Author Topic: Orthotics  (Read 2432 times)

Offline chrysochloridae

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Orthotics
« on: June 14, 2008, 02:44:07 PM »
It is highly important to keep the good foot in the best possible working order - as being a double amp is far more difficult than being a single amp. Orthotic insoles can help to reduce the high pressure areas on the good foot and reduce the chances of ulceration as well as helping to slow down / prevent biomechanical problems with the foot (such as flattening of the arch, clawing of the toes etc).

I was wondering how many people use prescribed insoles / footwear (from an Orthotist or Podiatrist) for their good foot?



Offline pegleg jack

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Re: Orthotics
« Reply #1 on: June 14, 2008, 03:47:39 PM »
Got a quesstion, just what is a good foot, you single bka's and your good foot, i haven seen mine for over 6 years, miss walking barefooted through mud and wet grass. LMAO. I wouldnt know what to do with one any more if i had one,
you-all have a great day.

Offline Steve C

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Re: Orthotics
« Reply #2 on: June 14, 2008, 06:44:32 PM »
Myself I wouldn't have any special shoes or insoles. My main shoes are chelsea style Doc Martins (for casual), Ecco boots (for work) or runners (for the gym or if I want a light weight shoe).  To be honest I have been wearing my sandals alot too!
The first shoes I got after my amp were the Ecco work boots. They go to my ankle for support, are gore tex to keep me dry, have a non-slip sole and lace up for ease.
Where ever I go, I'll always have one foot in Ireland   /   I'm not a complete fool. Some parts are missing.

Offline chrysochloridae

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Re: Orthotics
« Reply #3 on: June 14, 2008, 10:09:42 PM »
when i say good foot i mean the 'sound' (anatomical) foot!!! LOL

Most people have some biomechanical deficit in their foot, and it's really important to keep the remaining foot in the best possible condition!

check out:
http://www.amputee-coalition.org/inmotion/mar_apr_03/step.html
it explains good footcare for diabetic amputees; but all amputees are in the 'high risk' foot category because if anything happens to the remaining foot then obility is severely affected...

I'd recommend everyone wears footwear as Steve C said, along with orthotic insoles such as as Total Contact Insole (TCI) or Functional Foot Orthosis (FFO)...

Has anyones CP recommended Orthotics?

Offline tbrbeast

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Re: Orthotics
« Reply #4 on: June 16, 2008, 04:53:26 PM »
I am a bilat TMA and also a T2 diabetic so footcare is an everyday issue.  I use a prescribed orthosis in each shoe.  My insurance will not cover orthotics, even for diabetics.  Obviously, as a diabetic, sandals, flipflops, or any other open toed shoes are out.  Being a TMA also eliminates anything like flipflops or sandals with straps between toes ( a bit difficult with only a rounded end on the foot!).  I wear a pair of Montrail hiking boots which I have had to have wedged to reduce the supination of both feet.  When I buy footwear, I not only have to buy something with wide and tall toeboxes but also something that will fit my inserts.  Real pain to say the least.

Something else that contributes to good foot care/health is wearing good socks.  I wear ragg wool socks essentially every day.  They are very good at wicking away moisture, help control the edema in both legs, and don't contribute to ulcers or other foot damage.

One thing diabetics are told to do with their feet is to regularly use lotion on them to keep them soft and prevent damage.  I was introduced to 2 products - O'Keeffe's Working Hands and O'Keeffe's Work Feet - that I have found to be quite good for both hands and feet.  I use Working Hands (Working Feet for some reason is harder to find) on both hands and feet.  Coupled with my orthoses, modifications to my shoes, and my socks, I rarely have foot issues.  I have every hope that this combination will greatly reduce the risk of losing the rest of my feet or my legs.

Offline chrysochloridae

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Re: Orthotics
« Reply #5 on: June 17, 2008, 01:20:50 PM »
I can't believe they don't fund you to have proper (diabetic specification) footwear and orthotics from an Orthotist.....

Your insurance company should do everything in their power to preserve your feet as it would be considerably more expensive for them (and you!) to have a further amputation to say below the knee! So it's definitely in both theirs and your interests for them to pay for your orthotic treatment!
 
