amputee Archives - con moto prosthetics

May 23, 2017May 23, 2017

Amputee Inspiration – Winter the Dolphin

A few years ago, I had the privilege of meeting a young girl who opened my eyes to the wonders of Winter the Dolphin, and her story.

For many of you, you may have heard a few details about this dolphin and her miraculous recovery. But, how many people are aware of how her story instills hope for people who have undergone amputations and their families?

Young Chloe Healy introduced me to this inspiring story of hope and courage.

Clearwater Marine Aquarium tells her story:

“Winter was found stranded in Mosquito Lagoon, near Cape Canaveral, Florida when she was only two months old, entangled in a crab trap line which cut off circulation to her tail flukes. After disentanglement, she was transported to Clearwater Marine Aquarium for treatment of her extensive injuries. However, despite exhaustive efforts to promote healing, her tail deteriorated and could not be saved. Her story is unusual – most dolphins trapped in monofilament and crab trap lines do not survive. Despite overwhelming odds against survival, Winter’s energy and ability to adapt to her new physical form surpassed expectations. She recovered completely, adapted to a new swim pattern and learned to eat fish on her own… about 12 pounds a day!”

“Winter is missing her entire tail fluke and joint. Tail flukes are the powerhouse of the dolphin and are attached to the peduncle, the muscular part of the dolphin. To swim naturally, a dolphin moves the peduncle up and down and the tail flukes propel the dolphin forward.”

Due to Winter losing her tail, she required a prosthesis, much like on that would be fitted to a person, in order to get around. Without her tail fluke and joint she would not be able to swim, and thus survive. A prosthetic tail and gel liner was designed by Dan Strzempka and fit on Winter by prosthetist Kevin Carroll.

Winter has proved to be such an inspiration to Chloe’s family, and to her father Dan, who lost his leg due to a blood clot which progressed into a below-the-knee amputation.

Twelve-year-old Chloe Healy explains it, “seeing this dolphin Winter overcome, proves that my father can overcome.”

“I related to Winter and I related my dad to Winter. Winter lost an important part of her, which was her tail, which she needed to survive. And I immediately thought of my dad.” When her father’s leg was amputated, he went through the emotional roller coaster that many amputees go through, asking himself looming questions,

“Will I be able to walk?”

“Can I go back to work?”

“If I can’t work, what will I do?”

Dan and Chloe first visited Winter prior to Dan’s surgery. That visit proved to be the security that he needed to feel comfortable in deciding to go along with the amputation surgery.

“If a dolphin can swim without its tail, he can walk without his leg,” says Chloe after that initial meeting with Winter.

After receiving his preparatory prosthesis, Dan and Chloe made the pilgrimage back to see Winter. This time with resolve and confidence. With the questions and fears of unknowing if Dan would be able to walk again behind him, he and Chloe shared the sentiment of perseverance and courage with Winter the Dolphin.

Chloe feels her dad is an inspiration to other amputees. Dan works full time and “lives his life like everyone else. He swims, he runs, he rides bikes, he works. I am proud of my dad and think of my dad when I am unsure if I can do something…he is an inspiration to me and to other people.”

Chloe is a sea creature and animal lover to the core. She is a regular and a research visitor at the Clearwater Marine Aquarium in Clearwater, Florida. She finds it inspiring and amazing to see people there visiting Winter who have limb loss or other physical disabilities. This Dolphin has become a pillar of hope for people trying to overcome and prevail. As a young environmental lover and activist, Chloe has the hopes of starting a marine biology club in her middle school and potentially in her local high school. She hopes this club will have a relationship with the Shedd Aquarium Marine Biology program in Chicago, IL.

Chloe is impressive with her enthusiastic desire to share her story and her father’s story with anyone who will listen. Check out this awesome audio that features Chloe as “Kid of the Week” on WGN.

Chloe shared with me that Bridget Coughlin, the CEO of Shedd Aquarium heard about Chloe on WGN and reached out to her about her father’s story. Chloe hopes that this meeting will result in a future visit by the marine biologists from the Shedd to her middle school’s club so that they can talk “about the oceans and what the oceans are going through right now.” She hopes to bring an awareness of this field to the students at her school.

