The Amputee Network is an organization dedicated to educating all amputees, their families and friends. Our primary objective is to help in the prosthetic rehabilitation. In a confidential manner we exchange useful information among amputees and professionals with special skills - all designed with the common goal of improving the amputee's quality of life.
Two and a half years ago, 33-year-old Jonathan Bik was completing the final test to become a lineman for Sacramento Municipal Utility District (SMUD).
He was 45 feet off the ground when he lost his footing. "I came straight down the pole and landed flat-footed," said Bik. He snapped his femoral artery and doctors could not save his right leg.
The father of two young girls was not going to let his injury keep him down. "All I have to do is look around a little bit and there's always somebody that's got it a little harder than I do, so it kind of puts it in perspective," he said.
While Bik was in the hospital his thoughts turned to running. "I wanted to be able to run again. I'd seen it in magazines," he said.
He calls himself extremely lucky, saying "SMUD's been great. They've taken care of all of my prosthetic needs."
Hanger Prosthetics & Orthotics fitted Bik with three different prosthetics: one for everyday use, one to help him run, and one for biking."I jumped right into the highest technology stuff," he said.
With the support of his wife and daughters, Bik began training to compete in triathlons. On Sunday he will compete in the Triathlon World Championships in Hamburg, Germany.
He laughed when he said that all he wants is a medal. But even without a medal Bik will tell you he's a winner.
He said he's become a better person after losing his leg. "I don't think I really realized what I had before," he said. "One of my greatest improvements is appreciating the things that I have and what I'm able to do."
Call is the president of Virginia Prosthetics Inc. in Roanoke, the largest orthotic and prosthetic provider in Southwest Virginia.
"Believe in your possibilities."
That's what I tell patients I see for the first time who have recently lost a limb to amputation. For most patients it's not what they want to hear, and understandably so. Limb loss, whether it's the result of an accident or disease, is a traumatic, life-changing event.
Regardless if the new amputee sitting in front of me is a 17-year-old long-distance runner or a senior citizen who's an active gardener, the reaction is invariably the same. They're skeptical their life can ever be good again -- let alone believe that, with the proper treatment, they'll be able to do the things they once loved, like run a marathon or tend to their garden. But in time, most become believers and realize their possibilities, thanks to continued advancements in the field of prosthetics, experienced and compassionate practitioners, individual determination and a strong family support network.
So imagine my frustration, and more important my patients', when I have to tell some amputees the following: "I have the expertise and technology to fit you with a prosthesis that will help restore the active, fulfilling lifestyle you knew before the amputation, but your insurance policy won't pay for treatment because your insurer either doesn't cover prosthetic care or has reduced its coverage significantly."
In these situations, which are happening with increasing frequency, we still treat the patient because we don't believe in turning anyone away, even if their insurer won't cover the treatment. Previously, we've donated tens of thousands of dollars in treatment and materials to patients, and I'm sure that we will continue to do so.
However, we are not a nonprofit organization and the alarming changes we are witnessing among insurers when it comes to covering prosthetic care threaten our continued ability to treat patients unless changes are made.
Amputees in Virginia today face the grim reality that a growing number of group and private insurance companies are imposing unrealistic caps on prosthetic coverage or are eliminating coverage altogether. Depending on the amputee's level of activity and type of amputation, a prosthesis can cost anywhere from $5,000 to upwards of $40,000. Some insurers force their insureds to accept policy limitations, such as one limb per lifetime, a $2,500 maximum lifetime benefit or a $500 limit on treatment per year.
Unbelievably, some companies are even eliminating prosthetic coverage altogether. There is no consistency among insurers when it comes to prosthetic coverage and there needs to be. Several states, including Colorado, Maine, New Hampshire, Rhode Island, Massachusetts and California, have already recognized this problem and passed legislation requiring insurance companies to pay for prosthetic care.
In Virginia, a concerned group of patients, orthotic and prosthetic providers, legislators and the Amputee Coalition of America have joined forces under the banner of WAVE, Working Amputees of Virginia for Equality. Together, we are supporting Senate Bill 931, prosthetic parity legislation that requires health insurance companies to provide coverage for the repair and replacement of prosthetic devices and components.
This draft bill is presently before Virginia's Special Advisory Commission on Mandated Health Insurance Benefits, whose members will decide this fall whether the bill dies or takes the next step toward becoming a reality. Commission members should allow this bill to move forward, especially in light of the facts.
Mandating prosthetic coverage can actually save the commonwealth money through cost savings in unemployment insurance, state employment and training programs, rehabilitation and counseling programs and other social welfare systems. According to the coalition, it is estimated that every dollar spent on rehabilitation, including prosthetic care, saves more than $11 in disability benefits. The fiscal savings that result from legislation requiring prosthetic coverage pale in comparison to the nonfiscal benefits that accompany mandated prosthetic coverage.
Amputees who have access to prosthetic care and devices show a reduction in the secondary conditions caused by a sedentary lifestyle, have decreased dependence on caretakers and a reduced chance of diabetic-related complications leading to additional limb amputation. Most important, this segment of the population can become contributing members of society again instead of being dependent on it.
I urge the commission to allow a prosthetic parity bill to move forward and the nearly 40,000 Virginians living with limb loss or limb deficiency to once again believe in their possibilities.
The kids and I had to go to Walter Reed Hospital in DC today to get Abby's new orthotics. We spent 3 hours in the prosthetics clinic watching men whose lives and bodies have been obliterated by tragedy in far away places.
The doors to the clinic would swing open wide and these men would roll themselves in the clinic in their wheelchairs and throw their old prosthetic on the counter, laugh and joke with the staff and then minutes later you would see them test driving the new limb while running up the hallway.
Several of them had wives push them in - women with a strength of spirit and heart that seemed too great for words - put pain that was still so close to the surface that they couldn't make eye contact with you.
I could have gotten a babysitter for the two little guys - it was an all day affair. But frankly, I wanted them there. I shared with Michael before we went in what we would see, how he should behave when he saw it and then assured him I'd answer all of his questions when we got back in the van. He was a trooper - amazed while not really understanding how amazing it all was.
Truthfully, I want my kids to see the ugliness of reality - actually I guess I want them to see that NOTHING is FREE. I want them to know of great men and heroes, and people who pay the price and march on.
