What am I signing for if I am asked to sign when I leave the office?

3DPO demonstrates the electronic signature pad.

Question:

There are times when I am leaving your office that I'm asked to sign my name on a signature pad.  What am i signing for? - Daniel L.

Answer:

Daniel, this is a great question.  In most cases, you are signing a Proof of Delivery receipt for the item and/or service you received that day.  Proof of Delivery is required in order to verify you received the device(s), repair, adjustment, or supplies.  The document includes:

 

  • Your name
  • The location where the item/service was delivered to you
  • A detailed description of each item delivered to you
  • The quantity
  • The date of delivery
  • Your signature

Proof of Delivery is a Medicare requirement based on their Supplier Standards which states providers must maintain proof of delivery for all items delivered to a patient.  There may also be instances when your insurance company requests confirmation that you received all of the items submitted on the claim.  With your signed Proof of Delivery, the items can be verified and the claim for that service gets paid.  If you would like to see what you’re signing for, please ask us, we will be happy to print you out a copy at any time!

- 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 a personalized lamination?

QUESTION:

I would like to understand what is meant by lamination and in particular what is a personalized lamination?   - Kerry J.

ANSWER:

Hey Kerry!  The quick answer - a personalized lamination is anything other than the traditional colors used for the outside layer of a lamination of a prosthetic leg socket - colors which would match a person’s skin tone.  All laminations are customized for the patient’s individual prosthesis.  Sometimes a patient selects to laminate their socket with a layer in something more personal - something other than a skin tone.

A lamination can consist of a number of different materials layered one on top of the other - from carbon, fiberglass, nylon and Nyglass (a combination of nylon and fiberglass.) These materials are used in different ways and layers to meet each prosthesis wearer’s strength, activity level and weight bearing requirements.  We want the prosthesis to be as light as possible but also hold up to those requirements.  Once the layered materials are put on the cast, a poly vinyl alcohol (PVA) bag is pulled over the material on the cast and a laminating resin is introduced into the bag. The technician will work the resin into the layered material so that each layer is saturated. After this is achieved, the technician will work out the extra resin so as not to add weight to the socket.  

A personal lamination is the same as a regular lamination except that the final, outermost layer of material will be a fabric that the person has chosen to express a personal look on the socket. What is a good fabric to use?  The fabric must allow water to go through the fabric, because if water will not go through then neither will laminating resin. For instance, silk screened fabrics and fabrics with iron-ons do not work. These seal the fibers of the fabric and don’t allow the resin to saturate it.  A heavy fabric like t-shirt cotton soaks up a lot of resin and can increase the weight of the prosthesis.  A nylon based material (like leggings) works great and does not add any significant weight to the prosthetic leg. 

Why would someone want this kind of lamination?  Some of the factors in selecting a personalized lamination might be to express a person’s personality.   Sometimes the lamination allows the wearer to make the leg their “own” - making it a little easier to adjust to the prosthesis.   Sometimes that final look can make the difference in whether or not a person wants to wear the prosthesis. We see this a lot with children - with anything from superheroes to favorite animated characters on the finished socket.    

We have a gallery of some personalized laminations here - each of these was created by using a fabric that the patient supplied - so these are one of a kind sockets!  Click on any picture to enlarge the image.  Be sure to scroll down below to see a slideshow of Brian Day, Fabrication Technician, as he finishes the socket after a fabric with a wolf's head has been used as the final layer of the lamination.   

Dankmeyer is happy to personalize a lamination at no extra charge to Dankmeyer patients.   Thanks for your question! - Chuck Poole, Director of Fabrication

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

 

How do I travel with my prosthesis?

QUESTION:

I am a fairly new amputee and plan to take several trips this summer.  What should I know about traveling with a prosthesis?

Melissa C.

ANSWER:

Melissa,

Here are a few tips regarding the most commonly asked questions in terms of summer travel.

