Aqualeg
David Hendricks, CPO
Description
Collection
Title:
Aqualeg
Creator:
David Hendricks, CPO
Text:
Dear listserve:
Last week I asked this question:
I am about to make an aqualeg for a BK amputee. This is for a 26 year old
female who has always loved water sports. She has Medicare coverage. I have
very recently fitted her with a new endoskeletal BK prosthesis, Iceross sleeve
suspension, dynamic response foot. I have read articles on aqualegs, discussed
them with patients, but it has been a while since I provided one for a
patient.
My questions are these:
1) Can I use the same mold?
2) What is the best way to build an aqualeg?
3) What articles have been written on the subject?
4) What codes are used to bill an aqualeg?
5) Will Medicare allow an aqualeg for the above patient?
Here are your responses:
1) From: <Email Address Redacted> (Jeffry G. Kingsley)
I have several options for you, the low-end and the high-end.
First the low-end is the Kingsley K16 Beachcomber which incorporates
an exposed keel foot into the BK leg.
The High-End is the RAMPRO Active Ankle which allows for ankle flexion
for swimming. This ankle is very compatible with our Steplite feet which
are stored energy with a carbon fiber keel plate and are waterproof.
RAMPRO has a web site, but I am not sure what it is (maybe rampro.com)
If you are unable to find it, send me an E-mail or call 800-854-3479 and we
will send you information on it as well as the Steplite.
There is also an ankle adapter from OrthoEurope in England called the L.A.
Ankle which would work for this application.
2) From: <Email Address Redacted> (John Fergason)
Ohio WIllow Wood has a water leg kit available and Otto Bock has a nice TI on
fabricating a hollow shell BK.
3) From: BB 4 O N P (Robert N. Brown, Sr., CPO, FAAOP)
Perhaps the following may help. It is information about a supplemental
definitive prosthesis I produce and offer, as a custom or prefabricated (to
measurements) prosthesis to Certified Prosthetists only.
(Mr. Brown sent a great deal of information on his BB-d prosthesis. You can
obtain it by contacting him at the following:)
Robert N. Brown, Sr., CPO, FAAOP
CEO/R&D
FLO-TECH O&P Systems, Inc.
1(800) FLO-TECH (356-8324)
FAX: (607 387-3176
4) From: <Email Address Redacted> (Wayne Renardson)
Several years ago I tested the DryPro. I posted the following long-winded
evaluation to my list, AMP-L, at that time:
---------------------------------------------------------
The DryPro arrived yesterday and last night I gave it the electric
kool-aid acid test (apologies to Tom Wolfe and Ken Kesey)
First, the DryPro. It is a waterproof covering for BK amputees to wear
over their prosthesis while swimming, bathing, engaging in water sports,
(yeah) whatever, that is supposed to keep everything, including the
stump sock, dry. It is form fitting, reusable, and nicely constructed.
It is made of a durable latex (my sample is cream colored) 30 mils thick
(the mils refers to a millimeter, which is 0.001 of a meter. A meter is
39.37 inches so for the metrically challenged, hey...enjoy) and uses a
sealed top to prevent water from getting into the device.
It also has a rubber non-slip coating on the sole of the foot to prevent
slipping on a wet surface.
While useful only for BK amputees, there are four sizes available:
Size Length Thigh Circumference
---- ------ -------------------
C/S 19-26 13-10
C/M 24-29 15-13
A/M 26-32 18-15
A/L 31-36 20-17
The C refers to a child (small and medium) and the A to an adult size
(medium and large). All sizes cost $59.95. No discrimination here.
I am told that James Haggerty, a BK amputee, had a hand in designing the
DryPro.
How did it work: The acid test...
Donning the devil:
----------------
They recommend using talc to allow it to slide over the prosthesis more
easily but I did not have any so I did not use it. I went naked,
without greasin'the skids...
The literature recommends sitting with the ankle of the prosthetic leg
resting on the knee of the other leg and working the cover over the foot
until the toes enter the foot of the Drypro.
I found this convoluted, so I removed my prosthesis and suspension and
slipped the DryPro on, which required only a small amount of
effort---minor tugging.
However, the heel of the DryPro did not slip over my prosthetic heel, in
spite of tugging and pulling with considerable (well, my limited)
strength. It was as if the bottom part of the DryPro was too short to
fit over the heel. The heel portion almost came over, but it simply did
not make it. In the last analysis this was not a major problem since I
just walked on the small bunched up part that did not slip over the
heel. It served as a good replacement for my J.S. Smith suspension,
which was not needed since the DryPro served to hold my prosthesis on
quite nicely.
