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Globetrotting with a Prosthesis

Brian Donnellan has always been active, but two years ago he was hit with the news that his leg would need to be amputated below the knee. Over the past two years he has been partnering with Abilities In Motion to achieve his goals of an active lifestyle. 

This past month, Brian took a two week European trip with stops in Ireland and Italy. “This was the best trip ever, because I got to do everything that I wanted to do,” said Brian. He also shared some pro tips with us about traveling with a prosthesis:

  1. GET A TUNE UP. A few weeks before traveling, Brian made an appointment to see the experts at Abilities In Motion. They were able to check his prosthesis and were able to make adjustments before he traveled. Brian was also fitted with a swim leg*, which is a secondary device that is waterproof. This helped Brian use smaller showers that are typical when traveling internationally. 
  2. GIVE YOURSELF EXTRA TIME AT TSA. We have all been told to arrive early and allow extra time to get through security, but this is especially true when wearing a medical device. Brian strongly recommends using the handicap line when going through TSA. Brian also chose to wear shorts to make inspecting his leg easier. 
  3. CHECK AN EXTRA BAG. According to Air Carrier Access Act (ACAA), a suitcase that contains only “assistive devices” are exempt from checked bag fees. You will want to notify the agent that your bag contains such equipment and will likely be asked to open the bag to verify its contents. Remember, baggage can be misrouted or lost during travel, so it is important to make sure you carry on your most important equipment and supplies. 
  4. ASK FOR EXTRA LEG ROOM. Brian asked his airline for extra leg room to help accommodate his prosthesis. The airline responded to his request, and because he was comfortable assisting in the event of an emergency, this allowed him to sit in an exit row. During a longer flight, this extra room can be invaluable. 

During his trip, Brian was able to enjoy the Cliffs of Moher. “I felt comfortable the entire time. My wife was a little concerned that I was standing on a 1,000 foot cliff, but it was easy,” says Brian. He was also able to walk though the Coliseum in Rome and walked for miles on his trip.

“I just proved to myself that I can do whatever I want to do, and nothing is holding me back now.”

HEAR THE INTERVIEW HERE:

Please note, the information contained in this post is based on this individual’s experience. Individual situations vary. We recommend that you do your own research to fully comply with TSA and airline policies and restrictions. 

Additional Information from TSA:

EXTERNAL MEDICAL DEVICES:
https://www.tsa.gov/travel/security-screening/whatcanibring/items/external-medical-devices

DOT, Guide: Air Travelers with Developmental Disabilities:
https://www.transportation.gov/sites/dot.gov/files/docs/Developmental_Disabilities_Guide_0.pdf

*Swim Leg: Standard prosthetic legs are not able to be exposed to water because of some components are not waterproof. Swim legs are designed for swimming, bathing and other aquatic activities. They are typically not covered by insurance, but Abilities In Motion works to help accommodate patients with affordable solutions when necessary. 

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Students Gain Hands On Experience

Students Gain Hands On Experience

The Physical Therapy Assistant program at the University of Cincinnati, Clermont gained valuable, hands on experience today at Premiere Physical Therapy and Abilities in Motion.

Carolyn Shisler, who leads the program at UC, Clermont said that this experience gives future physical therapist assistants the opportunity to hear stories and ask questions to recent and veteran amputees. “They are real people and students are able to hear their story and empathize with their life situation. Our students get to see the person and not the diagnosis,” said Shisler.

Caitlin Rausch participates with PT Training

Caitlin Rausch is a student at UC, Claremont and she echoed those feelings. “It’s so different than being in the classroom. There, you don’t get to see patients and hear their backgrounds”.

Students heard an hour long presentation from experts and then broke into smaller groups to see demonstrations and interact with patients. The patients participating in the program had below knee, above knee and bilateral leg amputations. Each had different experiences that informed students and each saw this as an opportunity to invest in the future.

Andy Beardslee is the PT director at Premiere Physical Therapy and he understands the value of these types of experiences. “Many times, new students are apprehensive when meeting with amputees. They may have a fear of saying the wrong thing and this experience gives them a change to get comfortable with real people.”