That's true of their knowledge of Jesus too. I want them to not only know Him as the Savior who rescued them - but also the Savior who was broken and bled and nearly crushed- I want them to know the tomb, only after they've sat at the feet of the cross where the blood trickles down over them. The truth is we need a Savior who bled for us and we need soldiers who will do the same for our freedom in this country and around the world. The sad thing is - very often we want the victory without the battle to the extent that we'll ignore the battle altogther and those who fought.
Wasn't it David who said - "I will not give Him that which costs me nothing".
Today was a reminder of people who say that sort of thing and then have to live with it.
The crazy thing is - the Prsthetics and Orthotics clinic is the rowdiest clinic at that hospital I think - those guys laugh and joke, and talk and share a camaraderie - some unspoken connection that is sacred and precious and solid. It was awkward to be in the room at some points - not because of their injuries - but because of their laughter. I felt small, and shallow and trite.
As we left today, another gentleman was being rolled out to the elevator in front of us - his injuries looked new, his face still carried grimaces of terror and shock - one leg was gone, the other in a cast with tubes hanging out where the foot should have been, one arm in a cast and a tube running out of his shirt at his neck - I never saw him blink. I hope we see running down the halls the next time we're there, or maybe just sitting in the room next to us deciding whether he wants the shiny silver leg, or the flesh colored one made for running. Pray for him - it's a long way from where he was today, to that moment - but at the very least we owe him and others like him a prayer.
AN AMPUTEE who lost an arm and a leg while clearing landmines in Mozambique, is currently cycling from the Thai border to Sihanoukville, Cambodia, to help raise funds and awareness for the Thame charity, The Cambodia Trust.
Chris Moon MBE's fundraising will help the Cambodia Trust to provide prosthetic (artificial) limbs, wheelchairs and the opportunity to go to school for many Cambodian children disabled by landmines, polio and other conditions.
"In 1993 I was clearing landmines for a charity in Cambodia and I saw the terrible circumstances in which Cambodian disabled people struggle to survive," explained Chris. "In 1995 I learned the importance of artificial limbs when I lost my lower right arm and leg walking in a supposedly clear area in a minefield in Mozambique."
Moon has undertaken a number of extreme challenges to raise funds for the Cambodia Trust, including a 300-mile run across Death Valley. "I’ve witnessed the work of the Cambodia Trust first hand for more than ten years. It’s a very worthy organisation doing excellent work," he added.
The Cambodia Trust is a UK Registered Charity, established in 1989 and runs rehabilitation centres, community-based rehabilitation projects, and Prosthetics and Orthotics education centres in Cambodia, Sri Lanka and East Timor.
CHRIS Moon studied Agriculture with a development bias, worked as a volunteer at a centre for the homeless and then joined the army. On leaving the army in 1993, he began work for British charity the HALO Trust, clearing landmines in Asia and Africa. Whilst working in Cambodia in 1993, he was abducted by Khmer Rouge guerrillas with two Cambodian colleagues. He is one of the few Westerners to have survived the experience, avoiding execution and negotiating their release from a remote jungle base, finally walking 50km overnight through patrolled and mined jungle.
In 1995 in Mozambique he was blown up by a landmine while walking in a cleared area. He lost his lower right arm and leg, but does not consider himself a victim because he chose to work in mined areas, “whereas people who live there have no choice”. Doctors say he survived against the odds because of his high level of fitness and his knowledge of first aid. After leaving hospital he did a Masters Degree in Security Management at the University of Leicester.
In 1996 Chris was awarded the MBE from the Queen for services to the HALO Trust, clearing anti-personnel mines and received a bravery award from Diana, Princess of Wales. In 1998 he received the US Centre for Disability and PALM international leadership award. In March 1999 Lord Snowdon honoured Chris with the Snowdon Special Award for his leadership and support of disabled people. He has also been awarded honorary degrees and doctorates by the universities of Plymouth, Leicester and Exeter.
Less than a year after leaving hospital, Chris completed the London Marathon to raise funds for land mine-injured people in Cambodia. In April 1997 he was the first leg amputee to complete the 250km Great Sahara Run, described as the toughest footrace on earth, raising £100,000 for an International Committee of the Red Cross centre providing prosthetic limbs in Vietnam. He carried the Olympic torch into the stadium in the Nagano Winter Olympics in Japan in February 1998 and ran from Hakone to Tokyo to raise funds for a Japanese charity. In April he started and ran the Flora London Marathon (the first person to ever do this), captaining a team of 500 runners raising funds for charity. In September 1998 he completed Australian’s ‘Outback Challenge’ to raise funds to support mine action programmes. In 1999 he ran the length of Cambodia (700km), supported by a team from the Red Cross, to challenge attitudes towards the disabled, to raise funds and to support requests for the Cambodian government to ratify the Ottawa Treaty.
In July 1999 he was the first amputee to complete the Badwater Death Valley Ultra-marathon. In April 2000 he jointly led a party climbing Kilimanjaro on a new north route. In May 2000 he completed the 100km Kumamoto volcano run in Japan and in July 2000 was one of only 12 people in the world to do the Death Valley 300 miles, from the lowest point of the USA continuously on foot to the highest point and back again in just over six days in temperatures over 130 degrees Fahrenheit. He did it again in 2001 to test false legs and is one of only a handful of people in the world to complete this double desert crossing twice.
Chris Moon established his own company, MTB (Making The Best - his philosophy in life), and is a well-known speaker on the subjects of change management, motivation, leadership and challenging the concept of limitation. His autobiography, ‘One Step Beyond’, was published by Macmillan in 1999.
Chris' story was shown on Channel 4 television in September 2006, as part of the ALIVE series. For more information please visit Channel 4's website: http://www.channel4.com/science/microsites/A/alive/programmes_6.html
A local puppy is preparing for prosthetics. It's never been done before, artificial limbs on not one, but two legs of a nine week old maltese.
Hope barks and looks like most little maltese puppies do.
"Hope is like any normal nine week old puppy, she's playful and lively and plays with the other dogs like she has all of her legs," said Mary Dube, who got Hope.
However, the four legged friend was born with only two.
Dube got Hope through an organization called Southern Comfort Maltese Rescue that welcomes in dogs in need of help.
While Hope has no problem getting around, Dube wants to give her a fair chance to walk around like a dog, instead of hopping like a bunny.