I finally said to hell with it, stood up, and pulled the DryPro up over
my thigh, which came up about midway.
The Aesthetic
-------------
I asked my wife what she thought about the aesthetic of it all. A most
interesting comment, which I preface with some history:
My wife's father had polio. As a young man he dropped out of medical
school when he developed it since it affected his right arm and he was
planning to become a surgeon. His arm was akin to Robert Dole's---there,
but not terribly useful. He was not an amputee, but...
My wife knew me a year before she realized I was an amputee. It simply
never came up in our daily conversations (I once worked with and for
her). She seemed amazed when, one fine day, I mentioned I lost my leg in
a motorcycle accident. And amputation is not something today we discuss
often. No reason to, I suppose.
Tonight, when I asked her what she thought about the aesthetic aspect,
(strictly for her highly valued opinion) she said she liked it very
much---it was much better. Much better than what I asked. Looking
at a stump?
She said: Well, yes. It is better for people who have to look.
He said: What do you mean? Does it make you uncomfortable to look at an
amputee or an amputated part?
She said: Well, people don't know what to say. Yes, it makes them
uncomfortable. They don't know how to deal with it.
Anyhoo, she really liked the aesthetic aspect.
The DryPro felt good, and held my prosthesis snugly. I walked on it with
ease, and got into the bathtub. I do not have a shower.
The first thing I noticed was it was buoyant. My right leg had a strong
tendency to float. Nice.
I remained in the water with my legs totally submerged for about 20
minutes. I stood up in the tub and the bottom, in spite of the heel not
fitting properly, felt quite secure. No slip. And I moved the foot along
the bottom of the tub with vigor...
When I got out I stood on a quarry tile floor, which at best is
extremely slippery when wet. I moved the right leg around and yes, it
was slippery, but so are my rubber soled shoes on this tile. I then
moved onto a hardwood floor and that surface seemed to grip it much
better. The non-slip bottom of the DryPro is nice.
Doffing the thang:
-----------------
Doffing was simple. Pull the thigh portion down, slip it over the foot,
and voila, there you have it. And the good news is that my wool stump
sock was bone-dry. If it kept my sock dry, it surely did not permit any
water to get into the prosthesis, so it passed the acid test for
waterproofing.
I am happy to send this product (am not a water-boy---swimming is not my
thing) to the first BK who is active swimming or whatever. Drop me a
note and I will send it to you for your appraisal and comment to the
list. Two opinions are better than one in this case...
The DryPro is also available from:
Medical Industries America, Inc.
2879 R Avenue
Adel, Iowa USA 50003-8055
1-800-759-3038
(515) 993-5001 (phone)
(515) 993-4172 (fax)
Dean Safris is the national sales manager. And the good news is you can
go direct without intervention from a third-party. They offer a color
brochure featuring a handsome young woman stepping in or out of a
bathtub, a swimming pool, and a sauna. Is she an amputee? I have no
idea. The aesthetic does not reveal if she is or not. It would probably
make my wife, uhhhh, comfortable.
I also spoke with Joelle Peterson in customer service and she is willing
to take comments or answer questions about the product.
Russell Bird is the president if you wish to go to the top of the
pile...
They can be e-mailed via: <Email Address Redacted>
Wayne Renardson
5) From: <Email Address Redacted> (Pacific Orthotic Prosthetic Service) (Steve
Childs, BOCP, C.Ped.)
I have built a few shower legs over the years and just finished making
one yesterday.
The one I fit yesterday is being used to get to the pool at a local YMCA.
The patient does lap swimming every day.
>1) Can I use the same mold? Yes, I used the check socket as the
mold, or take an impression out of what fits.
>2) What is the best way to build an aqualeg? Design and create for the
individual. I use 1 1/4 schedule 40 PVC pipe with R.T.C.'s connecters
for the socket and a 3 round peg.
>3) What articles have been written on the subject? I'm not aware of
any articles but have seen a couple of lectures. There was a technique
that Kingsley Mfg. had with their aquafoot.
>4) What codes are used to bill an aqualeg? You would have to use
Prosthetic dump codes.
>5) Will Medicare allow an aqualeg for the above patient? NO.
Medicare will not pay for a shower type leg, at least I haven't been
lucky enough to see it happen yet. I did one for a Veteran and was
reimbursed for that.
That wraps it up. Thank you all for your responses.