It sounds like you're doing everything right to look after your feet though....


Offline tbrbeast

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Re: Orthotics
« Reply #6 on: June 17, 2008, 05:04:59 PM »
Oops.  Need to clarify something.  My insurance will cover orthoses but not orthotics (don't ask me to explain the difference as I still barely understand what is going on anyway). When I got my current pair, my orthotist had to code them differently for the insurance to cover at least part of them.  I still had to pay almost $600 out of the $1600 dollar cost (not like going down and buying a pair of Dr. Scholls!).  I suspect that my guy is/was playing the system but I agree, especially for diabetics, stuff like this should be covered.  But as we all know, this seems to be the situation for any amputee regardless of other medical issues.  Fortunately, I may be able to get 7 years out of this pair whereas most need replacement after a year or so.

I totally agree with your comment about amputees taking care of their feet, regardless.  Now that I think about it, it is a topic of conversation that I have rarely seen discussed (at least since I have been on) on amp forums. 

Offline chrysochloridae

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Re: Orthotics
« Reply #7 on: June 17, 2008, 06:48:46 PM »
Definitely should be covered, along with specialist Diabetic footwear (that has no seams on the inside of the shoe)

Common sense would say that the cost of a pair of Orthopaedic shoes every year or two would be far less than the cost of an amputation + lifetime supply of prosthetic limbs!

You're right too.... this subject isn't debated enough on forums or in clinics!!! Its all too easy to focus on the prosthetic limb rather than the person as a whole

Offline pegleg jack

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Re: Orthotics
« Reply #8 on: June 18, 2008, 08:18:46 AM »
Just read up on all of this in my 2008 manual and they dont cover the shoe either, coping this right out of my book,

ORTHOPEDIC SHOES(with few exceptions)

So it looks like you that are diabetics need to start yelling at your congressman or women and see it you can get this changed.

And i agree with you that those shoes are on the expensive side.
you-all have a great day.

Offline tbrbeast

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Re: Orthotics
« Reply #9 on: June 18, 2008, 05:58:05 PM »
Jack - I agree that something needs to be done to cover footwear for anyone who is prescribed to have special footwear.  However, most diabetics don't need the footwear that is commonly advertised for diabetics.  Because the concern is for injury to the toes and/or foot, diabetics should be buying shoes that have wide and tall toeboxes and which are comfortable.  Somehow this sounds exactly like what podiatrists are telling everyone else.  Unfortunately, people seem to want to buy narrow shoes with short toeboxes.  Women scarf up high highs and pointed toes.  I buy footwear off-the-shelf and not the stuff advertised and sold to diabetics.  My primary criteria beyond size is that my inserts fit in them and that they have a wide and tall toebox.  Beyond that, it is open to negotiation.  There are quite a range of brands and styles of quality footwear - men's and women's - in the marketplace that meet those criteria; more than I thought but less than there can or should be.  The change really needs to come in how people in general treat their feet and buy their footwear.  In that case, there would be no need to worry about insurance to cover it.  For me, what I do wish insurance would cover is the modifications - wedges, etc. - and the replacement soles I need to correct the biomechanical issues (supination).  For the pair of hiking boots I bought late last year, the cost of the wedges and replacement soles was almost the same as the cost of the boots.  I don't mind spending $150 on a quality pair of footwear but another $150 per pair to have them wedged etc.  starts to get ridiculous.  Gets expensive in a hurry.

Offline chrysochloridae

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Re: Orthotics
« Reply #10 on: June 18, 2008, 07:24:47 PM »
if everyone was as well informed about footwear as you  tbrbeast then there would be alot of prosthetists out of work!!!!

You totally hit the nail on the head there; footwear should be wide and deep enough and fitted around the insole,

Womens shoes in the UK are terrible, the orthotists and podiatrists in this world are never gonna be out of a job! As i said earlier, i think that the insurance companies in the USA should pay for the orthotic treatment cos it would save them loads of $$$ in the long run -as well as insuring a good quality of life for amputees (and all other 'at risk feet ' people out there!)