tool name

Wednesday, Dec. 05, 2007

Comeback: Marine rehabs to get fit again for war

Pain is weakness leaving the body. So says a motto on the wall in the Marines area of Merced's military recruiting center.

With it hangs a Marine's photo as he pulls himself over steel bars, a snarl on his face.

Marine Staff Sgt. Raymundo Perez, 26, relates to that message in more ways than one. And it hung as a constant reminder just to the right of his desk on Monday morning as he solemnly finished packing. "I'll be done in a about 10 to 15 minutes," he said in the same soft-spoken tone he always uses. He took a wooden name plaque bought in Okinawa, Japan, down from a shelf to wrap in newspaper.

He placed it in a cardboard box along with other memorabilia -- a Marine Corps coin presented to him by a two-star general, a recruiting award with a Raiders jersey and a Pepsi can with Arabic writing on it from Iraq. His starched desert-camo uniform fit his lean frame like a tailor-made suit.

The moment was bittersweet. "I'm excited because I'm getting ready to leave," he said. "But I'm sad to leave my guys behind. We did a lot of great things here."

He also did a great thing for himself. To overcome a debilitating injury, he pushed his physical and psychological limits to the edge -- just so he could return to the battlefield. And, with some expert medical help and inspired therapy, he made it. The noncommissioned officer is on his way to Afghanistan.

For the last year he has worked as a recruiting supervisor for the Merced area. To counsel local young men and women, he applied his experiences from 2003 when he was stationed in Baghdad with the 1st Battalion of the 5th Marines.

Those experiences -- including contact with insurgents -- helped him overcome his own injury. His pain, however, didn't come from a combat wound. There was no Purple Heart involved.

Instead, a knee injury from a snowboarding accident a year after he left the war zone became the biggest hurdle in reaching his goal: to be deployed as soon as possible back to a war zone.

As the wars in Afghanistan and Iraq enter their seventh and fifth years, repeat deployments have become the rule, not the exception, for Marine and Army units. Some troops are on their fourth tour of duty in Iraq, and many more have completed at least two. Besides those who've already made the journey to the battlefield, thousands remain who, for the first time in their lives, must pack their rucksack at home for what may turn out to be a year or more as a stranger in a stranger land. How they prepare for an unprecedented and hostile phase of their lives can literally save their lives.

Tim O'Brien's novel, "The Things They Carried," lists what some grunts in Vietnam took on patrol -- and it's not that different from what a desert camo-clad trooper would pack for Iraq or Afghanistan: "The things they carried were largely determined by necessity. Among the necessities or near-necessities were P-38 can openers, pocket knives, heat tabs, wrist watches, dog tags, mosquito repellent, chewing gum, candy, cigarettes, salt tablets, packets of Kool-Aid, matches, sewing kits Military Payment Certificates (instead of greenbacks), C rations, and two or three canteens of water. Together, these items weighed between fifteen and twenty pounds."

Perez has had to carry a load much different from either his Vietnam or war-on-terror counterparts. He has had to carry the burden of rebuilding his body.

"When I first got back I thought that it was going to be a quick, easy war -- it's not," he said. "Now I feel like I'm being left out. I've gotta get back there."

After a daily grueling regimen that left him drenched with sweat, the Marine is getting back into the fight. His request was granted. He leaves Merced on Friday to head to Afghanistan. And preparing for this journey has meant more than just packing up and saying goodbye to his friends.

Years of intense exercise to get his body into military shape were negated by his injury, followed by months of pain and attempted rehabilitation -- which failed. So arthroscopic knee surgery in June was the next option, followed by more months of rehabilitation.

Just getting back into shape wasn't good enough. His legs needed to be in prime form before he shipped off. Weak muscles have no place in a combat zone.

Soldiers' entire bodies endure intense physical stress, especially their legs. They must be able to run in combat boots and move quickly hefting 60 to 120 pounds of armor, weapons and other gear. They have to lift and carry supplies without slowing down their comrades.

Being weak compromises more than their integrity -- it could mean their lives.

That's why any Marine or soldier must dedicate himself to serious physical training from the moment he first decides to join the military.

Perez was naturally athletic even before he joined the military. He grew up playing football and basketball. But these regular exercise sessions are necessary to get stronger, even for people without injured knees to recover from.

And suffering an injury that caused him to lose about an inch-and-a-half of muscle from his left leg meant his workout just had to be that much more intense. He ran five days a week at 5:30 a.m. and continued his exercise at In-Shape City gym on G Street. On Tuesdays and Thursdays at 4:30 p.m. he trained with the recruits at Bear Creak Center.

Tack that on to appointments three times a week with a physical therapist to build back muscle and strength.

It's hard to believe that just five months ago, Perez couldn't run or hike at all. But as of late October, his muscle memory was at about 85 percent of normal. Physical therapist Bob Walsh said in November that Perez had almost reached his goals.

Perez leaves for Camp Pendleton on Friday to prepare for his deployment to Afghanistan. "I'm looking forward to being on a base," he said Monday. "It's a more military environment, more gung-ho."

It was no easy journey to get to this point. Dealing with his knee was a 2½-year ordeal. Perez remembers the exact date of his accident -- March 26, 2004. He went snowboarding for the first time ever at Sierra Summit Mountain Resort near Yosemite National Park. He caught on quickly to the sport and tried sliding on a rail.

But he went off the rail, hit his head and twisted his knee. At the time he was more concerned about the concussion he got. "I wasn't worried about my knee," he said. "But then it started to hurt. I ran, and then it went out on me."

A grimace shot across his face as he remembered how intense the pain was.