Sweat

Many prosthesis wearers find sweat in the summer months to be a frequent concern.  One way to help battle the sweat is to use an antiperspirant on your limb (e.g. Certain Dri has a roll-on version).  With antiperspirants, it is best to apply them at night so they have time to absorb into your skin.  Consistent use of them will also aid in decreasing your sweating over time.  Also, as you sweat, your limb could shrink in size over the day.  It may seem counterintuitive, but putting on extra prosthetic socks could help improve your comfort by tightening up the fit of the prosthesis to reduce pistoning and keep it more tightly secured on your limb.  It is also a good idea to take the prosthesis off a couple of times during the day to let your limb air out, and it would give you a chance to rinse out (using warm water and gentle soap) and towel dry your gel liner, or wipe off your sleeve.

Beach

Taking your prosthesis on the beach?  You may want to consider protecting the components by wrapping any exposed components with clear plastic wrap, or even better – using a waterproof cast sock (such as Xerosox).  If your prosthesis does get wet with salt or chlorinated water, rinse it with fresh water and then dry it completely with a towel.

Airplane 

If you are traveling by air, TSA has some rules for traveling with prostheses and other medical devices. Before you head to the airport, review TSA’s rules so you don't get any surprises at security!  Check here for traveling with prostheses and other medical devices:  https://www.tsa.gov/travel/special-procedures?field_disability_type_value=6%20

You can print out and fill in a TSA disability notification card to have ready to show the security officer, in order to help avoid unwanted delays:  https://www.tsa.gov/sites/default/files/disability_notification_card_508.pdf

Car

For those long car rides, you may be more comfortable taking your prosthesis off completely.  Never store your prosthesis in a hot car.

Prosthesis maintenance

Do a visual inspection of your prosthesis before you leave.  See any crack or tears in the liner or sleeve?  Feel any excessive motion or loose parts?  Or hear any strange sounds?  It is recommended that you schedule a routine maintenance check of your prosthesis before your vacation, to help prevent any problems that may occur while you are away.  If you have any concerns about your prosthesis following your trip, that is also a good time for a check-in with your prosthetist.

Thanks for your question! - Angie Bryl, CPO

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

 

Will Medicare pay for a new ankle brace whenever I need one?

Question:

Will Medicare pay for a new ankle foot orthosis whenever I need one? - Candace F.

ANSWER:

We wish it were that easy!  The determining factor for whether or not there is a Medicare benefit depends on the reason a new orthosis is being ordered by a physician.  Has your medical condition changed and your current orthosis no longer meets your medical needs?  If yes, Medicare will provide a benefit for a new one.  However, if it’s simply because you want a new orthosis, then no, Medicare will not pay for a new one.  Medicare also considers a 5 year Reasonable Useful Lifetime policy in regards to normal wear and tear of lower limb orthoses.  What does this mean?  If you have had your current orthosis for less than 5 years and it is simply showing signs of normal wear and tear, Medicare will not pay for a replacement and you would be financially responsible for the cost of a new one.  It is important to note that the five year period begins with the date the device is delivered to you, as that is the date used on the claim submitted to Medicare.     

Provided we receive an accurate medical history and appropriate insurance information from you, you can rest assured our Patient Services Coordinators will apply their extensive insurance knowledge to your service and will notify you of any financial responsibility you may have prior to proceeding with the service.  If your service is in process and there is a change to your insurance benefit, we will immediately notify you of any changes to your financial responsibility, as well.  We are committed to inform you of your insurance coverage, as well as any financial responsibility you may have, each and every time you receive care from us.  Have a great summer!

- 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.

As a prosthesis wearer, why should I "Check My Foot"?

Question:

Why should I check my prosthetic foot, and how do I do that? - Carolyn M.

ANSWER:

After a mild winter, spring has arrived in full force. Many of us will start to become a little more active in the warmer months.  We are busy fertilizing yards and mowing grass, preparing our gardens or taking walks in the community.   This means we are on our feet a lot more frequently than in the colder months. 

