Thanks to all that have helped!!!

Friday, April 18, 2014

Louisville Metro and Open Doors

On Tuesday I attempted to take the Louisville Metro EMS physical agility test. For an overview here is what the test consists of...
100' Serpentine Carry: Carry an approximately 80 pound hose bundle 100 feet
zigzagging through cones spaced 5 feet apart
you have 1min 10sec to complete

Enter through the window of a standard size car window and then exit 
through the same window

The following tasks are performed continuously, you have 5min 30 sec to
complete these tasks

Enter the driver side of the ambulance, touch the radio, emergency
equipment, gas and brake pedals then exit

Open the rear compartment and remove the stretcher with 2 med bags placed
on the bed. Move the stretcher next to the fire tower

Carry the med bags (approx 33 pounds) to the 3rd floor (although their paperwork
says 3rd floor they made me go to the 4th)

Once on the 4th floor put the bags down and pick up the 80 pound hose bundle and
carry back to the stretcher.

Put the stretcher with hose bundle back in the ambulance

Return to the 4th floor, retrieve the med bags and place them on the floor of the
ambulance (end of test)

As stated above, I had 5 min and 30 sec to finish this task. I completed the skill in 5 min and 57 seconds. 27 seconds over my allotted time. I had asked prior to testing for another minute or 2 to complete the tasks as an accommodation under the Americans with Disabilities Act. I was denied this accommodation and therefore failed the exam. To say I was bummed was an understatement. I was crushed. Thankfully, I have a very supportive group of friends and family, who helped me realize that considering I climbed effectively 8 stories in under 6 minutes as an amputee. That's not to shabby. 

I did email the HR rep for LMEMS and brought to his attention that although their departmental paperwork said we would be tested by going to the 3rd floor, we were instructed on test day to go to the 4th. Had I went to the 3rd floor as on the paper they gave us I very well may have passed. The rep responded that since I didn't say anything before my test then I forfeited all rights to complain. So, that's it. My future with LMEMS is over. I can retest in 6 months if I chose too, but I think this ship has sailed. That leaves me with a decision to make. Do I continue on in EMS or do I try a new path? I think I've made that decision. I may take a part time job on the ambulance, just because I really do enjoy patient care, and I am good as a medic, but in the long run EMS is just too hard on our bodies. Most people in this field end their career with a back injury. The days of making it 20 or 25 years are quickly coming to an end. An ever expanding population of bariatric (obese) patients is increasing the rate of injury on duty, and ending careers almost quicker than we can replace those left by the wayside. 

I have decided that I will continue in some function in medicine. I may teach paramedics, I may go back to nursing school, who knows where my path will lead. One thing is for sure. I am turning my focus. For the next few years my focus will be on helping Kate go to school and continue to push for Insurance Fairness for Amputees. I am going to try to focus on a national level instead of state level. My number one priority will be Kate. She has supported me throughout this insane journey we have been on. Up till now, the focus has been squarely on me, it's her turn for center stage. I will continue to write, do the occasional speaking engagement, and always mentor others (amputees and EMS). 

So, with that said, please continue to follow along. I have decided to stop trying to open this closed door and search for a door that is open. 

Until next time, 

PM

Sunday, April 13, 2014

The Six Million Dollar Man and PTSD Breaks

Yesterday I did an AMA (ask me anything) on Reddit. It was a great experience. It reminded me of the power of the internet. I was able to reach out to thousands of people with a simple  post. More importantly, I was able to connect with a person who is facing an amputation and after reading and participating in my AMA felt much better about the prospect of amputation. It amazes me that it's 2014 and still amputation is looked upon as a life ending prospect.

