Issue Date: October 04, 2004

Tough call for amputee
War-wounded staff NCO pushed docs to cut off his leg — and has no regrets

By Laura Bailey
Times staff writer

When Staff Sgt. Mark Graunke was rushed to the hospital in critical condition after an explosion in Iraq ripped apart his body, Navy doctors said they could save his severely mangled leg.

It would be a long, hard road with numerous reconstructive surgeries, a great deal of pain and no hope of returning the leg to perfection. But Graunke, a tough-minded explosive ordnance disposal technician and former embassy guard from Texas, was onboard with the plan.

Almost two months later, however, the beefy staff noncommissioned officer was still bedridden, his body wasting away from inactivity. A golf ball-sized hole in his leg was not going away and he had so much pain that the slightest touch of his hospital bedsheet would set off shock waves of agony.

So when surgeons at National Naval Medical Center in Bethesda, Md., suggested a second try at using muscles from other parts of his body to patch the open leg, Graunke decided he’d had enough.

That’s when he began the unusual battle to convince doctors that amputating was the right thing to do.

“I just saw it as something that was keeping me from getting better,” he said. “It was basically a piece of meat hanging off my body.”

But Graunke said his doctors did not like his idea.

“At first they didn’t help me at all,” Graunke said. “They were dead set on salvaging it.”

The leg injury was just one of many the Camp Pendleton, Calif., Marine sustained when a bomblet exploded in his hands in Iraq in early July 2003. The 26-year-old lost his left eye, his left hand and the thumb and index finger of his right hand. Both of his legs were ripped open and missing large amounts of skin, muscle and soft tissue.

But the right leg was a particularly terrible mess. Tissue was missing from his knee to the bottom of his shin and his leg bone was blown open.

After months in recovery, Graunke was so sensitive to pain that he wanted no one to lay a finger on him except for his wife, Len, who temporarily left her job at a hospital in California to help take care of him at Bethesda.

The pain was excruciating and getting worse, and because amputation is often less painful than a salvage operation, doctors said they were concerned that Graunke’s request for an amputation was based on his level of pain.

“You’ve got this guy who is missing both of his hands and he looks at you and he says, ‘I want you now to cut my leg off.’ … It was difficult,” said Lt. Cmdr. (Dr.) David Dromsky, one of the Bethesda surgeons who worked on Graunke. “We did everything we could to make him understand what he was asking for. We wanted to make sure this was not despair talking.”

Differing opinions

A patient electing to amputate a limb, while rare, is not totally unheard of. In cases where there’s no guarantee of success, or significant walking problems or where there’s a great deal of pain in the cards, patients will opt to amputate.

“A lot of young guys just want to get on with their life. Amputation provides that for them,” said Army Maj. (Dr.) Michael Frisch, an orthopedic surgeon at Walter Reed Army Medical Center in Washington. “Once the amputation is healed, they really get moving on.”

In most cases, especially with young and motivated people, patients can function almost normally with a prosthetic leg, said Dr. Lawrence T. Donovan, a former Army surgeon who now has a private orthopedic practice in Spirit Lake, Iowa.

But Donovan said doctors can be reluctant to perform amputations if they feel a patient is looking for a quick fix for the pain.

Graunke said he firmly believes his decision was based on having a more active life.

In order to keep the leg, Graunke, who had already undergone multiple operations, would to need continue his trips to the operating room and keep wearing a set of external pins and rods to keep his bones in place. Even once the repairs were made, he would need a brace to walk and would have little range of motion in his knee, causing him to drag his leg.

But, most importantly, doctors would have to steal muscles from his stomach, back or thigh to cover the hole in his leg. They had already tried the procedure once.

After losing so much already, Graunke said, he simply didn’t want to continue raiding healthy areas of his body for the benefit of a losing cause.

Graunke convinced his wife and mother that an amputation was the best choice, but winning over the doctors proved more difficult. Every time he brought the idea up they would go straight to the benefits of salvaging, he said.

After a back-and-forth with hospital officials, Graunke interviewed several Vietnam war amputees, as well as veterans whose legs were saved after being severely wounded. The interviews made him more resolute.

“Everyone I talked to who had their limbs salvaged just didn’t seem to be enjoying their life,” he said.

So Graunke got a second opinion.

After meeting with the Marine, doctors from Walter Reed agreed to the surgery. Graunke was transferred to the hospital in mid-September and the leg was removed on Sept. 18, 2003.

The Army surgeons who performed the operation could not be reached, but Dromsky said it was simply a matter of differing professional opinions. He stressed that there is no textbook answer to the question about amputation because every situation and individual is different.

No regrets

The amputation turned out to be a bright light at the end of Graunke’s recovery tunnel. After months of pain and isolation in his hospital bed, Graunke was finally able to sit in a chair within a week of the operation. Within two weeks, he was in a wheelchair, and within a month, he was discharged from Walter Reed.

The operation, was like a huge weight being lifted off his chest, said Graunke’s mother, Maggie Brown.

“He wasn’t who he is when he had his leg. He was mean and crabby … but then after that, he was back to being who he was,” Brown said.