This is the first time prosthetic limbs will be attempted on an animal like this. Hope will come to Dynamic Prosthetic and Orthotic where they'll make a cast of Hope before making her new legs.
Locke Davis will be making the device, that's much different than the human legs he's used to, but hopes it will work.
"Basically it's a mechanism that's gonna have wheels on the bottom, it's more like a rolling wheelchair or something rather than an artificial limb so he can propel it and drive it with his hind feet," Davis said.
Dube said,"It will help her around on a surface in a home or yard as any other normal dog would, she's not going to be able to go up stairs or anything, that haven't made doggy prosthetics that advanced yet."
But advanced enough to give young Hope hope for a somewhat normal, playful doggy life.
Hope will get the fitting for her new legs this Friday.
Afterwards she will have to go through rehabilitation to build up her back legs.
Tyler Ritchey sits to take a closer look at Kirsten Witbeck's new right leg. "That's amazing," he says. "It looks just like your other leg. How are you doing with it?"
Witbeck, 26, of Tempe, has been fitted with several artificial legs since being diagnosed with bone cancer and getting an above-the-knee amputation at age 12. This one, with a rechargeable-microprocessor knee and a button for rotating the leg, is a technological marvel.
Better still, one of Ritchey's colleagues at Pongratz Orthotics & Prosthetics in Phoenix recently covered the leg's working parts. Now, its color and the curve of her ankle and calf, visible where Witbeck's capri pants end, mimic those of her left leg.
"I don't think I've ever had a cover that looks this good," she says.
Ritchey asks her about the fit, weight and resistance of the leg when she walks on it, the questions instinctively coming to him.
In one moment seven years ago, a car speeding 80 mph turned him into both a prosthetic user and a prosthetics and orthotics health-care professional.
Many people find work designing and customizing artificial limbs and orthopedic braces by chance, the Chandler man says: An uncle who is an amputee or a classmate who wears a wrist brace opens the possibility of careers not previously imagined.
Ritchey's career route was more direct. In the last month of a two-year church mission in Mexico, he was struck and carried about 300 feet while attempting to cross a winding road on foot after his car broke down.
The driver who hit him swerved hard to fling Ritchey from the hood of the car and kept going, leaving Ritchey with broken bones and injuries to his stomach, lungs, shoulders and knees.
"My leg was the least of my problems," Ritchey says.
His parents were beside him when he emerged from a coma after several days on life support. But there was no one like the Ritchey of today at his bedside in Mexico, no person who had been through a similar experience and was equipped to reassure and educate him about life without a leg.
"It was a shock to wake up and find that my left leg below the knee was gone," he says. "It didn't look good for me to be this active person anymore, the one who played basketball and was always busy."
Phoenix vascular surgeon Jeromy Brink says people who undergo an amputation - about 135,000 are performed each year in the United States - face not just the obvious physical challenges, but emotional ones as well.
"Learning to use a new prosthesis is 90 percent mental and 10 percent physical," he says. "It's (dealing with) the loss of an entire part of their lives and getting accustomed to the way things are now."
For patients who lose a limb because of an accident, the emotional loss may be worse than for those with a chronic illness that eventually makes amputation necessary, he says.
"A lot of patients I deal with are long-standing diabetics who have known the score for many years and are facing amputation as a last resort," Brink says.
Diabetes, cardiovascular disease, accidents and cancer are responsible for most amputations.
Ritchey had unstinting support from family, friends and the medical community. For him, adjusting psychologically to the loss of a leg turned out to be easier than adjusting to the demands of therapy and recovery.
Back in the Valley a month after the accident, he came face to face with an unfamiliar frailty. There were daily rehab sessions for a year, 27 surgeries, mending bones, and metal rods and steel plates placed throughout his body.
Still, says Ritchey, 27, "the toughest day I ever had was the first day I was fitted with a prosthetic leg. I thought I'd get the leg and walk out of here, but it required a lot more work."
Even with the lightweight leg he uses on most occasions, walking expends more energy than it did when the legs he was born with propelled him.
Ritchey was fitted with his first artificial leg by the man who later hired him, company owner Joe Pongratz.
Pongratz began calling on Ritchey, who is fluent in Spanish and English, to talk with patients, and he created a paid position for him as amputee liaison when the calls became increasingly frequent.
"I would see Tyler in the lobby before his appointment, and he would talk with the people sitting next to him," Pongratz says. "He was affecting them in such a positive manner. They'd see him walk in, cheery as always, and hear his story and think, 'I can deal with this.' "
Recalling the uncertainty of those early days of recovery, Ritchey decided to take the job. He had survived what he now saw new amputees facing, still in shock emotionally and drained physically from the loss of a limb. He could answer questions from people resisting the surgery their doctor told them they needed.
He enrolled in peer-support counseling classes to improve his job skills, was mentored by Pongratz and other co-workers and quickly learned how rewarding the new job could be.
"You work with people who wheel in here, and you see them walk back out," Ritchey says. "You're giving them back something a lot of them haven't had in a long time."
He and Pongratz organized a support group, Limbs 2 Life, to give new and longer-term amputees further opportunities to share stories.
During informal gatherings, members talk about technical advances that allow them to make a jump shot on the basketball court, wear high heels of varying heights or grasp a gardening tool.
Witbeck, for example, shared with Ritchey that she recently danced at a wedding reception, and she is soon to go camping with friends, a first for her.
"The alignment's good," she says of her prosthetic leg, "and there's a smooth transition from the ankle to the foot. This knee is great, so much more stable. I feel like I can trust it."
Ritchey, married now and the father of two, need not have worried about remaining active. Since the accident, he has earned a bachelor's degree in marketing and made his first parachute jump, his artificial leg proving up to the challenge of absorbing the landing's impact.
He is completing a master's degree in business administration and just began an eight-month prosthetics-certification course through Northwestern University, to be completed online and at the school's Chicago campus.
"Far more doors have opened for me since the accident than have closed," Ritchey says. "With a good family and good doctors and a good company behind you, you can't fail. They keep you up when you're about to fall."
Developed for an injured dolphin, ‘Easy Gel’ limits amputee’s pain By Patrick Winn - Staff writer Posted : Tuesday Aug 21, 2007 15:21:42 EDT
Brian Kolfage had reasons to be skeptical. After all, the triple-amputee could hardly count the techniques doctors had devised to help him settle into prosthetic legs without stinging pain. Now there was this Irish practitioner named Kevin Carroll, a supposed wizard with prosthetics, claiming he’d found the solution: a gel-like cushion he invented for a dolphin with an amputated tail.