Spring is a great time to “CHECK YOUR FEET”.    Our feet are our foundation, much like the foundation of a house.  If the house foundation is cracking and in poor condition, the building upon it will not hold up well.  Your prosthetic device is part of your walking foundation and it is a good idea to have your device checked out.

Prosthetic feet wear down from daily use.   Some feet are a completed design, meaning the inner mechanics are enclosed by a foam foot casing.  Other feet have foot shells and protective socks, which can be removed to inspect the carbon foot design.   When your foot begins to wear down, your walking pattern, or gait, may be affected.   You may also hear noises such as a metal “click” or “squeaking”.

Spring is an excellent time to schedule an appointment with your prosthetist.   We will inspect your prosthetic foot for signs of wear or damage and advise you of any recommended repairs or possible replacement.   Sometimes repairs may be completed on the same day you are seen or, may require us to order appropriate parts for your prosthesis.   Either way, it should help you start off your spring on the right foot, or possibly your left!!!

- Mary Reedy, Certified Prosthetist

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

Should my son wear his orthoses all the time he is awake?

Question:

My son had an appointment and I forgot to ask a question. After the breaking in period, should he wear his shoes with his orthoses all the time when he is awake? Or only when he would normally wear shoes - like when going outside?  And how will I know when they need to be replaced?  Debbie K.

ANSWER:

Thank you for your questions! He should wear the orthoses for activities when he would normally wear shoes. For example, when he is active and running/jumping/playing, whether inside or outside, he should wear his orthoses inside of his shoes. If he has any down time like long car rides, before bedtime, right after his nap, or during meals, he does not have to wear the orthoses.  

How will you know he has outgrown them? A couple of good signs that the orthoses are too small due to growth are if the toes are hanging over the edges of the orthoses, or if they appear to be too tight in general or in specific areas. Your child may complain about them pinching or hurting, or his skin may be more red than usual. If you are ever unsure, call our office to schedule a follow up appointment or to speak with your child’s practitioner. Also, all practitioners developed a long term follow up plan (usually 3 or 6 months for children), and our office will be scheduled to call you at that specified time to check in.

- Kristen Beltran, Resident Prosthetist and Orthotist

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

How do I find a shoe to accommodate my ankle foot orthosis?

QUESTION:

How do I find a shoe to accommodate my ankle foot orthosis so that I can wear it comfortably and get it on and off easily? - C.M.

ANSWER:

Hi C.M.,

Thank you for your question.  Finding a shoe that fits an AFO is not an easy task, which many other people struggle with as well.  I have a few suggestions that may help you.

In terms of shoes,  we have found that out of the standard tennis shoes, New Balance tends to be a little wider and easier to fit overall than some of the other brands.  Removing the insole, if you have not already, will also give some additional room in the shoe.  Some orthopedic brands come in extra-extra depth that will accommodate AFO's easier.  These include Drew Shoes, P.W. Minor, Orthofeet, Darco, and others.  Some patients have also mentioned that they have found inexpensive shoes at Walmart that actually are more accommodating than a standard tennis shoe.

For help in selecting the proper shoe and size, I would recommend going to a Van Dyke and Bacon store, as they have experience with fitting shoes over AFO's.

Several innovative companies have also come up with rear-opening shoes that allow you to pull the heel back when donning.  An example is EasyUp AFO shoes, which use the Boa system to close the shoe and is meant to be able to be donned one-handed.

If it has been a while since you received the original AFO, I would also recommend coming in to see one of our practitioners to have a re-evaluation done.  These can be done at no cost to you and will help to determine if you are still in the most appropriate device.  If size or function has changed at all, an adjustment may help to make the AFO a little smaller and easier.  And of course, bring in the shoes you might be struggling with to the appointment and the practitioner may be able to give you some further insight.

I hope that helps!

- Angie Bryl, Clinical Director, Certified Prosthetist Orthotist

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

What is the purpose of clinic?

