Confessions of a technology Snob
Having lived in New York City for 20 years and worked in the medical and technology fields, I was sure this was the best place to find the latest prosthetic technology. I had all the latest options, I thought, even a special prosthesis for scuba diving. So what was going to happen when I moved to the small island of Bonaire in the Dutch Caribbean? Well, for five years I maintained my techno-snob attitude and traveled back and forth to New York for repairs of my AK-prosthesis
Not fun and very expensive.
Remote Access
Fortunately, an urgent repair on my prosthesis forced me to seek help on our sister island of Curacao, changing my haughty attitude forever. Not only did I get my repair done quickly and professionally, I also learned about several new concepts for dealing with some of those nagging little (and big) problems that I didn't think could be solved. Such as:
Most Nagging Problems:
- Loss of suction or leg slipping when hot and sweaty -- the heat is just part of
Caribbean life!
- Inability to regain suction completely - I could never get that little release valve to
work
- Discomfort when sitting for long periods - which seemed to be part of life with the
Ischial.
Containment shape I had for over 15 years (also discomfort on a bicycle and certain exercise equipment).
- Difficulty in accommodating different heel heights - changing feet is just too much trouble.
- Lower back pain when standing or walking slowly - even when I held in my abs.
- Hassles taking the prosthesis off and putting it back on during the day or after swimming or scuba diving.
- Callused hands from years of pulling on the prosthesis - hey, that's life, right? Wrong.
- Unsightly hole for the valve in the front and hydraulic mechanism in back - even though they were covered they were still very visible.
- Big trouble when I had weight changes - even minor monthly shifts we women must endure.
I thought these were all just part of life as an amputee and never really thought about them. I had dealt with them for the past 37 years. And, after all, I did have some of the latest technology available, didn't I?
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How to Solve Problems
"Let me show you a quick video," said mild-mannered Tom de Windt, of Sentro Orto Fisiko Kòrsou, after replacing my broken Hydraulic unit, as requested. "It's something new we are working on."
OK, thought the techno-snob, just to be polite. What could you expect in little Curacao, population 200,000 and located in the southern Caribbean about 50 miles north of Venezuela?
Hmmm, what's this? A roll-on socket for an above the knee amputee? Are you sure? What?
You think you can change the socket shape to give me more comfort while sitting?
"Just a thought," said Tom. I told you he was low-key. "Here is my e-mail address if you want to know more."
I left the quiet, pleasant office in the lovely residential section of Curacao and flew back to my even smaller little island. I wonder what else he knows that I don't know about? How can I be a techno-snob if I don't stay up to date? We started an e-mail correspondence in which he uncovered all those nagging little, and big, problems I listed above. He suggested a different, lighter weight knee that had the "stance control" I liked about my hydraulikó, but without some of the negatives. He even suggested a new foot that allows me to adjust it to accommodate different shoe heel heights. Now you're talking.
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Price
But changing socket shape is not an easy project (been there, done that). To tell the truth, I just don't like changing prosthetists. And changing all those components is expensive. This was the biggest surprise of all - I could get all those improvements in a totally new prosthesis for less than half of what I paid for a new prosthesis several years ago. It would cost less than my last round of major repairs just six months ago!
Process
So I took the plunge. In less than two weeks I went from socket cast to whole new system, including some walking lessons from Tom's physical therapist partner and wife Mieke. Her specialty is working with amputees. While I have been working with a physical therapist for the last couple of years, Mieke and Tom both gave me several good pointers to make walking easier and smoother.
Result
The result was much more than I bargained for. Not only is the new prosthesis more
comfortable (sitting, walking, standing), it also stays in place when I'm hot and sweaty. Great holding power! I'm even walking better, according to my friends and family. The prosthesis is about 2 kilos lighter and takes much less energy to walk. The new shape socket, which is part ischial containment and part something else, lets me control my abdominal muscles more easily, so there is much less back pain. The new foot is more adaptable to different terrain levels and is very easy to adjust for different heel heights, from flat sandals to about two inches.
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Downsides
There are two downsides. First, I had to buy some new shoes to celebrate. Second, I have had some changes in the shape of my residual limb, mostly because I had stopped all exercise for about a month. But all in all, it has been change for the better.
Experience
What I found on the little Dutch Caribbean island of Curacao, when I finally gave up my techno-snobbery, was a very up to date prosthetist who is also very creative and was willing to look for solutions to my specific problems. (Tom and Mieke both studied and trained in Holland.) He asked a lot of questions and he listened to my answers. Then he customized a shape and a solution that was right for me. He even let me help in the creative process. All this and saving money, too! Wish I hadn't waited five years to find him.
Improvements
So now I have a new prosthesis, with a brand new "shape" that fits my body and my lifestyle. It's part ischial containment and part "creative adaptation" by the prosthetist, Tom de Windt.
I also have a totally new, non-suction device, which holds all day long with no slipping or funny noises.
But most of all I have walking and sitting comfort. I walk more and I walk better. So I've made great steps forward from what I thought was a remote part of the world.
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