9.11 Ceremony and PT

September has been a great month for Kyle and his recovery.  The month has been filled with hard work, lots of company and visual signs of improvement.  He mostly gets around with crutches now, and as he says, "Isn't it great to see me vertical?"  Yes it is.  All of Kyle's doctors, his physical therapist and family and friends have been extremely impressed with his fast pace of healing.  He has come so far in just three months.  He is very determined and focused on taking care of his leg and making a full recovery. 

Kyle returned to Bethesda this month to meet with a pain management doctor and his plastic surgeon, Dr. Basile.  All reports were good!  The wound on the inside of his leg is really closing up and new skin is growing.  He will return to Bethesda in four weeks to see Dr. Basile again and also meet with his orthopedic surgeon to see how his bones are healing. 

Kyle attended a 9/11 Ceremony recognizing those who perished in the terrorist attacks and our fallen heroes on that day.  Brian Barbieri sent in some photos for the blog so I have included those here.

 Kyle shakes hands with Brian Barbieri during the 9/11 Ceremony held at the Lower Burrell American Legion.  It was the terrorist attacks on September 11th that motivated Kyle to pursue a military pilot career and defend our country's freedom.  

Kyle talks with U.S. Congressman Mark Critz, of Pennsylvania, during the 9/11 Ceremony.  Critz had gone to Bethesda to visit with Kyle when he was an inpatient at the Naval Medical Center.  

Kyle walks down to the gym at physical therapy using his crutches.  He used to have to use his wheel chair to get there because it's a fairly long walk.  But now he is much stronger and can walk down with his crutches.  (Kyle's mom, Elsie, was able to take him to this physical therapy session and she sent in all of these photos - these are from the week of September 20th)

Kyle uses the leg press to strengthen his quads.  

Kyle walks on the stair master working his muscles and gaining strength in his legs.  

He rotates his ankle with weights in all four directions so it works his ankle and helps the mobility in his foot.  

Kyle stretches his calf and right leg.  

Kyle cleans out the wound on the inside of his right leg.  He does this once a day now after his morning shower and then covers it with a bandage for 24 hours.  

The open wound on the inside of his right leg has drastically decreased in size and is looking very good.  Dr. Basile even exclaimed, "Wow!", when he first saw it.  

A view of his entire leg with the spatial frame. 

The inside of Kyle's leg with new skin and a very small wound.  It's so exciting to see how much it is healing!  He has been using an ointment that helps remove dead skin tissue and promote skin growth. 

 

The outside of Kyle's leg, with the other skin graft, that seems to get forgotten about sometimes because the inside has been the "problem area".  The outside graft, which is rather large, is looking really good.  Dr. Basile said it was coming along well and he was very pleased with it.

Moving Around on Two Feet

Kyle has made significant progress over the last few weeks and is really getting around so much better using both of his legs.  Over Labor Day Weekend he was just starting to walk a few strides at home, and more at therapy, without his crutches or a cane.  He relies mostly on his crutches still to get around, but it's wonderful to see him standing upright every day.  This has also helped Kyle get out of the house more and have some time to visit with friends and family beyond the boundaries of Hillview Drive.  Although he's always ready to get back home and enjoy some home cooking and time with his parents. 

Kyle walking through the front yard on his crutches.  

Taking some steps without using crutches!

Standing up in the kitchen, using a cane, and getting his own water and everything.  

The inside of Kyle's right leg, the "problem area", that is visibly getting smaller and healing with some ointment treatment the plastic surgeons gave Kyle in August.  He will return to Bethesda on Sept. 22 to meet with them again and have his grafts examined.  

Looking down Kyle's leg where some of the drills enter his skin.  

Kyle applies other ointment to the outside graft on his right leg which really looks to be healing very well.  

Out visiting with some friends on his neighbor's property, Tree's Hill.  

Enjoying the fire on Tree's Hill before heading home to rest for the evening.  It was a beautiful night and nice for Kyle to spend some time with some of his close friends. 

Therapy at Home

Kyle goes to therapy three times a week and does therapy at home on most of the other days.  He's working hard to regain mobility in his right leg and foot.  He has made a lot of progress in the last few weeks and has begun walking with just one crutch!  He is determined to walk again, and soon.  And he is ready to get rid of his wheel chair too.

Kyle works with his mom, Elsie, to stretch his right leg and work at moving his foot up and down while she applies pressure on his foot in his bedroom at home.  

Elsie applies pressure to create resistance for Kyle to push against and exercise his foot.  

Kyle counts his exercises while laying in bed.  

Kyle works through the exercises while laying in bed; it's not too painful for him but does require a fair amount of physical and mental effort. 

Kyle tries to grasp a towel with his toes; an exercise he does at physical therapy which can be frustrating but is helping him improve the mobility in his foot.  

Kyle practices walking down the hallway on both feet with his walker upstairs in his parents home. 

 

Walking down the hallway with just a little pressure on the right foot.

 

A short walk with some pressure on the right foot with the walker has helped Kyle tremendously and now he can really get around on his crutches.  

 

An update on the skin graft site on his upper right quad. 

  

Kyle lays in bed doing a few more exercises with his right leg before finishing his home therapy for that day.  

Kyle stands in front of his parents house on his crutches.  He is walking around much more like this every day.   Photo by Elsie Deem. 

