Prosthetics and the horrors within

This page is dedicated as both a harbinger of slight emotional reassurance, along with information needed to hold your head up along with your body for the rest of your life.

About myself: At the age of 33 while driving a cruiser motorcycle through a left-hand turn light, a side impact by a large ford truck whose cruising speed was approximately 45 miles per hour caused a below-the-knee amputation of my right leg, along with repair of other internal body portions.  I count myself the luckiest person in the world as I reportedly walked away from the accident to the curb.  Everyone else thinks the ride ends when the bike stops in those cases, however it only begins at that moment.

I’m scientific in thought, and I have to know why something happens and how to either fix it or work around it to make things the same as before.  The answers are next to impossible to find, and drives you clinically insane enough to be given medication simply to stop the thoughts.  There does come a time you throw those bottles away, and realize that the war is yours alone.
On the field, you don’t fight for glory or an award, you fight for the person on your left and right.  Welcome to my squad.

The first piece I have to talk about is if you are in your first 6 months, don’t hold it in.  In my experience, there is very little emotional support during the healing process.  Most of the time, people who witness the amputation do not know the right way to respond due to their own thoughts on the severity of it.  From the outside, it’s a horrific thing at that point.  The key is to remember that these people really do notice and have emotions about it.  Also, remember that your amputation is in no way something you must hide due to being unfit to view.  Covering with clothing is normal, however exposure is not your worry.  BE YOURSELF.  That is the hugest part, since you have lost yourself already.  Learn over time to not have your voice change more passive when telling others about the amputation after they ask what happened.  The more you accept it, the more others will.

During the first 3 months, the amputation heals and is not fully toughened.  If you are exposed to prosthetic extensions in that time, be gentle with the edge of our residual limb. (amputated limb remainder)  While the use of prosthetics is perfectly acceptable in this time, overly zealous use can split or sever the residual limb area that was stitched together before.  As time goes on, the area becomes much stronger and folds  further back onto the residual limb so not be right on the edge.  Just be patient and take advice from your prosthetist.

As far as amputation styles, I have only had experience with below the knee amputation on the leg.  I have seen full leg amputations, and my leg removal is like a bullet graze  in comparison.  below the knee amputation (not including foot/ankle style)  is referred to as “transtibial” due to the tibia being amputated, and above the knee amputationis referred to as “transfemoral” due to the femor being amputated.

5-3-2009

Everything for myself has come to a seeming plateau with the prosthesis.  I have come to a final style, a carbon fibre socket around the residual limb with a vacuum hose attachment with a univeral attachment at the base for connection of the pilon or any other attachments that possibly could be used.  For this type of setup, I am using a polyurethane liner over the residual limb which I fold onto the skin snuggly every morning.  A porous fabric sleeve is over the liner, and  polyurethane outter vacuum sleeve is pressed over the outside of the socket and is folprosthetic-socket-topded over the upper leg to contain the vacuum.  The advise is as high as possible, however the sleeve only requires 1-2 inches of space above the seal to properly contain the vacuum.  I’ve cut the inner seal to 2 inches above the knee to enable an outter seal to be as low as possible.  I do this because my upper leg muscles take most of the activity and usually break the outter seals… not a good thing.

Attached to the universal attachment on the base of the socket, I currently have an Otto Bock Harmony P2 suspension system as the pilon connector.  This system acts as a 3-phase device.  The 3 phases performharmony-and-axtioned are:

  • Removal of air (vacuum) within the socket via vacuum connection.
  • Suspension of the socket to buffer impact during running/heavy walking
  • Torsion control to allow a twist of the foot when pressure is placed upon it.  The twist is under pressure the whole time, returning to the neutral position by design.

The foot prosthesis is currently an Otto Bock 1E56 Axtion low-profile attachment.  This foot has taken hard take-off runs, along with hikes over heavy offroad rocky terrain.