As far as her future career in marine biology? Chloe has her future all figured out. She plans to attend the “University of Tampa because it is close to Clearwater, and get an internship and work with animal trainers in Clearwater” She plans on pursuing a “four-year degree in psychology, marine biology, and minor in environmental science.”

Chloe’s take-away message from her father’s experience is simple,

“You can do anything you put your mind to.”

“Don’t let anyone tell you can’t do something.”

“You are not different from anyone else. We are all people and we all deserve to be treated equally.”

“The only thing that holds you back is you.”

These are very wise words from a very wise girl. Thanks, Chloe, for being an inspiration to your dad, to me, and to the kids at your school, and to everyone who has the opportunity to hear you share your story.

Some of Chloe and my favorite Winter the Dolphin merchandise:

Dolphin Tale DVD

Dolphin Tale Blu-Ray

Dolphin Tale 2 DVD

Dolphin Tale 2 Blue-Ray

Hope For Winter – The True Story of a Remarkable Dolphin Friendship

February 20, 2017May 15, 2017

Amputees, Prosthetics and the TSA – TSA Amputee Guidelines

TSA Amputee Guidelines
　
I have been asked a lot over the years about what to expect when traveling with a prosthesis. Having traveled quite a bit, both domestically and internationally, I have experienced a wide array of security protocols. I have gone through security check points all over Europe, the Middle East, Central America and at airports all over the United States, from small towns to large urban centers. Before traveling, it is always helpful to review the TSA’s amputee guidelines.

What I have found is that the security personnel are just as uncomfortable with the search as you.

Since a prosthesis is an unknown to many people, security personnel are cautious about hurting or making the traveler uncomfortable. For individuals wearing prosthetic devices, here are important things you need to know before going through security:

Security Officers will need to see and touch your prosthetic device as part of the screening process (this does not apply to mastectomy prostheses).

Security Officers will not ask nor require you to remove your prosthetic device, cast, or support brace. If they ever ask you to take it off, ask to speak to a supervisor as this is against TSA rules and regulations.

During the screening process, please do not remove or offer to remove your prosthetic device. You have the option of requesting a private screening at any time during the screening of your prosthetic device, cast or support brace. In fact, I am often asked if I would like a private screening. It is entirely up to you.

You have the right to refuse the offer of a private screening; however, you will need to allow the screening to be conducted publicly if you wish to proceed beyond the security checkpoint.

You may have a companion, assistant, or family member accompany and assist you into the private screening area (once he or she has been screened) and remain throughout the screening process.

TSA will make every effort to have two Security Officers of the same gender as the passenger being screened present during the private screening.

If you are too weak or unstable on your feet to stand for a hand held metal inspection because of your prosthetic device, cast, or support brace, you may request to sit down after you have passed the walk through metal detector.

Please notify Security Officers if you need assistance during the screening process such as a hand, arm, or shoulder to lean upon, or a chair in which to sit. At any time during the screening process you can request a disposable paper drape for privacy.

The Security Officer will describe the explosive trace sampling procedure in advance to help you along with the process. The explosive trace sampling process may require you to lift or raise some of your clothing in order to obtain the explosive trace sample. (Sampling areas can be accessed by you lifting your pant leg or shirtsleeve or by raising your skirt to knee-level.). They typically just swap my prosthetic ankle or sometimes my prosthetic knee.

If clothing will need to be lifted or raised in order to obtain the explosive trace sample. You will not be required to remove any clothing during the process or remove or display the belt that holds your prosthetic device to your body.

Your hands will also be swabbed. I flew out after working all day in the prosthetics lab and must have had traces of carbon and acetone on my hands because they had to perform the test multiple times. Not to mention, it required some explaining on my part. So, make sure you wash your hands before going through the security checkpoint.

If the device alarms the explosive trace machine and the Security Officer cannot resolve the alarm, you will not be permitted through the security checkpoint. To be safe, make sure your prosthesis is free of an suspected explosive materials. If you work with chemicals vocationally please do your due diligence and research which chemicals the TSA tests and make sure your prosthesis and your body are free from those chemicals.

