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Messages - chrysochloridae

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1
General Discussion / Re: New AK Set-up
« on: May 20, 2012, 06:35:33 PM »
I hear that there may be some new microprocessor components released soon..... don't know much more than that yet but it looks exciting!

2
General Discussion / Re: College Park feet
« on: May 20, 2012, 05:21:07 PM »
Hey steve,

This thread is going back a few years...

If i was an amputee i would have a College Park Trustep - end of story. One of the best feet on the market ; reasonably priced, highly durable, easy to maintain, excellent conformity, extremely natural gait, excellent on uneven ground. Job done!

3
General Discussion / Re: A angry leg
« on: February 15, 2012, 04:17:40 PM »
Hi all, really interesting to read through this thread.

On the Alpha liner front; they aren't durable at all - but they've always said that hey are made for comfort not durability! 5 Alpha liners in 7 months is pretty impressive by anyone's standards; Good work ann! LOL
Alpha liners are particularly bad when using Locking liners as they don't have a stabilizing matrix to re-enforce the end of the liner (hence for years Alpha liners were renowned int he industry for the end attachment/umbrella tearing off the liner)

Alpha have released 2 new types of liners the HYBRID and the SILICONE. The Hybrid is the same gel with Kevlar additive to increase durability (i've found them to be about 25% more durable than the standard Alpha Classics (Max, Spirit, Original); the Hybrid is retrofittable into existing Alpha liner 6mm sockets.

The Alpha Silicone liner is  meant to be their heaviest duty liner yet,  I'm currently trialling 2 heavy duty users on them - i shall keep everyone informed

The Hybrid and Silicone liners also have some nice features (flexible panel for the knee, Accordion (flexible) umbrella) - check out WillowWood's website for more info

Alps liners are about half as durable as Alphas; they are good on comfort but poor on durability and terrible for controlling pistoning!

Alpha also have a Custom service like Otto Bock. My preference are the Bock liners overall - super durable, nice and comfortable, do exactly what they claim to do (typically German designed equipment - efficient and functional but costs a little more! - saying that all of Otto Bocks liners are cheaper than even the most basic Alpha (Otto Bock SiliconeGel = 300E, $400USD)

4
General Discussion / Re: A angry leg
« on: January 21, 2012, 04:05:42 PM »
I'd definitely leave it off for a few days until it heals - open wounds and liners (warm moist) environment are good breading grounds for bacteria.

Herb has hit the nail on the head, stopping problems before they become major is definitely the way forward.

I've seen many people on liner systems to try to prevent skin breakdown, but many of them experienced problems due to the distal pressure required for a pin system. (Most) Liners also come in a Cushion option (i.e. no pin and lock) and use a suspension sleeve; this has a number of advantages 1) you can put a cushioned end pad into the socket to give more gel cushioning to the end of the stump, 2) you can add a valve in and turn it into a suction socket which in itself has numerous advantages.

if you came in to see me and told me that you'd battled on with a socket for 2 years without success then i'd likely have a rethink and make a new socket.

PLJ, good to hear from you! The Alpha liners are notorious for that happening. I found a great trick is to use one of the Alpha Gel cups on against the skin then the Liner over the top of it - that way the hole wears in the gel cup (which cost a fraction of the price of a new liner)

5
General Discussion / Re: A angry leg
« on: January 19, 2012, 02:10:00 PM »
Alpha liners do do a 9mm. Really good for bony residual limbs i find.

Sounds like you've got an Iceross Dermo or Synergy. They are alot thinner than the standard Alpha liners and don't have gel at the front (well, their new cushion one does but thats their first!) - Excellent for very fleshy stumps with no scarring; on the whole not so good for very bony stumps with heavy scarring.

Alpha liners have always gone for comfort, if they worked for you then i'd stick with them. Some of their new kit seems pretty good (Hybrid and Silicone), but i can't give you any long term experience of these liners till i get some feedback from the people testing them.

If your prosthetist has CAD-CAM machine then they could copy and reduce your big socket and make it 3 socks smaller... (assuming your overall shape has remained roughly the same). Also steve, if the big socket is for an Alpha liner, they do Volume Management pads http://www.willowwoodco.com/products-and-services/suspension/suspension-aids/volume-management-pads

6
General Discussion / Re: A angry leg
« on: January 17, 2012, 05:46:33 PM »
What thickness Alpha liners has he got you? I find the 3mm one problematic for bony/scarred stumps. I would say 6mm Alpha liners are the best.

