been met by the Army, and our many friends old and new. She is concerned, however, about some of our wounded comrades who do have outstanding needs, and the Soldiers, Marines, Sailors and Airmen who will be hurt in ongoing operations. Of the many people who have helped us; three charitable organizations have expended large amounts of money and frequent flyer miles on Tammy's behalf. The website links are listed below for: Soldier's Angels, The Fisher House Foundation, and For the Fallen. These organizations have:

- provided kevlar blankets with which soldiers have lined their vehicles in order to protect against grenades and IEDs, and hopefully prevent as many injuries as possible

- provided airline tickets to wounded Soldiers' loved ones

- provided voice activated computers and other equipment to disabled warriors

- provided grants for accesible housing

- brainstormed, co-ordinated and planned extensively to meet the special needs of specific patients which would be impossible for our government to anticipate and meet, and which would otherwise "slip through the cracks".

In lieu of any Christmas gifts, Tammy would apreciate donations to these organizations to replenish their funds, and further their good work. Thank you, one and all.

Saturday, December 11, 2004 7:57 AM CST
The medical teams have completely removed the epidural pain blocker, and the similar pain blocker that were in her arm. Tammy is doing fine, with very little pain. She still has a button that she can push to administer some pain meds through the IV, but she rarely uses it. Her wounds are healing, her infections are either cured, or under control and responding well to the anti-biotics. She hasnt had any fever for several days, and she is resting a lot. This coming Wednesday they will cut her arm loose from her abdomen, and try to close both the arm, and the abdomen.

We will be able to wheel her around in a wheelchair next week. This will be good as it will provide a change of position, and a change of scenery. It looks like we will be able to get her away from the hospital for a while on Christmas day.

Tammy's folks will both be here for Christmas. Her mom has been here, but had to go back to Hawaii in order to care for Tammy's dad. Her father has been released from the hospital and is resting at their home in Pearl City, HI. I dont feel at liberty to release too much medical info on her dad, but he had a pretty serious medical event a week before Tammy was shot down, and another one a week ago. His doctors have determined that he is stable for the time being, and released him to travel here and see Tammy.

We are not alone or isolated here at Walter Reed. Throughout this entire episode Tammy's brother, Tom, and my three siblings have been right here with us every step of the way. They all live relatively close. Tom has been here all day, every weekend, and a lot of weeknights. My brother and sisters are in constant contact with me; running errands, and obtaining anything the hospital doesnt provide. They would probably be here every night also, but they are very careful not to show up too much and overwhelm her. My extended family visits quite often, makes available their homes which are in the local area, and looks for every opportunity to help.

The Guard family has taken every opportunity to embrace Tammy. We have recieved numerous visits from retirees from her unit, spouses, the State Aviation Officers of both IL and MO, the General Officer in charge of The National Guard Bureau, the Assistant Adjutant General of IL, and many other guard soldiers and employees. The Adjutant General of IL will fly out to see her this month also.

The larger Army family, and servicemen and women from the other services stop in, or send cards, emails and letters to show their support. The amputee peer group here have done wonders for Tammy's morale, and shown her exactly what is possible for her. She deeply apreciates all of the time and effort these folks have expended while reaching out to her repeatedly.

People we dont even know, and will never meet, have gone out of their way to help us. I have heard it said that the American people are jealous proprietors of their Army. From our current perspective it is clear that they also take care of their own.

Thursday, December 9, 2004 7:50 AM CST
No surgeries today, Tammy will have another cast placed on her left leg. She will have a series of casts which will shape the leg to fit better in a prosthetic socket.

The doctors were monitoring a slight bump in white blood cells, and and apparent infection of Tammy's blood yesterday. The Infectious Disease Team, in conjunction with Tammy's primary team of MDs, (the PM&R Team, and sorry I dont know exactly what PM&R means), tweaked her anti-biotics, and changed her catheters and PIC line. (The PIC line is a long term IV line which keeps them from having to stick her again every time they need blood, or to administer a drug). Her body responded immediately, and all of the lab numbers looked good, both late yesterday and this morning.

