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.

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

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.