Willow Wood have brought out 2 new pin liners since you last had sockets made the Alpha Hybrid and Alpha Silicone range. They only do these in the 6mm version. Might be worth having a chat with the new prosthetist guy about trying one of these new types - i've found em pretty good and a bit more durable (and a longer warranty on them!)

If your old Work Leg is proving comfortable still then it could be worth asking for a copy of it to be taken using a CAD-CAM system or using duplicating foam http://www.ottobock.se/cps/rde/xbcr/ob_se_sv/materials_3_plaster_forming.pdf (page 41)

IMHA 2 years is plenty of a breaking in period! If its not right after 2 years then i personally would start from scratch / copy a functional socket.

7
General Discussion / Re: A angry leg
« on: January 16, 2012, 02:12:18 PM »
Hi steve, Happy new year to you!

This sort of thing can cause a problem. I find that skin grafts can be problematic as the skin is not as elastic as the undamaged section. I've found thinner liners absorb less shear and so can cause problems over sensitive areas.

An Invaginated scar (deep, healed scar which produces a 'crater' in the flesh - often caused by slow healing wounds) is always problematic. Changing the liner is one option, but this would likely mean new sockets and all the fun and games associated with that. Alpha Custom liners can be made to have gel filling these areas - but they are expensive.

The simpler answer is trying some of the various prosthetic lotions and potions on the affected area. I have a few people who swear by Alps Prosthetic Lotion. Otto Bock Derma Repair and Derma Prevent are also really good.

Has this been an ongoing problem Steve or has it only begun recently? I tend to find people struggle with this sort of thing in hotter weather or by being more active than usual

8
General Discussion / Re: Stump volume control, questions
« on: October 18, 2011, 02:11:47 PM »
PTB (Patella tendon bearing) sockets for below the knee are widely considered the best for newer amputees who are likely to reduce in volume - as you can add more socks. Below knee suction sockets are also quite good. Vacuum systems (e.g. Otto Bock Harmony, Ohio Willow Wood LimbLogic) are generally used to help control volume fluctuation
Lock and Pin liners are generally indicated for those who's volume is stable; this suspension may fail if your size changes considerably from the liner size - although socks can be worn on the outside of the liner. new amputees using this type of system will likely need smaller liners as the stump matures - new liners = more cost and new fittings
Seal-in liners and Transfemoral suction sockets are volume critical and are unlikely to work if you are experiencing volume change

9
General Discussion / Re: Knee problems
« on: October 04, 2011, 06:07:51 PM »
The Multiflex is a pretty good all rounder, but they do get a bit worn after a while. They're notorious for the toes going soft after a while (especially if getting wet); the ankle unit that attaches to them (the ankle Ball and Snubber) needs replacement (i would suggest) at least once a year as the rubber degrades. The inner keel can begin to come away from the foot cosmesis after a while and this can also affect function.
I don't think a service would hurt! not expensive to replace the whole thing wither. The ankle snubber only costs about £5 if money is an issue (the snubber is usually the 1st thing to go!)
Glad you're on the mend Steve!

10
General Discussion / Re: Horse back riding for amps?
« on: October 02, 2011, 04:45:38 PM »
Steve, this comes up more than you'd think. I've had a few people riding, some with more success than others.

One person i see does dressage. He found a good farrier/saddler who made a modified stirrup out of leather (like a leather Number 8 socket attatched to a saddle!), the stump then fits into this. The person said that he had better proprioceptive feedback without the prosthesis and thus had more control of the horse. If you have an experienced Leather Working technician at your limb centre then they may be able to knock something up for you (you're prosthetist may get gutted about the paperwork involved with Risk Assessing such a thing though LOL!)

You have noted the main pitfalls of using conventional stirrups with prosthetic legs - you have no way of disengaging from the horse if you come off (unless you have lock and pin and can access the button) and this could be a BIG problem, however, if you use an unconventional system as described above, you have no protection for your stump(s) if you come off and so could damage the ends of your stumps and be unable to wear the prostheses.

Another solution i have tried is to wear a socket without the prosthesis and the above mentioned 'leather stump holster'; this gives you ability to disengage from the horse if required and alos the ability to walk on the socket(s) in an emergency.