The Occupational Therapy and Physical Therapy Teams stop in every day to limber up, and strengthen her muscles. They are constantly working on her right hand even though it is swollen, and that arm is still stitched to her abdomen. I have secured a Blackhawk, (helicopter), model for her to put together as part of the therapy on that hand. The younger soldiers build '57 Chevy models and the like, but I thought I could better target my girl's interest.

Each day I look at her right arm, which was a shattered appendage when I first saw her, and marvel. The arm had been placed in an external fixator, a large metal "tinker toy" looking contraption which holds a shattered limb together with pins through her wrist bones, and pins through her upper arm bone. It looked, (to me), as though the back part of her arm was gone, including all the flesh, and the tricep muscle. One of the two arteries in the arm was blocked.

To my amazement, (and initially my disbelief), the medical teams seemed completely unconcerned for her right arm and acted as though it would be an almost simple effort to fix it. They explained that her hand already had adequate blood supply, though the Vascular Team could easily rebuild the blocked artery and give her "a little more juice in that arm" when the time was right to do so. At the time, they already knew she had at least two thirds of her nerves intact, (we later found she had all 3 nerve bundles intact). Though both bones in the lower arm, and the bone in her upper arm where shattered, her elbow joint was still usable. She also had a great deal of her tricep muscle intact, and they were able to re-attach it after patching together all of the bones with plates and pins. The Orthopedic Team with help from all the other medical teams, has rebuilt that arm into a scarred, but functional limb.

Tammy is extremely thankful for all of the efforts which have enabled her to survive. She is keenly aware that her survival depended on efforts that began at the mobilization station, starting with the leaderships' policy to exceed the Army's requirements to train soldiers as Combat Life Savers. Though we are aware of some of the operational details, we will not post them on this public site. Rest assured, however, that she knows the cool judgement and swift action of the other pilot in her aircraft, as well as the other two pilots in the trail aircraft were crucial. While she does not remember the trip from the ambush site, the MDs have told her that she would have bled out within minutes if it hadnt been for someone's actions in the back of that helicopter. If, (as has been reported to us), anyone has the impression that they "failed to stop the bleeding", that impression is wrong. Those efforts slowed the arterial bleeding and got her to the hospital with some blood still in her body, and without them she would have died. While we dont know many of the details about the actions of the medevac personnel, or what happened at the hospital in Baghdad, the results of their work are evident. Thank you, Thank you, Thank you.

Monday, December 6, 2004 10:09 PM CST
Tammy would like to thank everyone that has sent emails, notes, cards, bears, flowers and encouragement of every kind. We hope that she will be mobile enough, (and have enough dexterity in both hands), in a couple of weeks to return some emails on her own.

We found a large piece of shrapnel embedded in the bridge of her nose yesterday. The medical folks, (and me), all thought that the thing was a piece of dried blood from a deep cut in that area. As I was cleaning her face this hunk of metal fell out of the hole in which it had embedded itself. It left a large hole, which we got cleaned out and covered with some antibacterial gel. It is already visibly closing and healing. Had that shrapnel hit her an inch either left or right of where it did, she would have lost an eye. In my religious tradition we say that He notes the fall of each sparrow. After that discovery, and another review of the incredible and miraculuous chain of events that led to Tammy's survival, it occurs to me that He must be battletracking on each Blackhawk crewmember also.

We had a visit from an MD who was checking on Tammy at the request of a friend of his at the surgical hospital in Baghdad. Apparently they tried to revive Tammy when they amputated her legs. They were unable to get much interaction from her but she repeatedly asked "How's my crew?". My understanding is that one of the enlisted guys in her aircrew was quite insistent at the hospital in Landstuhl, Germany when the medical staff didnt initially want to share Tammy's status with him. One of the enlisted guys was brought to Walter Reed, and as soon as he was able he had his nurse whell him over to see her. Tammy's unit tells me that the other pilot, (who actually landed the stricken aircraft and forged the first link in the chain of events that saved her), had asked the Chain of command for info on her status nearly daily. I dont think these guys had flown together that long, or that often. I am impressed with how "tight" they seem to be.