Jay Estoquia is a resident at Abilities In Motion

Students would be hard pressed to find a better environment for this type of learning as Premier Physical Therapy is the regions leader in working with amputee patients. Their partnership with Abilities In Motion allows a patient to meet with their prosthetist and physical therapist all in same visit.

Shisler summed up the experience this way, “PTAs work in many different areas of physical therapy, Amputees are one facet of the field. It’s important that they are able to work with people and help them reach their full potential.”

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Get Moving!

Bob Haggard serves as an active reserve in the US Army. As a typi- cal 23 year old, he enjoys many high energy, outdoor activities such as cycling and running.

In January of 2012, Bob was involved in an automobile acci- dent. Due to his accident Bob had his right knee fused in slight flexion.

This caused difficulty sitting in tight spaces, such as bleachers at sporting events. He has had multiple surgeries to his elbows, as well as amputa- tions of fingers and thumb of his right hand. Bob continued to have pain in his left knee and limited range of motion in his left ankle.

In April of 2013, Bob decided to undergo an above knee amputation on his right leg. This was a big decision, but one that he felt was right for him. On June 6, 2013 we fitted Bob with his above the knee prosthesis.

Bob’s rehab has gone very well. He quickly learned to walk without assistance. With his youth, strength and agility working in his favor, he even taught himself to run.

Bob’s next goal is to be able to cycle. As seen in the photo, he has converted his bike into a stationary unit. This allows him to learn how to

balance and pe- dal safely before hitting the trails.

His prosthetic knee has the option of turning off the stance resistance and functioning in a free swinging mode.

We can certainly say as far as Bob is concerned, he is definitely moving forward!

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Gerald Evans

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Gerald Evans is a basketball man. Simply put, he loves the sport. A keen player for many years, Gerald has been talking about it since we first met him.

Gerald has been playing basketball all his life, starting with playing on youth teams. He also played for Woodward High School and started as a center.

In his college years, Gerald continued to play ball. He started for two years as a forward for Cincinnati State University.

He went on to play many years of pick up games after he finished college. Gerald would often play several times a week.

When we began his rehabilitation from his amputation, basketball was always part of the conversation.

At first he would joke about getting his jump shot back. This was when he was getting measured for his first prosthesis.

After fitting him with his initial prosthesis which included a highly efficient energy storing foot, Gerald quickly transitioned to a cane, then walking without assistance in just a couple of months.

Gerald keeps himself in shape at home using a treadmill, which he uses daily.

More recently, he was fit with an elevated vacuum system, which provides greater control of the prosthesis. This system has really helped Gerald on the court. He has been working hard with the new prosthesis on perfecting his jump shot. He told us that the new system has really helped with the control needed to jog around the court and to jump in the air without having to worry about the landing.

So with the jump shot now perfected, there is just the matter of working on the slam dunk!

When we asked Gerald if this was a goal of his, he replied,

“It’s been many years since I last did that! Maybe it’s something to look forward to, but not today.”

Keep up the great work Gerald. Once you get that slam dunk down, you’ll be ready to play a little one on one against Tom!

Benefit Questions

Although most people know about Social Security retirement benefits, far fewer know that people with disabilities—those who can no longer work because of injury or illness—may also qualify for Social Security benefits, regardless of their age. The process of obtaining such benefits can be confusing and as a result there are many misunderstandings. Here are a couple of myths explained from the inMotion Magazine May Edition.

1. If I am disabled, it is easy to obtain disability benefits.
Actually it can be a difficult and frustrating procedure. Initially you must be interviewed either in person or via phone. The majority of applicants are turned down upon initial application. However chances of approval increase when you file an appeal, which can take differing forms in each state.

2. Disability benefits and Medicare benefits are unrelated.
Once you have received disability benefits for 24 months, you qualify for Medicare benefits, regardless of age. The rules for disability are complicated, and you should seek assistance to determine whether you are eligible for benefits and to assist you in applying for them.

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Jan Beckemeyer

Jan Beckemeyer first came to AIM in August of 2005, for a consultation considering a below knee amputation. She had been through multiple surgeries after a motorcycle accident, which resulted in an artificial ankle. She had continued pain which was not improving, and it had become increasingly difficult to function.

