Spring 2015 - Prosthetic Care Facility of Virginia
Transcription
Spring 2015 - Prosthetic Care Facility of Virginia
Spring 2015 Prosthetic Care Facility of Virginia COMPASS Steering a Course Toward Mobility and Function for Limb-Loss Patients In Jessie’s case, he had only two inches of femur on his residual limb as a result of falling into a grain auger because someone had forgotten to replace the cover. That was in 2003 and Jessie spent 39 days in the hospital, not only mending from his massive, extensive injuries, but also fighting Mucormycosis, which is a rare fungal infection. But Jessie has a remarkable attitude and is a fighter. “I am happy to be alive,” he said. “It took about a minute-and-a-half for the auger to get to the point where it cut off my leg. I was conscious the whole time, waiting for more than two hours for life flight to get to me because of the weather. Being conscious, I realized I had to choose whether to live or die; I chose to live.” Meet JESSIE: HE CHOSE TO LIVE Jessie H. has spent more time than he cares to remember in a wheelchair, in a bed, or in a chair. And he didn’t like it one bit. Jessie is a hip disarticulation patient and hip disartics, because of how high the amputation is, are hard to fit so they can walk, stand, and sit comfortably. In addition his accident left him with a colostomy, which needed to be accommodated in his socket. Not only was Jessie’s leg traumatically amputated, but he also lost his rectum, suffered a torn prostate and had a radical prostatectomy, underwent a colostomy revision, had a partial knee replacement, four shoulder surgeries, and a nerve revision on his left arm. Through all of his surgeries and recovery he had who he refers to as an angel by his side – his amazing wife Nora. Jessie had numerous surgeries but eventually was fit with a C-Leg, a computerized knee system. Unfortunately, his socket was more low-tech – a pin and lock system that can work fine for some amputees, but not all, especially those with a high amputation. Plus, the best technology in the world will not do an amputee any good unless he has a socket (the component that joins the residual limb to the prosthetic device) that fits securely and comfortably. Continued on next page >> We Welcome Darren Hattingh to Our Practice Darren, son of John and Michele Hattingh, has joined the family practice as a technician. Darren fabricates and repairs prostheses according to patient measurements and casts in compliance with a physician’s prescription. Darren, wife Alyssa, and son Liam moved to the Leesburg area from Seattle last year. National Limb Loss Awareness Month April is National Limb Loss Awareness Month, a campaign sponsored by the Amputee Coalition. More than 2 million Americans live with limb loss and that number grows by 185,000 each year, either through trauma, disease, or birth defect. Returning patients to a lifestyle they enjoyed prior to losing a limb is the goal of prosthetists and prosthetic companies, continually researching and marketing innovative devices that provide higher levels of function and mobility. Still, Jessie gave mobility a good try. But with the traumatic amputation, debris and blood loss, he developed heterotypic ossification, where muscles and tendons turn to bone, causing fractures and pain. He tried to put his weight on the right side (his “good” side) but eventually his right knee joint gave out. “That is why I was in a wheelchair; it was the least amount of harm,” Jessie said. “Even then, sitting would throw my femur in an awkward position. I needed a special cushion because of all the scar tissue and ossification. Through networking on Facebook, Jessie’s plight caught the attention of Michele Hattingh, administrator of the Prosthetic Care Facility of Virginia. Michele knew Jessie could be helped by her husband, John Hattingh, CP, LPO, CPO(SA), who specializes in difficult cases and has helped find a comfortable fit for dozens of hip disarticulation and hemi-pelvectomy patients. Michele made travel arrangements for Jessie and his wife, Nora, to “Being conscious, I realized I had to choose whether to live or die; I chose to live.” - Jessie Herring come to Virginia for a consultation through a special program called Destination Prosthetics, which provides rehabilitation care to those who want to achieve mobility, but are unable to receive the prosthesis they need in their own community or from their own prosthetist. Destination Prosthetics is a means for them to receive intensive oneon-one treatment with no interruptions, with travel and accommodations provided for those who qualify. style” socket and is contoured to fit the patient’s body. It effectively captures the pelvic rotation of the user, providing greater control. It also was made so that Jessie could manage his colostomy bag with ease. Once John Hattingh reviewed Jessie’s X-rays, he could see that pin and lock were not a good match and he recommended they try what is called a “bikini socket.” “I went down steps the first day too,” he said. “John is good, there are no ands, ifs and buts. He saw my X-ray and he said he could do it and he did it. Thank you John, Michele, and also Darren Hattingh, who helped make the socket.” The bikini socket is less than half the size and weight of the traditional “bucket- “On Sunday John did an evaluation, on Monday he molded a socket, and late Tuesday I was walking,” Jessie said. “It feels good and my weight is distributed evenly. My old prosthesis, I couldn’t sit in it. With this, I can sit, drive, and walk. Bikini Socket Provides Higher Level of Comfort for Hip Disarticulation and Hemi-Pelvectomy Patients The most high-tech componentry available is not going to make any difference if the most important part of the prosthesis, the socket (or interface), which holds the prosthesis to the residual limb, is not comfortable. The job of the socket is to support body weight and hold the residual limb firmly in the prosthesis. Patients who are hip disarticulations or hemi-pelvectomy often have a very difficult time finding a comfortable socket fit because of their challenging level of amputation. Ischial containment sockets have been