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Vital Signs with Dr. Sanjay Gupta

Advances in Prosthetic Limb Technology Examined; Paralympic Athletes Profiled. Aired 2:30-3p ET

Aired August 13, 2016 - 14:30   ET


DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: It comes from the Greek word meaning "addition," and today prosthetics are more like extension of the human body than ever before.

This is "Vital Signs." I'm Dr. Sanjay Gupta.

The first known prosthetics were used in Egypt 3,000 years ago. These wooden toes were found in a mummy's tomb thought to be world's oldest prosthetics. But advancements in functional limbs were still a long way off. Amputations from disease or injury were often fatal.

In the United States it was the Civil War in the 1860s that first put the prosthetics to the forefront. Today there are nearly 2 million people living with limb loss in America. The most common reasons for amputation are trauma, infection, diabetes, heart disease, and cancer. Thankfully, technology has come a long way, and losing a limb no longer means an end to a patients' life or even certain aspects of their way of life. And for some athletes, prosthetic advancements means never losing a step.

Meet paratriathlete Andy Lewis. He is a British hopeful for the Rio Paralympics. 2016 is Andy's year. This is the first time his event is included in the Paralympics. At the European triathlon championship in Lisbon, he is in peak form, but for potential Paralympians, physical fitness is just part of the equation. Amputees like Andy need prosthetics that are also at the top of their game.

ANDY LEWIS, PARATRIATHLETE: It has to be comfortable for that moment you're wearing it. It has to be mechanically sane. You have to trust it. I have got a new knee that they have given me now which is a cylinder hydraulic system. The oil in it is thinner, which means that it moves a lot quicker. So who knows? In the next race, or if I hopefully get that spot in Rio, then it will be even quicker.

GUPTA: The triathlon is a three discipline event -- swimming, cycling, and running. It is challenging enough changes kits without having to think about changing limbs. The transition zone is where crucial seconds are gained or lost. The engineering of Andy's prosthetics is versatile and gives him the edge.

LEWIS: I have the fastest transition for an amputee, so we are doing something right.

GUPTA: Andy is supported by clinicians back home in the U.K. JAMIE GILLESPIE, PROSTHETIC PACE REHAB: The simple definition is that

we provide prosthetic support, we provide them with a prosthesis. But the reality is that it is much deeper than that. It is a very intimate relationship working with these people. We need to understand them as people. We need to understand their daily lives, their changes, their demands, and also the ups and downs with them, which everybody goes through.

GUPTA: At Pace Rehab they specialize in making the spoke sockets, the piece that fits over the residual limb. They describe themselves as craftsmen.

LEWIS: The way which we capture the shape particularly here is to wrap somebody in a Plaster of Paris bandage. We get plaster under our fingernails. There are more modern, high-tech ways of doing it, but we find that we have the best results of wrapping the plaster. We then take an empty shell upstairs, fill that with liquid Plaster of Paris where we then have a positive mold of somebody's leg. We sculpt, we adjust, we reduce, we change the shape according to the anatomy, and then over the top of that mold a prosthesis is made.

LEWIS: So this is the prosthetic socket made of carbon fiber. It is very thin. Again, they have it spot-on. When I first had it made, it was giving me brief rubbing in areas. But going to pace, as you can see here, they actually cut pieces out where I am getting the issues.

GILLESPIE: There is a crossover between science and art in this job. We understand the science, the anatomy, the mechanics, the materials and the properties, but then upstairs when we are sculpting with the Plaster of Paris, it is a lot more artistic.

GUPTA: Prosthetist James Gillespie has been an amputee for 21 years. He competed in the Paralympics in Atlanta in 1996, so he understands Andy's needs.

GILLESPIE: I started on the other side clinical table, if you like. I was a patient. And I remember 20 or so years ago having to fight my corner to get carbon, fiber designs of feet, to get silicon gel, areas in between my skin and the hard prosthetic socket, because all these things makes a big difference. But what has moved I think is just a better understanding of what athletes, definitely athletes need, so that we are not making a generic socket. We are making sockets specifically for a sport or event.

[14:35:00] GUPTA: Back in Lisbon, Andy had a tough race. He went hard on the swim, placed third after the cycle, and made up time on the run, crossing the finish with first place with delight and Rio in his sights.

LEWIS: I just can't believe that I am the European champion. I just can't believe it.

UNIDENTIFIED FEMALE: How were you in the transition zones? How were the change overs?

LEWIS: Yes, really, really slick. I perfect that. GUPTA: The hours of preparation by Andy and his team pay off in

moments like this.

Next up, we meet another inspiring athlete who defied the odds on the way to Paralympic gold.


GUPTA: Early morning, Baltimore, Maryland. On the campus of Loyola University Brad Snyder arrives for swim practice. His guide dog Gizzie leads the way. Brad changes into the swim gear, and leaves Gizzie in the back corner of the pool deck. He follows the drain with the feet, using it to guide him back to the blocks where his coach is waiting.

The water is the one place where Brad doesn't need much help, and here, though he is completely blind, he feels free. Brad Snyder grew up in Florida, the oldest of four kids. As a young boy, he idolized his grandfather, a World War II veteran.