QUESTION:

What is the purpose of clinic?    - Douglas S.

ANSWER:

Dankmeyer participates in several multi-disciplinary orthotics and prosthetics clinics that allow our patients to be followed by a care team. Clinics are particular blocks of time set aside for a team of healthcare professionals to see patients together. Our clinics normally include a physician, physical therapist, and an orthotist or prosthetist from Dankmeyer. The clinic team works together to address the patient's needs from their respective specialties. This allows the clinic team to provide a recommendation that will work with the patient's various healthcare professionals. For someone who is a chronic user of orthotic or prosthetic devices, being followed by a clinic team facilitates regular follow-up and tracking of a patient's health status.

Attending clinic is a convenient way to be examined by multiple experts at once instead of making separate appointments. For example, a patient can be evaluated for a prosthesis, obtain a prescription from a physician, and have orders written for physical therapy all in the same visit. The clinic team also works together to ensure the patient is receiving all of the external support he or she needs. Whether a new patient is looking for resources to help modify their home, is seeking peer support from someone who has a similar condition, or wants to learn about events in the area in orthotics and prosthetics, the clinic team can help guide the patient to the appropriate resources.

While many of our clinics are geared toward adults, we also attend several pediatric clinics. We attend both prosthetic and orthotic clinics for pediatric patients. Pediatric clinics emphasize childhood development milestones and ensure that the child has the opportunity to interact with others of his or her age with a similar condition. We work closely with patients' families to ensure we are taking care of them not only from a prosthetic or orthotic standpoint.

Feel free to ask us about multi-disciplinary orthotics and prosthetics clinics and how they may become part of your care plan. We look forward to seeing you there. 

- Nina Bondre, Board Eligible Prosthetist Orthotist

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

How do we know if the office is closed in wintry weather?

QUESTION:

Now that winter is upon us, what is the best way to find out if one of your offices will be closed due to inclement weather?   - Ellie B  

ANSWER:

There are several ways to find out about our office closures due to inclement weather.  You can call our main office, 800-879-1245, to listen to a recorded message which will state if the office is on a delayed opening or is closed that day.  If you do not hear a message regarding office closure due to inclement weather, you can expect our offices will open at their regular 8:00 am time for all scheduled appointments.

Another option is to visit our website where any office closure information will be posted on our main page no later than 6:30AM that morning.  A list of our 2017 Holiday closures can be found on our website, as well! 

You can also check out our Facebook page (check it out by clicking here) for posted office closure information.   

Should one or all of our offices be closed due to bad weather, we will call you as soon as possible to reschedule your appointment.

Please note, our offices will be closed on Monday, December 26, 2016 and Monday, January 2, 2017 so our staff can spend time with family and friends during the holiday season.  Happy Holidays to all! 

- 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.

 

Do you take donations of a used orthosis (or prosthesis)?

QUESTION:

Do you take donations of a used orthosis?  I don’t know what to do with my old orthosis - it is in good shape, I just don’t need it any more. - Mary P.

ANSWER:

Mary, thank you for your interest in donating your old device.  Yes - we gladly accept donations of orthoses and prostheses and supplies. Sometimes patients find that they no longer need a particular device or supplies.  Occasionally a patient passes away and a family member wants to make sure that the device can go to good use to someone in need.

For orthoses, gently used is best.  For prostheses, if the device cannot be used as is or with minor repairs, then the parts can be used.  We receive the device and provide you with a receipt which itemizes your donation.  We do not assign a dollar value - that is up to you.  Since all organizations we work with are non-profit, then this donation is a tax deductible item.

IMG_0043.jpg

Once you leave it with us, we evaluate the device for its best use, and sort items into a holding place until we can move them along.  We donate pediatric orthoses to an orphanage in China (you can read about that patient story New Day Foster Home in our archive by clicking here.)  Other devices make their way to organizations we work with in Mexico, St Vincent and the Grenadines, or Guatemala.  We have also sent practitioners on mission trips to work with patients and they take devices with them.  Sometimes we send devices to organizations who make requests of us.

