Bristol man on fast track with high-tech leg braces

BRISTOL — After 25 years of restricted mobility and chronic pain, 47-year-old James “Bub” Cole of Bristol stepped on a track last month and ran for the first time in a quarter century. The experience, he said, was unforgettable.
“Imagine wearing glasses and then losing them,” Cole said. “After 25 years, you finally get them back and you can see what you’ve been missing.”
Cole’s return to free movement was made possible by a new type of brace for the lower leg. The new style of brace, originally designed for use by wounded veterans, has been demonstrated to be more comfortable and effective at restoring speed and range of movement, according to a report by the U.S. Army Institute of Surgical Research.
Cole is said to be the first civilian in Vermont to use the brace, originally used only by wounded servicemen and women.
At 22, Cole fell some 15 feet out of a second-story apartment window and landed on the concrete sidewalk below. Both of his tibias — one of two bones below the knee — exploded. Cole underwent surgery, during which a series of four-inch plates were used to reconstruct his ankles. Portions of his hip were used to fill in spots where the bones in his leg or ankle were too weak or too fragmented.
“I got screwed back together,” was how he described it.
After surgery, Cole’s journey to recovery began. He spent five months in a wheelchair before using other devices including walkers, crutches, partial crutches and canes. He underwent 15 months of physical therapy and relearned how to walk. But he was only partway there.
“If you saw me walking down the street, I’d be taking a slow walk and you wouldn’t notice any difference,” he said. “But I have really bad arthritis in the joints and all the hardware is still in there so it causes difficulty. The more I do — the more time I spend standing or walking — it starts to hurt worse and worse.”
As a result, Cole has worked jobs that don’t require him to stand or move frequently. Today, he works at a desk for the boating engine parts company Marineengine.com based in Brandon.
“I couldn’t be a chef or even a school teacher,” he said. “I couldn’t stand long enough to be a school teacher.”
Until recently, Cole wasn’t able to walk distances greater than a mile and could only stand for 30 minutes at a time.
But help came in the form of a new piece of military technology that this year has been approved for civilian use. The Intrepid Dynamic Exoskeletal Orthosis, or “IDEO” (pronounced eye-DAY-oh) was developed at the Center for the Intrepid as an alternative to amputation. The center, located at the Brook Army Medical Center in San Antonio, Texas, is dedicated to treating amputees and burn victims, principally service men and women returning from war in Iraq and Afghanistan.
After reading articles on the new braces, Cole contacted the developer of the orthotic, Ryan Blanck, who had since left the Army and whose braces had been licensed for public use. Cole traveled to Seattle twice to meet Blanck and to be fitted for the device. It was in Washington on Aug. 25 that Cole took his first steps using the IDEO, and his first trot around the track.
Each brace is constructed of lightweight black carbon fiber that is custom-fitted to each wearer. A footplate inside the shoe attaches to a strut that runs up the back of the calf to a cuff that fits around the leg below the knee. When the wearer takes a step it applies pressure to the footplate, which bends the strut and transfers energy forward. Like a pair of running blades, now popular among amputees, the braces provide both stabilization and forward propulsion.
“It provides the forward momentum that you can’t create after an injury and gives you weight bearing and forward power,” Cole said.
Cole says the braces weigh no more than a pair of winter boots and after receiving them in late August, his mobility has improved significantly.
“I can do things now that I haven’t been able to do for five years,” he said. “I can jog, I can hike, I’ve been able to walk three and a half miles at once and if I wanted to dance I could dance if I were so inclined. I can spend much more time on my feet and I am more able than ever before.”
In addition to moving more, Cole says he looks forward to using his new ability to lead a more active lifestyle in the outdoors and volunteering with Bristol Boy Scout Troop 543, of which his son Oliver is a member.
“With some hard work I will be able to keep up with these fine young men on the trail in the future,” he said.
Cole stressed that his main reason for seeking the braces was to alleviate pain and prevent further degeneration of his ankle joints. He knows that as osteoarthritis progresses, the pain in his ankles will worsen leaving Cole with the options of medication and inactivity or having major surgery to fuse the joints so they no longer move; both of these are outcomes Cole wants to avoid.
“The incredible new physical ability I have now with the IDEO was not my main motivation but it is a wonderful icing on the cake,” he said.
But such a piece of medical technology doesn’t come for free. Each brace costs $9,000 and after his health insurance plan defined them as “dynamic splints,” instead of an “orthotic device,” it refused to cover the cost of the equipment because it was not covered by his plan, Cole said. Cole formally appealed the decision of Blue Cross Blue Shield of Vermont twice — the maximum appeals allowed, and was rejected both times.
Saddled with an $18,000 bill and no help from his insurance, Cole is seeking help through the giveforward crowdfunding website; to learn more visit www.ideobracefund.com. To date, he has received almost $5,000 — a portion of the total amount needed to cover the costs of his two trips to Seattle and the cost of the braces
But cost aside, Cole says the improvement was well worth the cost.
“I’m ordinarily not the kind of person who asks for help,” he said. “But in this situation it was either ask for help or not make an improvement in my life.” 

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