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In medicine, addition consistently has to be first. Seven years ago, that being was Jeff Kepner, now 64, who became the aboriginal being to accept a bifold duke displace in the United States.

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The anniversary fabricated headlines: “A Touching Tale of a Activity Changed,” apprehend one from the Pittsburgh Post-Gazette. But Kepner’s crude easily accept never worked, and today they abide actually non-functional. If he could, Kepner says he would accept them removed, he tells TIME in an absolute interview.

“From day one I accept never been able to use my hands,” he says. “I can do actually nothing. I sit in my armchair all day and abrasion my TV out.”

Kepner is one of abounding Americans who accept undergone beginning displace surgeries that do not save their lives, like a heart, but angle to abundantly advance them. In the aftermost few years, doctors accept performed groundbreaking face transplants and the aboriginal uterus and penis transplants stateside. But Kepner’s adventure highlights the cede that can appear from demography a accident for a bigger life—and for accurate advancement.

In 1999, Kepner, of Augusta, Ga., absent his easily due to sepsis that started from a strep throat infection. He acclimated prosthetics, and while activity wasn’t easy, he was able to drive and accumulate a job—things that are absurd for him today.

Ten years afterwards the infection, Kepner underwent a nine-hour anaplasty at the University of Pittsburgh Medical Center (UPMC) to attach easily from a donor. Kepner knew there was a accident that his anatomy could adios the easily or that the anaplasty wouldn’t be successful, but he had consistently assumed, and says he was told, that in a worst-case book he could accept the new easily removed and go aback to application prosthetics. He’s back abstruse that that advantage isn’t so simple.

Dr. Vijay Gorantla, the authoritative medical administrator of the Pittsburgh Reconstructive Displace Program at UPMC, is administering Kepner and tells TIME that abounding or fractional abatement of the easily has been discussed, but the procedures are not afterwards risks. According to Gorantla, it’s ambiguous if Kepner would be able to use prosthetics if the easily were removed, and that accurate concrete analysis would be required.

If the easily were to be alone partially amputated, Kepner would charge to break on circadian drugs that anticipate his anatomy from abnegation the hands, wrote Gorantla in an email, abacus that: “We accept that additional, accessory surgical procedures—and charge to added concrete therapy—could advance the action of his easily to advice him with activities of circadian living.”

Kepner says that afterwards seven years, he’s annoyed of surgeries, and will acceptable accumulate the non-functioning easily absorbed to his body. “I am not activity through all those operations again,” he says.

The surgeon who led the displace in 2009, Dr. W.P. Andrew Lee, is currently at Johns Hopkins area he’s advancing to accomplish penis transplants for American veterans. Lee says the charge for abatement is aberrant and has occurred in six out of 100 agnate transplants in the U.S. and Europe.

“Mr. Kepner’s crude easily do not action as able-bodied as those of added duke displace recipients,” said Lee in an email to TIME. “Our aggregation has performed mutual hand/arm transplants in four patients to date, including Mr. Kepner. The added three patients accept had cogent anatomic acknowledgment in their easily and accept been able to resume actually absolute living, including driving, working, and activity to school.”

“Complex anaplasty such as duke displace do not aftermath compatible after-effects in everyone,” Lee adds, “but we accept been encouraged by the anatomic acknowledgment in the abundant majority of our recipients whose lives accept been adapted by the procedure.”

Kepner says he hasn’t heard from Lee or any of the surgeons complex in the antecedent operation in years.

He says his beneath affection of activity has taken a toll. With prosthetics, Kepner says he was 75% functional, but today he says he feels “0%” functional. His wife, Valarie, retired in May to booty affliction of him full-time, and the Kepner ancestors launched a GoFundMe folio to awning costs they’ve incurred through the years. .

Kepner says that in hindsight he would not do the anaplasty again, but he does not criticize the doctors who did the operation. “That’s the adventitious you take,” he says, “and that’s the adventitious I took.”

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