We were recently able to donate two prostheses to Patsy Douglas’ Youth Empowerment Foundation in Maryland.  

“Our organization would like to take this opportunity to thank Dankmeyer Prosthetics & Orthotics for your donations of two prosthesis legs….Both prostheses were shipped to St. Vincent and the Grenadines respectively in May of 2015 and September 2016.  Your organization has afforded the privilege to the recipients to live a productive life.  We thank you for your generous donations.”

One of the recipients of that donation, Matthew, sent back a video to show how well he was using the device.  We would like to share that video with you. Click here.

We are always grateful that our patients and their family members recognize that others can make good use of items that they may no longer need and that we can facilitate that donation. If you have any other questions about donations, please do not hesitate to give us a call!

-Mark Hopkins, PT, CPO, MBA, CEO and President Dankmeyer, Inc.

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

End of Year Benefit and Scheduling Planning

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.

How Do I Learn About New Technology?

QUESTION:

Hello Team Dankmeyer,

I have been practicing Physical Therapy for ten years and have worked with orthoses and prostheses a little over the year, but I just moved to the rehab setting and have both inpatients and outpatients with O&P needs. Since I have not been doing a lot with orthoses and prostheses I want to know what is new. How I can learn about new technology and treatment techniques?

Sincerely,  -  Suzanne H

ANSWER:

Thank you for the question, Suzanne. There have been some changes in the O&P service delivery over the last few decades including medical/surgical, skill training for Physical Therapists and Occupational Therapists, and orthosis and prosthesis design and technology. For example, the use of microprocessor controlled and powered prosthetic joints (hand, elbow, foot/ankle, knees) is now much more common than even ten years ago and has allowed us to achieve improved patient functional outcomes. This is particularly true when coupled with good medical/surgical management and, most importantly, solid use training in therapies. Some of the advances include application of that same microprocessor technology to knee ankle foot orthosis design. To see information on Ottobock's  C-Brace click here. You will also see more frequent use of composite material in lower limb orthoses to reduce weight, increase flexibility and energy return and improve gait safety and efficiency - such as Ottobock's WalkOn products. Click on any of these links to get more Information about a number of other prosthetic and orthotic technologies from Allard, BeBionicBecker OrthopedicCustom CompositeFillauerKinetic ResearchOttobock, Phatbrace, Trulife. There are way too many details to include in this post.

As far as learning about new treatment options - there are continuing education (CE) opportunities available from a variety of organizations.  The American Orthotic and Prosthetic Association (AOPA), and the American Academy of Orthotists and Prosthetists (AAOP) have many online opportunities. Your own regional PT association and your regional O&P association may have CE options as well.  At Dankmeyer, we provide as many courses as we can.  In fact, we have a course coming up in November on 11/19/16 - Trans-femoral Prosthesis Prescription and Training Considerations: An Update. You can take a look at details on our Events page.  We also offer a variety of inservices and courses to review O&P info with busy clinicians at their facilities during the day or after work. We generally set up the course or inservice based on the request of the practice. For more information, you can click here. Another tool is our monthly newsletter and you can subscribe to that via our website as well. 

I hope this has answered a few of your questions - obviously there is a lot to look at and think about here as you pursue your goals. We are always ready to help.

-Mark Hopkins, PT, CPO, MBA, CEO and President Dankmeyer, Inc.

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

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!  Robert Tyler, Resident Prosthetist Orthotist

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

What is a Patient Navigator?

QUESTION:

I recently spoke with someone at Dankmeyer called a “Patient Navigator” about a future appointment.  What is a “Patient Navigator” and can I expect to hear from him again?