He first tried to rehabilitate his leg without surgery. The macho approach didn't work. Then he started seeing Walsh, who has been a Merced physical therapist for 25 years. "When Ray came in he'd had a history of trouble with his knee," Walsh said. "His attempt to re-strengthen failed because of the pain."

Perez underwent an arthroscopic procedure on June 14 at University Surgery Center to remove a plica from his knee. A plica commonly results from a knee injury and becomes part of the cushioning. It is a pain-sensitive structure that can interfere with the function of the knee cap, Walsh said.

During the minimally invasive procedure to fix the problem, a small optic device was inserted into the joint through a small incision to trim damaged tissue.

At the beginning of July, Perez began seeing Walsh regularly to rehabilitate his knee. "My muscles had turned into mush," he said with disgust.

Walsh's practice -- Advanced Physical Therapy and Sports Rehabilitation -- focuses on active clients like Perez. But each client has different needs and goals. In Perez' case, Walsh said, he needed to work up to the point where he could carry heavy loads and be on his feet for long periods of time. He needed to be able to run and jump with ease.

Perez began with basic stretches. When his knee became stronger, he added weights to his exercises. He started with 2½-pound weights, then worked up to 17½ pounds. It was a slow progression -- a tough, gradual ordeal. The first time he tried to jog, he couldn't do it. "He was chomping at the bit to get out there," Walsh said.

When Perez could finally walk without a limp, the physical therapist had him do an exercise called forward resistive gait. He pressed against the Marine's shoulders, who pushed back against him to walk forward. Walsh also pressed against his side as Perez moved sideways for the exercise resisted lateral gate. Leg raises and time on the exercise bike also worked his muscles.

Perez remembers the exact date he could first complete a 10-minute jog -- Aug. 23. "I was ecstatic," he recalled. "I was jumping up and down."

However, it's not a competition, Walsh warned repeatedly. Slow and gradual is the name of the recovery game. "He was missing an inch-and-a-half of muscle before," Walsh said, motioning to Perez' left knee. "It's pretty close to his other leg at this point." In fact, he said at a session on Nov. 6, Perez was about a week away from completing his physical therapy. "We're about done with him. He's making me look good," Walsh smiled.

Now just days before he leaves Merced, Perez says he's feeling strong and healthy. And the successful physical fitness test he took last Friday proves it. He plans to spend the rest of his week working on cardiovascular exercises. "Get the last kinks out of my knee," he said.

It was all hard work. But Perez likes challenges.

Born in Mexico City, he was 18 months old when his family moved to Porterville. There, he earned good grades throughout his schooling and was considering studying pre-med at California State University, Fresno. His brother, Efrain, now 28, had already joined the Marines. Perez considered the idea for himself. "I wanted to grow up, pay for school," he said.

He was impressed by the uniform and challenges being a Marine presented. With his parents' permission, he joined after high school at age 17 on April 29, 1999. "It was difficult the first two or three weeks," he said. "I wasn't sure if I made the right choice. But I had training, and after boot camp, everything else was easier."

He excelled at boot camp in San Diego and graduated on Jan. 14, 2000, as "the guide" or leader of a platoon. He went on to Marine Combat Training and then Military Occupational Specialty School at Camp Johnson in North Carolina. Perez concentrated on supply administration, learning to manage gear, weapons and computers.

After managing supplies for the 1st Battalion of the 5th Marines at Camp Pendleton for about three years, he attended a unit deployment program in Okinawa, Japan. He also trained in Australia, simulating a three-day war scenario. His travels brought him back to Camp Pendleton for six months before he deployed on Jan. 3, 2003, for Kuwait. He knew that country was the launch point for Iraq.

At 2 a.m. on March 20 that year, his unit got the orders to move. "We were asleep, it felt kind of like a dream," Perez said. "It was exciting, but it was also like, 'What are we going to do?'" By 4 a.m. they started pushing north in a convoy. Although a severe sandstorm assailed the vehicles, they kept moving -- mostly at night -- until they reached Baghdad. "It was unique to see the people," he remembered. "They were a lot more friendly than was being reported. ... It was amazing to see how other cultures lived."

First Baghdad, then all of Iraq, fell to the U.S. and its allies. On May 26, 2003, he flew back to Camp Pendleton. And he immediately re-enlisted for recruiting duty.

He began working as a recruiter in Clovis after attending recruiter school in San Diego. He came to Merced to work as a recruiting supervisor on Oct. 1, 2006.

But the whole time he was itching to go back overseas. "If I had it my way I'd keep doing six months overseas and then six months in the States." World travel appealed to him, and he believes that his work in other countries can help people who have less than he does. "After getting back from Iraq, I appreciate life here a lot more," he observed.

Still, he felt the need to go back. He enjoyed being a part of history. "I just want to make sure I'm physically ready," he said in October. "Mentally -- I'm ready."

On Monday, he felt ready in both mind and body. "No complaints," he said. "I'm feeling good."

By about 10:30 a.m. that day, his desk was almost empty, soon to be taken over by another Marine recruiter.

He feels no nervousness about shipping off after his stop at Camp Pendleton, where his coffee cups and Raiders and Marines memorabilia will find a new home. He's excited about all the Asian countries his ship will dock in on the way to Afghanistan.

But he's sad to leave the recruiters and other people he has met in Merced. The memorabilia go with him, along with many fond memories.

And he'll leave some of himself here: the sweat and pain of rebuilding his knee; the pride and joy of running on it again.

The weakness has left his body.

Reporter Dhyana Levey can be reached at 209 385-2472 or dlevey@mercedsun-star.com.