“I said, ‘Uh, OK. I guess we’ll try it,’ ” Kolfage said. “I didn’t really think it would work.”
He distinctly recalled Carroll walking into an Arizona treatment center, laying down a hunk of the jelly and doing handstands on it to prove the substance’s worth.
After they lined the sockets in Kolfage’s steel legs with the material, he attached them and, miraculously, jumped up and down with little pain.
“Instantly, I felt it working. It kind of mimics fat. It was gushy but didn’t bottom out,” Kolfage said.
Life has tested Kolfage each day since he lost his right forearm and both legs. A mortar hit him Sept. 11, 2004, when the former senior airman was assigned to the 887th Expeditionary Security Forces Squadron, serving at Balad Air Base, Iraq.
Kolfage left his tent to grab a water bottle about 2 p.m. He made it 20 feet before a 107mm artillery round sailed over the wire and practically liquefied his lower limbs. His right hand, he recalled, looked like a dog chewed on it.
He awoke three days later at Walter Reed Army Medical Center in Washington, D.C., with his hand and both legs gone. Doctors checking for internal bleeding left a long scar from his breastbone to pelvis.
Kolfage’s resolve was strong. His recovery, considering his near-fatal injuries, was fast. But the airman could not overcome pain he felt standing upright on prosthetic legs. His left leg was removed at the pelvis, and bone spurs — bony growths that often jut out after amputations — were thinly covered.
His body weight bearing down on those spurs was excruciating.
“There’s no fat or tissue covering those spots. Just a little skin,” he said.
Practitioners tried scores of different cushioning materials on Kolfage’s legs. “They probably made 50 pads out of foam. Even my dad was sending bucket loads of stuff, anything he could find,” he said.
No matter the material, walking was deeply painful.
The answer finally emerged last year, in the form of a prosthesis expert and a tailless marine mammal.
A fisherman found the baby bottlenose dolphin in 2005 in the waters off Cape Canaveral, Fla. It was flailing in a crab trap, its mouth caught in rope and its tail losing circulation in a clamp. The state’s Harbor Branch Oceanographic Institution adopted the dolphin, named it Winter, amputated its badly injured tail and found it a home in the nonprofit Clearwater Marine Aquarium.
A pet project
Carroll, an Orlando resident who heard Winter’s story on the radio, detected a challenge. His job title is vice president of Hanger Prosthetics and Orthotics. His job description is more compelling: visiting amputees around the nation and providing unorthodox solutions to those with the most difficult problems.
In 2005, Winter became his pet project. The dolphin was relying on its rounded tail nub and flippers to swim, an adaptive technique that could damage its spine. Carroll wanted to design a prosthetic tail for Winter, but he knew he couldn’t use the standard foam pads used to secure prosthetic legs to humans.
So, with an Italian chemical engineer also living in Florida, Carroll helped develop a tacky, transparent, gel-like cushion they call “Easy Gel.” It fits around Winter’s nub, securing a socket fixed to a jointed plastic tail. Winter, about 20 months old, now performs routinely at the aquarium while adjusting to the gel and new prosthesis.
Carroll, who is nearing his 29th year as a prosthetist, had seen bomb-blast wounds similar to Kolfage’s many times before: He began his career treating bomb injuries, a toll of “the Troubles” — the conflict between Catholics and Protestants in Northern Ireland. From those beginnings, Carroll has carved his niche as the man to call when prosthetic treatments plateau. His firm, Hanger, has assisted Hurricane Katrina evacuees, given an injured Marine a camouflage prosthetic arm and aided an adolescent who tripped a mine in postwar Kosovo.
The war in Iraq has presented Carroll with fresh challenges.
“In my position, I see some awful cases,” he said. “Brian would be up there with the worst of them.”
About seven months into his work with Kolfage, Carroll perceived parallels between Winter’s missing tail and Kolfage’s missing legs. Kolfage’s bony spurs, he said, “are very pointy. If you put pressure on the tip of your small fingernail, it’s like that coming through the skin.”
“But Brian just floats on the gel,” he said. “He just sinks into it, but the socket is still stable.” The seemingly simple solution has finally given Kolfage the ability to walk, his ticket to mobility and freedom.
Kolfage was deemed too injured to continue serving in the Air Force. But through a program called Helping Airmen Recover Together, the service secured him a civilian position as the security manager at Davis-Monthan Air Force Base, Ariz. He lives in Tucson with his wife, Nikki, who married him at the hospital several months after the accident.
Kolfage is one of 312 airmen wounded in action during Operation Iraqi Freedom. Throughout the military, he’s among only three or four triple amputees from the war. Yet with only one limb intact, Kolfage can shave, type and even drive.
“I’ve learned like a baby to do everything all over again,” he said.
Kolfage would wear his prosthetic legs more often, he said, if it weren’t for Arizona’s sun-baked summers. Walking already costs him about 300 percent more energy than the average person. The signature on each of his e-mails reads: “Pain is inevitable, suffering is optional.”
As for plans to unite with his finned counterpart in Florida, Kolfage is noncommittal.
“One day. Maybe,” he said. “You know, if I’m ever down there.”
Yesterday I panicked. Two years ago I decided I wanted to become a practitioner in the field of orthotics and prosthetics. About a year ago I changed my mind, mostly out of fear and the fact that it will be a LOT of work. A few months ago I changed my mind again and half decided to become a practitioner. By half I mean I figured out that God really has given me talents and abilities in this field and it is a field I am passionate about. I figured out that God put these desires in my heart, but I didn’t look the path directly in the eyes. Yesterday I did the research. Since I already have a baccalaureate degree, I have two possible paths. I can either get postbaccalaureate certificates (one for orthotics and one for prosthetics) or I can get a masters degree (in orthotics and prosthetics). I can do most of the coursework for certificates online but I would have to either go to Georgia Tech or East Michigan University for the masters. Masters programs in this field are a relatively new thing so if I go for certificates, I will probably eventually have a way to be grandfathered into a masters. (Probably just have my coursework for certificates count towards a masters and then take a class or two extra, or something like that.) Either path will take about the same amount of time. Either path requires me to take more coursework to meet the prerequisites. To go for a certificate, I will probably have to take out loans. Big ones. To go for a masters, I have opportunities to obtain assistantships, which would pay for my tuition and provide me with a stipend. Did I mention my husband is working on his doctorate no where near the states in which I could get a masters? Either way I am scared of the school work. A lot of it will be memorizing information, which does not come naturally to me. I am a lot better at analyzing a situation and applying knowledge. I am scared but I know I need to do this.
