Responses [OANDP-L] Shower Limb/Water Prosthesis
Steve Galluzzo
Description
Collection
Title:
Responses [OANDP-L] Shower Limb/Water Prosthesis
Creator:
Steve Galluzzo
Date:
7/24/2013
Text:
Thank you to all that replied, the information was helpful.
Thank you to all that replied, the information was helpful. I will gladly post any new responses if others come in. I have all the responses to date posted below.
Original Post:
Hello List,
I am looking to the List to see what others are doing for amputees in the area of a secondary prosthesis for water activities. Whether it be for recreation at the beach or pool, or as a primary component to aqua therapy or showering, we have many choices for components and suspension systems. I would like to get a sense of what the field is primarily using in these situations.
Responses:
1. Aqualimb from Endolite. Attach a thermoplastic socket and ready to go.
Todd Hall
COPC
Louisville, KY .
2. Otto Bock Aqua line components for BK and AKMark Benveniste CPHouston , TX
3. Hello,This is just my own personal experience with this. I am a BK amputee, and love water sports. I made my own water leg using a simple carbon laminated socket, using the 4 prong male pyramid (Titanium), with a hole in it. I drill out the hole using the Seattle Systems drill/reverse countersink drill bit, and then use their air expulsion valve that fits into this hole, using some fast setting epoxy to make sure it seals in place. The foot I use is a Flex Foot Mod III (but a Vari Flex or any other carbon foot module similar), and have glued on a vibram shoe sole material on the bottom of the carbon foot module. (I do NOT have a foot shell on this, so no sand or water will get trapped inside the shell). I use basically any kind of knee sleeve to seal the system, and keep the leg on while in the water. I also will tape it to the socket when in a waterpark or in the ocean, where the water force or waves or diving off a board, might pull the liner off of the socket or off of my thigh. I also use a vecro/elastic strap that goes around my thigh, at the proximal edge of the knee sleeve to keep it securely on my thigh.I have made probably 10 legs like this for my patients, using an old foot module that they already own, from their old leg, and glue on this same sole material to protect the carbon while walking on concrete, and also provides good traction while walking. The sole I make using a layer of crepe (still crepe) first, using 3/8 thick under the heel section to make the foot level, and then 1/2 thick crepe under the entire module, which is cut as the same size and shape of the matching flip-flop that will be worn. Then under this crepe, I glue the vibram shoe sole so it is stiff and not flimsy. (My first one did not use any crepe, and the Vibram material quickly broke down, and cracked where it was glued to the carbon module.)For my patients, I have figured out how much materials it takes to make a 2nd socket, using the existing check socket as the mold. I have figured about $400 for materials for the carbon, resin, plaster, and the 4 prong pyramid, and air valve. This way they can use their same liners and knee sleeves for this water leg, back up leg. I explain to them that insurance will NOT pay for a 2nd socket or leg, and that I am willing to make this for them for cash only. (I do NOT offer this to Medicare patients, I have always been worried about the rules about providing a service that I know they won't pay, and what about an ABN, and all the other paperwork that I must have to protect myself....I am still unclear on how this would work if they audited my chart and some patient had turned me in for charging them for this socket and water leg, and not filing it with Medicare when I know it isn't going to be covered anyway.....it's just NOT worth the risk or the headache of it.....sad to say.)But for other patients, I think it is totally legal and ok to do this. It is after all the patient's choice to ask me to do this, and to also pay me for this IF they want it. It is something I offer as a perk I guess for them. I have figured that I have already been paid for the prosthetic leg (the real leg, or definitive leg), and so I don't need to make more money for this 2nd socket. This is something I would want my prosthetist to do for me if I was not making my own legs.This is just an idea, and it has worked GREAT for me for several years now.As for showering with a prosthetic leg....I discourage my patients from showering with a leg on. It is critical that they wash their skin thoroughly with soap and water EVERY time they shower. And if they are wearing a prosthesis, they cannot wash their limb (kind of like showering with water shoes on, or wearing socks and rubber boots....you NEED to wash your feet). I encourage my patients to install the grab bars in their showers, and all over their bathrooms for safety. And, what works best is to have a shower bench, like what you can buy many places these days, including Bed Bath and Beyond, they even have some really decorative ones as well now. The small ones fit great in most showers, and that is what I take with me when I am driving for a vacation or trip. Most hotels have them available as well, if you just ask for them. But, each patient will most likely do what they want anyway, but at least I can tell them what I feel is best in order to keep their skin clean and protected.I hope this provides some ideas for you.ThanksJim DeWees, CP
4. Steve, I am the General Manger of Aqualeg. We are a brand new company inthe United States with the office only open for a few weeks, though thecompany has been active in Europe for a little over a year. While the onlyproduct currently offered by the company is a cosmetic cover that can beworn in water, the basic concept of the company is to build a definitiveprosthesis that can be worn in water, including salt water. The coverholds its shape without the need for supporting foam underneath. Thecompany has worked with Otto Bock and Freedom Innovations regarding feetand components that the two companies have agreed to offer warranties whenselect products are used in salt water. You can get more information fromour website, which is www.Aqualeg.com.Michael BurtonGeneral ManagerAqualeg, Inc.
