Shower/swim leg results

Shower/swim leg results

Marty Mandelbaum

7/6/2000

Thanks to all that have responded, your comments were helpful. If you have
specific billing or coding suggestions
please forward them as well. However I will not post billing issues to list
only privately to those that are interested.
Thank you
Marty Mandelbaum CPO

Responses to: Does anyone have suggestions for types of swim or shower legs
(BK's and AK's)?
Componentry, suspensions, techniques and coding/pricing suggestions would be
appreciated.
Please let me know if you do not want your name posted when posting
responses.

Marty:
-We use primarily two techniques for swim/shower limbs: the Endoflex
thermoplastic system and a hollow exoskeletal technique popularized by the
German's many years ago. We usually bill them as such and seek approval in
addition to the daily use limb, often at a reduced or discounted rate that
we
negotiate based on the duplication of an existing positive mold etc. As far
as feet go, USMC has a marginal foot called the Beach Comber which we have
used; there is a swimming foot/fin by the folks who also make the Active
Ankle which works well; and we generally utilize any foot we can waterproof
effectively. For AK's we have used the nylon knee unit that is produced by a

small company relatively new to the scene. If you want the name e-mail me
back and I'll track it down. Good luck getting Medicare to pay for a second
prosthesis however, in our region that is not possible regardless of
functional levels/activities. Hope this helps.
Jim Rogers, CPO

Marty:
-Tony Denson has a shower limb which may be OK for both BK and AK amps. Tony

can be reached at <Email Address Redacted> Endolite has a BK shower limb and I
believe is working on an AK shower Limb. They are available at
<Email Address Redacted>
Bob Brown, Sr. CPO, FAAOP

Marty,
-I have had a run of patients requesting a swim leg lately. All have
admitted to actually swimming only 2-3 times a year, so I tell them if they
can get their insurance to cover it, I'll do it. I don't think it's ethical
to bill for a swim leg unless I have an amputee who actually uses it
regularly (vs 2-3 times in a year). However, I have two alternatives for
swim/shower Px.
When I was in Harmarville tech school (long, long ago) we made a swim leg
using PVC piping, foam, then laminating. The pipe extended from the foot to
a hole in the distal socket and had four extensions running perpendicular to
this piece (open holes in the lamination where the pipe was). Water filled
it so that it didn't float when swimming. It was very rudimentary, but was
an inexpensive alternative and something you could easily do in your lab. I
could explain this further if you're interested. Give me a reply e-mail.
Secondly, for shower only Px: When making a new Px, save the check socket.
Have the patient bring in an old Px that they won't use again. Attach the
check socket (maybe add some vent holes distally) to the old prosthesis. It
will eventually rust out, but they should be able to get years out of it for
the shower only. You can't bill for this (as far as I know or at least I
have never tried), but it's simple to do. The patient paid for the check
socket, after all, and it should take only a few minutes to transfer out the
sockets. We do this on occasion. You can add a wedge under the Px heel to
simulate heel height. You can even pull plastic over the metal parts to
help protect them somewhat. You're not getting paid for it, so putting too
much effort into it seems rather charitable.
I am interested in reading your responses to see if others have had any
success in getting insurances to pay for this. We have only ever made one
true swim leg and it was ordered through a VA clinic. None of my patients
have ever pursued it.
Good luck to you and I hope this has helped or at least given you some
ideas.
Joan Cestaro, CP
RPI- Winchester VA


hello
-i suppose it would be better to use a silicon sleeve with
an additional elastic knee support if your patient is going
to swim seriously. besides you should use an adjustable
ankle part to fix it in about 120 degree for swimming and
scuba diving.
good luck

-Endolite has a new shower leg out that comes with everything except socket,
which if you vacuum form or laminate should be waterproof as well. The foot
has suction cups style bottom for better grip. Call them and they will fax
you the info.
Steve Hoover, C.P.

-ENDOLITE NORTH AMERICA HAS A NEW PRODUCT WHICH MAY INTEREST
YOU CALLED AQUALIMB
ENDOLITE NORTH AMERICA
105 WESTPARK RD.
CENTERVILLE,OHIO 45459
800-548-3534
FAX 800-929-3636
<Email Address Redacted>

THANKS
KEVIN HICKEY

-I was reading Marty's repuest about swim and shower prosthesis. Instead of
making a whole new prosthes for only showering and swimming. Why not
just
put on a sock, made of rubbery material, pump out the air, to make a vacuum
around the limp and prosthes. That way you keeps the prosthes dry and it
sure is
easier, than carying a spare leg around.
One company who deals whit such a device is Tec Motion Scandinavia AB, from
Helsingborg, Sweden. The product is called XeroSox. It should be waterproof
even
for swimming at the beach.
Mary I know it wasn't what you repuested, but I couldn't help it. I had to
tell
about it.

Greetings
Klaus Moldt, Physiotherapist
Holstebro, Denmark

-i'm sure you already got plenty of replies - contact endolite

-This confirmation of the post from Bob Brown He knows my work because I am
talking with him about marketing the product. I have no patent yet and ir
seems that Finneston may have beat me to it with his aqualimb but I have
not
seen it yet. E mail back if you want to know more.

Tony Denson CO

-endolite makes a very inexpensive kit for BKs. Use a suction valve and a
silicone sleeve over the outside of the assembly and viola...a shower/water
leg.
Good luck,
Larry Wiley, CP

-O.K.
Call Bock, Endolite, and Endoflex to start. They all have a design and can
produce, send you the info. to do it, or refer it out for you. Also check
the Active ankle, and Ferrier Coupler. Best Regards, Richard Feldman,CPO

-Thanks for all the replys