Melissa Stockwell after taking second place at the Paratriathlon World Championships in New Zealand in 2013.

After 1st Lt. Melissa Stockwell came to on Baghdad’s Route Irish, she looked down and saw the terrible truth. “Where my leg should have been, there was just a whole lot of blood,” she said.

It was April 13, 2004, and the roadside bomb that took Stockwell’s left leg was a precursor to thousands more, a bell curve mapping some of the worst wounds of war over the next dozen years. Recognized as the first U.S. female soldier to lose a limb in combat, Stockwell doesn’t especially welcome the distinction. Instead, she sees herself in a larger context, as one of about a dozen U.S. troops in Iraq who suffered an amputation that month, and one of the lucky ones. “I had only lost one limb,” she said. “I felt very lucky.”

Since 2001, about 1,650 U.S. troops have lost hands, arms, legs or feet during the wars in Iraq and Afghanistan. Year after year, combat in both theaters created amputees — scores in some years, hundreds in others. Six years ago, in June and July alone, 78 servicemembers who entered the service with all their limbs left with one or more missing.

But in 2016, the number of deployed troops who suffered amputations was zero.

The milestone was assessed recently in the Medical Surveillance Monthly Report, a publication from the Defense Health Agency’s Armed Forces Health Surveillance Branch.

The report tracked amputations involving deployed troops by month since 2003. That year, nearly six deployed troops a month, most of them soldiers, had an amputation.

Tracking amputations, which the health surveillance branch breaks out by service, helps military officials identify incidence, distribution, impact and trends, said Col. Douglas Badzik, health surveillance branch chief. Ultimately, he said, such analyses help provide “a force that is healthy and ready to carry out its mission.”

The data, based on hospital dismissal records, is not flawless. A medically retired Air Force airman injured in a 2012 roadside bomb attack in Afghanistan had his foot amputated in June, for instance, and was not captured in the MSMR data.

Still, the data tell a story — about troop numbers, intensity and nature of combat and the ferocity of attacks — as about 5,000 troops remain in Iraq and 8,400 in Afghanistan. Just one deployed person lost a limb in 2001 after the U.S. invaded Afghanistan, but two years later, after the Iraq invasion, the number had climbed to 80, according to a Congressional Research Service report.

Almost every year showed significant increases until a respite in 2008-09, which was followed by the steepest increase yet until 2012.

Amputations in both theaters increased with troop surges, closer combat and increasing use of improvised explosive devices by enemy combatants.

In 2007, as troops poured into Iraq, 197 troops — 50 more than in each of the two previous years — lost a limb. When the surge ended, the numbers dropped to 67 in 2008, then 24 in 2009, according to the CRS report, which broke out its data by year and theater.

As the Iraq numbers fell, however, Afghanistan combat amputations were increasing rapidly. They went from 67 in 2009 when President Barack Obama began surging troops there, to three times that in 2010.

There were more amputations in 2011 than any other year, with 260 troops, many of them Marines, losing at least one limb. That June — as 39 troops were rendered amputees, the most of any month — Obama announced that 10,000 troops would be withdrawn by the end of the year. The numbers began dropping in 2012.

Afghanistan became infamous for “dismounted complex blast injuries,” in which both legs and an arm or hand were blown off, along with severe injuries to the abdominal, pelvic and genital areas. Some troops — more than 100 in 2010, according to an Army report -- died of their injuries. But others lived, including five who lost all their limbs — both arms and both legs.

“When we started off (with the wars) it was onesies and twosies,” said Bob Bahr, a physical therapist at Walter Reed National Military Medical Center in Bethesda, Md., one of the military’s three centers for amputee care. “Then we got a triple amputee and said, ‘What do we do?’”

They decided to use the same techniques — get patients up and walking as soon as possible, with humor, kindness, firmness and camaraderie.

“It seemed to work,” Barr said. “It’s amazing how people adapt and become whole again.”

Recovery from such a significant wound is usually a long, arduous process often with setbacks: infection, bone growth in soft tissue, repeated surgeries. “It was frustrating,” Stockwell, now 37, said of her own repeated surgeries. “But I’ve always been a glass-half-full type.”

She took her first steps on a prosthetic leg 52 days after she lost her real one.

Often the blast that caused the amputation came with additional injuries: burns, vision loss, brain injury. Some amputees have committed suicide. “We’ve lost a few,” said Steve Springer, Walter Reed amputee care coordinator. “That’s the exception.”

Many have thrived. Experts said that’s due to skilled medical care and rehabilitation, advances in prosthetics, youth and nonprofit groups engaging wounded troops in sports. Stockwell credits the Wounded Warrior Project, which brought her to ski in Colorado, as well as organizations that helped her to handcycle the New York City marathon and compete in triathlons, including the U.S. Olympic Committee’s Paralympic Military Program.

James Sides, a Marine explosive ordnance disposal technician who lost his right hand, also pointed to athletics as a powerful motivator that provides a sense of mastery and accomplishment. He was wounded in Afghanistan in July 2012, on his fifth combat deployment, when a booby trapped IED he was inspecting blew up. He learned his hand had been amputated only after waking up from surgery. “I had a rough two weeks,” he said. “But nobody else got hurt and I’m still here — that was my take on it.”

At Walter Reed, they called him “Paper Cut.” “I was like the least injured guy there,” he said.

Sides is a competitive snowboard racer, a college student, “house husband” and father of a new baby girl. “I’m doing well,” he said. “I get frustrated sometimes when I need help with something, but day to day I’m good to go.”

Stockwell is a national paratriathlon champion and coach, due to have her second baby this summer.

She has chatted with Tom Hanks, Sharon and Ozzy Osborne and all of the living former U.S. presidents. She went bike riding with George W. Bush.

After losing her leg, “it wasn’t always easy, getting looks,” Stockwell said.

Any self-consciousness or regret is long gone. “I wear shorts all the time,” she said. “I’m proud of it.”

montgomery.nancy@stripes.com

