Re:

Re:

Levy, Charles

8/20/2003

Dear Darren,

Thanks for sharing your experience. You may or may not know that in the
U.S. new legislation (HIPPA) has made very aware of issues surrounding
patient confidentiality. I would discourage the identification of patients
by name, even using first name only.

I hope you don't interpret my remarks as disrespectful. They are not meant
that way.

Yours,

Charles E. Levy, MD

-----Original Message-----
From: Darren Thomas [mailto:<Email Address Redacted>]
Sent: Wednesday, August 20, 2003 2:22 AM
To: <Email Address Redacted>
Subject: [OANDP-L]


Dear Mr Bass

I have just been directed to your enquiry regarding clients with self
harming behaviour. I have also been dealing with a similar problem and
publish a short case study in the Australian Orthotic and Prosthetic
Association Gazette.

I have attached the article and hope that it helps.

      <<John is a ten.doc>> <<Pic01.jpg>> <<Pic01.jpg>>

Since the article was published we have been called upon to service the
helmet on a number of occasions. John managed to crack the clear face
bubble twice. We changed material to 3 mm poly carbonate and while the
material did scratch, the polycarbonate did not crack.

The main problem we had with this design was hygiene. John constantly
dribbles into the helmet and I found that the padding around the chin needed
replacing every 2 or 3 weeks regardless of how often the helmet was
cleaned.

After almost 9 months of adjusting John's medication, his behaviour is now
controlled to point where the restrictive custom helmet was no longer
required. John is now wearing an ice hockey helmet with clear face grill.

If asked to make John another helmet I would certainly use this design
again, however using these materials the helmet should probably have been
replaced after about 6 months. I would also include protection for John's
ears as he did turn his attention on them once he was unable to injure his
face.

Regards

Darren Thomas
BPO. MAOPA

Orthotics Department
The Children's Hospital at Westmead
Locked Bag 4001
Westmead NSW 2145
Sydney Australia

<Email Address Redacted>

 <<helmet 21.jpg>>