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

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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.

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.

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.

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, BeBionic, Becker Orthopedic, Custom Composite, Fillauer, Kinetic Research, Ottobock, 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.

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.