I still haven’t come to the point of running any more than 1/8-1/4 mile without needing to stop due to hip muscle pains or just plain being winded.  I’ve decided to hold off on running due to the high impact and gear myself towards low-impact cardiomuscular activity such as heavy hiking, stationary cycling at the gym (for now, til I move), and incline walks on the treadmill at a 5-9 setting for 30 minutes.  All in moderation, siince the body only wants to do more as time progresses.
The next step will be a running attachment which is a simple bowed flex arm which are commonly used in paralympic sporting events.  I will be able to pump the socket vacuum by hand, and disconnect the Harmony P2/Axtion foot combination and connect the carbon fibre composite foot-keel blade which would lower the weight tremendously along with being geared design-wise for one particular pupose: storage of energy in large amounts, storing it in potential energy, and releasing it as kinetic energy during rebound of which would not be possible in a walking foot due to the flex containing too much recoil and not being contained within a foot container.  I have not purchased this, since it will cost $5,000.  I am still repairing other damages to my body but I will never give that up until I can no longer physically perform it.  When you are 34, it’s too early to give up.full-prosthesis-cropped

5/27/2010

Even with the routine exercise regimen, the hip muscles are the weakest section.  I don’t believe that the healing with ever reach that area, since the area has screws in place and appears to brush the muscles.  One week I pushed myself to a 30 minute 2% inclined 3.5 mph walk with a 30 minute elliptical interval exercise.  Afterwards, I took the time in the locker room to examine the hip.  While pressing on the side and gluteral muscles while bending the upper leg, I could feel the screws impacting the muscle, along with the numbing of the area afterwards for a period of time.

This is something I will keep in mind in my future, along with working around it to reach what I want… to be myself again.  This should help others who have had hip reconstruction and are feeling the same… the main piece to remember is that the muscles will reform, and adapt to the new working environment.  Work on the area slowly, and don’t destroy yourself… if you are not a masochist like myself, back away and do what is comfortable.

04/27/2011
With everything that I’ve done, the sleeve around the leg which holds the vacuum has been worn apart so many times it’s irrepairable.  Also, the pedilon foot piece has been punctured and ripped from activity, and that had to be replaced.  The plus side is the pricing on these items are not out of this world.  The pedilon is only about $100 (well, for a plastic hollow foot it’s a lot, but hey, what choice is there?)  The sleeve is $60, but the new one I got is a new technology which is much thinner and far more flexible.  It’s an Otto Bock variety and has a slick fabric on the outside that is blackish silver.  The most pronounced part of it is the rubberized material it is made out of.  The material feels like a thick balloon, is very flexible, but is very durable.  That, along with a new material for the “Gaitor” to cover the knee portion, has made it very comfortable.  The new Gaitor is made of a composite material that I have never seen before, however it is form fitting and very durable against tearing under stress.  It’s also black… but that coolness factor isn’t a part of it since it’s covered 99% of it’s life by the sleeve.
My rotating ankle piece has gone through quite a lot since I’ve had it as well.  The rotator part inside has given way through it’s life and freely rotates under light pressure for about 15-20 degrees.  It’s not a show stopper, but it tells me I’ll need to either convert to pilon in the future or think about other alternatives.  Buying a new one is approximately $4,000, which is a little out of my price point.

EDIT 5/30/2015:
I’ve gotten to the point financially that I am able to replace my full prosthetic, since I landed a position with excellent health insurance along with an HSA account so I can sink cash into it (and spend it on the prosthetic) without taxes coming out of the money.  Luckily, the insurance was able to cover 80% of the cost, while the rest I’m paying on through HSA month to month for the next year or two.  The new prosthesis is using Ossur Iceross Seal In V sleeve which has a built in seal that locks itself inside of the socket through vacuum.  This tech works with and without vacuum seals, as all it takes is a one-way valve for air exit and voila, instant seal.  It’s what I use for the temporary socket, currently.  Below is a final finished prosthetic.

front-prosthetic

It looks like the tech has gotten better over the years.  I was able to get a pump system, however the entire pump is located inside of the prosthetic foot itself. There’s a suspension system in place also that resembles a leaf spring from a car.  it connects vertically, and as you step it bends to support.  It works quite nicely, actually.

side prosthetic

My prosthetist had the socket made with a decompression button on the side for removal of the socket, and ran the vacuum hose through a cavity in the socket to hide it nicely.
This socket in the picture is not existent any longer as I had to go back in to be resized due to socket size issues, however once it’s time it will look the same.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s