I’ve been reading The Cost of Discipleship by Dietrich Bonhoeffer. In the chapter I read today, he broke apart Mark 8:34:
“If any man would come after me, let him deny himself, and take up his cross, and follow me.” It was a VERY good chapter. One sentence in particular hit me.
“To deny oneself is to be aware only of Christ and no more of self, to see only him who goes before and no more the road which is too hard for us.”
Some of you may feel I am overreacting about the path I am starting to see in front of me. You may even feel Mark 8:34 is overkill for my situation but here is what I see. I see God leading me somewhere I think is over my head. I feel very incapable. But if this is truly something God is calling me to do, I need to do it and trust Him to provide and pull me through this. I need to deny myself and trust Him. As my dad is always so quick to remind me that God has pulled me through so many situations. He has never given me a reason not to trust Him. This situation isn’t any different. I don’t have to decide right now if I am going to get certificates or a masters but I can at least get started on those prerequisites.
The next post I make will be a lighthearted one, I promise.
BIG BAY — “Yes, you can go swimming!” “Yes, you can ride a bike!” “Yes, you can play baseball!”
Phrases like these are what prosthetists at Wright & Filippis found themselves constantly repeating to their young prosthetic patients. Looking for a way to further encourage patients to try new activities, Wright & Filippis developed a summer camp where kids with artificial limbs are taught that “YesICan” DO ANYTHING!
Aug. 19-25 marks the third year for Camp YesICan. This week-long camp aims to build courageous, confident and self-sufficient children to lead productive lives through traditional camping experiences. Amputees, ages 4-17, are encouraged to attend and given the opportunity to learn things like playing golf, trying a martial art, sharpening a pencil, and swinging on a swing.
“Our young patients needed the reassurance that after they lost their limb, they could still do any sport or activity they used to do,” said Wright & Filippis prosthetist, Lynn VanWelsenaers. “I found many other patients throughout the state who had the same concerns and wanted a place where they could all work together to accomplish their goals.”
Camp YesICan is held at Bay Cliff Health Camp, which is located on 170 acres of land along Lake Superior near Big Bay, in Marquette County. Through an intensive program of daily therapy and traditional camp activities, children learn to become more independent and are inspired to believe in themselves and their potential.
Director of Prosthetics of Wright & Filippis, Ken Woodward, explains, “Each child who attends Camp YesICan will learn that with their prosthesis, there truly are no limits. They will learn how to use their prosthesis more fully, try activities and sports they may not have had the opportunity to learn, and practice activities with which they had a hard time. This year, we’re planning to have about 30 kids attend. Our goal is to make a difference in each and every one of their lives.”
Sponsored by the Bay Cliff Health Camp, the Filippis Foundation, and the Wright & Filippis prosthetic department, this week-long experience will give children an environment where they learn to believe that “Yes I Can” DO ANYTHING!
Wright & Filippis is a Michigan-based healthcare company, specializing in prosthetics, orthotics, respiratory services, and home medical equipment. Founded in 1944, Wright & Filippis is the state’s largest home healthcare provider.
Belize is a tiny country once known as the British Honduras. Bordered by Guatemala to the west and the Caribbean Sea to the east, it is a major tourist destination thanks to lush tropical forests and the longest living barrier reef in the Western Hemisphere, as well as its rich Mayan history. As beautiful and breathtaking as those parts of the country are, Belize is, in reality, still a third-world country with the ugly truth hidden from most tourists.
Travel away from the luxurious coastal resorts catering to upscale American and European tastes, inland over its unpaved roads, past field upon field of sugar cane and one ramshackle house after another, and the real Belize is revealed – abject poverty of a large majority of the country’s 294,385 residents and an overwhelming lack of modern conveniences and services, including basic medical care.
The country’s economy is fed by two industries, tourism and agriculture, in that order. Sugar is the chief agricultural crop as well as a main staple in many Belizean diets because of its accessibility. As a result, the incidence of diabetes is high, as is the loss of limbs from the disease. Those lucky enough to have employment often toil on the sugarcane farms. The downside is the number of workers who lose limbs while operating unsafe, outdated agricultural machinery. Lack of medical care also means that many seemingly minor cuts, scrapes and broken bones frequently lead to gangrene and the necessary removal of a diseased limb.
Canyon Lake resident Michelle Whitehead was struck by what she learned about Belize. Having just sold her business of five years, Temecula Valley Orthotics and Prosthetics in Murrieta, Michelle was online researching new opportunities in which she could help others when she came across the Sonrie Ministries program, Project Hope: Belize. What she discovered is that, among all else it lacks, Belize is also the only Central American country without any form of prosthetic services.
Michelle became interested in the field of prosthetics while still in high school when family friend and fellow Canyon Laker Rod O’Conner introduced her to the specialty. She has been working in the field since 1996.
“He offered me my first opportunity and taught me what prosthetics was all about, including teaching me how to fit, cast and fabricate prosthetic devices,” says Michelle. She went on to study at California State University, Dominguez Hills, where she earned a specialized bachelor’s degree in health science with an emphasis on prosthetics and orthotics after making it through a highly selective process to be named as only one of 12 students accepted to the two-year program.
The specific goal of Project Hope: Belize, founded in 2000, is to provide prosthetic services to those most in need; it has given new hope to more than 120 patients to date. Services are offered free of charge, with all materials donated and practitioners volunteering their time as well as paying their own costs.
In addition, local Belizeans now train with the team to become technicians so that maintenance and follow-up care can be provided even when a Project Hope team is not in town. Its first permanent facility in Belize is located in the community of Orange Walk Town, also known in the local dialect – a mix of English and a type of Creole - as “Shuga Town” for its role as top sugar producer in the country.
Michelle made her first trip with Project Hope in May, and the effects of the trip were immediate and lasting. Accompanied by her husband, Chuck Whitehead, their two children Trevor and Ryan, and her mom, Margaret McCoy, this would be Michelle’s first foray to a country like Belize.