Link to Reddit AMA

What comes to mind when you hear the word amputee? Do you still get flashes in your head of peg legs and wheelchairs? Do you see a person who is downtrodden and broken? These are the common perceptions of the amputee. I hope to change that. No, when I hear the word amputee I see a fighter. I see strength. I see a future where man and machine are joined to not only replace, but enhance our abilities. Yes. I am a bionic man (play the six million dollar man theme here). It is an exciting time to be an amputee. No longer are we going to be forced to sit idly by and watch the world pass. We are out on the front lines of the blurring of flesh and bone limbs being replaced and augmented by gears and neural interfaces.

After such a high of course, I came crashing down. I was quickly reminded that while I am happy with my decision to have an amputation, and about where the future of prosthesis are headed. I still have my demons that I must deal with. As I lay down last night to try to sleep, the PTSD demon reared his ugly head in full force. It was different than any attack I had ever had. Not only did I feel like I was reliving the moments after my fall. I was there. My background noise of what ever show I was half watching was replaced with the sounds of birds chirping and water splashing down against rocks. For most it would be a serene scene, for me it was Hell envisioned. The walls lit by the television light were replaced with the sights of trees passing overhead as I was carried up the mountainside by Fort Knox Fire and Rescue. This was the first time that I had a full on hallucination of my fall. I WAS THERE! I felt like my bones were trying to crawl out of my skin, my phantom pains added to the delusion by recreating the burning sensation of an open ankle dislocation. Yes it was truly terrible. Yet, today...I'm still here. I'm alive. No demon; PTSD or otherwise, will stop me on my quest. I am thankful today that I was reminded in vivid detail of why I'm here. I'm not saying I'm thankful that I have PTSD. On the contrary I loathe this disease with all my being. I am thankful that I have a place to go talk about it and it can be seen by anyone who wants to read it. I hope this message reaches you. I know your in Public Safety and being affected by the atrocities you see is perceived as a weakness somehow. I want you to know you are not alone. I realized now that I have had these issues for awhile. Sometimes it's my fall, other times it's that SIDS baby or the pediatric full arrest or the dead husband that I couldn't help and had to break that news to his wife on Christmas morning. Yes, we all deal with it. I have just chosen to stand up and say I am a Paramedic, I am an Amputee, I am a PTSD sufferer, and this is OK.


If this is you, if you want to talk I am available. You can contact me via my email at ProstheticMedic@gmail.com You have complete and total privacy. No one and I mean NO ONE you do not want to know will no. I promise I won't say a word. I care about you and all my readers. Weather you are an amputee, member of public safety, or just a normal person feel free to reach out. Someone is here who is willing to listen.

Until Next Time.

PM

Saturday, April 12, 2014

Hosting an AMA on Reddit

I'm doing an AMA on Reddit right now...come on and join in. If it doesn't take off I may try again later tonight!

Prosthetic Medic

Friday, March 28, 2014

The Amputee Interface

One lesson I have learned as an amputee is that no matter how great the technology in your prosthetic; be it a myoelectric hand, a microprocessor knee, or a bionic ankle, that tech is completely useless without a proper interface. In the case of amputees I'm talking the socket. For the uninitiated, the socket is the part of the prosthetic that the limb goes into. There are several different methods of attaching the socket to the body, but all of them have one thing in common; if it doesn't fit right it doesn't work. Currently, I have been waiting over 6 months for my socket. When it finally arrived and was put together it was 6 months and 30 pounds too late. It no longer fit. When I put it on my leg went straight to the bottom of the socket, appropriately called "bottoming out." This is when your residual femur makes contact with the bottom of the inside of the socket. This is pain that is difficult at best to describe. The best I can approximate the feeling is like the worst toothache you have ever experienced, only inside your femur.

What makes socket fittings so difficult is that they are entirely dependent on the patient's weight, activity level, and individual body chemistry (do they swell or do they shrink throughout the day). This means that you can't just run down to the local mega mart and pick one up. They have to be tailored to each individual. That is the frustration. If you gain weight or lose weight you have to start the process all over. Ask any amputee, we live and die by our sockets. Yes, we all long for the latest and greatest prosthetic, but we mourn the loss of a great socket.

