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

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

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 180º 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!