Tammy's wounds are all closed, and her right arm is stitched back together. (Tammy says the right arm currently has a very Frankenstein-ish look about it, with lots of large gauge thread,and very widely spaced stitches). They are monitoring her for the next couple of days for signs of infection.

She picked out an electric powered wheel chair, and a "haoli boy powered" wheel chair, (me being the haoli boy), today. She will use both for the iterim period where she is not up to speed with the prosthetic legs.

Since some of the viewing audience will be Aviators, I was sure to ask "What is the top speed of the powered wheel chair?" Answer - 7 mph, or 6.09 kts. Top speed of the "haoli boy powered" chair is "to be determined".

Sunday, December 5, 2004 1:13 PM CST
Tammy had surgery today to close up her left leg. She did fine, and is sleeping well. With luck, she will have no infections, and we can get to the business of healing, and then being fitted with prosthetics. In another 1.5 weeks they will cut her right arm free, and it will be much easier to work on her right hand. Her left hand and arm are still a little stiff, but completely functional.

I am hopeful that she will be mobile enough at Christmas that we can take her on a small excursion away from the hospital. She may be done with the IVs by that time, and maybe even the epidural pain block also. They have already dialed back the pain blocker on her right arm.

Friday, December 3, 2004 10:14 PM CST
Tammy received the Purple Heart from Brigadier General Mundt the Assistant Division Commander for Support for the 1st ID, (that's first infantry division, aka "The Big Red One" for those who arent fluent in the Army dialect). BG Mundt, his father, and Tammy had worked together to place wheelchairs in Iraqi hospitals through Rotary International prior to Tammy being deployed to Iraq. The General is also an Aviator, and it meant a great deal to Tammy to receive the award from him. It was especially meaningful to me when I realized that during Tammy's 2 week leave from Iraq, she and I retreated to our house and did absolutley nothing but enjoy each other's company for the entire time. The General and his wife chose to spend some of the precious few hours that they had while he was in the states to see Tammy and another wounded soldier at Walter Reed.

No surgery today. Tammy is tired of being in bed, uncomfortable, and ready to move on. I think the sameness of lying on your back in the same place, eating the same food, and not being able to get on with your life for weeks, is hell for those of us with Type A personalities.

The photo above shows Tammy and some of the boys from Orange County Choppers. She has watched that show, (American Chopper), at every opportunity for about two years now. Those guys didnt get paid a dime to come here with the USO. My wife, and many of the younger Soldiers here really enjoyed their visit.

Thursday, December 2, 2004 3:01 PM CST
Tammy had surgery today, (see yesterday's journal for the details of the plan). They washed out both leg wounds, re-looked at the arm graft, and tried to close the right leg.

I got a little reminder that we are not quite out of the woods when the pumps on her pain meds started to malfunction, and her pain began to rise. The MDs quickly administered a shot of a different pain med to ease the pain, but the side effect of the drug was to make her a little loopy. Doesnt sound so bad, but I have never seen Tammy even drunk. She was talking a little non-sense, and got a little emotional.

I had begun to see only the upbeat, happy Soldier that Tammy is careful to project when she is in complete control. Today was a reminder that, while we can see some glow in the direction of the end of the tunnel, it is going to be a many months before we again have some semblance of normality. Dont get me wrong, I know this woman and she will attain all that she sets out to do. It just wont be next month that she will be walking as per normal.