A great example is the current bilateral below knee amputee on "Dancing with the Stars" Amy Purdy. Yes, she has some great prosthetic feet, but I'm more impressed with the fit of her sockets. They fit like they belong on her leg. They don't look like an awkward juxtaposition. They smoothly transition from her leg into her prosthetic. This is how a socket should fit. This is the goal every amputee who wears a prosthetic strives for. The technology is out, there are new sockets available. The trick is finding a prosthetist who is willing to learn new techniques.

As for me, I had to go to the prosthetic office again today and make yet another adjustment to my new socket. That leaves me in my ill fitting and painful socket for a few more days. While it is painful and I can't wait to get the new one; I'm thankful that I have the opportunity to try new tech and speak out on a problem that exists in every facet of amputee life. No matter what body part you no longer have, we all need the interface technology to catch up with that of our prosthetics.


FYI...For you lower limb amputees out there check out these sockets.

RevoLimb
High Fidelity
MAS

Till next time..

PM

Tuesday, March 25, 2014

A Call to Arms!

This is a call to arms. To everyone in a public safety field. To everyone who has a loved one who has been ill. To everyone who can help. 

Picture this scenario:
You arrive on scene of yet another run, inside you find an elderly man lying bed, weak and frail. He is covered in God knows how many days of his own filth. You and your partner go to move him from his bed to the cot when you feel something on your forearm...great, you think, I just got his nastiness on me, I'll wash it off with some hand sanitizer in the truck.

Days, Months, possibly Years pass, you notice yourself getting sick, you are smart enough to see the jaundice in the mirror. You head to your local ER and find that you have Hepatitis C, your mind flashes back to that elderly and frail man, at the ER they told you he had Hep C, you ran the tests, took the drugs, but it wasn't enough. Now your only hope is a liver transplant, but Workers Comp says you don't qualify and you have long since been forced into a medical retirement. Where do you turn now?

This story is very similar to what happened to Joe Tomaso. Now Joe needs our help, our brother is reaching out in his time of need and we need to reach back. I'm asking for whatever you can give, be it money, a kind word, or spreading the word about this fundraiser. Let's rally around our own. Please spread the word



This is a scenario that is possible in anyone's lives, not just EMS. How many times do you pay attention to the small scratches and cuts on your arms? How many times have you found blood or another fluid on your work pants, shirt, boots, gear? Please consider reaching out and showing support to a real world hero. 

www.gofundme.com%2F7q0fs8&h=tAQEATTS9

Sunday, March 2, 2014

Yes It's Painful; but It's Worth It

Fear. Fear is a commonality among all us carbon based lifeforms with a sentient brain. Tonight I have been writing on my (hopefully soon to be done and released) book. I started remembering when I first started having the nightmares associated with PTSD and could feel the fear start to build up inside me. As the fear built, I had a flashback of some sage advice Kate gave to me after I woke her up thrashing my way through another nightmare. Here's is an excerpt from this section of the book. I thought it was appropriate for you guys to read.

