UE Challenge Response

UE Challenge Response

PP240Z

Dear colleagues,
My apologies for a late return of these responses most generously posted to
me. I suffered one of the worst type of computer problems imaginable.
Here are the last responses before the event.

Pat--
I have successfuly fit three Cornelia de Lange kids over the past few years.
Most have been a bit older when the attempt was made--the youngest being about
5 years.

The first was a bialteral BE (In WY) with forearms tapering to single digits.
Hermetically sealed switches were used to actuate cookie crusher enabled
VASI 2-6 hands. Measured IQ of 7. Originally fit at about age 12 and as far
as I know, the first CdL to attempt electric prosthetic fitting. Training
began by using a microswitch operated fan--(she liked the fan to blow on her
face) until she understood cause and effect. Once the arms were fit, her
favorite food (french fries!) was inserted to demonstrate the hand's
usfulness.

She is now about 22 years and wears the arms all day. In fact, she gets quite
upset when they are missing. If we have to keep them for repairs, she ends up
wearing slippers on her arms or she's not happy. We presented this case at
ACPOC a few years ago w/ video.

#2 was a bilateral AE (In NY)--short right/ very long left (a skinny stick
basically). Measured IQ--I don't remember; however, greater than patient #1.
We fit with a cookie crusher enables single electrode and a VASI 0-3 hand
mounted on a modified Otto Bock ball & socket wrist which was itself mounted
at almost 90° to the axis of the humerus on the anteromedial corner of the
distal humerus, i.e., No Forearm. A so-called Mommy swtich was installed so
the OT & Mom couild open the hand esternally to insert objects. Training was
basically accidental discovery of the hand.

#3 is a bialteral BE with chicken wing appearing arms. He is being fit with
our collaboration in TX. The fit presently is unilateral, BE, with a
microswitch/cookie crusher actuated w/ Mommy switch and VASI 0-3 hand--similar
to the first case.

Dexterity of the digit is questionable. The switch is being incorporated into
an electric toy for training. Final result is pending.

I'd be happy to consult in the case if you have the need.
I can be contacted at this eMail address or at <Email Address Redacted>

otherwise, call 801-328-9728.

J. Thomas Andrew, CP
Ability Prosthetic Systems, Inc.


Dear Pat Peick,
Just some comments for thought.
We recently evaluated an (otherwise healthy) 22 month old BE child for the
consideration of a myo arm.
This young girl has been using a passive prosthesis for more than a year
..
---The mother has made it painfully clear that her daughter would not
tolerate the necessary harness for a body powered prosthesis.

---Keep in mind the child would also have to learn that an extended reach
for some object would open the terminal device of the body powered arm.

---The mother of this young patient said the most difficult problem for her
daughter has been proprioception; and recognizing that her prosthetic arm
(and thus prosthetic hand) are much longer then her residuum. She reports
that the child often, and accidentally, pushes objects away with the
prosthesis on her approach.

Perhaps obvious observations but just thought I'd share these comments.
Once again, this was a young patient of normal cognitive abilities.

Good luck,
Dan
Once again I apologize for the lateness of these postings, I hope you all find
them informative.
Pat