Tammy got a visit from a former Special Forces Soldier who lost both of his legs as a parachutist with the Army's Golden Knights demo team. After the accident he returned to jump as a member of the Golden Knights on active duty. He is a civilian pilot now flying and instructing in airplanes and helicopters. This gentleman is also very inspirational. I think he can physically teach her to use the prosthetics to fly helicopters. Turns out Tammy knows some excellent Army IPs who can get her up to speed on Army helicopters and airplanes. Tammy has already begun planning how she will physically prove that she can stay in, (the Army that is), and fly.

Wednesday, December 1, 2004 7:33 PM CST
Tammy is doing well and is upbeat as ever. Paul Sr., Mikey, and some of the other guys from Orange County Choppers stopped in to the ward yesterday and visited for a bit. I'll get a picture of Tammy and those guys posted just as soon as I can get it scanned.

She will go back to surgery tomorrow morning to clean out her right leg wound again. Both of her leg wounds are still open, and they periodically take her back to the OR to wash them out. They used to try to close up wounds in theater, but the newer procedures are to get the soldier back to a stateside hospital with the wounds still open. They cover the wounds with a thin sponge, and then a layer of cellophane like plastic. Then they poke a hole in the plastic, and attach a tube through which they pull a vaccum on the wound. This sucks all of the fluid out of the wound in which bacteria used to grow. The MDs want to be sure not to close her up before they know that the nasty bacteria she picked up in Iraq are defeated, along with any ecoli, (or the like), she might have picked up in the various hospitals. The docs are constantly adjusting the cocktail of anti-biotics she is getting, and her white blood cell count,(an indicator of how bad the infection is), is looking good.

She has almost no pain. The docs have installed an epidural (sp?) pain blocker, (like women get when giving birth), to block the pain in her lower extremities. She also has a "shunt" pain blocker on her right arm. Addiction to pain meds is aparently no a problem with the current methods.

The right arm bones have been completely rebuilt. She has good blood supply to her right hand and all three nerve bundles to her hand are intact. Her ulnar nerve, which controls sensation and some motor function in the outside part of the hand, is bruised and may take some months to completely recover. The major long term effect will probably be a slightly stiff elbow. Her arm is currently stitched to her right side because they will graft some of the skin from her abdomen to cover the back of her arm.

Tammy receive a truckload of mail today. Everything in the system finally caught up with us. The best address is listed below on this website, and I will update it should they move her again.

Tammy apreciates all the support and kind words from our comrades, extended families, and friends. She also apreciates that there are various opinions concerning the war in Iraq, and folks who have been supportive of her have spanned the entire spectrum of political beliefs. As Soldiers, Tammy and I feel honor bound not to publicly endorse any partisan political agenda. We know and love good people on both sides of the fence.

(I know some Soldiers have forgotten themselves and publicly expressed partisan beliefs in contradiction to Army regulations, (AR 600-20), and the underlying Code of Federal Regulations. While we could probably "get away with it", we wont do it, as such actions would compromise everything in which we believe).

In the final analysis, from the time she swore the Oath of Enlistment at Georgetown Army ROTC, (14 years ago), she has been honored to, "obey the orders of the President of the United States and the officers appointed over" her. This applies to all lawful orders, and nothing can negate that obligation. She still does not regret that commitment, nor would she allow her soldiers to go into harm's way with out her.

I wish all of you could see her. She is full of life, and spirit, and ready to overcome the obstacles in her path.

Tuesday, November 30, 2004 8:36 AM CST
No big news today. I have uploaded a new picture in the picture section showing her aircraft after the shootdown. The holes in the nose and the roof were caused by a rocket propelled grenade. Tammy was sitting in the right seat, right between the entry and exit holes in the airframe. The grenade appears to have detonated between her feet. We are very fortunate to have her alive and doing so well.

The cast from "American Chopper" are visiting Walter Reed today. Tammy is a big fan, and they will visit her in her room. Maybe we can talk them into fabricating a "Blackhawk bike" on the show.

