By Mass Communication Specialist 2nd Class Jessica Tounzen, Naval Medical Center San Diego Public Affairs
SAN DIEGO -- As children, when we fall off our bikes the first time riding without training wheels, when we sprain our ankles playing football, or when we take a line drive to the shins during a baseball game, we are encouraged to stand up, dust ourselves off, and get back in the game. As adults, we'll go on to face bigger obstacles and more troubling injuries, but that voice is always there in the back of our head, telling us not to give up and helping us get back on our feet.
For amputee patients undergoing treatment in the prosthetics lab at Naval Medical Center San Diego's (NMCSD) Comprehensive Combat and Complex Casualty Care (C5) facility, Brian Zalewski is doing just that.
Zalewski, a native of Marshall, Mich., is C5's newly-appointed Head Prosthetist who has fabricated nearly 75 prosthetic limbs for approximately 200 patients over the past five years of employment in C5's prosthetics laboratory. A compact frame, neat appearance and quick smile are the first things you notice about Zalewski. The next is his genuine desire to help amputees regain mobility.
Zalewski describes his experience treating a Navy diver with a single amputation back in 2009. The diver had lost his leg below the knee, and told Zalewski he wanted something to help him continue to pursue his love of swimming.
After conducting some drag tests in the swim flume at San Diego's Naval Health Research Center, Zalewski came up with a solution: a makeshift fin. Zalewski was able to obtain a special ankle from a prosthetic manufacturer that was designed in such a way that pressing a button would allow the foot to bend backwards, an effect similar to that of standing on tiptoe to reach a high object.
Zalewski then constructed a socket to allow for seamless movement between the patient's leg and the prosthetic ankle. The finished product was a success; Zalewski still receives calls from the patient occasionally, updating him on his progress which was made possible with his help.
Zalewski earned his Bachelors in Zoology from California State University Dominguez Hills in 2004. Following his graduation, he completed a year-long residency at the West Los Angeles and Long Beach Veterans Affairs hospitals. He started out fabricating prosthetic legs for wounded warriors at these two hospitals. He was interested in a medical field that was unique and would allow him to use his hands - prosthetics seemed like a good fit.
After gaining experience as a prosthetic technician, he went on to earn his certification in prosthetics in early 2007.
During his subsequent employment in the orthotic and prosthetic clinics at the University of New Mexico's Carrie Tingley Hospital, he heard about a new facility opening in San Diego to treat the diverse and complex needs of wounded, ill and injured service members and others in need of comprehensive care. He investigated the opportunity and was hired as one of C5's prosthetist in, June 2008.
"I just heard about the facility and wanted to get into that type of prosthetic work," said Zalewski. "I wanted to help those young, active patients who want to push the limits of their prosthetics. I have a great deal of respect for the military and I wanted to give back."
Giving back to those who have made such great sacrifices meant caring for patients whose injuries are often extensive and complex, requiring prosthetics to be custom designed to each individual patient's needs.
"Over the last year or two, the number of bilateral amputations (more than one limb) has been very high. Anytime there are multiple amputations, the greater the complexity of prosthetics needed," he said. "If it's one joint, two joints, if they're missing an arm or fingers, it all has to be able to work together. If someone's missing an upper extremity they still have to be able to put a prosthetic on their lower extremity ... my job is to make it all mesh seamlessly," said Zalewski.
Despite his daily contact with patients coping with such devastating injuries, Zalewski says those patients are also some of the most tenacious of any he has ever met.
"They don't think about what they could be doing; they just want to do it. They're always asking me, 'what can I do next?' They never settle. They want to walk, and if they can walk, they want to run. If they can run, they want to ride a bike."
Zalewski is determined to help them get there. His methods are simple: assess the patient's medical condition and unique needs, but also sit down with them to find out what their end goal is. He is also careful to impress the importance of patience while allowing the wounds to heal. He encourages setting goals and helps his patients understand what it will take to reach them.
Once the patient's individual treatment plan is laid out, it's time for Zalewski to fabricate a device that will allow the patient to do something they might not otherwise be able to do. It's a science but it's also an art, he says. And it doesn't stop there.
"I've built lifelong relationships with my patients," he says. "It's not like a surgery where you follow up after the procedure and that's it. With these guys, they're always going to be adapting, doing this activity or trying that sport. It's an ongoing thing and that's what's so unique about this field."
The fruits of his labors and the success of Zalewski's relationships with his patients can be seen in those who have gone on to train for various Paralympic events or participate in the Warrior Games. Additionally, one of Zalewski's recent patients just scaled the 10,000-foot-tall Mount Baldy, the highest peak of the San Gabriel Mountains and the highest point in Los Angeles County. His next goal is to travel to Argentina to climb a mountain double its height.
Zalewski will accompany ten C5 amputee patients to the 25th Annual Hartford Ski Spectacular at the Breckinridge Ski Resort in Colorado, Dec. 2-9. During this weeklong adaptive ski program he will be able to see his patients hit the slopes and discover their ability to get back up after falling off that bike without training wheels.
"They'll be able to get out there and see people with similar injuries doing things they themselves thought they'd never be able to do again, or something they thought they'd never be able to try after they were injured," he said.
Zalewski says he feels very proud when he sees the difference he has made in his patients' mobility and the positive effect he has had on their lives.
"It's very rewarding seeing my patients come into the prosthetics lab in a wheelchair and leave with running legs when they never thought they'd have to learn how to walk again," he said. "It's like seeing your kids take their first steps."
In addition, C5 has hired an additional new prosthetist scheduled to start Dec. 10 and a third prosthetist position is currently being advertised.
Since 2007, C5 has provided medically-advanced rehabilitation to more than 1,600 wounded, ill and injured service members through outpatient rehabilitation and inpatient care prior to returning them to active duty or transitioning them to civilian life. In the first three quarters of 2012, C5 fitted patients with 470 devices. The prosthetics lab recently underwent an expansion during which the therapy pool was filled with concrete to make room for two additional treatment rooms, a check-in area, storage space, and a second set of parallel bars.
For more information on Naval Medical Center San Diego, visit http://www.med.navy.mil/sites/nmcsd, www.facebook.com/nmcsd, or www.twitter.com/nmc_sd.