End of Year Benefit and Scheduling Planning

This is question that comes up close to the end of the year, so we thought it was worth reposting.

QUESTION:

Hello, with the holiday season quickly approaching and winter just around the corner, I’m concerned my prosthesis will need repair or I will need supplies and I might not be able to get an appointment.  Do you have any recommendations to ease my concerns?

 - Peyton K.

ANSWER:

We certainly understand your concerns, Peyton, and highly recommend scheduling an appointment with your practitioner prior to the holiday season and end of the year.  Many insurance policies renew January 1st, which may translate into your annual deductibles and out of pocket costs starting all over again.  This is something you certainly want to keep in mind as the end of the year approaches.  We are more than happy to review your benefits and provide you with the anticipated cost difference for services you receive prior to January 1st compared to after January 1st.  Just give us a call and one of our patient service coordinators will be happy to verify your benefits and answer your insurance questions.  In most cases, receiving repair to or supplies for your prosthesis prior to the end of the year will help keep cash in your pocket!  Make your appointment now for November or December.   We look forward to hearing from you soon!

 - Kristin Boswell, Director of Patient Services and Billing

 

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

What is 3D printing about in O&P?

QUESTION: 

I keep hearing about 3D printing in orthotics and prosthetics. How does that work?  - Paul W.

ANSWER:

Paul, what a great question! This is a very exciting time for 3D printing in Orthotics and Prosthetics and one of our favorite subjects.

The start of 3D printing
Most people think that 3D printing is relatively new. The truth is that it was started in 1980 when Hideo Kodama first described a layer by layer approach to manufacturing. About four years later a French team filed a patent for the stereolithography process (later to be re-named as 3D printing). They later abandoned their efforts, saying they just couldn’t find a viable market for this process. At about the same time, Chuck Hull filed his own patent for a stereolithography fabrication system. Through the ’80s, with much work and experimenting, 3D printing moved from its infancy and childhood to its adolescence. Though there are certainly others, three main printing methods have emerged: SLA - which uses a photo-sensitive liquid polymer; SLS - fuses material in a powder form; and FDM - deposits heated filament on a build plate to create objects layer by layer.

3D printing and prosthetics
One of the things that make 3D printing so appealing is the possibility to design, alter and customize objects. This has led to manufacturers using it to create prototypes in a much more efficient and timely manner. In the world of prosthetics almost everything is custom built for an individual patient - making 3D printing a very useful tool. 

In the last decade, groups like e-NABLE began creating, through open-source collaborations, hands for people who were missing fingers. This has sparked the hope for customizable, lower-cost prosthetic devices.

Often when a prosthetic leg is made, the patient wants a shape that resembles a real leg. This is most often done by encasing the metal tube that connects the foot to the rest of the socket with a foam material and sanding it to a leg shape. It can then be covered with a stocking or an artificial skin. This is known as a cosmetic cover. 3D printing has given rise to a market for personalized cosmetic covers for patients who aren’t as interested in natural-looking devices or really want to have an artistic way to express themselves.  

Dankmeyer’s involvement in 3D printing
Dankmeyer began their adventure in 3D printing in 2013 with the purchase of their first printer. Several people began the process of learning to design 3D objects as well as run the printer. That year also saw a number of staff members participated in an e-NABLE sponsored event where a number of pre-printed hands were assembled. 

The first real foray into creating a 3D device was for a patient who was less than pleased with the prospect of needing to wear a “traditional” prosthetic hand. We designed and produced an Ironman-inspired hand for him. The movie was in the theaters at the time and he was definitely a fan. We later made him a Batman version as well.

The next hand we produced was for a baby born with a defect to his right hand. He was beginning to crawl and his parents thought it was important for him to become used to wearing a prosthetic early enough that it would just be normal as he grew up. You can read more about this device and see pictures on our 3D Printing page. Click here.

If you are interested in seeing a video we made as an introduction to 3D printing, just click on the video link below.


Thank you for your question!  - Art Ross and Shawn Ross, Fabrication Technicians

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com

Back to Class with Orthotic and Prosthetic Devices

This is an encore posting of some Back to Class questions!

We have three questions about returning to school with orthotic and/or prosthetic devices.

QUESTION: 

The start of school is approaching and I am about to start my back to school shopping.   I wear both a prosthesis and an Ankle Foot Orthosis.  Is there anything I should be aware of for my brace or prosthesis?  - Tammy V

ANSWER:

Hi Tammy,

Before going back to school, it is a good idea to do a thorough inspection of your orthosis and prosthesis.  If there are any cracks, creaks or abnormal movements with either device be sure to schedule an appointment with your orthotist or prosthetist to have the devices checked out.   Also, if any of your liners, socks, sleeves, straps or buckles are ready to be replaced, it is better to schedule an appointment before school starts.  This way you won’t miss any classes.

As for your personal shopping, it is important to pay attention to what shoes you purchase for both your prosthesis and orthosis.  Typically, with an AFO we recommend that patients purchase shoes ½ size longer.  It may also be important to purchase a wide shoe in order to fit the device into the shoe.   For both your AFO and prosthesis, it is important that the new shoes also have similar heel heights to the shoes you brought to your most recent appointment with your orthotist or prosthetist.  