Sunday, November 28, 2004 7:54 PM CST
No large medical changes today. The Operating Room schedule was full today with other casualties. Tammy has been scheduled to go to the OR for two days, but only to continue to debride and inspect her wounds for infection. Her pain is almost completely blocked with an epidural (sp?), and a local anesthetic block for her right arm. The Physical therapists stop by each day and work with both arms and her left leg.

Some of the other amputee soldiers who have been here a while visit her each day. Tammy and I are older, and officers, and we know and understand the obligations to which we have committed ourselves. When the young ones who have lost a limb encourage Tammy to "keep the faith" it evokes in both of us a strong emotional response. These young kids who have already paid such a heavy price cant wait to return to duty. They remind me of the immortal words of Thomas Paine:

"These are the times that try men's souls. The summer soldier and the sunshine patriot will, in this crisis, shrink form the service of his country; but he that stands it NOW, deserves the love and thanks of man and woman."

Tammy has rededicated herself to the mission, chosen some long and short term goals, and is moving forward.

Saturday, November 27, 2004 3:28 PM CST
Tammy is doing well today. She has had no surgery, and been able to get a day of rest. She is eating solid foods and is feisty as ever. She is able to receive visitors, and an old friend from her days in the Army Reserve stopped in to visit. I think that visitors give her some diversion from the standard topics of conversation that she can get from her mother and me.

Her wounds are not yet free of infections, so the doctors take her back to the operating room every few days to clean them out. We hope to have her wounds infection free and closed up within a week or so. Physical therapy has already started. She is working both hands and her right leg.

Her right arm is currently stitched to her abdomen, as the doctors are grafting some skin from her abdomen to cover the back of her arm. The arm will remain stitched to her side, and supplied with blood from her abdomen, while the transplant skin develops blood vessels through her arm. Once the transplant skin can supply itself with blood through the arm, the Docs will cut her arm loose, fold the abdomen skin around her arm, and close both wounds.

The doctors have already rebuilt her right arm bones, and verified that the nerve bundles to her hand are intact, repositioned her ulnar nerve and re-attached her tricep muscle. Her elbow may be somewhat stiff, but she should have good use of the right arm and hand.

Tammy has asked me to post the Soldier's Creed by her bedside, (see the photo area on this page). It seems to give her great strength and resolve.

Thank you for the continued support and kind words and messages.

Friday, November 26, 2004 1:35 PM CST
She is doing well after an all day arm surgery session two days ago. She probably wont have full range of motion in the right arm, but all three nerve bundles to the hand look intact. She has moved all her right fingers and thumb, and seems to have some sensation in the right hand. Sounds to me like she should easily have enough range of motion to at least fly a civilian fixed wing.

She has also decided to set precedent for the Army and try to be the 1st bilateral amputee to make it back to flight status in recent times. We are encouraged to think this may be possible by a USAF visitor who has made it back on to flight status with an amputation. In addition, Tammy had a visit from an old crusty Vietnam Vet, (who is well known and loved throughout 1-106th), who told her of a Vietnam era Army Aviator who was a bilateral Amputee. There may be precedent. Even if attaining flight status again may be slightly optimistic, we are pretty sure the Army will find some MOS where she will be able to continue to serve.

We soldiers talk about the Warrior Ethos, but I am not sure I understood it intuitively until I saw it in the eyes of our wounded comrades here at Walter Reed. They are indomitable.

Soldier on.

God Bless.

Friday, November 26, 2004 9:30 AM CST
I am CPT Bryan W. Bowlsbey, Tammy's Husband. The following are exerpts from email SitReps that I have sent back to her Army Unit:

14 NOV 04

My wife is manifested today on a flight from Landstuhl to D.C. arriving at 1530 local time. I will meet her at Walter Reed. Though I am in Maryland currently, I anticipate the Dept of the Army casualty office will still cut invitation to travel orders, in order to get me a room, and bring her mother here from Honolulu. I will forward you those orders as soon as I get them.