{It was during these moments of doubt that I first started having flashbacks of my fall and the subsequent hours afterwards. I would have flashes of memory, hear myself begging Kate not to let them amputate my leg. Flash again, and I can feel the splash of the cold spray of water ricocheting off of the rocks at the bottom of the falls, I look down to see my mangled appendage and start to feel the burn in my ankle where the skin had burst open with the rotational force of my toes spinning 180ยบ to where my heel once held residence. Then as quickly as they started, they would end. Leaving me in a panic; sweating, heart racing, trying desperately  to catch my breath that is just out of reach. This only concreted my doubts in my mind. I begged to keep it; now I want them to remove it? It doesn't make sense. As I am going down this rabbit hole of doubt and despair, Kate would anchor me back into the real world. The most poignant moment took place late one night; close to New Years. We were both sound asleep when I found myself grasping that branch; dangling off the edge of the waterfall. I look to see Chase's face and terror written on it. Without warning the branch gives way and I wake up in a cold sweat, my fight or flight senses running overtime attempting to take control of a situation that occurred months prior. I woke Kate up with my thrashing. This had become common place as my mind attempted to stitch together the events I had unconsciously blocked out. She whispered softly to me that I was O.K. It was a dream, and I am safe at home. She asked me why I thought I started having these panic attacks after meeting with Dr Ross, and I had no answer for her. She continued on to tell me of some of her worse days in Baghdad, Iraq. Kate is a sufferer of PTSD as well. She lived the life that most people will never experience, and that is a blessing. We had told each other our horrific stories of patients we have cared for, but this was different. It was a different level of intimacy that I wasn't prepared for. She told me that the reason I'm suffering from these attacks now is because there is an end to my suffering in sight. In order to prepare for the closing call of this unfortunate act in the play of my life, my brain had to get the events in order. Yes, it's going to be painful, but it is going to be worth it.}


That last line. That is some of the most concrete truths that I have ever had told to me. Life is painful (at times), but it is worth it. Anything I have ever decided to do, if it was going to be worthwhile, it was a fight to achieve. Becoming a paramedic was painful; aside from the seemingly unending clinicals and ride time; during that time my marriage ended, my son was taken hundreds of miles away from me, and I felt like I had hit rock bottom. Yet, looking back, the decision to become a medic led to that marriages end, which led to Kate being in my life. It was painful, but it was worth it. 
I can say the same about becoming an amputee. This has been the single most terrifying time in my life. I have lived years in uncertainty. I have dealt with setback after setback. I have lost so much...and I would do it all again. I lost my leg and gained my meaning in this life. I am meant to serve as an example, an advocate, or as the fine people at Stanford dubbed me "persistently disruptive but in a good way." I lost a part of my body in order to gain a better understanding of what it means to be a patient. I have treated thousands of people in my career, but I had never taken into consideration what it meant to be a patient. Now, I have a profound respect for the "other side" of medicine. The fear, the doubt, the anguish of the unknown. Yet I know now that It is going to be painful; but it is going to be worth it!

Thursday, February 27, 2014

The words I hate

Can't. Can Not. Impossible. Not feasible. Unlikely. These are all words that as an amputee I have grown to hate. Once you have a limb removed society has an entire list of things that you "can't" do. Ask an amputee, I assure you they have a list of things they can no longer do. Not because they don't want to, but because it has been told to them that they can't.

I bring this up because I've been doing a lot of research on the upcoming Paralympic Games. I'm lucky enough to know a dual paralympian; she is an olympic rower (who won the bronze medal) and this March, competing in the biathlon in Sochi. She is also a bilateral above knee amputee. Can't isn't in her vocabulary. Luckily for her, it wasn't in her families dictionary either. This is the difference maker. Do the people you surround yourself with fill you with doubt or with support? I've been blessed enough to have an army of supporters. I was also raised to believe that anything was possible. My stepfather beat the phrase "Can't never could no nothing" into my head. Aside from giving you grammer nazi's a heart attack, it meant that if I said I can't do something, it just meant it was hard and I didn't want to. Like Yoda said, Do or Do Not, there is no try. That has become part of my core philosophy. I have realized that being an amputee just requires me to take alternate paths to the same goals. It may take me longer, I may have set backs, and I will get frustrated. That's allowed, you can get upset, you can get mad, you can throw a pity party and wonder why me?, but quitting is not an option. Have your moment, then dust off and get back to work.

This is where I am at now, I've had my set backs, I'm ready to dust off and get back to work. With my new socket finally being framed, and set to be delivered, I have a new breath of air. I'm hopeful for the future. I'm not sure where I will land, I'm not sure what I'm going to do, but that's the exciting part. I have an open road ahead and with Kate and the kids by my side I'm ready for a new adventure to begin.