Thank you,

JR

ANSWER:

Our Patient Navigator role is being developed and we will have more details about that later.  In the meantime, what is that?  A Patient Navigator is someone who provides guidance to patients as they move through the health care system, helping their patients to access resources that speed the delivery of treatment and follow-up care. The Patient Navigator may at times guide patients through and around barriers to their care which might include financial barriers (insufficient health insurance); educational barriers (inadequate health literacy); transportation barriers (a need for dependable private or public transportation); and any life circumstance that impedes a patient's access to timely treatment and follow-up care. 

The Navigator seeks to provide resources which might include lists of private and non-profit organizations that may help; written information regarding support groups and other community organizations; and educational materials that serve to increase a patient's health literacy. Patient Navigators also develop relationships with individual staff at local healthcare, government, and non-profit organizations, who may be of service to his/her patients. On an as-needed basis, the Navigator connects particular patients to particular staff at these organizations to expedite the problem solving process. 

We frequently receive requests to provide our new amputees with driver information and resources. Many new patients are unaware that they are legally obliged to self-report their medical conditions to the Motor Vehicle Administration (MVA), to have their cases reviewed by a medical advisory board, which is charged with evaluating their medical fitness to drive. We provide these patients with a summary of the MVA's requirements, contact information for the MVA's Driver Wellness and Safety Division, as well as a list of local driver rehabilitation programs and adaptive driver equipment suppliers. As patients most often endure long waits to receive the results of their MVA medical evaluations, we advise them to consider completing a driver rehabilitation program while waiting for their medical review results; this way, their certifications are at the ready upon receiving word from the MVA. This information serves to significantly shorten the amount of time it takes to get our patients back on the road.

There are other resources that we provide to try and smooth a patient’s way through their own health care system.  We have a new web page where all these resources are available. Visit the Patient Navigator page.  

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

 

 

 

Do I need a new Ankle Foot Orthosis (AFO)?

QUESTION:

I have been a customer of your practice for many years. I had a stroke in the late 1990s and use a leg brace, AFO, daily and walk with a cane. My current brace is old, maybe 10 years??, and needs to be replaced but, I am not sure how to go about that. There have been some stories in the paper and on TV about new prosthetics and braces. Maybe one of those new braces is right for me? Let me know if I need to see my doctor or just come in. I have Medicare.

Sincerely,

Penny G.

ANSWER:

Dear Penny G,

First, thank you for your business and for contacting us with this very common question. 

If your AFO is 10 years old, I recommend you have it looked at to be sure it is working properly for you. The place to start is with a visit to your primary doctor to be sure that you still require the AFO and that the overall care plan is in place to maintain optimal health. You can specifically ask your primary doctor to look at the AFO and, if they agree you still need to use the AFO and it is not optimal, they can write you an order to see us for an evaluation. During that evaluation we will talk with you about your goals, your experiences with the current AFO and problems or issues you are having. We can share with you advances in orthosis design and answer questions about those new braces you saw on TV and in the paper and, in the end, make a recommendation for repairs, adjustments or replacement of the current AFO. We will share that information with your primary doctor and make a plan to get the work done. In many cases, simple repairs and adjustments can be done that same day. If your primary doctor requests more information, we can help you with a referral to one of the specialist multi-disciplinary clinics we work with for a specialist evaluation for a new AFO and, possibly other rehabilitation treatment ideas. The specialist clinics are generally headed by a Physiatrist which is a physician who specializes in Physical Medicine and Rehabilitation (PM&R) and who have special training in the evaluation and prescription of orthoses, including AFOs like yours. We attend the clinics with you and can provide our recommendation in person and help with the development of a new AFO prescription. Medicare does require some specific evaluation documentation for coverage of an AFO and, the specialist clinics are often a very effective method of getting that done.

Thank you again for contacting us with your question. Please feel free to call 800-879-1245 and talk directly to one of our Orthotists to get more information or ask additional questions. We look forward to working with you.

Sincerely,

Mark S Hopkins PT, CPO, MBA and The Dankmeyer Team

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