Doctors: Prognosis good for Kaua'i shark victim

By Alice Keesing
and Brandon Masuoka
Advertiser Staff Writers

The courage that pulled Hokuanu Aki through a shark attack this week will help him pick up his active life, doctors said yesterday.

With a prosthetic leg, which will be fitted as soon as possible, the 17-year-old from Koloa will be able to run and jump and do almost anything he sets his mind to, said Dr. David Rovinsky, the orthopedic surgeon at Wilcox Hospital on Kaua'i who helped save Aki's life after the attack.

"He's a very determined and courageous young man," Rovinsky said. "The key is getting him moving quickly. He participated in physical therapy today. This morning he was up and around in physical therapy and walked 150 feet with the walker, which is incredible. He's a tough kid."

The shark that attacked Aki when he was bodyboarding at Brennecke Beach on Monday bit him twice. One bite took his left foot. The other took a chunk of his calf.

The quick action of a vacationing nurse saved Aki from bleeding to death, Rovinsky said. He was rushed to Wilcox Hospital, where he was stabilized and in the operating room within 15 minutes. To stop the bleeding and rid the wound of any bacteria from the shark's mouth, Rovinsky removed Aki's leg below the knee.

Aki was flown to Queen's on Tuesday, where surgeons performed a second amputation halfway down his thigh.

Dr. Byron Izuka, the orthopedic surgeon at Queen's who did the amputation, explained that it was necessary to cut above the knee because of extensive damage to Aki's calf.

"That limb could have potentially been saved below the knee, but it wouldn't have been able to work in a prosthesis," he said.

In the days ahead, Shriners Hospital will fit Aki with a temporary prosthesis and begin teaching him to walk again.

"The physical therapy department is involved on a daily basis, if not several times a day, in getting these patients to bear weight and to walk with an artificial limb," said Shriner's orthotist Elton Bacon. "It's a little bit different, because there's hardly any response back from the prosthetic device."

Experts say that people with prosthetic limbs can continue to live their lives to the fullest.

"Once the wound is healed and he's comfortable, he will be able to get into the water and swim. With the proper prosthetics he'll be able to run and jump," Rovinsky said.

Michael Coots, the Kaua'i resident who lost his right foot when attacked by a shark in 1997, said having a prosthetic foot hasn't held him back.

"I'm not restricted at all," said Coots, who has reached out to Aki's family since the attack. "For going to school and going to the beach, it's perfectly fine."

Coots can still ride waves, but he cannot hike or run with the foot he has, and is trying to get the $10,000 to get another model.

Prosthetics are not cheap. Bacon said that while simple models are available for a few thousand dollars, the most commonly used prosthetics for an above-knee amputation can cost from $20,000 to more than $40,000.

There have been great advances in prosthetic technology in recent years, according to Bacon and medical experts. By tapping advances in computing, electronics and materials engineering, manufacturers have been able to more closely mimic the complexity of a human limb and its joints.

Early prosthetics were simple wood or leather devices, but today's models are crafted with super-strong, lightweight materials developed for jet planes or bulletproof vests. Researchers are working on limbs that would restore the sense of touch and experimenting with ways to grow skin and bone for prosthetics.

Already there are artificial limbs available that harness bioelectric technology, using nerve impulses from the severed limb to move the artificial one, Bacon said.

More commonly available are hydraulic knees that give a full range of motion, and artificial feet that absorb impact energy and return it back up the device to help the wearer walk.

There also have been advances in cosmetics, Bacon said, and the prosthetics can be crafted like a natural limb — or more creatively.

"We have pigment to match skin color or tone, and we can also go to the fabric store and pick out a Hawaiian print if the patient desires a Hawaiian print-looking leg. Or I did one that was WWF, because the young gentleman was a wrestling fan," he said.

Bacon said it is too early to say what type of prosthetic Aki will use.

"It's up to the individual patient," he said. "If they're the athletic type, nothing really stops them. They find ways to continue doing the things they love to do."

Rovinsky said Aki remains upbeat. His room is filled with cards, pictures and letters from friends. Hospital staff yesterday relayed a message from Aki to friends and family back home on Kaua'i: "Hi. Miss everybody. Can't wait fo' come home."

Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014. Reach Brandon Masuoka at bmasuoka@honoluluadvertiser.com or 535-8110.