Tuesday, June 19, 2018
Health

Experts say kids who lose limbs adjust to prosthetics quickly

Ireland Nugent lost her lower legs to lawn mower blades on Wednesday, and few things make the accident more heartbreaking than the fact that she's only 2½ years old.

But it's also her age that could hasten and improve her recovery.

"She's so young," said Bryan Sinnott, a prosthetist at Shriners Hospitals for Children — Tampa. "She's going to improve quite quickly as opposed to an older person who's used to walking with their regular gait. It's harder for an adult to adapt than a child."

Ireland remained in serious condition Friday at Tampa General Hospital after her father accidentally ran over her with a lawn mower at their Palm Harbor home Wednesday, severing both legs just above the ankles. She has two more surgeries scheduled, one today to further clean the wounds and another Monday to close the wounds and prepare them for prosthetic limbs.

Her family's minister, Dennis Reid, said Friday that doctors are on high alert for any possible infections. Ireland is being given antibiotics and fever-relieving medications, he said. She also is sedated and is being fed through a tube, but is able to squeeze her mother's hand.

Infections are a particular danger in part because of the lawn mower blades, which sent dirt and debris into her body. If doctors can keep her infection-free and the wounds heal properly, Ireland could be fitted for prosthetic limbs in as little as one to three months, several prosthetists told the Tampa Bay Times.

"She's going to do way better than people think," said Ron Gingras, also a Shriner's prosthetist. "It's going to get better, and it's going to get okay."

Once Ireland goes home, experts will try to reduce the swelling in her legs, possibly by giving her special sleeves to wear, said Paul Weott, the owner of Orthotic and Prosthetic Center, which has several Tampa Bay area locations. The sutures must be very secure because that tissue "will take a lot of beating" once she receives prosthetics, he said.

Young children can be difficult to measure at first because they have trouble communicating what feels right. So prosthetists must observe them very closely as they walk with their new limbs. But once they are ready, said Weott, "they just go. They're fearless."

They're also growing. Children with amputations need new prosthetics regularly. Ireland might need new prosthetics every year.

"When kids are growing, all bets are off," said Matt Bailey, president of Florida O & P Services in West Palm Beach.

The expenses add up. Prosthetics for people amputated below the knee, like Ireland, run $6,000 to $10,000 each, Bailey said.

Health insurance may cover some of the cost, but it's often inadequate. Bailey says he has seen plans with $10,000 lifetime limits on prosthetics. Sometimes, families have to fight for more advanced versions, which an older child who wants to play sports may need.

Even without a lifetime limit, a typical 20 percent co-insurance on a $20,000-a-year purchase could quickly deplete a family's funds.

The Nugents have insurance — dad Jerry works for Pinellas County and mom Nicole is a church preschool director — but their out-of-pocket expenses for the Bayflite transportation to Tampa General, plus the physician services and hospital care will be considerable.

The community already is stepping up to help. Money collected by Trinity Presbyterian Church will go toward medical costs, Reid said. If any is left over, it will be applied toward Ireland's prosthetics. Pinellas County is also starting a fundraiser for the family.

Ex-wrestler and amputee Steve Chamberland of Indian Rocks, who has a foundation called 50 Legs, told the family he would purchase first-rate limbs for Ireland. Chamberland did not return a phone call Friday, and it's unclear how much money his foundation has. The last available tax form, from 2011, showed about $325 in assets.

But Chamberland has come through for a number of other children, including a $2,500 donation each for two of Bailey's patients. Chamberland has also helped patients at Shriner's Hospital, spokeswoman Jamie Parker said.

Shriner's has reached out to the family to let them know about the pediatric prosthetics services offered at the hospital, which is near the University of South Florida campus.

Gingras, the prosthetist at Shriner's, said the hospital has a charity to help families with costs.

Experts who work with children who have lost limbs said that not only do very young children readily adapt to their new situation, they even have fun with their new limbs. Bailey said he has made prosthetics decorated with images of cars for a little boy and a pink zebra pattern for a girl.

Teenage patients have a rougher time, they said. But in some ways, the parents will have the more difficult transition.

"They felt that despair in the beginning," Bailey said. "You think, 'Will my daughter go to the prom?' You think the future is gone. But it's not."

Some of the prosthetists said they were heartbroken by the haunted gaze of a red-eyed Jerry Nugent they saw in Friday's newspapers.

"I think it's going to be harder for the parents to get better," Sinnott said. "The child will improve every day, and the parents will hold this with them with every day."

Times researcher John Martin contributed to this report. Jodie Tillman can be reached at [email protected] or (813) 226-3374.

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