5. SteveYou waterleg inquiry was forwarded to me this afternoon.I have been developing a waterleg for the last few years now. I just got back from our first national meeting of the Amputee Coalition this weekend in Orlando where we were introducing our WaterLeg the WaterGait.Since most waterlegs are not covered, we redesigned our waterleg to use a standard laminated socket, bonded to a hollow poly-propylene exo shell. We cover them with Skinergy skins. They are either provided with the Seattle Light Foot or their new carbon keeled Energy foot. Ours is a completly waterproof design, not water resistant.Check out our website www.watergait.com for more details.When patients have coverage, you bill for a standard WaterLeg and we bill you $1850, depending on the components being used. Patients without coverage come to us directly.We duplicate their existing prosthesis and clone their socket shape and alignment to create the WaterGait. It nearly never needs modification or alignment changes since we are using the DupliCone to make a perfect duplicate of their socket shape.Practitioners can send us the prosthesis or a fitted test socket on a foot and pylon, and we can duplicate it here, or we can send you the DupliCone kit and portable transfer jig and you can duplicate their prosthesis in your shop as well. No up-charges for those services. You can provide the foot and components, although, we are getting them at a discount, so you might not be saving that much money ordering them yourself.I will be in the office Friday if you would like to call and go over details, otherwise I can be reached by cell phone if I'm out of the office, as I will be most of this week.Lee ShirerReplacement Arts, Inc.708-922-0580 wk708-220-3694 cell
Steve Galluzzo, CPO, Manager
American Prosthetics & Orthotics, Inc.
1250 NW 142nd Street, Suite 100
Clive, IA 50265
515 223-8900 Office
515 223-1879 Fax
<Email Address Redacted>
www.apoinc.com
If you have received this e-mail in error, please immediately notify the sender by e-mail at the address shown. This information is intended only for the use of the individual(s) or entity to which it is intended even if addressed incorrectly. Please delete it from your files if you are not the intended recipient. Thank you for your compliance.
Thank you to all that replied, the information was helpful. I will gladly post any new responses if others come in. I have all the responses to date posted below.
Original Post:
Hello List,
I am looking to the List to see what others are doing for amputees in the area of a secondary prosthesis for water activities. Whether it be for recreation at the beach or pool, or as a primary component to aqua therapy or showering, we have many choices for components and suspension systems. I would like to get a sense of what the field is primarily using in these situations.
Responses:
1. Aqualimb from Endolite. Attach a thermoplastic socket and ready to go.
Todd Hall
COPC
Louisville, KY .
2. Otto Bock Aqua line components for BK and AKMark Benveniste CPHouston , TX
3. Hello,This is just my own personal experience with this. I am a BK amputee, and love water sports. I made my own water leg using a simple carbon laminated socket, using the 4 prong male pyramid (Titanium), with a hole in it. I drill out the hole using the Seattle Systems drill/reverse countersink drill bit, and then use their air expulsion valve that fits into this hole, using some fast setting epoxy to make sure it seals in place. The foot I use is a Flex Foot Mod III (but a Vari Flex or any other carbon foot module similar), and have glued on a vibram shoe sole material on the bottom of the carbon foot module. (I do NOT have a foot shell on this, so no sand or water will get trapped inside the shell). I use basically any kind of knee sleeve to seal the system, and keep the leg on while in the water. I also will tape it to the socket when in a waterpark or in the ocean, where the water force or waves or diving off a board, might pull the liner off of the socket or off of my thigh. I also use a vecro/elastic strap that goes around my thigh, at the proximal edge of the knee sleeve to keep it securely on my thigh.I have made probably 10 legs like this for my patients, using an old foot module that they already own, from their old leg, and glue on this same sole material to protect the carbon while walking on concrete, and also provides good traction while walking. The sole I make using a layer of crepe (still crepe) first, using 3/8 thick under the heel section to make the foot level, and then 1/2 thick crepe under the entire module, which is cut as the same size and shape of the matching flip-flop that will be worn. Then under this crepe, I glue the vibram shoe sole so it is stiff and not flimsy. (My first one did not use any crepe, and the Vibram material quickly broke down, and cracked where it was glued to the carbon module.)For my patients, I have figured out how much materials it takes to make a 2nd socket, using the existing check socket as the mold. I have figured about $400 for materials for the carbon, resin, plaster, and the 4 prong pyramid, and air valve. This way they can use their same liners and knee sleeves for this water leg, back up leg. I explain to them that insurance will NOT pay for a 2nd socket or leg, and that I am willing to make this for them for cash