I think your idea of bareback could work, but it might be uncomfortable and further affect your sitting balance. As you said, plenty of practice and familiarity training for the horse is a must before attempting them irish hillsides! Púcán sounds the better bet of the 2 as she has some familiarity with a riding situation, i'd imagine a wild horse may still have some of its wild instincts / tenancies....

11
General Discussion / Re: Knee problems
« on: October 02, 2011, 04:30:49 PM »
Hey steve, long time no see!

It's most likely to be the activity that you were carrying out that has caused this. when you are walking up and incline, the front of the socket will push back on your knee more as the heel won't be on the ground; the additional weight of the (i'm presuming full) wheelbarrow will mean that a larger force will be needed to propel you and the wheelbarrow up the hill; the hill itself will mean that even more force is required as you are fighting Gravity also.

If the leg has been fine for years then the above is the most likely cause. Adding padding can sometimes increase the pressure or a localised area as you will be further reducing the size of that socket.

It sounds bruised to me Steve, unfortunately, bruised bone takes a good while to heal (when i've kicked peoples elbows when Kickboxing my shins have taken ages to heel!)

If its an old leg then it might be worth having the foot and ankle checked as they will cause a mechanical deficit of the prosthesis. With your activity level, i'm sure you'd compensate for a mechanical deficit but this would put additional stress on your body and cause injury long term. Have you any idea what foot is it Steve?

12
General Discussion / Re: Stump volume control, questions
« on: October 02, 2011, 04:18:50 PM »
Its quite common to have alot of volume change when you're new to prosthetic use.
There is also a 'breaking in' period which is longer for some than others, i compare wearing a new socket to breaking in a new Hiking boot or Safety shoe - they can be really uncomfortable and hurt like hell until the material has bedded in and your feet have got used to the feel, the same applies to a socket and a stump. I would recommend starting off wearing for no more than an hour a day for the first week, then build up to 2 hours the next and so on; that way, you will gradually increase your tolerance. I remember the last pair of safety shoes i bought, they felt fine on day 1, but my heels were in shreds by day 3 and i had to go back to my old shoes and look like a hobo!
As for the volume control, most people will experience volume changes for between 1 and 3 years after wearing their first prosthetic limb. factors such as activity level and other medical conditions can make some people more prone to changes than others. Some people are constantly fluctuating (e.g. those on Dialysis)

13
General Discussion / Re: Funeral for a friend
« on: October 02, 2011, 04:11:53 PM »
Hi all, sorry for my prolonged absence!

How is everyone doing?

14
General Discussion / Re: Hydraulic Mach knee
« on: October 02, 2011, 04:11:19 PM »
Hi all, sorry for my long absence....

jek2616, Hydraulic knees usually weigh 1-2kg (2-4lbs), carrying that sort of weight around will certainly be more tiring. The estimated energy expenditure of an AK amputee is about an extra 50-75% (depending upon the length). Hydraulic cylinders do give good function as they usually offer swing and stance control as well as yield. I often feel that people get prescribed these devices for 'High Activity' use, however if you could walk twice as far with a lighter knee joint then i would question the how much more functional a hydraulic device is compared to a lighter device such as a Pneumatic cylinder or mechanical extension assist. have you ever tried any other knees?

15
General Discussion / Re: Newbie amputee, have some questions
« on: December 28, 2010, 07:56:46 PM »
it depends upon the person really - each prosthetist will make each socket differently

Firstly, as an above knee amp, you shouldn't be feeling alot of pressure on the end of your stump but because you appear to be on a liner with pin system you will probably feel some pressure there. I'd have a guess at the reason for you feeling that pressure on the end is that the back seat is at an angle rather than a seat (i.e. the bone that should be loaded is probably not been supported enough)

Other thing about the socket is that the inside seems to be cut quite low (but some people like it that way)

Is there any chance of a picture looking down into the socket?

You mentioned the problems with the knees not being level - thats pretty clear why now. its because of a few things; 1) the length of the pin has to be accommodated, 2) that knee has quite a big build height anyway, 3) your stump looks like it could be on the long side.
 - if you were my patient i'd probably have used a knee with a lower build height (e.g. Otto Bock 3R60, ossur Total Knee or Endolite KX06). I'd probably try a different suspension system such as a belt until such a time as you were ready for a suction system (assuming you'd be suitable for a suction system)

Do uou know what foot you have on that leg frey?

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