Broken Prosthetic - Temporary Repair

This morning I was greeted with a snap, crackle and POP! Unfortunately, it was not my Rice Krispies but my prosthetic limb...

The carbon in a Flex-Foot Modular III doesn't usually snap in two all at once - which is lucky since there would be a lot of face plants if it did. Instead, over time, it starts to fray, crack and the foot gets softer and softer. Eventually, the foot starts to go downhill a little faster - this is what happened today - the noises were just more serious cracks developing.

As you can see above (barely), the carbon is pretty screwed up. I am now flexing on about half as many strong strands as before. That means the foot is pretty soft.

Given the state of the carbon, this foot is pretty much at the end of it's useful lifespan. The problem is that I don't have a new one yet... Therefore I need to get out the defibrillators and squeeze an extra week or two out of this thing. You can see my efforts at that in the video below.

So the good news is I am back up on the foot.... The bad news is that it is screwed and going downhill fast. (And the new one will cost thousands...)

This fix should buy me the time I need to get a new one though. There is A LOT of satisfaction in fixing your own leg. More amputees should have the courage to tinker....

When it comes to prosthetic problems, failures and general issues to do with my leg I have learnt that I can play a large role in getting the most out of my equipment. I don't have to run down to my prosthetist once-a-week for minor tune-ups or to get a small adjustment made. I have learnt over time to do a lot of these things myself.

If you are an amputee here are a few general things I'd recommend:

1. Learn how your leg/arm works.

2. Ask your prosthetist lots of questions.

3. Watch your prosthetist work on your limb - (it's better than reading 4 year old magazines).

4. If your prosthetist won't let you watch ask "why not?" Then tell them you aren't comfortable with what they just said.... you want to understand how it works and how to take care of it.

5. Don't be afraid to try making an adjustment on your own - just don't do anything stupid and break the prosthetic.

6. When selecting prosthetic components be certain you understand why each one is the right one for you. Don't accept anyone else's opinion (no matter how highly trained they are) without thinking about it yourself.

7. Consider your options, ask opinions, read reviews.... these things cost as much as cars - you don't just go onto the lot and ask the salesman which car you should buy... so don't do that with your prosthetics.

8. Empower yourself by being a leader in your own care. Your doctor, physio, prosthetist, chiro, shrink, wife, husband, dad, mom etc... are your team but YOU need to be the captain.

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Sit Rep: 3+4=5

Here's the SitRep (situation report) re (regarding) my f'd-up (you can figure that one out yourself) leg.

I have had a little problem developing within my socket for the last couple of weeks. [Socket = the top part of my prosthetic limb i.e. the part I slide my leg into when attaching it to my body.]

Let's call the problem an inflammation since neither of the doctors I have seen have named it anything else.  [Note:  First bad sign - patient has seen two doctors.]

Though one would have thought inflammation was a fairly obvious and self-explanatory condition, medical types (who speak latin) have created a handy checklist called  the "Five Signs of Inflammation"....  these are, drum roll please:

1. Rubor (redness) √

2. Calor (increased heat) √
3. Tumor (swelling) √
4. Dolor (pain) √
5. Functio laesa (loss of function) √

This problem was diagnosed early by Myself M.D. (pictured above),  the prescription was a heavy dosage of "ignoring it" augmented by a daily therapy resembling praying (though I am not religious.)

Despite these efforts I am experiencing a lot of #3 which in turn has lead to plenty of #4.  The additional problem with #3 is that I my prosthesis was not built to accommodate any at all, which only results in more #4.  

Unfortunately something just isn't adding up because:

3+4 = 5

As annoying and painful as it is, it is the Functio Laesa (#5) that is the most troubling....  I am at a point now where walking is quite painful at times, running completely out of the question, riding less irritating though there is still plenty of discomfort.

Suspecting that Myself M.D. may have missed the mark somewhat, I sought the opinions of two other doctors.

Doctor #1:  Bla, bla, bla, bla - you should probably just rest it.  Maybe don't wear your leg for a week or two.

MJ:  Thanks.  [Thinking:  I need a second opinion.]

Doctor #2:  X-ray requisition, ultrasound requisition, blood test, anti-inflammatory prescription, thorough examination, thoughtful analysis...  Recommends:  RICE, but concedes that I have to wear the leg at times.  Advises that the more I wear it and endure pain the longer this will take to go away.  Training:  Sure - but you will be setting yourself back and will only find more and more loss of function, pain, etc.