Jan is very active and was considering an ankle fusion or an amputation. After speaking with her surgeon, Tom Walsh, and several of AIM’s patient advocates, she decided to undergo a below knee amputation on September 21st 2005. She remarked, “at some point you get to the stage where you have to decide if you want to continue a life of pain, or take a chance on another way. I knew there was a chance that I may not get all that I was looking for, but I was willing to take the chance, and for me it has worked out really well”. Together with her husband, Ron, a retired engineer, they discussed the pros and cons and educated themselves on what was ahead.

Jan was initially fitted with an Immediate Post Operative Prosthesis, which allowed for early ambulation. She experienced some phantom pain, but otherwise healed very well. By mid October she was fitted with a prosthesis and started the road to rehabilitation.

Within a month Jan had moved from a walker to a single cane, and shortly after Jan was walking unassisted. She progressed quickly and soon began researching different feet to compliment her active lifestyle. Working as a surgical technician meant standing for long periods in flat shoes, while her social life demanded higher heel shoes.

Jan volunteered to participate in some product development trials with a local manufacturer and AIM. Together an ankle which allowed adaptation of heel height change and dynamic movement was developed. Jan continues to help with this products next stage of development.

Jan has joined the team of patient advocates that AIM has to assist new patients with educating themselves on prosthetic issues from a patient perspective. She is also active in statewide patient avocation. She is working with Tom and others in the state to ask the Ohio legislator to pass a Prosthetic Parity law, which would require insurance companies to cover prosthetics under the same rules as Medicare.

Jan has returned to her summer activities of boating and frequently visits the lake with friends and family. AIM designed an Aqualimb for her so that she could return to water activities and also use the shower.

Jan has a fantastic attitude and outlook, which coupled with her sense of humor, has helped her transition back to a full and active lifestyle. The adjustable heel ankle has allowed Jan to use a large variety of shoes for all occasions. Which is just as well as Jan has many, many shoes.
A fact she proved when asked to bring a selection of shoes to an appointment, we heard the beeping of the truck backing up! Of course Jan said she only brought a small selection!

New Technology

We are a certified facility for not only the latest in microprocessor knee units but also for the newest generation of elevated vacuum sockets.

Ohio Willow Wood’s Limb Logic system, enables the patient to have control over the amount of vacuum applied through a remote control. The vacuum pump is located in the build of the prosthesis below the socket. It is charged each night just like a cell phone.

The device adds approximately 0.4 lbs of weight to the prosthesis and utilizes an additional sleeve on the outside of the socket to create a seal. There is also additional maintenance to be considered when choosing such a device. However, users have reported significant increase in the feeling of security and comfort.

Don McKenzie has been a wearer of traditional non-pin vacuum systems for many years. He recently was fitted with the Limb Logic system. Don commented, “this exceeded my expectations for comfort, it is by far the most comfortable system I have ever had”.

Call us for more information if this system interests you. (513) 245-0253

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Amputees Meet State Representative

Tom Walsh, Amputees Meets State Representative to Discuss Amputee Insurance Protection Legislation

August 22nd, State Representative James Raussen, (R – Springdale) visited Abilities In Motion’s White Oak office to discuss insurance protection. Prosthetic insurance protection is a subject close to Tom’s heart. Tom is a leading figure in the drive to have Ohio State legislature pass a bill that would require ALL coverage of prosthetics to be equivalent to that of Medicare guidelines.

In recent years we have seen an increase in the number of healthcare plans that cap the funding for prosthetic devices. Some of theses caps are annual, some are for lifetime.

For example, some insurance companies have recently begun lifetime prosthetic benefit caps of $2,500 or have limited patients to one prosthesis per lifetime. Other insurers have annual caps as low as $500.

The effects of these caps can be devastating for patients trying to maintain productive, healthy and active lifestyles. Depending on activity level, health changes to the body and age, a lower limb prosthesis usually needs to be replaced every 2 to 5 years.

Some of the large insurance companies, namely Aetna and Anthem have announced changes starting 2007.

These changes will cap prosthetic devices annually at $2,500 in all states other than California, Colorado, New Hampshire and Maine. These states are exempted from the national prosthetic insurance benefit cuts because amputees and prosthetists already worked together to pass legislation in these states to ensure that insurance benefits include adequate coverage for prosthetics. This is the legislation that Tom is trying to get passed to protect the interests of the amputees of Ohio. Other states, New York, Connecticut, Massachusetts, New Jersey, Washington, Alabama and Louisiana have legislation pending.