BRAD SNYDER, PARALYMPIC SWIMMER: From the age of three or four, I remember hanging out with my grandpa down in Florida.

[14:00:00] That is kind of like what drove me at the beginning was I want to live a life when I get to be 65, I carry the same amount of respect or have the same legacy that my grandpa had, not like word- for-word legacy, but that sort of the intangible aura sort of thing.

GUPTA: Brad saw the military as a way to earn that respect. He was accepted to the United States Naval Academy where he learned about the explosive ordnance disposal unit, responsible for clearing potential explosive threats.

Your grandpa was injured in the war, so you saw that. You knew about the risks. Did you worry about yourself getting injured?

SNYDER: Not very much, I think. I think that, you know, that is why we send the young the war, because we are young, naive, and we think we are invincible. I saw the scars on my grandpa's arm and I saw the scars on his forehead, and I heard the stories, and to me, I guess that as a kid, I thought that it is a prerequisite for being a hero, I guess. To do something admirable, you have to take some level of risk.

GUPTA: Brad was deployed overseas twice, first to Iraq and then to Afghanistan. It was there on September, 2011, that the trajectory of his life would change forever.

SNYDER: Two of our Afghan partner force, two Afghan special commandos, had stepped away from the path, and sure enough there was a 40-pound IED in that area, immediately taking the legs of the first guy who stepped on it, flinging him forward about 10 feet, and then it took the off the legs of the guy standing behind him as well.

GUPTA: Brad stepped on the IED, a hidden improvised explosive device. It detonated to the front and right of him instead of directly under him, saving his limbs and likely his life.

SNYDER: So I remember getting knocked back, and I remember waking up kind of looking down, and I actually could still see out of my left eye at the time, and I did not see any blood or any damage or anything. And the fact that I looked fine, I thought that it must mean that I had died. Time seemed to go by very, very slowly, and I laid there for what seemed like a really long time. I thought that I had lost my dad, or will I see my grandpa again, or will I get to see my dad again. And I got really kind of excited about that.

And all of a sudden the tinnitus kicked in, I had the ringing in my right ear, and I remember that kind of sound bringing me back to reality, like, wait, I am not dead. Then all of a sudden I became acutely aware of all the damage to my face, that there were really severe lacerations across the entirety of my face. And I thought, OK, I sustained a blast and I'm still alive.

GUPTA: Brad was airlifted out of Afghanistan, and he woke up 60 hours later in Walter Reed hospital near Washington, D.C., surrounded by his family. Brad had multiple operations on his eyes, but the blast caused permanent damage and blindness. To reduce the risk of infection, the doctors decided to remove his eyes and replace them with prosthetics. Brad was just 27 years old.

SNYDER: Sitting in the hospital with that, now it is no longer a phantom of uncertainty, right. Now I know what it is. It's blindness. Everything else is fine. I have 10 fingers, 10 toes, heart is fine, no traumatic brain injury or PTSD to speak of. My thing is blindness. So I have got it now in front of me, and I can do this.

GUPTA: Brad began to adjust to a life without vision. Just a few weeks after he was released from a hospital, he attended a barbeque in his honor.

SNYDER: My old swim coach came over and just being the person that he was, he was not one to exist on the past too long. Great, you are backer, when are you coming back to the pool is the way he encounters the world.

GUPTA: Brad had actually been a competitive swimmer all of his life. At the Naval Academy, he had been captain of the swim team. The water was familiar territory for him, but how different would it be without his vision?

SNYDER: When I was dove in I found this really cool sense of freedom and liberation of the burden of this new reality.

GUPTA: Is there a point when you realized, hey, I'm pretty good at this and maybe this is something where I can go to the Paralympics?

SNYDER: Well, people were talking about the world record is in reach, and this and that and the other thing. And I said, guys, no, no, no. You guys don't understand. This is not -- you can't just happen into this. It takes years and years and years of dedication and hard work and mastering these different techniques that I am only just now learning. It would be impossible for this to happen.

UNIDENTIFIED MALE: Well, this man here, Bradley Snyder dominated the morning heats.

[14:45:00] GUPTA: Against the odds, Brad did qualify for the London Paralympic Games in the summer of 2012.

UNIDENTIFIED MALE: Lane number six was twitching and moving.

GUPTA: He was scheduled to swim the finals in the 400-meter freestyle on September 7th, 2012, just a year after his injuries. Brad touched the wall far ahead of his competition. He had done it, won gold exactly one year to the day after losing the eyesight in Afghanistan.

UNIDENTIFIED MALE: He had the race of his life.

SNYDER: I don't even believe it sometimes. It seems very surreal, and even the memories are very, they seem like something that was put into a movie or something like that.

GUPTA: Brad left London with two gold medals and a silver. Since that time, his life has been a whirlwind. He is focusing full time on training for this year's games in Rio, and the athletic brand Under Armour based in Baltimore where Brad now lives, signed him to a sponsorship deal last year.

