BK Amputees Needs Advise

BK Amputees Needs Advise

8/7/1999

Ms. Asby posted this to AMP-L listserv with the request I cross-post to
OANDP-P. All responses should be directed to Ms. Asby

              < <Email Address Redacted> >

who will summarize and repost for your edification.

Wayne Renardson, AMP-L.
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From: Stacey Asby < <Email Address Redacted> >

Subject: BK Amputee Needs Advise

Sender: <Email Address Redacted>
        < <Email Address Redacted> > Wayne Renardson

To: Amputee Information Network < <Email Address Redacted> >

As many of you know, I have been battling to get my new leg aligned for
almost a year. Unfortunately, the difference between the last two legs,
both of which took a similar amount of time to nail, by different
prosthetists, is that we are making no headway and we (me and the two
prosthetists who have worked on it) are equally frustrated and confused
about where to go from here.

I understand the difficulty trying to make suggestions without the
person in front of you, but in this case any SUGGESTIONS would be
welcome, whether on the list or privately, so I can answer questions
that may help you understand the situation. Here is the best description
I can offer.

I am R-BK. RL is 6 inches in length. At 5'4 + and about 110 lbs., I use
a total contact socket with a semi-supracondular support to minimize
movement.

The socket is snug to within 1-ply of sock and I am using an Alpha liner
(6mm) with pin, and finally, a silipos sleeve to minimize movement. The
movement I feel in the socket and in all planes of alignment is
immeasurable, with the closest increment less than 1/10 mm.

These increments off aren't tolerable because of a gap in the hips
(arthritis) plus some back problems in the L4-L5 region. (We are talking
Percosets after an hour or two of misaligned walking because the back
goes out!): Been there--done that, and AM NOT doing it again if at all
possible! :o)

The foot we are trying to get working is the Vari-flex for flexibility,
low maintenance, and cosmesis. According to my CP, the socket is aligned
about 1-1/2 inches anterior (forward) more than normal, and is also
about an inch inset more than normal.

This situation, apparently and seemingly contrary to the laws of physics
and prosthetics, has me feeling I am sitting sloped back on my heel and
that I have to fight somewhat to push UP TO the ball of the foot, at
which point I receive the response of the foot that I should, and then
fall over the toe. The foot is comprised of a cat. 4 with the thinnest
wedge in the heel and cat. 2 in the toe. We started at cat. 1 all the
way around, according to FF specs, and progressed to this because of my
very hard heel strike.

We also tried increasing the wedges in the heel, but lost all
responsiveness in the foot.

Now, trying to visualize this, so far, according to almost every CP who
has worked on this little problem to date (all very competent and
respected in their field), I respond the opposite to most normal
adjustments, for some reason. I can feel the slightest changes.

We have tried other feet during this process including: the College Park
(no response, heel too soft), Genesis 2 (same inflexibility to inclines
that my current set up has, which is a Seattle Lite foot with Endolite
ankle), the Chiles Campbell, and the Safe foot (very similar to the
college park).

All these feet resulted in me falling forward to the outside, or tilted
back, as I do on the Vari-flex, when attempting to align them. Oh yes,
and not that I think it has much relevancy to this issue, but the lack
of a good, working prosthesis for a year is putting additional stress on
my sound foot, which is in the beginning stages of the Charcot joint
disease (diabetes complication) which took the right foot, and the now
too-large socket of my current leg has caused an open area on the RL,
but I do have a lifetime of diabetes to contend with, which also causes
a bit of fluid retention in the limb.

So how many of you brave souls would like to have a crack at this
problem? In the words of Popeye, I've about had alls I can take!!

Oh yes: I am poor and have two small children, so the possible
suggestions can not include a requirement of large sums of money or
travel. :o)

So this means ask your amputee friends, colleagues, technicians,
prosthetists, and pets if you think of a possible solution or if you've
resolved a similar problem yourself, please!! :o)

Sincerely,

Stacey Asby