Bob Green—Grabbing Life by the Fingers

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By Karen Henry

Today, Bob Green of Bel Air, Maryland, uses his fingers to do things like open drawers, type on a computer keyboard, hold a fork, pick up small objects, and sign his name. Not too bad considering that six months ago, he didn't even have fingers.

Green sums up his experience over the last 18 months by saying, "I've been to hell and back."

Dark Days

Over the Thanksgiving holiday in 2008, the 59-year-old father of three started to experience flu-like symptoms—fever, achy joints, and vomiting. When he noticed a purple spot on his hand and another one on his thigh, he immediately went to the emergency room at the Upper Chesapeake Medical Center, Bel Air. Within hours, he was diagnosed with meningococcal meningitis. Shortly thereafter, he developed sepsis.

The bacteria wreaked havoc on Green's body. All of his fingers on both hands had to be amputated at the metacarpals; he also lost the thumb on his left hand, half the thumb on his right hand—which he describes as "a savior"—part of his left elbow, and part of the heel on his right foot. His knees suffered extensive damage, resulting in the loss of both kneecaps, and he has tendon damage in both legs.

"It was at the point where they were deciding whether or not to amputate my legs at the knees," Green says, "but they thought they could save my legs and have done so."

Green spent the next four months in the intensive care unit, during which time he endured 12 surgeries on a schedule of two surgeries per week—mostly to debride his wounds and put in wound and muscle flaps. Recently, he also had reconstructive surgery on his left knee.

Outlook Brightens

The ProDigits system has helped Bob Green be more independent in activities of daily living. Photographs courtesy of Bob Green.

During what has otherwise been a very dark time for Green, there have been a number of bright spots—the love and support of his three children and his wife Deborah, whom Green refers to as his "angel;" the dedication of his physicians, surgeons, and extended healthcare team; and Green's own determination to cling to the life and family that he loves. But perhaps one of the brighter spots to date has been a discovery Green's son made while searching the Internet for ways to help his father, who at the time had just had his fingers amputated.

"My son came across this company that had come up with this thing called the i-LIMB Hand, and he sent off a note to them saying that his father had lost his fingers, and is there anything you guys can do for him," Green recalls.

A representative from Touch Bionics got in touch with Green's wife, but at the time, it was too early in his recovery process to even consider a prosthesis. The possibility was dropped until July 2009, when Green's wife received a follow-up call from the company. Touch Bionics asked if they would be interested in traveling to Philadelphia to see its ProDigits partial-hand prosthetic device. The Greens decided to take the trip and listen to what the Touch Bionics people had to say.

"Within the first 30 minutes," Green says, "they looked at me, and they said, 'Mr. Green, I think we can help you.' The next thing I know...we are in Ohio, and they are setting me up with these fingers on my left hand."

A Good Candidate

Touch Bionics clinician Nate Wagner, CPO, LPO, OTR/L, says he knew very little about Green when he first met him in Ohio, but the first thing that stood out to him was "his positive outlook on life. He is just an amazing guy."

Wagner says he knew right away that Green was a good candidate for the ProDigits system because of the length of his residual limb—"it was long enough that it provided suspension but short enough to allow us to add the ProDigit fingers without making the length too long," he says—and because they easily found two myoelectric sites that they could use for control.

Nate Wagner, CPO, LPO, OTR/L (right), works with Bob Green on gross motor tasks.

"We wanted to see how he would function with the ProDigits system, so we decided to go with just one hand at a time," Wagner says. "Because both hands presented in a similar fashion, we decided to fit his dominant hand thinking that it would be the more natural approach.

"When we first put the fingers on...he just stood there and looked at it, and I thought something was wrong," Wagner continues. "He was actually tearing up and saying, 'It actually looks like I have my hand back.' I was in the moment of 'Was it working? Was it fitting? Was it functioning right?' And he was just looking at what he saw to be his hand again, which just put me back. It was a great moment."

"I just broke down and cried," Green says. "I said, 'I can't believe this—that anybody was able to come out with a product or tool for someone...who has their palm but no fingers...and I was being set up with it.... It's just totally unbelievable to be able to get back some of that ability and functionality I had lost because of the illness. It is a miracle."

Over the course of the next three days, Green worked with Wagner and a Touch Bionics occupational therapist to learn how to use the muscles in his hand to manipulate the ProDigit fingers.

"We usually start with gross motor tasks—open and close around an object—and then progress to fine motor tasks such as picking up Skittles, which you can imagine being very difficult to pick up," Wagner says. They also worked with Green on performing a variety of activities of daily living (ADL) such as tying his pants and being able to pull them up and down.

"One of the things I had to do is sign my name...." Green says. After he had completed the task, he remembers Wagner saying that he wished they had something to compare it to. Green's wife produced her husband's driver's license, which Green had signed two years before. When they compared his newly penned signature with the driver's license signature, Green says he was overwhelmed to see that "it was dead on."

Learning to use the ProDigits system "was extremely easy," Green says. "I lost my fingers, but I didn't lose the process in my mind, so it was interesting for me to learn how to do these things again."

'Luckiest Day'

Green went home with his new fingers on Friday, November 13, 2009—a day he refers to as his "luckiest day"—and says that eventually he would like to have ProDigit fingers fit on his other hand.

"It doesn't give me back everything I had before," Green says. "But it does give me back my confidence in the way that I can live going forward. It's unbelievable. Totally unbelievable."

Karen Henry can be reached at