David Hendricks, CPO
Last week I asked this question:
I am about to make an aqualeg for a BK amputee. This is for a 26 year old
female who has always loved water sports. She has Medicare coverage. I have
very recently fitted her with a new endoskeletal BK prosthesis, Iceross sleeve
suspension, dynamic response foot. I have read articles on aqualegs, discussed
them with patients, but it has been a while since I provided one for a
patient.
My questions are these:
1) Can I use the same mold?
2) What is the best way to build an aqualeg?
3) What articles have been written on the subject?
4) What codes are used to bill an aqualeg?
5) Will Medicare allow an aqualeg for the above patient?
Here are your responses:
1) From: <Email Address Redacted> (Jeffry G. Kingsley)
I have several options for you, the low-end and the high-end.
First the low-end is the Kingsley K16 Beachcomber which incorporates
an exposed keel foot into the BK leg.
The High-End is the RAMPRO Active Ankle which allows for ankle flexion
for swimming. This ankle is very compatible with our Steplite feet which
are stored energy with a carbon fiber keel plate and are waterproof.
RAMPRO has a web site, but I am not sure what it is (maybe rampro.com)
If you are unable to find it, send me an E-mail or call 800-854-3479 and we
will send you information on it as well as the Steplite.
There is also an ankle adapter from OrthoEurope in England called the L.A.
Ankle which would work for this application.
2) From: <Email Address Redacted> (John Fergason)
Ohio WIllow Wood has a water leg kit available and Otto Bock has a nice TI on
fabricating a hollow shell BK.
3) From: BB 4 O N P (Robert N. Brown, Sr., CPO, FAAOP)
Perhaps the following may help. It is information about a supplemental
definitive prosthesis I produce and offer, as a custom or prefabricated (to
measurements) prosthesis to Certified Prosthetists only.
(Mr. Brown sent a great deal of information on his BB-d prosthesis. You can
obtain it by contacting him at the following:)
Robert N. Brown, Sr., CPO, FAAOP
CEO/R&D
FLO-TECH O&P Systems, Inc.
1(800) FLO-TECH (356-8324)
FAX: (607 387-3176
4) From: <Email Address Redacted> (Wayne Renardson)
Several years ago I tested the DryPro. I posted the following long-winded
evaluation to my list, AMP-L, at that time:
---------------------------------------------------------
The DryPro arrived yesterday and last night I gave it the electric
kool-aid acid test (apologies to Tom Wolfe and Ken Kesey)
First, the DryPro. It is a waterproof covering for BK amputees to wear
over their prosthesis while swimming, bathing, engaging in water sports,
(yeah) whatever, that is supposed to keep everything, including the
stump sock, dry. It is form fitting, reusable, and nicely constructed.
It is made of a durable latex (my sample is cream colored) 30 mils thick
(the mils refers to a millimeter, which is 0.001 of a meter. A meter is
39.37 inches so for the metrically challenged, hey...enjoy) and uses a
sealed top to prevent water from getting into the device.
It also has a rubber non-slip coating on the sole of the foot to prevent
slipping on a wet surface.
While useful only for BK amputees, there are four sizes available:
Size Length Thigh Circumference
---- ------ -------------------
C/S 19-26 13-10
C/M 24-29 15-13
A/M 26-32 18-15
A/L 31-36 20-17
The C refers to a child (small and medium) and the A to an adult size
(medium and large). All sizes cost $59.95. No discrimination here.
I am told that James Haggerty, a BK amputee, had a hand in designing the
DryPro.
How did it work: The acid test...
Donning the devil:
----------------
They recommend using talc to allow it to slide over the prosthesis more
easily but I did not have any so I did not use it. I went naked,
without greasin'the skids...
The literature recommends sitting with the ankle of the prosthetic leg
resting on the knee of the other leg and working the cover over the foot
until the toes enter the foot of the Drypro.
I found this convoluted, so I removed my prosthesis and suspension and
slipped the DryPro on, which required only a small amount of
effort---minor tugging.
However, the heel of the DryPro did not slip over my prosthetic heel, in
spite of tugging and pulling with considerable (well, my limited)
strength. It was as if the bottom part of the DryPro was too short to
fit over the heel. The heel portion almost came over, but it simply did
not make it. In the last analysis this was not a major problem since I
just walked on the small bunched up part that did not slip over the
heel. It served as a good replacement for my J.S. Smith suspension,
which was not needed since the DryPro served to hold my prosthesis on
quite nicely.
