[Bungleau]

Okay, this one caught my eye. From one of those bad-@$$ Canadians...

'I GOT MY ARM. I CAN'T COMPLAIN' Jim Gibson , Canwest News Service Published: Thursday, October 16, 2008 VICTORIA - Shawn Clement knows that his left arm looks as if he lost out to the shark in Jaws. Sometimes the 30-year-old tells gawking strangers that's exactly what happened to his arm, now a tributary of scars running from his wasted bicep to below his elbow. What actually happened to the former Gold River, B.C., shake and shingle mill worker is as horrific as anything Hollywood conjures up. In February, a flying 1.2-metre saw blade severed his left arm about 16 centimetres below the elbow. Clement had chalked up about 15 years in the forestry industry by the time of his accident. Over the past two years, he had worked on-and-off as a sawyer, turning blocks of wood into shakes and shingles. He had been filling in as a sawyer since early January, and was just a few days away from a new posting. He wasn't comfortable around the two blades the job involves. "I was scared of it for a long time," he adds, concerned about what he saw as limited escape room. "Nothing ever happens," he was assured, but his concerns became a brutal reality in the early afternoon of Feb. 21. Suddenly, one fast-spinning blade looked terribly wrong. He knew it was coming off. "Son of a bitch! Fifteen years and this is how it's going to end," Clement thought as he fled. "I ran away. It caught up to me." The blade pinned him to the mill floor, breaking his nose and several teeth. "My buddies were on it fast - it seemed like an eternity - they all thought I was dead. They pulled the saw off of me. "My face hurt. I went to grab my face. My hand was gone. I got up and grabbed the stub that was left and ran to the first aid room." He was heavily sedated for the helicopter ride to Royal Jubilee Hospital. His severed arm had been wrapped in moist sterile sponges, placed in a plastic bag and set in a bucket of iced, saline fluid. A Victoria medical team reattached it during an 11-hour operation starting that evening. Almost 24 hours after his accident, Clement woke up to see his mother and ex-wife in the hospital room. He looked down at his heavily padded arm and thought, "Wow. It's cool. It's an arm." "I looked at my mom and ex-wife and they were crying," Clement says. "I got my arm. I can't complain," Clement says eight months later. At the time, they weren't even giving him 50/50 odds. "When I woke up, Ken (surgical team leader Ken Smith) came in the room and said, "Chances are you might not keep the arm, but we're going to see what will happen.' " For Smith, it was his first arm reattachment in 16 years of practice. Smith likens what he does in the OR to renovating a house. Initially, the builder must decide if the renovation is both possible and worthwhile. The surgeon must decide if there is enough left to do the reattachment, and what, if any, function can be restored. Some patients never regain any use. The attached part becomes a hassle so they later choose amputation, Smith says. Clement had two pluses even before reaching the OR. The flying saw blade severed his arm cleanly below the elbow rather than splintering bone and mashing the flesh. Secondly, the severed arm was well-prepared for transport. Clement was wheeled into the OR about 7 p.m., giving Smith an easy six-hour leeway to restore circulation before the severed arm would be deemed dead. Continuing with the builder analogy, Smith describes orthosurgeon Colin Landells as the framer. He stabilized the bone first with plates on Clement's arm and then moved to prepare the severed piece on which Smith had already tagged which nerves, veins and arteries were usable. Again with an operating microscope donated by the Firefighters Burn Fund, Smith tagged Clement's remaining arm. Once Landells joined the bones over three hours, Smith began reattaching first the blood vessels (the plumbing) and then the nerves (the electrical). Zooming in with the microscope, he first trimmed the ends before stitching them together, as he later did ligaments and muscles to allow some future function. As Smith worked, Clement's arm began regain colour. The "plumbing" was working, but the next day the arm turned an ominous deep purple. Clement was back in the OR where two veins were transplanted from his right leg to the arm to improve blood flow back to his heart. Smith now says Clement's arm is there to stay, stopping short of touting a full recovery. "It's safe to say he'll never have normal function," says the surgeon, who envisions Clement's left arm only in an assistance role to his right arm. Time, therapy and medical procedures have given the right-handed Clement partial use of his left arm. "I can pick up a screwdriver, scratch my nose, but I can't wipe my ass or pick up a dime," he says. Nor will he ever again play ball, curl or return to being a volunteer firefighter. In the months or years ahead, the father of three envisions retraining as a pilot or surveyor. Clement still faces an unspecified number of medical procedures. There is a bone graft to come, as well as surgery for internal scar tissue before the year's end. He is in constant pain. The consequences are not all physical. Any loud noise has Clement looking "behind me to make sure nothing's coming after me." There are nightmares in which he sees his arm come off. He has returned to the mill to thank colleagues for their quick action, but he avoided his old work area. "I couldn't. I wouldn't go back in there," he says. jgibson@tc.canwest.com © Victoria Times Colonist 2008

I'm... impressed. Really.