Her Blackhawk was hit by an RPG in the chin bubble on her side of the aircraft. The round exited the roof of the aircraft without hitting the rotors. My wife has lost most of her right leg, and her left leg below the knee. The round, or spall of some sort, impacted her right arm, (which was on the stick), shattering it in several places. She can move the fingers on the right hand, so nerve damage is minimal at worst. She is conscious and responding.

18 NOV 04

Tammy Duckworth has arrived at Walter Reed, and gone through the initial rounds of assessment and debridement of wounds. She has been heavily sedated the entire time, but her skin color has returned, her temperature and heart rate have returned to normal parameters, and the swelling has lessened dramatically. She will probably stay in the Intensive Care Unit for several weeks. In the ICU they monitor every hiccup, 24/7, with a dedicated nurse who does nothing but track on Tammy's condition. They have a bunch of sensors, and tubes attached to her, but the data they are receiving is encouraging.

Her leg wounds have not changed very much since she left Baghdad, though they have cleaned them up. Her right arm has a viable blood supply, and at least 2 of the 3 nerve bundles that actuate her right hand are undamaged. Early next week the hand doctors here will obtain some cutting edge new equipment with which they will rebuild the bones in her arm. This equipment has recently passed some clinical/prototypical type testing with the Docs here and Tammy will get the first of the production run. They will also fix an arterial blockage in her arm, and assess any damage to the third nerve bundle that allows her to have some sensation in her hand. She has a nasty looking flesh wound on that arm, but as it turns out, that will be rather easy for Walter Reed to fix.

She periodically fights through the sedation and opens her eyes to look at her mother or me, and nod or blink when we speak to her. She still has a breathing tube inserted since she will be going through surgery every other day for some time. The tube is not necessary for survival, her lungs, heart and internal organs are fine. (Note: I dont know if the new body armor is uncomfortable, but please tell the aircrews to wear it. I am not sure if Tammy would be with us otherwise.) The Docs assure me that, barring any odd infection, she will survive.

The staff here at WRAMC are incredible, causing me to rethink my attitude toward the Army Medical Community. There is a steady stream of Doctors, (all tops in their respective fields), that comes to see her every day. All that I am able to find on the web and elsewhere suggests that Walter Reed is the premier facility in the world for this injury.

The outlook for Tammy is now a question of quality of life. She is a warrior, and I am sure will launch herself into rehabilitation as she has everything else in life. There will be no impact to her civilian job, (I have spoken with them), and though she may have flown her last Blackhawk mission, she will be able to fly civilian aircraft if she chooses. At some point in the future a medical board will determine if she can stay in the Army. The Army has retained some amputees recently, but she is a double amputee with one very short leg. I am not sure if she will have the option to continue to serve in any capacity. While she was home on leave she had indicated that exercise would be a big part of the rest of her life. She will be able to swim, and the prosthetic experts here are already looking into what other forms of exercise she may be able to enjoy, (and there are many from which to choose).

20 NOV 04

Tammy is awake, with the breathing tube gone, and she is talking to us. The greatest joy in my life to date was the realization that she was nodding in response to me. As soon as they pulled the breathing apparatus out of her throat she looked at her mother and me, and said, "I love you", and then "Put me to work", (she had overheard the nurse explaining a respiratory exercise to me).

It was necessary to tell her that she had lost her legs, as she felt the phantom pain in the appendages, and didn’t understand why the pain meds weren’t taking that away. The head MD in the ICU and I told her of the extant of her injuries this morning. While that was probably the most difficult thing I have ever done, she received the news with poise, and stoicism. She listened to my run down of all the things amputees are doing here, and my explanation of how this injury will actually not have much impact on the quality of her life, (and amazingly, it really wont). She then told me, "I love you, but you stink. Go Shower."

So we are in good shape. Her injuries are on the mend, the medical team is incredible, and her attitude is top notch.

Thank you for all the words of encouragement and support.

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