As with many countries, Belize has beautiful places to visit – the cays, the resorts, etc. We went to the ‘real’ Belize and saw how the people really live,” she recalled of her impressions. “The country is very rundown and very poor. We were told the average weekly salary was around $7 to $8 per week.”
While in Belize, Michelle spent her time building legs for a number of patients – people with diabetes, cancer patients, a teen who was electrocuted and car accident victims. The group of practitioners she traveled with included the head of Georgia Tech’s prosthetics department. She worked closely with Adrian, a local man born with no legs who helps coordinate patient services when they are in town.
“He believes he was given his disability to help inspire amputees and to teach them that through courage and faith they can do anything and their lives can still have meaning,” explains Michelle, adding that she was absolutely taken by his joy for life despite his obvious handicap.
Over the years, Michelle says she has made many different types of prosthetics for a wide variety of patients, from infants to seniors – even a horse leg – and has always felt a certain joy at having the ability to give someone an opportunity at a better life; but never more so since her return from Belize.
“I am hoping to help build more legs for as many other less fortunate people around the world as possible,” she says. “It makes you realize how lucky we are to live in such a great place and how much of an impact we, as Americans, can directly make on the lives of others. It also makes me proud that I am in a profession that can so directly change peoples’ lives.”
To find out more about Project Hope: Belize,
visit the Sonrie Ministries website at www.sonriesministries.org.
By Michael Ireland, Chief Correspondent, ASSIST News Service SAN DIEGO, CALIFORNIA (ANS)
-- Gene Roberts is a former Marine with a big heart – and an even bigger goal: to run more than 3,500 miles across the United States on prosthetic legs. Roberts is a double amputee who served in the Vietnam War until he stepped on a land mine in Da Nang in 1966. He is in the process of running across America to inspire other war veterans and raise money for his favorite charities in the name of Jesus.
Eugene Starks Roberts was born December 14, 1945 to Lyle and Margaret Roberts. Eugene was born an identical twin of two boys; his twin is named James. Gene was educated in the Baltimore City School System.
He graduated from Forest Park High School where he excelled in cross country track and wrestling. After high school, Gene entered the Marine Corps. He went through his basic training and was soon sent to Viet Nam. He was in Viet Nam for about a month when he was hit by a land mine and had to have his legs amputated. One leg was amputated above the knee and one below the knee. Gene was an excellent patient and before too long was walking on artificial legs after extensive physical therapy.
In 1967 Gene met his wife, Marian Alicia, and they were married December 15, 1967. They have three girls, Cherie, Lawana, Bonita, and one son, Eugene Jr. They now have 10 grandchildren.
Gene continued his love of sports, that was nourished in high school, by swimming and running. He ran the Boston Marathon on his hands one year and in his wheelchair another year.
When he was participating in wheel chair races, he participated in races in Indiana and Maryland. When he decided to swim, he trained at the Druid Hill Park Pool one year and in his back yard pool another. He attempted to swim the English Channel on three occasions and was defeated by cold water on one and the weather on the two other attempts. After the last swim, Gene decided to return to his first love, running. He trained hard and finally entered the Baltimore Marathon. Gene finished the marathon and said, “ It wasn’t pretty, but I finished.” The next year he entered the 5K portion of the Baltimore Marathon and was quite successful. Gene now runs in several 5K runs because he just loves to run. His goal now is to run across the United States to raise money for the poor and the needy and a couple of his other favorite charities.
As a kid, 14 or 15, the neighborhood boys would play in Baltimore City’s Druid Hill Park. We would sometimes race around the reservoir.
Roberts recalled: "The summer before I went to high school, I spent the summer in DC with my sister and worked in a barber shop cleaning up and shining shoes. On my way to work one day, I saw a body building magazine in a store window. I said to myself that I would like my body to look like that. When I got paid, I bought a set of weights, a bench, and a sit-up board. My sister and her husband allowed me to set up my gym in one of their empty rooms. When I returned home to Baltimore, I built a gym in my basement."
School began in the fall and he attended Forest Park High. "One day my gym teacher instructed us to run around the gym. After observing me run, he recommended that I attend the track and cross country practice. I did and joined the Junior Varsity track team. That winter I also joined the wrestling team. I wrestled in the 138-pound class and successfully out wrestled everyone on the team," said Roberts.
In the junior year of high school, 1964, Roberts won the two-mile track championship for Baltimore City Public Schools. A couple of times that year it was announced over the school PA system when he won a big race. The Sun newspaper featured Roberts in an article, which included a picture of him.
Roberts continued: "I ran all summer, lifted weights, and played basketball at Cloverdale near Druid Hill Park. I recall my mother telling me not to over do it during this period. I certainly didn’t listen, because I simply loved to workout and run. In September, during the cross country season, there was a cross country state championship called the Spike Shoe Meet. I wanted to win that race more than anything; I led all the way right to the tape when three county boys ran passed me.
Shortly after the championship run, Roberts was involved in a fight with some boys in Druid Hill Park. "I sprained my ankle very badly and was forced to use a cane. As a result, I was unable to finish the cross country season. During the wrestling season I was undefeated. I went to a talent show at my twin brother Jim’s school, Carver High. After the show, my brother, his girlfriend and I stood outside talking. Another teenage boy said something to my brother’s girlfriend, I responded, and he pulled out a gun and shot my brother and me. In the hospital they got us mixed up and were going to operate on him, but I was the one who required the operation. They realized the error and I had my appendix removed. I missed the wrestling championship and was unable to run track that season. I trained for two weeks and ran the championship. Surprisingly, I came in 3rd place in the mile with a time of 4:32 and 2nd in the two-mile run with a time of 10:04. That year Wake Forest sent me a letter inviting me to run for their school."
Roberts said that when he graduated from high school he had to make a decision about his future. "I knew I wasn’t the college type, so I decided to enlist in the Marines. I recalled being ten-years old and my oldest brother returned home in his green Marine’s uniform. I was so impressed and vowed to one day be a Marine. My sister’s friend told me that it was not a good idea to go in the Marines because they were fighting in Vietnam. I had never heard of the place before and decided to join despite his warning. I took the necessary test and was sent to Paris Island in the fall of 1965."
