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A gift of hands: After loss, a man finds hope from healing ones (w/video)

Francisco Piedra hugs Danielle Ayala, a medical assistant for Dr. Luis Jovel in St. Petersburg after Piedra received prosthetic hands recently. The hands were made from 3D printers by members of Handling the Future, which provided them at no cost. Ayala led the effort to find Piedra prosthetic hands after his hands and legs were amputated last year. [SCOTT KEELER | Times]
Published Dec. 8, 2017

ST. PETERSBURG — Francisco Piedra fixed his eyes on the man sitting beside him. His name was Richard Brown, and in his hands he held Piedra's new ones.

The prosthetics were black and plastic. Each one took about 20 hours to build from a 3D printer.

Piedra wouldn't be able to put them near hot water or even hold a hot cup of coffee, Brown explained. They could melt.

But by flexing his wrist, he could grasp and hold objects. After strapping one 3D-printed hand onto Piedra's wrist, it was Brown's turn to watch as the 61-year-old patient gave it a try.

"Wow," Piedra said quietly. The fingers curled into a fist and he smiled. "That's going to be a lot better than what I have now."

• • •

It began with a scary diagnosis.

Always active, Piedra worked two jobs every day, and in the spring of 2016, he was having trouble breathing. Dr. Luis Jovel, his primary physician, urged him to see a cardiologist, who diagnosed severe aortic stenosis, a disease that made it harder for his heart valve to pump blood.

In May 2016, chest pains sent him to the emergency room, where he was told he was also suffering from coronary artery disease, Jovel said. An aortic valve replacement would help his heart pump blood, and a bypass graft would improve the flow in his coronary arteries.

Jovel didn't perform the surgeries, but he explained that the first one on July 12 went well. Doctors went back the next day to perform the bypass, and during the procedure, they gave Piedra Heparin, a medication routinely used to stop blood clots.

TO YOUR HEALTH: Keep track of trends and new developments that affect you. Visit the Times health page.

In rare cases, patients can have bad reactions, Jovel said. Instead of preventing clots, it can produce them.

By the time the doctors realized the extent of the damage, it was too late, Jovel said. Dead tissue had built up from the loss of circulation. In September, doctors amputated Piedra's hands and legs below the knees.

Jovel said he was shocked when Dolores, Piedra's wife, called to tell him what happened. She said it was heartbreaking to watch her husband's whole life change in just months.

In the mornings, she woke up beside him because he was no longer leaving early to go to work. She carried him to and from the shower. She cleaned his ears and made sure he didn't fall over.

She could no longer leave for weekends, staying by his side while he went to physical therapy.

Months passed before Jovel saw his patient for the first time since the surgeries. Piedra showed up in his new wheelchair, but it was clear he wanted to start walking again and get back to work.

Jovel contacted someone at Hanger Clinic, which offers support and prosthetic limbs.

The clinic told them prosthetic legs would cost $15,000 and a pair of hands as much as $100,000, Dolores Piedra said. But Hanger provided the legs without charge, and she cried when her husband stood up for the first time in months.

"It was one of the best things ever," she said.

Jovel urged his patient to pace himself, but Piedra was eager to leave the wheelchair behind for good, to return to a life that resembled his old one. A walker replaced the wheelchair.

Step by slow step, he learned to walk again.

• • •

On every visit, Jovel asked Piedra: Was he feeling sad? Depressed?

No, he would say. I just want to work again.

Jovel tasked his intern, Danielle Ayala, with a project: Find Piedra a pair of hands he could afford. He had lost his insurance when he stopped working, and it would be another year before disability insurance kicked in.

She quickly learned that 3D printing would be the most cost-effective answer, and contacted the University of South Florida, where she plans to attend an accelerated biomedical program. The school agreed to let her use its 3D printer, and Ayala built small models. Creating real ones could still cost thousands.

It bothered her that the cost was preventing Piedra from getting his life back. It seemed unfair, she said.

She reached out to e-Nable, a volunteer organization with members around the world who use their 3D printers to create free prosthetic hands and arms. They aim to help people born with missing fingers or who lost them because of war, disease or natural disasters.

E-Nable sent Ayala to its local chapter, a Wimauma group called Handling the Future, which serves the Tampa Bay area. Its members are residents of Valencia Lakes, a community for people 55 and over, and they are led by Richard Brown.

Ayala sent Brown photos of Piedra's hands. In August, the process to print his new ones began.

A 3D printer creates an object using a design stored in a memory card or USB device, Brown said. It interprets the information to figure out the pattern, then puts out plastic filament, almost like a hot glue gun, building the object slowly in layers.

Piedra's fingers were built separately, because each one required a different design. The palm alone took 16 hours.

Brown built the right hand from his printer in New York, while Glenn Brown, a member of the local chapter who is not related, built the other from his printer in Wimauma.

Once every part of the hand is printed, a 3D-printed pin holds the pieces in place.

For the hand Richard Brown made, he ran wires through each digit and strung rubber bands on the top part of the prosthetic, like tendons.

On Nov. 17, members of Handling the Future drove to St. Petersburg and presented the hands to Piedra in the lobby of Jovel's office.

They explained the limitations. The hands weren't a perfect fit, Richard Brown said, but they would be soon.

The next step will be to get castings of Piedra's wrists to customize the hands. They also planned on making him multiple pairs in case he wants them for different uses, like fishing.

"We're more than willing to do what we can," Brown said.

Piedra looked up at his wife. She gave him a reassuring smile. It was their 33rd wedding anniversary. She had seen him take his first steps on his prosthetic legs, and she would see him through his new pair of hands.

"Hanging in?" she asked him.

"Oh yeah."

• • •

Wooden wind chimes tinkled in the breeze as Francisco Piedra sat on his front porch recently, recounting the loss of his limbs and the steps he's taken since.

After the amputations, he remembers thinking, "What am I going to do for the rest of my life?"

All around his north St. Petersburg home near Puryear Park, reminders of his previous life are everywhere — in the master bedroom and the walk-in closet, which he built himself. He built the front porch too.

Tears slid down his face.

His family had come together to support him, but he hadn't expected the same from his doctor, and he's grateful.

Recently, he pushed his four-wheel walker aside and began taking walks on his own. He fell once, but got back up.

He misses his job as a sheet metal worker in Largo, but his boss said it would be waiting for him once he was ready. His other job as a handyman would be there too.

With a new set of hands, the days on his boat with his family, grilling dinner, seem possible again.

"I want to be back as normal as I possibly can," he said.

He'd love to be able to turn a screw or hold his granddaughter close, or even help Dolores around the house. Give him some gloves, he said, and he'll mop the floor.

Contact Melissa Gomez at mgomez@tampabay.com. Follow @melissagomez004.

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