More information pertaining to the TSA amputee guidelines and screening of prosthetic devices, walkers, crutches, canes, augmentation devices, orthopedic shoes, support appliances, and other exterior medical devices, and dressings can be found on TSA’s website here: https://www.tsa.gov/travel/special-procedures

Finally, if you feel you are being treated inappropriately, not in accordance with TSA amputee guidelines and regulations, you have the right to request that a supervisor be present. If you are still unsatisfied with the supervisor, you also have the right to request a TSA Customer Service Manager (CSM). There is a CSM in every airport, and if requested, they will come to the screening area and answer any questions or concerns you may have, including questions about procedures or fair and respectful treatment. Any TSA Officers found not to be complying with TSA rules and regulations or not treating passengers with respect will receive additional training in the future.

To get updated information about the TSA’s procedures and the TSA amputee guidelines, you can visit their website here at http://www.tsa.gov. The above information is taken directly from the Transportation Security Administration’s website, and we encourage you to use the TSA as a resource before, during, and after you fly.

*information courtesy of the Amputee Coalition of America.

Travel safely!

January 14, 2017March 11, 2017

Amputee Limb Shrinkage | I’m Getting Smaller – Is This Normal?

Amputee limb shrinkage – yes, it is real.

Shrinkage…volume loss…volume reduction are all terms for when the residual limb (stump) gets smaller. Typically this is caused by either atrophying of the muscles or reduction in edema.

When a person undergoes an amputation, the distal end becomes swollen. It has fluid retained in the limb, especially the distal end. With compression (usually shrinker socks, ace wrap or rigid removable dressings), this fluid gets moved up out of the limb and the limb becomes smaller.

Compression will also keep the swelling from increasing and also reduce pain (throbbing, phantom pain).

Care and use of these compression garments will be given to the patient at the hospital after amputation. Most garments are machine washable. I typically instruct hand washing, to insure that the amount that they stretch is decreased. Like anything stretchy, it will stretch out over a couple of weeks and a replacement will be necessary. This can be provided by a prosthetist, as proper sizing is needed. If ace wrap is being utilized, it is imperative that the patient is taught how to properly wrap the limb.

Muscle atrophy will occur, typically 3-6 months post fitting of the prosthesis. Muscle atrophy is when the muscles get smaller from decreasing in use. This is largely seen around the back of the calf for transtibial (below the knee, BK) amputees and around the gluteus muscles (buttocks) or quadriceps for transfemoral (above the knee, AK) amputees. This is totally normal.

The muscles in the calf are used to control the ankle (dorsiflex, plantarflex, inversion, eversion). In transtibial amputees (below the knee, BK), the ankle is no longer there, therefore those muscles do not have the same muscular requirements as before, and they will atrophy.

In transfemoral amputees (above the knee, AK) the gluteus muscles, which are the main hip extensors, will tend to get smaller on the amputated side over time due to reduced use and over compensation on the sound side. The function of the quadriceps is to flex the hip and extend the knee, if the knee is no longer there, those muscles will get smaller too.

If you are concerned about atrophy or limb shrinkage consult your doctor.

An exercise routine can be incorporated to help strengthen these muscles. The best way to keep them strong and healthy is to walk and keep them active through daily exercise.

Consult your doctor and/or physical therapist prior to starting any exercise regiment.

December 1, 2016March 11, 2017

Let’s Talk About Amputee Socks – Volume Management For The Amputee

LET’S TALK ABOUT SOCKS – AMPUTEE SOCKS

Yes, let’s talk about amputee socks (for those of you in skin fit suspension systems this will not apply to you). Maybe it will bring back memories of when you used socks, or who knows, maybe a future prosthesis will require socks. Read along and enjoy.

Amputee socks. Yes the dreaded words that all amputees (well most) have to endure.

Socks will provide comfort. Socks will help wick sweat from a sweaty limb. Socks will tighten up a loose fit. Socks are just a part of amputee life.

I have found in my years of being a prosthetist, amputee sock ply management education is the topic de jour, a conversation I have multiple times a day, and sometimes multiple times with the same person. It can require a learning curve for some users – and that is ok. Below are the main points to remember:

Socks are a tool to manage your residual limb volume (size). This means that as your limb changes volume throughout the day the socks act as a filler between you and the socket. Remember, your limb will change sizes throughout the day. We tend to be more swollen in the morning and the swelling reduces after a few hours of being up and walking around. I know, I go through this personally, in the morning my socket fits much tighter than it does mid-day. After 1-2 hours of walking around my volume goes down and I start to feel much more comfortable. This happens to everybody. Don’t worry! This even happened to you before you were an amputee. The same principle applies to rings on your fingers. Do you ever find that your rings tend to fit a little tighter in the morning than they did when you went to bed? Do they take a little more effort to get over your knuckle in the morning? That is because there is more fluid in your extremities in the morning. After getting up and walking around the fluid will move up through your lymphatic system and your rings will have a normal fit again, and so will your socket.