Arlington

This week Kyle went to Arlington National Cemetery in Virginia to attend the funeral for Captain David Wisniewski, a fellow Pave Hawk pilot who died from injuries suffered in Afghanistan.  Two members of Kyle's squadron at Moody AFB, Captain Brion Stroud and Lieutenant Don Smith, came up to Pittsburgh to get Kyle and drive him down.  He was so appreciative for everyone's efforts to help him attend the service.  It was a sad day and a day to remember all those soldiers and their families who have served to protect our country, and those that still do.  Thank you and God Bless.  

Kyle stands by the van and is ready to hit the road with Capt. Stroud and Lt. Smith.  Photo by Elsie Deem. 

Kyle, Lt. Smith and Capt. Stroud getting ready to head out.  Photo by Elsie Deem. 

Captain Shonkwiler and Lieutenant Colonel Tom Kunkel walking through Arlington Cemetery to attend the funeral.  Photo by Kyle Deem. 

Arlington Cemetery.  Photo by Kyle Deem.

Capt. Shonkwiler and Lt. Col. Kunkel walking to the ceremony.  Photo by Kyle Deem. 

 

Members of the United States Air Force Honor Guard await their next commands during the military burial at Arlington.  Photo by Kyle Deem. 

Lt. Col. Kunkel and Capt. Shonkwiler drove Kyle back to Pittsburgh and had dinner with his family.  Photo by Elsie Deem. 

Lt. Col. Kunkel brought Kyle his first Air Medal and read the citation to him in his home on Monday evening.  Kyle was awarded this for his combat missions flown in Iraq.  Photo by Elsie Deem. 

Kyle holds his Air Medal.  Photo by Elsie Deem.

Follow Up in Bethesda

Kyle and his parents returned to Bethesda this week to meet with his orthopedic, vascular and plastic surgeons for follow up appointments.  The Deems left Pittsburgh on Monday afternoon and headed for Bethesda.  The drive went well and they settled in for the night and rested in preparation for Kyle's first appointments the following day.

Kyle sleeping in the back seat on the drive to Bethesda on Monday.  Photo by Elsie Deem.

On the computer in the hotel room - Elsie noted even the handicapped room was a bit tight in spots.  Photo by Elsie Deem. 

Kyle was discharged from Bethesda NNMC on Sunday, July 25th.  His first out-patient appointment at NNMC was scheduled with one of his orthopedic surgeons about three weeks later on Tuesday, August 17th.  The doctor reviewed Kyle's x-rays and the position of the spatial frame.  It did not need any adjusting at this time because the frame was supporting his bones in a good position for healing.

The doctor expressed their plans to keep the frame on his leg for six months.  This was the maximum time Kyle had been told the frame would remain on his leg for, so everyone was a bit disappointed it wouldn't be for less time.  But the doctor assured him he was healing at an appropriate and expected pace and he would walk again, it just may be a little while.  The orthopedic surgeon wants to follow up with Kyle in two months.  

The white dots and markings seen throughout his leg are pieces of shrapnel from the gun shot.  Kyle's body may force out some of the smaller pieces but some of the larger pieces will remain for his lifetime.  And yes, he will probably be setting off metal detectors at the airport. 

Following that appointment, Kyle went to meet with one of his vascular surgeons.  The surgeon Kyle met with was very informative and thorough.  Unfortunately, while feeling for a pulse for a long time on the back of Kyle's foot/ankle area, he told Kyle his artery was failing; this was information the doctors knew since the angiogram they had performed on Kyle back in the middle of July.  The lack of pulse confirmed this report.  This was the artery surgeons in Afghanistan had tried to repair by grafting a vein from his left leg and placing it in his right leg.  This combat surgery just didn't last and there is nothing they can do at this point.

He also had lost another artery from the original wounding.  Kyle will have to recover with one of three arteries functioning in his lower leg.  The doctor was encouraging saying he had enough blood flow to make a full recovery with, but he just had no reserve.   The vascular surgeon wants to see Kyle in six months, once the spatial frame is removed. 

The next day, Kyle met with his head plastic surgeon (he remains to be one of Kyle's favorite doctors whom he has the utmost respect for).  They needed to do some cleaning of his leg, debriding his wound and removing dead tissue.  They bandaged it up after and want to see Kyle back in Bethesda in four weeks to check on its healing progress.  He will need to be very careful to keep it clean from any infection.  

Kyle snapped this photo on his cell phone and texted it to me.  I was a bit surprised to see it pop up on my phone.  The doctor used a scalpel and a pair of tweezers to debride the wound, removing dead tissue.

The wound inside his right leg after the cleaning.  Photo by Kyle Deem. 

The inside of Kyle's right leg after the cleaning.  Photo by Kyle Deem.

An assistant talks to Kyle after the wound cleaning is complete and discusses some details about his wound with him, along with sharing stories from Afghanistan for she had also spent time working there.  Photo by Elsie Deem. 

Kyle on the sixth floor at Walter Reed Hospital headed for neurology on Wednesday afternoon.  They were planning to do a nerve conduction study on his right leg but it didn't take place because the doctors at Walter Reed were unaware of the spatial frame and overall physical condition of Kyle's leg.  The study would give a fairly accurate report on the functionality of the nerves in Kyle's leg.  Photo by Elsie Deem.  

Since they couldn't do the nerve conduction study, Kyle talked to two doctors about his leg and they answered many of his questions.  Everyone felt that was time well spent and appreciated the doctors time with Kyle.  Elsie, Kyle and Bill went back to the hotel and packed up their things and got on the road to drive back to Pittsburgh that afternoon.  They would return to Bethesda in four weeks.  Photo by Elsie Deem.