Representative Raussen was a keen listener and expressed concern for our issues. He made some suggestions concerning how to achieve greater statewide recognition and recommended Health Saving Accounts (HSA) for those that can afford to save.

Amputees have not had vocal national organized advocacy groups that can lobby for their rights, until the Amputee Coalition of America (ACA) mobilized with a support system for regional efforts to pass legislation.

The Colorado legislation is estimated to add just 14 cents per month to the cost of insurance premiums to adequately cover prosthetics state wide.

Options for the disabled on Medicaid are getting worse. Texas for example, dropped Medicaid coverage of prosthetics completely. Other states such as Missouri are debating similar cuts. This seems foolish as Colorado’s figures have shown. The year after passing a law to insure prosthetic coverage for Medicaid, the state of Colorado saved almost $500,000 through decreased medical expenses. This did not even include the savings of getting people back to work and off Medicaid.

If you are interested in helping the push for legislation in Ohio, give us a call and we can help you with letters to state congressional and senate reps. The more support Tom gets from the amputee community in addition to the effort he is leading with his fellow prosthetists statewide, the greater the chance of change being effected.

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How Far Would You Walk For A Friend?

Walk of Hope

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When Larry Robinson found out that his friend and pharmacist, Amy Glaser, had multiple sclerosis, he knew what he had to do.

“I thought that if Amy can’t walk, I’ll walk for her,” he said.

Robinson was one of the 30 members of Amy’s Army taking part in the 5-mile Western-Southern MS Walk at Thomas More College.
The difference between Robinson, 52, and other members of Amy’s Army is that walking poses a challenge for him. In June of last year, he had to have his left leg amputated below the knee.

“I was club-footed when I was born and then, when I was 13, I was playing sandlot football and I shattered my leg. It made a sound like a .22 rifle going off,” he said.

The series of surgeries and constant pain that followed became so difficult to manage that Robinson, a father of three, realized he had to have his lower leg removed. Now he says he walks better than he ever has.

“It’s taken some adjusting. Balance is the hardest thing, but I’ve adapted. I needed to do it for my family and now I’m realizing there’s a life out there. There really is.”

Shortly after his surgery, Robinson met Ken Glaser, Amy’s husband, at St. Mary’s Church in Alexandria.

“Ken told me what Amy was going through. I’d known her for nine years – she was my pharmacist – but I didn’t know she was struggling with MS,” Robinson said.

MS is a chronic, often disabling disease that attacks the central nervous system.

Amy Glaser was diagnosed in 1996.

Robinson said some higher power had a hand in shaping his friendship with Amy.

“I think God wanted us to cross paths like this,” he said.
Amy Glaser did not take part in the walk. She was on the sidelines cheering. for Ken, their three children, and Larry, who took strides for her and others whose lives have been irrevocably changed by MS.

What Does Larry Use?

Larry has a silicone locking liner. This is rolled on his residual limb and has a locking pin in the bottom of it. The pin locks into a locking mechanism in the bottom of the socket portion of the prosthesis, eliminating the need for straps or belts.

The foot on Larry’s prosthesis is a Variflex foot, made by Ossur. It is a carbon fiber spring like foot. The carbon fiber composition allows the foot to be light weight and flexible.

It has energy storing characteristics which stores the energy put into the composite material during heel strike and mid stance and returns that energy at toe off. This allows for a great amount of flexibility and a spring like feeling which helps the wearer do more while using less energy.

Useful Internet Sites

www.oandp.com

www.amputee-coalition.org

www.ossur.com

www.endolite.com

www.ottbockus.com

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A Patient Survey

Below is our panel of patients, we asked a set of questions concerning their expectations and experiences of surgery, being fit with a prosthesis and learning to walk.

 

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Larry Robinson, 51 is a below knee amputee who had surgery in July of thisyear. Larry had elective surgery with the intent of having less pain and increased activity. He had a target of four weeks to be up and walking, and now believes he will be more active than he first thought. He was walking unassisted in just two weeks!

