Stanford Speech and Steampunk Prosthetics

If you missed it, above is the link to my Ignite Speech and QA at Stanford Medicine X's School for Design Course. David Ruthven and I had the opportunity to speak about Designing for the Physical Environment. I focused my ignite speech on Prosthetic design. The biggest problem is lack of Patient Centered Designs. For a refresher:

Patient Centered Designs are generally customizable and retain some patient individuality. In the Prosthetic world you need to look no further than the Socket. The patient interface that connects to the prosthesis itself. These are designed for each patient, molded to fit their limb, and often some form of individual design added to make it feel like "mine." As an example:

      

 This is my first socket. Notice the "Jackass Jolly Roger" a great way to individualize a socket

In Contrast, the prosthetic itself is a cookie cutter design that is the same for each patient. No options on colors or exterior design. Otto Bock has helped with making the individual settings customizable to speed up or slow down, add resistance or take it away, or preset settings for specific sports and activities. However, for appearance you, have no options. 

Until Now...I was forced to eat my words by the guys at Digital EFX Wraps 

( http://www.digitalefxwraps.com ) 

They have taken the idea of wrapping a car with a vinyl design and applied to prosthetics. I am the second person to have the opportunity to have my prosthetic customized to a design I chose. I went for an Industrial/Steampunk look. It fits my personality...the great part is they can do anything. I've already been dreaming up my next cover, probably a mixture of anatomy and machine.

I'm so excited at what this will do for amputees and bringing amputation to the forefront of peoples minds. I love that my prosthetic is a piece of art. Let me know what you think. If you want one...message me and I'll get you in contact with Dallas at Digital EFX. Lets get this viral...spread the word!!!

Dancing with the Amputee Star...

I've avoided watching Dancing with the Stars. I have successfully avoided watching not only this season, but most seasons. Sure, I've seen an episode here and there, but for the most part, I'm simply not interested. That being said, tonight there's not much to watch and I found myself watching Amy Purdy's dance. She was amazing, for those who aren't familiar. Amy Purdy is a Paraolympian Snow Boarder who happens to be a bilateral below knee amputee. What struck me the most was the buildup to her dancing, and her decision to perform the quick-step with her "blades." Blades are the running legs most people are familiar with seeing, and for some reason the image most people associate with prosthetics.

Amy Purdy on "Cheetah" running blades



What I noticed is that she had several other pairs of prosthetic feet to choose from, in addition to the running blades. I realize that she is a gold medal winning Olympian and has several sponsors who are willing to pay for these prosthesis. I found myself getting upset. No, not upset, down right mad. Not at Amy Purdy, mind you, at the fact that in order to receive the prosthesis you need to live you have to either 1.)Be independently wealthy, 2.) Be extraordinary and have sponsors who want you to wear their prosthesis, 3.) Fight tooth and nail with insurance companies to "maybe" get a prosthetic...not the best one to let you live life again, no just a prosthetic.

I nearly found myself in the 3rd category, but thanks to those of you who read this blog, and, as I was described by Dr Larry Chu at Stanford Medicine X, being persistently disruptive for a positive change in the amputee community, I was able to pressure an insurance company into covering a prosthetic they deemed "Experimental." By the way, Experimental is an insurance term for prosthetic technology that has been around since the 1990's, being the microprocessor controlled prosthesis. There are nearly 2 million people with some sort of limb loss currently, not everyone of these amputees would benefit from this technology, but for those that would, it is a life changing prosthetic.

Imagine this...for an insurance premium of around 5 cents per person, microprocessor controlled prosthesis would be covered for those who meet the standard. That would be possibly hundreds of thousands of people able to return to a more active lifestyle and many of them would return to work.

Now for contrast, lets apply insurance companies logic to other areas of healthcare. Could you imagine an insurance company denying a pacemaker that a cardiologist wants to implant? How about denying the hardware for a hip replacement? Yes, these happen in rare occasions, but under normal circumstance these devices are implanted and covered. Now, realize that these are also prosthetics. A pacemaker is a prosthetic that assumes the function that the heart has lost the ability to perform, a hip replacement places a prosthetic ball and socket joint that resumes function of a joint that lost it's ability to perform the normal function. Now, why does implantation inside the body make these more important than a hand, knee, ankle, or other prosthetic device? I wish I had an answer...that's why we need Insurance Fairness for Amputees.

Oh well,

I will step down off of my soap box for tonight and hope this has given you something to consider.


Until Next Time ...PM

Happy Anniversary!!!!

Yesterday was the 3 year anniversary of my life changing fall. This week has seen a spike in my anxiety, while it has been rough, it was not unexpected. I have experienced the same problems for the past 2 years, so the increase in symptoms this year, while unexpected, were not preventable. The amazing part was that, on the actual day of the fall, I had a wonderful day. This is due to Kate and I celebrating our 1 year wedding anniversary. We made the decision to change the outlook of that terrible day into a very positive one, and I must say...it worked.

On to the updates,

I had the wonderful opportunity to speak to the Moving Forward Limb Loss support group a few weeks ago. It was a wonderful experience and I look forward to further meetings with those wonderful people. You can watch the speech here Moving Forward Speech

I spoke about one of my least favorite cliches..."Playing the hand you're dealt." We all have heard this euphemism before. A negative event happens, and inevitably you're met with at least one person telling you to play the hand you're dealt. I happen to disagree strongly with this though process. Playing the hand your dealt, leaves you in the situation. I say, instead of playing the hand you're dealt, why not change your cards. Life is not a poker game, No, life is more a game of Go Fish. You can ask your neighbor for help, and luckily, you can help your neighbor as well. Playing the hand you're dealt would have left me with a fused knee and ankle, and miserable.

In a few weeks, I will be travelling to Stanford University to speak to the School of Medicine. I will be giving an Ignite! style speech with a power point to back up my points. I will be posting a video of this once it's available.

I am happy to say that, while I'm not where I want to be in life, I am finally optimistic again. It has taken 3 years, but I feel like I'm finally getting back to who I am. I have finally mourned my loss of both my leg and previous identity. I have came out on the other side with a determination I wasn't aware I was capable of...I now understand the battles I have been through will be platform I stand on to help others either get through their battles or avoid them completely.

I'll be updating again soon,

Until next time.

PM

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

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

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

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