only. (I do NOT offer this to Medicare patients, I have always been worried about the rules about providing a service that I know they won't pay, and what about an ABN, and all the other paperwork that I must have to protect myself....I am still unclear on how this would work if they audited my chart and some patient had turned me in for charging them for this socket and water leg, and not filing it with Medicare when I know it isn't going to be covered anyway.....it's just NOT worth the risk or the headache of it.....sad to say.)But for other patients, I think it is totally legal and ok to do this. It is after all the patient's choice to ask me to do this, and to also pay me for this IF they want it. It is something I offer as a perk I guess for them. I have figured that I have already been paid for the prosthetic leg (the real leg, or definitive leg), and so I don't need to make more money for this 2nd socket. This is something I would want my prosthetist to do for me if I was not making my own legs.This is just an idea, and it has worked GREAT for me for several years now.As for showering with a prosthetic leg....I discourage my patients from showering with a leg on. It is critical that they wash their skin thoroughly with soap and water EVERY time they shower. And if they are wearing a prosthesis, they cannot wash their limb (kind of like showering with water shoes on, or wearing socks and rubber boots....you NEED to wash your feet). I encourage my patients to install the grab bars in their showers, and all over their bathrooms for safety. And, what works best is to have a shower bench, like what you can buy many places these days, including Bed Bath and Beyond, they even have some really decorative ones as well now. The small ones fit great in most showers, and that is what I take with me when I am driving for a vacation or trip. Most hotels have them available as well, if you just ask for them. But, each patient will most likely do what they want anyway, but at least I can tell them what I feel is best in order to keep their skin clean and protected.I hope this provides some ideas for you.ThanksJim DeWees, CP
4. Steve, I am the General Manger of Aqualeg. We are a brand new company inthe United States with the office only open for a few weeks, though thecompany has been active in Europe for a little over a year. While the onlyproduct currently offered by the company is a cosmetic cover that can beworn in water, the basic concept of the company is to build a definitiveprosthesis that can be worn in water, including salt water. The coverholds its shape without the need for supporting foam underneath. Thecompany has worked with Otto Bock and Freedom Innovations regarding feetand components that the two companies have agreed to offer warranties whenselect products are used in salt water. You can get more information fromour website, which is www.Aqualeg.com.Michael BurtonGeneral ManagerAqualeg, Inc.
5. SteveYou waterleg inquiry was forwarded to me this afternoon.I have been developing a waterleg for the last few years now. I just got back from our first national meeting of the Amputee Coalition this weekend in Orlando where we were introducing our WaterLeg the WaterGait.Since most waterlegs are not covered, we redesigned our waterleg to use a standard laminated socket, bonded to a hollow poly-propylene exo shell. We cover them with Skinergy skins. They are either provided with the Seattle Light Foot or their new carbon keeled Energy foot. Ours is a completly waterproof design, not water resistant.Check out our website www.watergait.com for more details.When patients have coverage, you bill for a standard WaterLeg and we bill you $1850, depending on the components being used. Patients without coverage come to us directly.We duplicate their existing prosthesis and clone their socket shape and alignment to create the WaterGait. It nearly never needs modification or alignment changes since we are using the DupliCone to make a perfect duplicate of their socket shape.Practitioners can send us the prosthesis or a fitted test socket on a foot and pylon, and we can duplicate it here, or we can send you the DupliCone kit and portable transfer jig and you can duplicate their prosthesis in your shop as well. No up-charges for those services. You can provide the foot and components, although, we are getting them at a discount, so you might not be saving that much money ordering them yourself.I will be in the office Friday if you would like to call and go over details, otherwise I can be reached by cell phone if I'm out of the office, as I will be most of this week.Lee ShirerReplacement Arts, Inc.708-922-0580 wk708-220-3694 cell
Steve Galluzzo, CPO, Manager
American Prosthetics & Orthotics, Inc.
1250 NW 142nd Street, Suite 100
Clive, IA 50265
515 223-8900 Office
515 223-1879 Fax
<Email Address Redacted>
www.apoinc.com
If you have received this e-mail in error, please immediately notify the sender by e-mail at the address shown. This information is intended only for the use of the individual(s) or entity to which it is intended even if addressed incorrectly. Please delete it from your files if you are not the intended recipient. Thank you for your compliance.
Citation
Steve Galluzzo, “Responses [OANDP-L] Shower Limb/Water Prosthesis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235420.