Larry experiences less phantom pain as time goes by and now has some discomfort but no pain. He quickly adapted to his prosthesis and has mastered sock fit with ease. He cites comfort as his favorite part of his prosthesis and would like to get more flexibility from his ankle to aid with his outdoor lifestyle of fishing and hunting. Larry also mentioned that he would like to have a prosthesis that lets his leg stay cooler.

Support/FAQWalter Lickliter, 57 had a right below knee amputation in July of 2004. Walter also has a left partial foot amputation. His main goal before surgery was to improve his balance and begin the process of learning to walk again. Within two weeks of being fit with his prosthesis, Walter said “I am encouraged by my progress from wheel chair to walker. I have not had any pain since just after the surgery”. He learned quickly through experimentation how to use socks to obtain a correct fit and does not feel his prosthesis limits him. “I like the comfort of my prosthesis and just being able to walk again”.

Support/FAQ
Tony Freeman, 50 is an above knee amputee who was fit with his first prosthesis in 1999. He said that after surgery the pain was “excruciating, but now I just have phantom pain that is annoying”. He expected to walk with a cane but after his initial fitting he thought he would have to work harder to be able to walk. Later during rehab, his target was to “just walk as normally as possible”. On the subject of learning the correct fit, “I just let my pain tell me what to do”.

“The thing I like most is my mobility, just being able to walk, although I would like to be able to go up stairs step over step”. Since rehab, Tony now cycles regularly and is able to run. Tony also said he would like a more flexible ankle, some rotation and a lighter prosthesis.

Support/FAQSarah Ammons underwent surgery for a below knee amputation in 2002. Sarah said “I expected to have less pain, as I have a great deal of phantom pain”. She did not expect to be walking unassisted immediately, “I expected a long rehab”. Although undergoing a second surgery earlier this year, she is walking without assistance.

“I am still learning to get the correct fit with socks” says Sarah. I would like to be able to walk longer distances without pain and to be able to go into the ocean. Also as a keen gardener, I would like more flexibility on uneven ground”. She also wanted it to be cooler and lighter.

Support/FAQSam Crosby has a left below knee and a right partial foot amputation. For Sam, a former college quarterback, rehab went very smoothly. “I just expected to be able to walk and I pretty much did. I knew I would be able to walk without crutches”. Sam reported that he never really had any pain and that learning sock fit was easy.

Sam is active, he plays golf and bowls. “I can pretty much do anything I want to”. “My favorite part of my prosthesis is the air pump that acts like a shock absorber”. Some of the improvements Sam wanted to see were a leg for swimming and a machine washable suspension sleeve.

Support/FAQDavid Fischer became an above knee amputee just a few months ago in May. David says he wasn’t really sure what his expectations were prior to surgery as it happened so quickly. He said of his expectations upon receiving his prosthesis “I didn’t expect I would just get up and walk. I had a pretty good idea about the rehab process”. After initial fitting and physical therapy, David says he was more confident of being able to return to normal mobility. He has suffered from some phantom pain “but I’m managing well”.

He quickly learned correct sock fit and gave some thought to the question of things he would like to be able to do. “I would like to be able to stand in the shower”. Like many of our panel, being able to walk is one of his favorite things about his prosthesis. As for improvements he would like to see, he agreed with several members of the panel in wanting to be able to get the leg wet and to have a lighter prosthetic foot.

A note from Tom:
Thanks to our esteemed panel for their time and thoughtful responses. Hopefully our panel’s shared experiences are relatable to most of you.

These comments will only help us to provide better service. We will also relay this information to our component manufacturers to address the needs of the people we serve.

Some of our panel had some questions for us, so we decided to do a little research.

Here are some statistics you may find interesting.

  • Approximately 2 million people are living with the absence of a limb in the U.S.
  • Approximately 40% of amputees are female compared to 60% male.
  • There are 150,000 amputations every year in the U.S. of which 82,000 people are diabetic.
  • 1 out of every 185 people diagnosed with diabetes undergo amputation of a limb.
  • The Midwest is the second highest region in the country for amputation. The South is the highest, followed by the Midwest, then the West with the Northeast being the lowest.
  • There are almost 10 times more below knee amputees than above knee.