Roberts did so well in boot camp that his drill instructor chose him to be one of his Pfcs out of boot camp. "Unfortunately, I came up short on the rifle range, missing the qualifying score by only 4 points. I went Camp LeJuene, N.C., then to Camp Pendleton in San Diego, CA. and finally I was deployed to Vietnam. I carried two Bibles to Viet Nam with me. I recall the Viet Cong shooting at my platoon, suddenly hitting the ground, and the noise from a bullet passing my right ear, so close I could feel its motion; this was my very first day in Vietnam," Roberts said. One day the Viet Cong hit one of his Companies really hard. "The next day we were sent on a search and destroy mission. We came to a gate and I warned the guys not to bother the gate because it might be booby-trapped. We walked through some trees, there were maybe four or five guys ahead of me, and there was an explosion; I was down. A helicopter arrived to transport me to the field hospital. When I awoke, I was at Clark’s Air Force Base in the Philippines, and was shocked to learn that both of my feet were gone. One of the guys from the mission apologized to me for getting me hurt and I responded, 'Don’t worry about it that is war.'" Roberts was shipped by plane to California and then to Andrews Air Force Base in Maryland and on to the Naval Hospital in Philadelphia, PA. He would spend the next seven months in Philadelphia. "I went home on crutches, with my left leg still healing after two skin grafts. After about 1 ½ years on crutches, I was able to wear both prostheses without the need for crutches." On a visit to a friend from high school, Roberts was sitting in her living room and a beautiful young lady appeared on the steps. "I said, 'Wow, who is that?!' She told me that was her cousin and I told her I wanted to meet her. After only three months of dating, we married. Before I met my wife, I was smoking and drinking alcohol. After we were married, I only drank a couple of times," Roberts said.
While Roberts was standing outside of his apartment one beautiful summer day, he thought there had to be an answer to life and death. "I said the Bible is supposed to be God’s word. I later told my wife, Alicia, I wanted to get a Bible so I could see what God had to say. One day, while at work, I was reading my Bible and a lady told me about a couple who could help me with the Bible. We started a Bible study with Tom and Olivia Harriston. They showed us, in the Bible, that we were sinners, Rom. 3:23, and sin brings death Rom 5:12. They also showed us that Christ died for out sins, Rom 5:8, and rose again the third day, Rom 10:9, so we could be saved, forgiven and have eternal life, John 3:16. Now I had the answer to life and death. Jesus said, 'I am the resurrection and the life,' John 11:25. We received the Lord Jesus Christ as our savior and Lord on June 26, 1969."
Roberts than began training to swim the English Channel and nicknamed himself the Black Seal. "The nickname symbolized black pride, but when I accepted the Lord Jesus it was no more black or white, it was Jesus. I never called myself the black seal after that," he said.
"I was watching a basketball game on television in 1998 and a commercial came on with someone running. As the camera zoomed in, I saw that both of the legs were artificial, yet she was able to run. I said then that I would do that. On August 24, 1999, I went to Milford Mill track to run, but my wife advised me to start walking first. I started running and only God knows how I made it around that track, it took me 5 ½ minutes! I made a decision to begin running on the street when I could complete five miles on the track. I began each race with the same inspirational quote, 'Just do it in Jesus' name!'"
In October 2000, Roberts tried to run the Marine Corps Marathon, but after twelve miles, had to stop due to lower back problems. In November he tried the Philadelphia Marathon and experienced the same challenges. "My prosthesist told me I needed to do stretches. I went to the Veterans Administration Hospital in 2001 to receive some adjustments. Then, in 2001, I finished the Baltimore Marathon, 26.2 miles, in 8 hours 41 seconds. It completely drained me, spiritually, mentally and physically, but thanks to my Savior, the Lord Jesus Christ, I was able to finish."
Roberts has run 5ks, 10ks, and 2 half marathons and in 2004 and ran across Maryland, 300 miles running 10 miles a day. "The Maryland run was really difficult, but extremely rewarding," he said. "As I ran, the word of God was my strength. When I went up those Western Maryland Mountains, I said, 'The power of Christ will get me over this mountain.' Running on prosthetic legs has been most difficult, but a most rewarding experience. Every time I run, it is to be a witness (Acts 1:8) for the one who is the answer to life and death, the Lord Jesus Christ. Even when I am not running physically, the race always continues spiritually," he states.
Now he is "running across America For Jesus."
He adds: "Running on prosthetic legs has been most difficult but a rewarding experience. As I run, the Word of God is my strength. Every time I run, it is to be a witness (Acts 1:8) for the one who is the answer to life and death, the Lord Jesus Christ. Even when I am not running physically, the race always continues spiritually. The God of energy, time and space has saved me by his wonderful grace and put me in this Holy race and one day I will see Jesus' face!" (1 John 3:2) Roberts has been training by running practically every day. He has maintained his physical fitness through exercise and eating a proper diet and has received clearance from his doctors for this run. He has also had his prosthesis changed, upgraded, tested and fine-tuned. He says: "The technological advances have been fantastic."Most of all, Roberts has prepared spiritually for this run by keeping it totally focused on Jesus. He prays and reads the bible constantly and has found many scriptures in the Bible that mention or refer to a race. One of the obstacles he faced initially was with his prosthesis. The ones he had were causing the skin to break down on his stumps and the feet of the previous prosthesis would turn/shift from being straight thus inhibiting his ability to run and causing him to fall. However, the Lord led him to a different company that was able to construct the prosthesis he is using today. Further, all of the changes to his prostheses were done shortly before he left to begin the run. While the problems may have discouraged a non-faithful person, Roberts pushed ahead knowing that the Lord will provide, if it is His will.The route Roberts is taking is outlined on the website www.raafj.com so that people can check the calendar on the website to tract his daily progress. Gene's wife, Alicia has taken a sabbatical from her job as a teacher so she can follow him as he runs.
Roberts expects to run from 10 to 20 miles a day, half in the morning and half in the evening. He will break up the day based upon the weather and terrain. Right now he is in the desert. He will run through California, Arizona, New Mexico, Texas, Arkansas, Mississippi, Alabama, Georgia, South Carolina, North Carolina, Virginia, Washington, DC, and Maryland. The total run is estimated to be about 3,500 miles.Roberts has three goals for Running Across America for Jesus. The goals are to share and exemplify the love and power of Jesus throughout the country by Running Across America; to inspire others, especially veterans with amputated limbs, to not be hindered by their physical disabilities; to demonstrate the importance of being and keeping spiritually, mentally, and physically fit; and, to raise awareness and money for the poor, the homeless, the disabled, and the underserved in the United States. Roberts was asked how can Christians across America pray for him and how can they get involved?
