November 4, 2012 in Features, Health

‘Rock star’ who outfitted dolphin helps pediatric amputees

By The Spokesman-Review
Dan Pelle photoBuy this photo

Kevin Carroll, a prosthetist whose development of the first prosthetic tail for a dolphin helped inspire the movie “Dolphin Tale,” pays a visit to Isabelle James, 9. Isabelle, who lives in North Idaho, lost her leg in a lawn mower accident.
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Isabelle James saw “Dolphin Tale” the day the movie came out, which happened to be her eighth birthday and the day she got another new leg.

A year later, she tried a prototype of the dolphin’s tail over her left leg – amputated above the knee – as her own prosthetic was off in the lab last week at the Hanger Clinic downtown, getting its extension resistance loosened up.

Joking with its creator, Isabelle called herself a “one-leg mermaid” and admired the material he used to create the prosthetic tail for the dolphin whose story inspired the movie – it looked soft, but it was hard, but it also was bendable.

The chance to see the first-ever prosthetic tail for a dolphin and meet Kevin Carroll, a prosthetist played by Morgan Freeman in the movie, merited a day off school, said Isabelle’s mother, Kim James.

“He’s kind of like a rock star,” James said.

Carroll was in town to meet with pediatric amputees and their families, checking their artificial limbs and sharing his knowledge about new prosthetic options, whether they’re feet that walk better or knees that bend better. Carroll is a vice president at Hanger Prosthetics and Orthotics, which operates hundreds of clinics in the U.S.

The prototype prosthetic dolphin tail he carries with him provides a starting point for his conversations with pediatric amputees about how their artificial devices are – or aren’t – working for them.

Child amputees have their own set of needs, different from adults’.

Because they grow fast, their devices should be checked every few months, Carroll said, and replaced every year. One boy Carroll talked with last week had “totally grown out of his device,” which can lead to musculoskeletal problems.

And kids are hard on their artificial arms and legs, which, because they’re smaller, tend to be less durable than adults’ devices, said Donald Meng, a prosthetist at the Hanger Clinic on Pacific Avenue, one of the company’s two locations in Spokane. “They’re running, jumping. They routinely break things.”

Thanks to technological developments, though, prosthetists can offer more and more choices to young amputees, Meng said. Among them are what he called “running feet”: the J-shaped prosthetics used by South African Olympian Oscar Pistorius, aka “Blade Runner.”

Children’s prostheses also have made advances in terms of durability, Carroll said. They’ve become lighter and more functional – their knees are “more fluidlike”; an amputee used to have to wait until adulthood to get a good knee.

But for both child and adult amputees, the most significant recent improvements relate to how the artificial device attaches to the human body, Carroll said.

It’s a “where-the- rubber-meets-the-road type of thing,” he said. “We focus on better fit techniques, better ways to provide more comfort for the user of a prosthesis.”

Crafting a tail

Among their tools is a gel developed to protect a tailless dolphin’s skin from the pressure of her prosthetic.

The story began in 2005.

A 3-month-old bottlenose dolphin got caught in a crab trap near Cape Canaveral, severely injuring her tail. Rescued and transported to Clearwater Marine Hospital in Clearwater, Fla., the dolphin was named Winter.

Her fluke, the part of the tail that propels a dolphin, eventually came off, leaving the animal to swim using a side-to-side style that veterinarians feared would damage her spine.

Carroll, based in Orlando, heard her story and volunteered to help, working with prosthetic clinician Dan Strzempka to build her a new tail.

Key to the process, they worked with a chemical engineer to create a protective, absorbent gel that serves as a cushion between the dolphin’s body and her prosthetic. Now that gel, sold as WintersGel through Hanger clinics, is used by human amputees, too.

While now she uses a different type of device than she did as a 2-year-old, Isabelle James’ first prosthetic leg incorporated a gel liner.

Studying the dolphin tail in the exam room, Isabelle told Carroll: “It must have been hard making this.”

“It was,” Carroll said. “We had to make 50 of them before we got it right.”

Falling down, getting back up

While sometimes he can offer practical guidance to children and families he meets on the road, Carroll said, other times he provides simply a “clap on the back. Parents need to hear that, that their child is doing really well. And the child, too, for that matter.”

Four months ago, Darren Ugolini, a 4-year-old in Spokane, was falling behind his four older brothers – tiring out faster outside and unable to ride a bike.

He has a rare skeletal developmental disorder called dysplasia epiphysealis hemimelica, or Trevor disease, that results in excess cartilage on the ends of the long bones of the arms and legs.

Darren’s left leg was almost three inches longer than the right, and his foot was deformed, making it difficult to wear a shoe. His mother, Crystal Ugolini, said he helped make the decision to amputate the longer leg below the knee and replace it with a prosthetic.

After getting his picture taken with Carroll last week, Darren was walking around an exam room at the clinic with just a slight limp. Now, he said, he can run around.

“He got his leg, and within a week he was riding a two-wheeler,” Ugolini said.

Isabelle James lost her leg in summer 2005, weeks shy of her second birthday. Her mother, unaware that her daughter was outdoors, backed over the toddler’s legs with a riding lawn mower. Isabelle’s right leg suffered only minor injuries.

Now the 9-year-old plays soccer and swims on a team at the Kroc Center in Coeur d’Alene, Kim James said. (After they saw “Dolphin Tale,” her mother said, she noticed her daughter adopting Winter’s moves in the water, “doing a dolphinlike kick with her long leg.”)

Isabelle calls her latest prosthetic a “robotic leg.” Her mother estimated it was her seventh.

Her first device attached below her knee. While the 2-year-old took to the device quickly – navigating the house within a couple of hours, her mother said – it had drawbacks.

Isabelle still had her knee after the accident, but it was stiff. If she fell, the knee locked up rather than bending, so she suffered soft-tissue injuries and risked bone breakage in the remaining part of her leg.

Sure enough, at 5, Isabelle fell from a piece of playground equipment, breaking her leg.

Surgeons removed her knee, making way for a prosthetic knee. Her mother called that new knee “miraculous.”

“When she falls, she’s not going to break her leg, we’re not going to get a soft-tissue injury, and she withstands a lot more wear and tear,” Kim James said. “So she can play soccer, fall down and get back up, fall down and get back up.”

The Freeman effect

Prosthetists may have gained some cachet by the release of “Dolphin Tale.” Carroll said his company gets a lot more calls than it used to from those seeking to enter the profession.

He credits part of that to his portrayal by Freeman. In the movie version, Carroll and Strzempka are combined into one character. Freeman represented them – and their profession – accurately, Carroll said.

As discussions began about the possibility of a movie, “We started joking about who would play who,” said Carroll, who is a native of Ireland, bearded and mostly bald. “I said, ‘I’d love to have Danny DeVito play me. I think he’d do a really good job.’ The producer comes along, and he says, ‘We’re going to get Morgan Freeman.’ We’re like, ‘Wow, absolutely honored.’ ”

In one scene, Freeman drops a glass to make a point.

“I do crazy things like that to capture somebody’s attention,” Carroll said. “If I have to stand on my head, I stand on my head. Absolutely, I have done that. I’ve stood on my head (to demonstrate) if you really want to stand, you can actually stand on your head.”

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