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It Takes More than a Shark Attack To Stop Champion Surfer
By Miki Fairley
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Bethany (second from right) receives her new bike from the Challenged Athletes Foundation (CAF). From left are her parents, Tom and Cheri Hamilton; Willie Stewart, noted amputee athlete; and Bob Babbitt, CAF vice president. Photo by Phil Mislinski, courtesy of the Challenged Athletes Foundation. |
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There was no indication of danger when Bethany
Hamilton, a 13-year-old star surfer from Princeville, Kauai,
Hawaii, went out on the waves early that day last October. Along
with her best friend Alana Blanchard, and Alana's father and
brother, she was surfing off Tunnels Beach on the North Shore of
Kauai, with other surfers nearby.
Then horror struck. As Bethany lay on her board in clear water
around 8 AM October 31, she was suddenly attacked by a shark that
bit off her arm close to the shoulder joint. The shark pulled her
back and forth, "but I just held on to my board, and then the shark
let go," Bethany told the Associated Press (AP).
Holt Blanchard, Alana's father, immediately applied a tourniquet
to Hamilton's arm, using a surfboard leash, a move that saved
Bethany's life, according to her mother, Cheri. Alana remembers her
friend as being "really calm." Doctors at Wilcox Memorial Hospital,
Lihue, said Bethany's athletic conditioning aided her survival.
The shark took a chunk out of her surfboard that was about 16
inches across and 8 inches deep, suggesting the shark was 12-15
feet long, according to Kauai Fire Battalion Chief Bob Kaden,
quoted by the AP. A spokesman for the state's Shark Task Force,
Randy Honebrink, said it may have been a tiger shark.
Tiger sharks are second only to white sharks in the number of
reported attacks on humans. Voracious predators, they are known to
eat practically anything they can catch alive; the fearsome fish
can grow to about 20 ft. long, with around 10 feet being
average.
Would Bethany Surf Again?
Before the attack, Bethany was expected to become a professional
surfer. She had already taken top honors in various surfing events
and had secured sponsorships. Would she ride the waves again?
When asked by Matt Lauer on the Today show shortly
after the attack if Bethany would try to return to competitive
surfing, her father, Tom, said, "It will take some time for her to
adapt, but she's so adaptable, and she's so strong, and she loves
the sport so much, I think she's going to surprise myself and
everybody else in the world."
Bethany did indeed surprise everyone. In less than a month, she
was back in the water--and she returned to competition in just ten
weeks, placing fifth in her age group in the Open Women Division of
a National Scholastic Surfing Association meet in Kailua-Kona,
Hawaii January 10. She did not allow any special treatment--she
wanted to be treated just like everyone else.
The young surfing star was the guest of honor of the US Olympic
Triathlon Team announcement in Honolulu, Hawaii April 14 and is now
an honorary member of the team. The Challenged Athletes Foundation
(CAF) gave Bethany a new bike, since she has expressed a desire to
become a triathlete. Willie Stewart, noted triathlete and an
above-elbow amputee, gave her guidance and instruction on how to
ride a bike with one arm.
What About a Prosthesis?
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Troy Farnsworth, CP, uses Hanger’s proprietary Insignia technology to scan Bethany’s residual limb as Randy Alley, BSc, CP, FAAOP, and Bethany’s father Tom watch. |
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What about a prosthesis for Bethany? The
orthopedic surgeon who treated her after the attack noted that it
was a clean amputation. In discussing Bethany's prosthetic
management, Randall Alley, BSc, CP, FAAOP, remarked that Bethany is
completely comfortable with her body image, unusual for a girl so
young. Alley heads clinical research and business development for
Hanger Prosthetics & Orthotics' Upper Extremity Prosthetic
Program. "Given her bone length, attitude, her age, her family
support, and the culture she grew up in, which is focused around
surfing and her athletic ability, her desire to wear a prosthesis
for anything other than surfing may be somewhat less than the
average 13-year-old girl, who is typically more concerned about her
self-image," Alley said. "She immediately became an icon in the
islands, and she is extremely comfortable with herself the way she
is. Most 13-year-old girls would typically want a silicone
restoration, but although she wears one occasionally, she is truly
focused on what we can do for her as it pertains to her greatest
love, the ocean."
However, Alley and Troy Farnsworth, CP, director of Hanger's
Upper Extremity Program, would like to see Bethany return to
bimanual usage "for her lifelong safety and ability to integrate
into society," Alley said. Even a passive (Alley prefers the
terminology "semi-prehensile") prosthesis, which she currently has,
enables her to carry lighter objects and stabilize objects against
her body.
Ultimately, they would like to fit her with an adaptive
prosthesis that would enable her to swim out through the waves
faster for competitive surfing. "Her ability to surf is not really
hampered or aided by a prosthesis, as she has excellent balance
with or without a prosthesis," Alley said. "Where a prosthesis
could really help would be paddling through the waves and getting
up on her board."
The length of Bethany's residual limb presents a challenge--it's
extremely short, making it difficult for her to manipulate a
prosthesis, Alley noted.
"We're looking at bone-lengthening techniques as an option down
the road, because she could really benefit from a longer humerus
bone to increase her leverage," Alley said. In this particular
case, Alley and Farnsworth prefer a technique which uses a titanium
fixture at the end of the bone, versus the Ilizarov technique,
which requires an external fixator. In the Ilizarov technique, the
bone is broken, slowly pulled apart, the gap fills in with new
bone, then the process is repeated until the desired length is
attained.
"How the Ilizarov technique works is very effective for specific
individuals, but it is very time-consuming and is often
debilitating during rehabilitation for others," Alley explained.
"We don't want to risk freezing up her shoulder joint's range of
motion if we were to use fixators up that high and immobilize the
joint for a long period of time. She really needs a strong and
mobile shoulder joint to help her propel through the water."
However, the titanium implant technique is not yet approved for
use in the US, and it hasn't yet been sufficiently used for
upper-extremity bone-lengthening, although it has proved successful
in lower-extremity use, Alley explained. Bethany thus would need to
be treated by a physician out of the country if this technique were
to be used. "The shape of the titanium fixture would allow better
suspension for the prosthesis and the healing time is much
quicker," Alley continued.
If the bone length is there, a prosthesis with a paddle-like
terminal device at the end, which expands as it goes through the
water and then collapses as she raises her arm out of the water,
would help her cut through the waves more effectively, Alley said.
"We have to be careful, however, that any such device does not
apply excessive forces to her shoulder joint and hence overly
stress the area and ultimately induce injury," he continued. "This
will take some careful design study and risk analysis, as well as a
healthy dose of trial and error."
But, whether she wears a prosthesis or not, this "surfer girl"
certainly hasn't let a shark attack and limb loss deter her from
her beloved sport! 
Table Of Contents - September 2004
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