I finally said to hell with it, stood up, and pulled the DryPro up over
my thigh, which came up about midway.
The Aesthetic
-------------
I asked my wife what she thought about the aesthetic of it all. A most
interesting comment, which I preface with some history:
My wife's father had polio. As a young man he dropped out of medical
school when he developed it since it affected his right arm and he was
planning to become a surgeon. His arm was akin to Robert Dole's---there,
but not terribly useful. He was not an amputee, but...
My wife knew me a year before she realized I was an amputee. It simply
never came up in our daily conversations (I once worked with and for
her). She seemed amazed when, one fine day, I mentioned I lost my leg in
a motorcycle accident. And amputation is not something today we discuss
often. No reason to, I suppose.
Tonight, when I asked her what she thought about the aesthetic aspect,
(strictly for her highly valued opinion) she said she liked it very
much---it was much better. Much better than what I asked. Looking
at a stump?
She said: Well, yes. It is better for people who have to look.
He said: What do you mean? Does it make you uncomfortable to look at an
amputee or an amputated part?
She said: Well, people don't know what to say. Yes, it makes them
uncomfortable. They don't know how to deal with it.
Anyhoo, she really liked the aesthetic aspect.
The DryPro felt good, and held my prosthesis snugly. I walked on it with
ease, and got into the bathtub. I do not have a shower.
The first thing I noticed was it was buoyant. My right leg had a strong
tendency to float. Nice.
I remained in the water with my legs totally submerged for about 20
minutes. I stood up in the tub and the bottom, in spite of the heel not
fitting properly, felt quite secure. No slip. And I moved the foot along
the bottom of the tub with vigor...
When I got out I stood on a quarry tile floor, which at best is
extremely slippery when wet. I moved the right leg around and yes, it
was slippery, but so are my rubber soled shoes on this tile. I then
moved onto a hardwood floor and that surface seemed to grip it much
better. The non-slip bottom of the DryPro is nice.
Doffing the thang:
-----------------
Doffing was simple. Pull the thigh portion down, slip it over the foot,
and voila, there you have it. And the good news is that my wool stump
sock was bone-dry. If it kept my sock dry, it surely did not permit any
water to get into the prosthesis, so it passed the acid test for
waterproofing.
I am happy to send this product (am not a water-boy---swimming is not my
thing) to the first BK who is active swimming or whatever. Drop me a
note and I will send it to you for your appraisal and comment to the
list. Two opinions are better than one in this case...
The DryPro is also available from:
Medical Industries America, Inc.
2879 R Avenue
Adel, Iowa USA 50003-8055
1-800-759-3038
(515) 993-5001 (phone)
(515) 993-4172 (fax)
Dean Safris is the national sales manager. And the good news is you can
go direct without intervention from a third-party. They offer a color
brochure featuring a handsome young woman stepping in or out of a
bathtub, a swimming pool, and a sauna. Is she an amputee? I have no
idea. The aesthetic does not reveal if she is or not. It would probably
make my wife, uhhhh, comfortable.
I also spoke with Joelle Peterson in customer service and she is willing
to take comments or answer questions about the product.
Russell Bird is the president if you wish to go to the top of the
pile...
They can be e-mailed via: <Email Address Redacted>
Wayne Renardson
5) From: <Email Address Redacted> (Pacific Orthotic Prosthetic Service) (Steve
Childs, BOCP, C.Ped.)
I have built a few shower legs over the years and just finished making
one yesterday.
The one I fit yesterday is being used to get to the pool at a local YMCA.
The patient does lap swimming every day.
>1) Can I use the same mold? Yes, I used the check socket as the
mold, or take an impression out of what fits.
>2) What is the best way to build an aqualeg? Design and create for the
individual. I use 1 1/4 schedule 40 PVC pipe with R.T.C.'s connecters
for the socket and a 3 round peg.
>3) What articles have been written on the subject? I'm not aware of
any articles but have seen a couple of lectures. There was a technique
that Kingsley Mfg. had with their aquafoot.
>4) What codes are used to bill an aqualeg? You would have to use
Prosthetic dump codes.
>5) Will Medicare allow an aqualeg for the above patient? NO.
Medicare will not pay for a shower type leg, at least I haven't been
lucky enough to see it happen yet. I did one for a Veteran and was
reimbursed for that.
That wraps it up. Thank you all for your responses.
David Hendricks, CPO
Citation
David Hendricks, CPO, “Aqualeg,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/211108.