More than a year later, Graunke is a different man. With regular trips to the gym, he’s gained back most of the 85 pounds he lost in the hospital. Now living in Texas, he’s mastered his prosthetic hand and leg, and he is getting back to a life of normalcy, including occasional hikes, joy rides on his new three-wheeled Harley-Davidson and planning for college this spring.

“He’s enjoying life again,” Brown said.

Graunke also returned to Washington in July on the anniversary of the explosion to visit two hospitals that nursed him back to health. During the trip, he spent hours talking with wounded service members, many of them with fresh amputations, hoping to give them encouragement.

Graunke says he doesn’t regret the decision to amputate for a moment. “I’ve never had any feeling of loss. I refer to it as ‘that thing I had removed,’” he said. “It was a good decision. I had no doubt in my mind.”

http://www.marinecorpstimes.com/story.php?f=1-MARINEPAPER-353684.php

Sad, but why was he holding it?

The pain was excruciating and getting worse

Dumbass Doctors and their stinginess with pain meds.

He is an EOD Disposal Tech.

Quoted: Sad, but why was he holding it?

I don't know if I should cry for his pain, or laugh at his resolve. That's a Hero!

Bomb Disposal Technician...

Quoted: Bomb Disposal Technician...

A big Semper Fi for that Hard Charger.

Man...that is ONE TOUGH JARHEAD!

Way to GO Marine!



During my career, I was treated by Navy and Army docs.

On one very memorable occasion for me, a Navy doc misdiagnosed my impending burst appendix, but at least the dude had the balls to call for a medivac.  When the helo got me to the hospital, the Army docs took one look and told me I had about one hour until surgery!  I still think those Army docs were Sierra Hotel for saving me.  After that, I was fine.

That said...I do remember once when a Navy doc saved my skin by operating on my leg in the field without anesthesia.  He said he had to before I got a moving blood clot and it killed me.  Go figure.  Guess he did ok too...  did kinda jurt though...

Quoted: The pain was excruciating and getting worse Dumbass Doctors and their stinginess with pain meds.

Unfortunately the meds kill receptors than confirm that there still is nerve activity, a primary consideration for the ability to heal.

Catch 22.  

Quoted: He is an EOD Disposal Tech. Quoted: Sad, but why was he holding it?

Yeah got that, just don't see why they don't explode it where it lies.

Quoted: He is an EOD Disposal Tech. Quoted: Sad, but why was he holding it?

I still don't understand why he was holding it.  I thought standard procedure for UXO was to blow in place.  Maybe there was some reason why they couldn't.

Please don't infer from my post that I have anything but the utmost respect for this Marine.  I'm just curious.

Damn... just DAMN.

Hope my brother "Crab" wearer gets well.

Google up his name, there are a lot of people behind Mark Graunke.

Marine Staff Sgt. Mark Graunke, Jr., was seriously injured July 2, 2003 while serving in support of OIF. Graunke, who was part of the Explosive Ordnance Disposal team, was in the process of disarming a bomblet when it exploded. He lost his left hand, two fingers on his right hand, left eye, and after realizing he would not have full function of his right leg he decided to have it amputated.

Quoted: Quoted: Sad, but why was he holding it? Yeah got that, just don't see why they don't explode it where it lies.

Quoted: Marine Staff Sgt. Mark Graunke, Jr., was seriously injured July 2, 2003 while serving in support of OIF. Graunke, who was part of the Explosive Ordnance Disposal team, was in the process of disarming a bomblet when it exploded. He lost his left hand, two fingers on his right hand, left eye, and after realizing he would not have full function of his right leg he decided to have it amputated.

Thanks, I wish the article had made that more clear.  That sounds much better than "he was holding it in his hands when it exploded."

Quoted: Quoted: He is an EOD Disposal Tech. Quoted: Sad, but why was he holding it? I still don't understand why he was holding it.  I thought standard procedure for UXO was to blow in place.  Maybe there was some reason why they couldn't. Please don't infer from my post that I have anything but the utmost respect for this Marine.  I'm just curious.

Because sometimes you can't BIP (blow in place) a piece of ordnance, it may be in a area where an explosion isn't  desireable like in a oil refinery, hospital, etc.  Usually clusterbomblets are not picked up as they tend to be extremely dangerous like the BLU-97.

Quoted: The pain was excruciating and getting worse Dumbass Doctors and their stinginess with pain meds.

Unfortunately, some physical pains cannot be covered/killed with any meds.


____________________________________
The only hope you have is to accept the fact that you are already dead. And the sooner you accept that, the sooner you will be able to function as a soldier is supposed to function, without mercy, without compassion, without remorse.

Damn.  Just damn.  Those people go through hell for us.


There is so much embodied in the spirit of this medal that words cannot express.
Thank you for your service and your sacrifice.

Quoted: Sad, but why was he holding it?

No wonder you're an Idiot, your Reading Comprehension is shit -

It would be a long, hard road with numerous reconstructive surgeries, a great deal of pain and no hope of returning the leg to perfection. But Graunke, a tough-minded explosive ordnance disposal technician and former embassy guard from Texas, was onboard with the plan.