Amputee socks come in different sizes, thicknesses, and even colors. For thickness (ply), socks usually have a number or a colored band at the top of the sock indicating its ply. Socks are the cornerstone of volume management. It doesn’t matter whether you like using them or not, you need them. As prosthetists, we will do our best to adjust the socket shape to minimize how many socks you wear, but we can not control your physiology. We can not change biology. We can do a lot, but we are limited in our super powers.

If you are not wearing enough socks, you may feel pain at the bottom of your limb or at your knee cap. Try putting on a thicker sock and see if that helps. If you have too much sock ply on, you will feel like the prosthesis is too tight and you can’t reach the bottom. Your prosthesis will also feel too tall. This is because with too much sock ply, your limb is not seated flush and snug in the socket. It is sitting up higher than it should, thus creating the sensation that the prosthesis is too tall.

Always carry socks with you. If you carry a purse, stuff some socks in there. If you don’t carry a purse, buy a bag to carry with you like a backpack, fanny pack, messenger bag, etc. If you have a car, put socks in your glove compartment or center console. Keep a stash in your desk at work. Please make sure socks of varying ply are easily accessible to you throughout the day.

Contact your prosthetist if you have questions regarding socks or if you need more. You can always order online here if you prefer.

Good luck and may the socks be with you.

November 10, 2016March 11, 2017

It’s Getting Hot In Here – Amputee Perspiration

IT’S GETTING HOT IN HERE!

Amputee Perspiration

When an amputee starts to get hot and perspire in their prosthesis, the best course of action is to find some way to keep their skin as dry as possible. Amputees experience great discomfort and difficulty when they are out in the community and start to get skin irritation due to sweat. Finding a private area (bathroom, changing room) is not always agreeable to the circumstance, so here are some suggestions to help keep the residual limb dry and healthy.

When a patient starts to get hot and sweaty in their socket the best course of action is find some way to keep the skin as dry as possible.

Unscented, spray-on antiperspirant. Spray an antiperspirant on your residual limb prior to donning the prosthesis. Use only unscented, as scented may cause skin irritation.

Cornstarch. This was suggested to me by a German prosthetist in the 1980’s. Thank you, Roland Doetzer! Take a little bit of cornstarch and rub it over the residuum (just a light coat), then don the prosthesis. I used this technique recently on a young man who lives in a very warm climate. He was experiencing a small area of itchy redness that looked rash-like in an area of invagination. He started adding a small amount of cornstarch over that area before donning the liner. This effectively eliminated the itchy redness. I ascertained that the rash was caused by sweat pooling in the bottom of the liner and eventually causing irritation. The cornstarch kept the limb dry and acted as a barrier. If this area had been caused by an allergic reaction, cornstarch would have no impact on it and the itchiness would have persisted. If an amputee is experiencing areas of itchy redness, discoloration and/or bumpiness have him or her consult a doctor, as this may be an allergic reaction.

Use a thin nylon sheath (a prosthetist can provide one, or you can order here. An article from 1974, discusses the benefits of sheaths as a perspiration wick.

Drysol. A prescription antiperspirant containing aluminum chloride hexahydrate that works by affecting the cells that produce sweat. This route is usually traveled when no other option works. This product was created for people with hyperhidrosis. I have only ever met a handful of people who have used this product. For most amputees, the other mentioned options tend to fix the problem enough to where sweat is a nuisance, but tolerable.

Certain-Dri. An over-the-counter antiperspirant. Similar to Drysol, however a prescription is not necessary. If you have a patient who in interested in either of them, please ask them to speak with their doctor and make sure they are a good candidate for these items. With residual limb tissue it is imperative that amputees are extra cautious about what gets applied to their limb.

Should amputees experience heat-related issues, ask them to consult their doctor and prosthetist.