QUESTION: 

I want to try out for a school sport this fall.  As a below knee amputee and prosthetic user is there anything specific I should know before trying a sport and are there any restrictions?  - Derek Z

ANSWER:

Hi Derek,

We never want a prosthesis to limit a person’s potential activities.  We have patients who play or have played many of the common fall sports, such as football, soccer, volleyball, cross country and more!  That being said, here are some things to think about when starting a new sport.  1) Before going through a large change in activity levels it is always a good idea to contact your prosthetist.  Different prosthesis setups are intended for different levels of activity.  If your current prosthesis was not built with the expectation of high activity it has a higher chance of malfunctioning or holding you back.   2)  In whichever sport you decide to participate, it is important that you regularly inspect your residual limb for wounds or bruising.  Especially in the beginning, new, unfamiliar movements can change how your limb contacts the prosthesis.  Changes can be made to your prosthetic socket if this becomes an issue.   3) Be ready to sweat!  Prosthetic users almost always deal with the issue of sweating in their socket/liner.  With increased activity, it is very normal and expected.  It may be helpful to remove your prosthesis during breaks in play in order to air out your limb.  Bring extra prosthetic socks to practice and games.   As you sweat the size of your limb may shrink throughout the day, if this is the case, socks can help improve the fit and can assist in preventing unwanted limb movement within the socket.  Also clean your socket and liners daily.  Mild soap a damp cloth and rubbing alcohol can help with personal hygiene, component longevity and odor!  4) Have fun!  

QUESTION:

I am a fairly new above knee amputee.  My limb is very sensitive and I struggle to wear my prosthesis for more than a couple hours at a time.  Any recommendations to help get me through a day of school?  -  Julia D

ANSWER:

Hi Julia,    

Never feel like you have to keep your leg on during an entire school day.  It is common for amputees, especially new amputees, to limit the wear time of their prosthesis.  Schools want to help students who may need accommodations, so rather than struggle, take your time and do what you need to get through the days.  Talk to your prosthetist about writing a schedule down to help you gradually increase your tolerance.  Bring your prosthetist’s recommendations and contact information with you to school. Speak with your school counselor and ask for a meeting with your parents, teachers and the school nurse about your necessity to take breaks with the prosthesis throughout the day.  Your school will help you develop a plan that works for your needs and they can call your prosthetist if they have questions.

We also recommend that you do some work to help desensitize the limb.  First, become aware of issues that create stress for you. Trying to control stress is very important.  Relaxation techniques have been shown to significantly help with residual limb pain.  A second recommendation would be to start desensitizing exercises.  A common exercise is to lightly touch and rub hypersensitive areas of your limb with different textured materials. At first the materials should be extremely smooth and soft, for example silk.  You can do this for about 2-5 minutes, or to your tolerance, several times per day.  Once your limb can handle the silk material you can gradually use more coarse materials.  A common progression in material would be silk, cotton, corduroy, then wool.  If there are any open wounds on your limb do not rub it with any material. Never hesitate to give us a call if you have questions.

Thank you all for your questions!  

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

How often should I follow-up with my practitioner?

QUESTION:

How often should I follow-up with my practitioner?

Nancy W.

ANSWER:

In general, when you have any skin problems (for example, redness that does not go away in 20-30 minutes after using your orthosis or prosthesis) or pain while using your prosthesis or orthosis, you should follow-up with your practitioner. If you notice that your device is not functioning properly (ankle joints not operating well, prosthetic knee is not bending appropriately) we also recommend that you call and follow-up with us.

Prosthetics

If your prosthesis is fitting and working well, it is still a good idea to come in about every 6 months. We can inspect your prosthesis for signs of wear as well as look at your liners, sleeves, and socks to make sure they are in optimal condition for use with your prosthesis. It's a great idea to follow-up with us regularly so we can catch any problems early.  At the beginning of the process, when you first receive your prosthesis, we may see you more regularly for follow-up, as your limb may be changing quickly. However, over time these changes usually slow down and less frequent follow-ups may be more appropriate. We will normally call you to follow-up with you about every 6 months to see how you are doing.

Orthotics

We recommend an annual follow-up for orthoses. This is especially important if you have an orthosis that uses ankle or knee joints that may need maintenance or replacement. We will normally call you once a year to check in and see how you are doing. 

In all cases, if something does not fit or function well, please contact our office at 410-636-8114. We may be able to resolve issues over the phone, and if not we look forward to seeing you in our office!

Thanks for your question! - Nina Bondre, CPO

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

 

What kind of education does my practitioner have?

QUESTION:

What kind of education does my practitioner have?

Kevin B.

ANSWER:

Many people do not know about the education involved with becoming a Certified Prosthetist or Orthotist, as our field is fairly small. This is a common question our patients ask of their practitioners.

The education level for prosthetics and orthotics was raised in 2012 to a master's degree. Prior to 2012, practitioners would complete their bachelor's degree in a major of their choice, and then complete a separate certificate for orthotics and prosthetics. Now, there are no certificate programs available. The only route to become a practitioner is to complete a Master of Orthotics and Prosthetics program.

Once the master's degree is completed, a clinical residency must be completed. Residents can opt to focus on one discipline at a time for 12 months each, or do both orthotics and prosthetics together over the span of 18 months. During residency, residents work under the guidance of the clinical director and clinical mentors to learn patient care, proper documentation, and fabrication techniques. Following the successful completion of the residency, residents then take their board exams.

There are three exams per discipline. One exam per discipline is a clinical exam that takes place in Florida, where candidates are evaluated on their patient care skills and knowledge. After the candidate passes all of the exams, he or she is then bestowed the title of Certified Prosthetist Orthotist (CPO). Practitioners continue to hone their skills after the exams for the rest of their career by completing continuing education through conferences and courses.

Dankmeyer's practitioners have completed education programs all over the country!  You can read about each individual and their education journey on our Clinical Staff page.

Thanks for your question! - Nina Bondre, CPO

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.