GUPTA: Watching brad do this, you'd never know he is blind. Typically blind swimmers are tapped with a pole by their coaches indicating it is time to make the turn at the wall. In practice, Brad does not use a tapper. Under Gizzie's watchful eye, he navigates the lane ropes and by counting the strokes. It is not a perfect method. He has crashed into the wall at least a few times, but the way Brad approaches it, swimming is a lot like life. It is what you do after you crash into the wall that matters.

And for a little boy in England, nothing is going to be stopping him from his dream of becoming a professional footballer.


GUPTA: Every day roughly 500 Americans lose a limb. The process of fitting for a prosthetic is painful, and adjustments are always being made. For children who are born without a limb or lose them through amputation, their growing bodies pose an even bigger challenge. Consider that a growing child may need a new prosthetic as often as every year. But that doesn't stop a little boy in England with arms or legs from pursuing his dream of becoming a football star.

Marshall Janson is a happy go lucky eight-year-old little boy living by the sea of Cornwall in the southwest of England. He likes nothing more than playing football with the friends on a sunny day. A quadruple amputee, Marshall's mother Stephanie watched her baby lose all four of his limbs to a devastating illness when he was just a year-old. We want to warn you, you may find the next images upsetting. STEPHANIE JANSON, MARSHALL'S MOTHER: It was three days after his

first birthday Marshall got Meningitis B, septicemia, which he was -- started off with just a temperature, and within four hours taken into hospital. He was on a life support machine, very, very poorly, and they said he wasn't going to be make it. So after being in intensive care for over a month, he started to make some signs of recovery, but it was decided that he would have to have all four limbs amputated.

HAYES: Marshall not only survived, he became the energetic boy you see today. But new challenges were still to come. Prosthetic limbs come in all shapes and sizes. The ones provided free of charge are not always the best for someone like Marshall. He is a sporty kid who enjoys playing football, rugby, cricket.

JANSON: What do you want to be when you grow up?

MARSHALL JANSON: Goalie for the Spurs.

JANSON: We have to provide for our own limbs, because the limbs for him to be able to do the sports, and he had very basic ones at the beginning, which he was just learning how to balance and stand on, which is good to get his posture. But he couldn't really do enough and they made him really sore. So when we started to fund for the blades, which he put on them, he just loved wearing, and which was brilliant, and he was able to keep up with his friends.

GUPTA: Keeping up with the peers comes at a huge cost to the Janson family. These blades, as they are called, cost over $17,000 and sometimes they require additional operations.

JANSON: And they are obviously, he grows out of them, so needs them replaced normally every year. It can be more depending on his growth. But he would have to have operations for the rest of his childhood, but hopefully if we can keep him on his legs and he can keep up with his peers, that's what we want him to be able to achieve.

GUPTA: Each set of new limbs means learning to walk again, regaining balance, posture, and confidence. It was Marshall's confidence which was suffering the most when he received the newest leg six weeks ago. They bend at the knee, and they're quite different from the blades he had grown to love.

JANSON: And he said, no I'm not wearing them. Everyone will laugh at me, and he would fall over.

GUPTA: After Marshall's story spread online, the boy who dreamed to playing in goal for Tottenham Hotspur received the biggest invitation of his life and a message of support from his heroes.

UNIDENTIFIED MALE: Here he comes through the tunnel.


UNIDENTIFIED MALE: And his dad. You're first? Yes, sign him up! I think everybody agrees. This is what it is all about.


JANSON: So, basically, these legs were not the same as these legs?

MARSHALL JANSON: Well, they definitely bend.

JANSON: These ones bend. And we have a special button here, and tell us what happens.

MARSHALL JANSON: That is the taking it off button.

JANSON: And it is a suction, so it's letting the air out. Probably a good idea. You can hear the suction.


JANSON: Pop. And so then you have the one. We have to make sure that that's all flat, don't we.

MARSHALL JANSON: Like a flying saucer.

JANSON: Like a flying saucer.

GUPTA: Marshall got his first set of artificial limbs when he was three years old.

[14:55:00] Now he is on the fifth pair, and these ones are going to take some getting used to.

JANSON: But these legs are different because they have the knee joint. And these are the blades. And they're all done from the hip, whereas these ones are done at a totally different posture, so they are much better for the back. He can't stand fitting in the blades, but he can stand still in these ones. It is quite a big difference.

GUPTA: This is the first time Marshall has worn his new legs on the uneven grass surface.

JANSON: OK. Well done.

MARSHALL JANSON: Now, the heel challenge.

JANSON: You are doing really good, baby.


JANSON: Oh, crash-landed.

MARSHALL JANSON: I have done this, man. I have done this.

GUPTA: Life threatening trauma injuries like amputation don't stop once the wounds are healed. For Stephanie Janson and her family, a carefree childhood is all they wish for Marshall and his sporting ambitions. That means supporting him each step of the way.

The resiliency of children like Marshall is astounding. Really everyone we met is an inspiration. Thanks to the advances in prosthetic technology combined with the strength of the human spirit, a disability like limb loss or blindness does not have to be the end of a distinguished sporting career. In fact, for these athletes, it was just the beginning.

For "Vital Signs," I'm Dr. Sanjay Gupta.