For some reason I have felt the need to hide this problem/injury/inflammation until now (not just from all of you, but from almost everyone) - I am not sure why I do that.  

Anyway, for now I am swimming... which ought to be fine preparation for Cycling Nationals in 2 weeks.  

[Sorry for the mega-word post....]

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Prosthetic Fit - If the leg fits, wear it!

This post is for the millions of amputee readers I have....  it may be of some interest to non-amputees but it might also bore you to tears.  If it is the latter I do apologize...

Prosthetic Fit

Your prosthesis should fit nicely - great function without pain is the goal.  Why then do we spend days, weeks, months and sometimes years accepting a less than ideal fit?

REASONS

 "I don't want to be too much of a pain in the @ss to my prosthetist."

 "I need to adjust to the socket."

"My limb is changing.  I might as well wait."

"I lost a limb - nobody said it would be all roses."

"Maybe this is as good as it gets."

"Maybe if I put more cream/vaseline etc. on the spot it will go away."

These are a few of the reasons I have put up with pain for longer than I should have.  None of them is particularly valid.  I have learnt over the years that I can reasonably expect a VERY high quality of service from my prosthesis.  When everything is perfect with my leg I don't think about it at all...  and I can push it to some pretty exciting places on the activity chart.

So then, what do I do when the fit is less than ideal?

The first thing is to realize it.  This sounds obvious but it is often the hardest part.  Often my fit will deteriorate so gradually that I won't notice until it is WAY off.  This process can, and often does, take months.  Try to pay attention and when others say "Hey are you limping?" or "Hey are you limping more?"  think hard about it.  Are you?  Probably.

Then I try to figure out why things are off.  I look for red areas on my limb after wearing the prosthesis for a few hours.  I do some rudimentary leg length measurements to see if I am in too deep or wearing too many (or few) sock ply.

Often I can figure out what is going on this way.  Part of this is experience - after you duff your foot on the ground for the thirtieth time you remember, "Hey the last time I did this I was wearing too many socks!"

Often hot spots or sensitive areas will develop when my prosthetic socks get a bit too old.  They don't have the same fluff-factor (thickness) as they did when they were new.  That means 5 ply = 4 (or maybe 3.5) either way it will very gradually start to fit wrong and hurt.

Skin problems will more than likely be the symptom that first alerts you to an issue.  It is important to know the difference between a skin problem that is a symptom of a bad fit and one that is a symptom of life...  i.e. super-red painful areas where there is some binding = bad fit.  Sudden red inflamed areas can be an ingrown hair or other issue....  experience will help you to figure out the difference.  You can read my post on skin problems for help.

I like to exhaust my own ideas before I trouble my prosthetist.  This is not because it is so much trouble for him, but because it is trouble for me too.  It's a whole lot better for everyone if I can learn to diagnose a bad fit and try a few things to relieve it.

If that doesn't work though, you can bet his phone will be ringing.  I tell him the issues and get some input from him.  Sometimes I will have been doing exactly the wrong thing to try to fix it - thus exacerbating the situation....  hey, at least I tried!

Nine times out of ten he can instruct me and I will not require any actual work to be done on the prosthesis.  Sometimes, I have decided that a new socket is the answer...  these decisions are yours and his/hers to make together.  In my experience the prosthetist should be willing to exhaust himself trying to make it fit.  There should be no limit to the number of adjustments he is willing to make in order to help you with your fit. 

The prosthetist should also be willing (and able) to teach you everything you need to know about your leg.  There are numerous small adjustments you can make yourself on most legs if you know how.  It isn't difficult and you shouldn't be afraid to ask.

Once I have a new socket I like to test it extensively in the first few days.  

- If it is a running leg - I run.  

- If it is a walking leg - I play golf.  The golf course is perfect for testing out legs - 6 miles of walking - uphill, downhill, sidehills, rough terrain (where my ball always is), flat terrain etc.  You know if the leg fits after walking the course.  (Note:  If you are a new amputee you will want to pick a challenge that is a bit less demanding - but use the same theories.)

Ultimately, I feel that you should "expect" comfort and function that will allow you to do the things you want to do in your life.  You should also "expect" that it won't always be easy...  There WILL be problems and you will need to get as good as you can at diagnosing them and working with your prosthetist to establish a great fit and maintain it.  Like almost everything in life it will get easier with experience and time. 

If anyone ever needs advice or to ask a question please leave a comment or drop me a line at: 

meyrick@meyrickjonesracing.com

Cheers!

P.S.  If this helped you please leave a comment - it feels good to help!

 

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