made of flexible thermoplastic materials contained within a rigid frame. They are considered more comfortable than the traditional hard plastic laminate socket. These have been called several names including the Scandinavian Flexible Socket (SFS). Ischial containment sockets are more successful on short, fleshy residual limbs and are better suited for high activity sports participation. The Canadian design uses unlocked hip, knee and ankle joints to achieve stance-phase stability while permitting flexion at the hip and knee during swing phase. A molded plastic socket encloses the ischial tuberosity for weight bearing, extends over the crest of the ilium to provide suspension during swing phase, and affords excellent mediolateral trunk stability by fully encasing the contralateral pelvis. The prosthetic hip joint is attached to the socket anteriorly, and this results in excellent stance-phase stability plus good swing-phase flexion. More recently, Jay Martin, president and founder of Martin Bionics Innovations, designed what he dubbed the “bikini” socket due to its less than half the size and weight of the traditional style socket. According to Martin, the design can more effectively capture the pelvic rotation of the user, providing greater control. Instead of rigid or semi-flexible materials, the design uses a compliant iliac crest stabilizer for a more comfortable fit and can accommodate the user’s weight fluctuations. In general, the more flexible the socket is, the greater the comfort level, enabling the amputee to utilize the prosthesis fully. Destination Prosthetics Since the Prosthetic Care Facility of Virginia opened for business a little less than two years ago, we have helped dozens of patients achieve mobility again through our unique program – Destination Prosthetics. Destination Prosthetics was created for amputees who wanted to achieve mobility, but were not finding the help they needed in their own community or from their own prosthetist. Destination Prosthetics provided an option for them to travel to Leesburg for evaluation and treatment. One of our patients was Michelle O., from Petaluma, Calif. Michelle lost her leg through a boating accident and had been struggling for more than a year to regain her mobility. But she had two bad experiences with two different prosthetists, one of whom said it would be impossible for her to walk again because she is non-compliant and difficult to fit. To make matters worse, she was more than several thousand dollars out of pocket with insurance refusing to investigate the situation. After talking with Michelle, we found that she was willing to do anything to get back to her job and being a “regular” mom to her young son. John Hattingh, CP, LPO, CPO(SA), fit her with the Revolimb system (see story on page 4) and we can say that Michelle is now walking for the first time in months – just in time for Christmas with her family. Said Michelle O.: “I am so grateful to this entire (Hattingh) family for helping me get back to me.” Another patient is Joy C., who was improperly fit, making walking a very uncomfortable, if not impossible task. “Thanks to John, I’m getting back to the sports I loved before. I’m also getting a bike with the left pedal modified so my prosthetic leg clips into the footholds so it doesn’t fall off and then I want to do rock climbing and hiking,” she said enthusiastically. “I’m so glad for the Hattinghs … I just appreciate so much all the work they are doing to help me.” John Hattingh has come up with a new design for hemi-pelvectomy patients which combines the Scandinavian design with the Bikini Socket. HPs require more soft tissue surface bearing because there is no skeletal ischium for weight bearing purposes. Therefore the combination still allows for a smaller and lighter socket with the adjustability of the Bikini, but enough surface to allow for soft tissue weight bearing. To be considered for Destination Prosthetics, a patient must live more than 100 miles from Leesburg. We will help with checking out-of-state and out-ofnetwork insurance. However, we cannot accept Medicare/Medicaid patients. With a call to (703) 723-2803 or email to [email protected], you can find out if you qualify for this unique program and assistance with travel and accommodation expenses. At Destination Prosthetics We Remember Mathias! Our little angel of a patient, Mathias Giordano, 13, passed away December 7, 2014. Diagnosed with osteosarcoma in 2012, we came to know him after his leg was amputated. He never failed to be strong of spirit and he brought much joy and appreciation of life to our family. Rest in Peace Mathias. You are free of pain now. in the Prosthetic Care Facility of Virginia, you will receive intensive one-on-one treatment with no interruptions. When you come to us for assistance, we will review your limb-loss history, fit you with the correct socket and components, analyze your ability to walk in our Gait Training Lab, and educate you in the care and use of the components. We also offer adjustments as needed. Hard-to-fit cases are our specialty. 44115 Woodridge Parkway Suite 180 Leesburg, VA 20176 703.723.2803 Fax: 703.723.2804 www.prostheticcarefacility.com Get social with us on Facebook: www.facebook.com/prostheticcarefacility Revolimb Technology Available at Prosthetic Care Facility John Hattingh, CP, LPO, CPO(SA), is licensed and trained in the Revolimb, a micro-adjustable prosthetic limb that allows you to instantly control the fit of your socket without ever having to remove it. You can easily customize the fit, feel and performance of your prosthesis by fine-tuning socket compression around your limb. John fabricates the Revolimb by customizing the floating panels around your limb. Precision placement of these adjustable panels allows them to flow with your changing body and your changing needs. The panels are lined with custom pads for soft, smooth compression and exceptional comfort. Your ability to tighten or release the contours of your socket puts you in control of your comfort and fit. For more information about the Revolimb, contact John Hattingh at Prosthetic Care Facility of Virginia, (703) 723-2803.