Mantra Helps Former Marine Thrive

On December 1, 2011, Nick Kimmel was a young marine on his second deployment in Afghanistan. That morning his unit was building a patrol base for a clearing operation in the Sangin Valley. Kimmel was standing on a forklift taking measurements for a guard post on the perimeter of the patrol base. Dressed in full combat gear, Kimmel says he weighed about 280 pounds. “When I jumped down off the forklift, I landed with enough force to set off a 40-pound IED [improvised explosive device],” he remembers. Kimmel said he was lucky that the device that detonated beneath him had likely been buried for more than six months, so only about 13 pounds of the bomb exploded. It was enough, however, to take Kimmel’s legs above the knees and his left arm above the elbow. “Had I not been holding my rifle against my chest as I jumped down, which shielded my right arm from the blast as it hit me from the back, I think I’d be a quadruple amputee,” he says. [caption id="attachment_244953" align="alignright" width="300"] Kimmel is working to get back to a single-digit handicap. Photographs courtesy of Nick Kimmel.[/caption] He woke up at Walter Reed National Military Medical Center in Maryland four days later. Kimmel says he doesn’t remember much about those first few days in the hospital, only that every time he woke, a nurse “would calmly tell me that I had been injured and had lost three limbs.” Despite the seriousness of his injuries and the road to recovery and rehabilitation, Kimmel says he’s never felt or had a moment of despair. “Early on I adopted the mantra ‘it is what it is,’” he says. “I knew I couldn’t change the past and that all I could do was push forward.” Pushing Forward When Kimmel, who lives in Southern California, was released from the hospital, he went to the Naval Medical Center San Diego to begin rehabilitation. One of the most challenging parts of Kimmel’s recovery came in trying to get his body used to the new way he had to walk. “I remember my first prosthetic being extremely tight and uncomfortable on my legs, and I had to get used to supporting my weight with all the soft tissue of my remaining limbs.” With Kimmel’s bilateral transfemoral amputations, his first set of prostheses were stubbies, short prostheses with platform feet and no knees. Kimmel says the prostheses helped him gain a new center of gravity and train his leg muscles to work in new ways. “With my legs, my right limb is so short that I struggled with even keeping my prosthetic leg on. If I pushed too hard, I would end up with a sore spot or skin breakdown, forcing me to be outside of my legs and in a wheelchair again, and I absolutely despise being in a wheelchair,” says Kimmel, who eventually “settled on skin or true suction for my legs and made do with what I could for seven years.” Enter OI He made do until he learned that osseointegration (OI) was being done in the United States, and he was placed in a trial that was being conducted out of Walter Reed. He had his first-stage OI surgery in November 2018, and the second stage in February 2019, using Integrum’s OPRA Implant System with Axors II, which has allowed him to experience reduced pain, have improved mobility, and continue his active lifestyle. “I haven’t looked back since,” says Kimmel, who is also a patient representative for Integrum and a spokesperson for the Gary Sinise Foundation, which keep him on the road often. He lives in a custom smart home that was built for him through the Sinise Foundation’s Restoring Independence Supporting Empowerment (RISE) program. Though Kimmel now uses Ottobock’s X3 microprocessor knees and Triton feet full time, and XT9 energy-storing knees for outdoor recreation, he says he still uses his stubbies when he doesn’t feel like wearing his full-length knees or when they are charging. Peter Harsch, CP, president of Peter Harsch Prosthetics, California, an Ottobock company, has been treating Kimmel almost since the day he arrived at the Naval Medical Center. Harsch was the director of prosthetics when Kimmel came for care, and when Harsch left to form his own company in 2012, Kimmel followed. Harsch says OI has worked well for Kimmel because it makes it easier for him to don and doff his lower-limb prostheses than with socket-based devices. “Donning and doffing can be very challenging for someone missing arms and legs,” he says. Bigger Challenge Kimmel says his arm prosthesis was initially more of a challenge than his lower-limb prostheses. In fact, his upper-limb device was so uncomfortable and cumbersome he eventually stopped wearing it. Currently Kimmel has two prostheses for his left arm, a body-powered system with a simple hook that he uses primarily in his workshop at home and when he’s working in the yard, and the Ottobock Dynamic Arm and Greifer hand. Nine Holes Kimmel’s true refuge comes from playing golf. A high school athlete who was offered a baseball scholarship, Kimmel started playing golf when he was about seven years old. By the time he graduated high school, he had a single-digit handicap. Soon after his injuries in Afghanistan, Kimmel says he had “zero interest,” in playing golf again. “I was first invited to [play] when I was still wheelchair-bound,” says Kimmel, now retired from the Marine Corps. “All I could do was chip and putt, and I wasn’t having it at all.” He stored his golf clubs away until 2016 when two of his buddies from his hometown in Washington took him out to play a round on Memorial Day weekend. “At this point I was fairly mobile and up in full-length prostheses,” he says. “That day gave me the golf bug again, and ever since I’ve been striving to get back to a single-digit handicap.” He’s getting close—his current handicap is 11.9. Harsch says Kimmel found his niche when it comes to playing golf, especially given that it’s a low-impact game. “Nick has chosen to be very active and he works hard at it,” he says. “Golf is just one thing that he does.” Kimmel says his main challenge on the golf course is balance. “Shots where the ball is below my feet on a slope are the hardest,” he says. “Imagine trying to swing a golf club with all your weight on your heels and your toes lifted off the ground.” Grip strength was also a problem early on for Kimmel. “Holding a club just wasn’t possible for me either, and I could barely make it through nine holes,” he says. The more he played, the easier the game became. Now he plays three to four times a week. He also has a makeshift golf simulator in his garage so he can hit golf balls when he can’t sleep or on the rare times the weather in Southern California doesn’t cooperate. “I can traverse pretty much any terrain now and can even walk nine holes,” says Kimmel. His goal is to be able to walk 18 holes, then attend caddy school in Scotland through a veteran’s organization. Surpassing Expectations Those who know Kimmel know that anything he has done in and with his life, he gives his all. “One hundred and twenty percent,” he says. Harsch agrees. “He’s never come in [my office] in a wheelchair.” Harsch says Kimmel is fortunate in that he has been able to achieve what he wants with his life after such devastating injuries. “Nick is lucky. He has found what he loves and has good support,” he says. “Not all of those [with traumatic injuries and amputations] figure out what they want to do with their lives afterward, but when they do, then they’re all in.” As Kimmel immersed himself fully early in his recovery, he had a single goal in mind: to be standing at full height on legs with knees when his unit returned home from Afghanistan. His physicians told Kimmel it would take at least ten months before he would be able to be up and walking. “I did it in six,” he says. When the time came for his troop’s homecoming from Afghanistan, Kimmel was there to greet them. “My dad and I flew out to Okinawa, Japan, and I stood on the flight deck as my guys got off the plane.”

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