"Christians and any other persons can pray for Gene's safety and health as he Runs Across America for Jesus. Special notes will be made on the calendar on the web site regarding special prayer requests during the run. People can get involved by telling others about the run and Gene's availability for interviews and speaking engagements during his run," said a spokesperson.
Additionally, you can look at the website to keep up-to-date on his progress and sign the guest book with words of encouragement. Lastly, if you want to contribute to the societal ills that Gene so deeply cares about, they can send a donation to the nonprofit Running Across America for Jesus, PO Box 206, 1498 Reisterstown, MD 21208. The use of all funds donated will be posted on the web site and all donations are tax deductible.Having recently completed a run across Maryland, the Baltimore Marathon, and other runs, Roberts is now running across America – for Jesus!
After a kickoff Sunday church service on July 1, 2007 at Camp Pendleton, located in San Diego, California, the run began from Camp Pendleton Marine Base on July 2, 2007 and proceeds along secondary state roads and highways until concluding in Baltimore, Maryland.
Roberts has the goal of running approximately 20 miles a day and anticipates finishing the run in the spring of 2008.
He has been training for this journey and has received clearance from his physicians. Also, Roberts has specially designed prosthesis that enables him to tolerate the hard and uneven surfaces he will encounter. His wife will follow him in a van throughout the entire run. She has mapped out the route of the run and will update the website as they progress across America. Gene Roberts is available for interviews and speaking engagements. He is particularly interested in inspiring other veterans, among others.
To arrange an interview or speaking engagement, call 410-298-2777 or 1-800-542-1638. Mail can be sent to Running Across America For Jesus, 1498 Reisterstown Road, #208, Pikesville, MD 21208-3842.
Roberts asks: "Are you running for Jesus? If not, run to Jesus by faith and then you can run for Jesus by faith! (Heb.12:1-2)."
At first, John German’s morning routine seems as mundane as most — coffee and shuffling into work clothes to begin his day as a specialty medical salesman. But where others are spritzing on cologne and giving their hair a final fluff, German’s daily drill differs slightly as he slides on his prosthetic arm — and bionic hand.
German, 40, who lives in Altoona, is one of 11 people worldwide to be fitted with Touch Bionics i-Limb Hand, the first prosthetic hand with five individually powered digits. Electrical impulses — known as myoelectrical signals — from the muscles in the remaining portion of German’s left arm control the hand, opening and closing it and moving each finger. The signals are sent by electrodes on the skin’s surface.
“There’s a way to do everything,” said German. As he played catch with daughters Maddie, 11, and Lauren, 14, the bionic hand’s plastic fingers opened and closed around the ball.
A bionic dad is the only kind Maddie and Lauren have ever known — German lost his left forearm in April 1987. He suffered from thoracic outlet syndrome, a condition in which a small, vestigial rib near his collarbone was putting pressure on a major artery to his left hand. Several surgeries relieved the pressure, but his hand developed gangrene and was removed.
He was given a hook to replace his left hand and enrolled in an inpatient rehabilitation program but was soon dismissed for trying to make the hook his dominant hand. Today, he’s mostly ambidextrous but relies heavily on his right hand.
“The truth of it is I use (the bionic hand) as a guide on a lot of tasks,” German said, as his plastic fingers slowly used scissors to cut through paper. “Unless you have all day, why would you do it this way?”
After the hook, German was fitted with a less-advanced bionic hand, which he wore for about 17 years. That hand didn’t have individually operated fingers or the array of thumb positions the new one has. He’s only had the i-Limb Hand for about a month but said he could never go back to his former myoelectrical hand — which was more of a C-shaped pincher. With the i-Limb Hand, he can point his index finger and rotate his thumb to meet the side of the index finger to turn a key in a lock or hold a plate — positions that weren’t possible before. The hand is battery-powered and the batteries are recharged every three to four days.
Watching the bionic fingers move — following the signals his brain is sending — is “exciting,” German said.
“It makes me remember what it was like to have a real hand, what it was like 20 years ago,” he said.
Through his prosthetist in Detroit, German (who is originally from Michigan) learned of a skin-like covering for prosthetic arms known as LivingSkin. The company manufactures “high definition silicon coverings” for different types of prothetics, said Phillip Castore, director of operations for LivingSkin.
Interested in a covering for his old hand, about six months ago, German met with a LivingSkin artist. It was at that meeting that German learned of the i-Limb Hand, as LivingSkin manufactures coverings for Touch Bionics, among other prosthetic companies.
“It’s (was) a two-and-a-half hour session,” Castore said. “The artist studied his hand in various light. We’re able to simulate skin tones ... as well as skin. We also do custom nails.”
German was selected as one of the 11 people in Touch Bionics’ market preference study because he is an “extremely demanding” prosthetics user — meaning he uses his prosthetic frequently and for many tasks, said Stuart Mead, chief executive officer of Touch Bionics, which is based in Livingston, Scotland. German’s previous experience with a myoelectrical hand also made him an ideal candidate.
“(German) uses the hand frequently and is able to assess,” Mead said in a telephone interview. “And he tells it as he sees it.”
Mead said that while the majority of those in the study had “very, very positive feedback,” Touch Bionics made some “minor tweaks” to the hand — such as increasing the strength of the wrist — before it was released to the masses July 29 at the International Society for Prosthetics and Orthotics’ 12th Annual world congress in Vancouver, British Columbia.
The LivingSkin covering fits German’s i-Hand, and he said that while it can slow down the finger’s movements, it also improves the traction of his plastic fingers.
The i-Limb hand cost German $18,450 and the LivingSkin, $10,000. The prosthetic arm is the same one German wore with his old hand, but with modifications to hold the new hand’s batteries. German has about four or five arms for different tasks, including one he modified himself to include a hockey stick. He’s been playing hockey since before he lost his arm.
The arm hangs on the corner bones of German’s stump. Like some other amputees, he occasionally suffers from phantom pain (a sensation as if he still had his arm, and it was in pain), but his prosthesis is comfortable to wear. He removes it to shower, sleep and sometimes while relaxing around the house.
“I clean up the arms before people come over,” said German’s wife, Lisa, with a laugh. “Other people lose their keys; he loses arms. He’ll be watching TV and leave it by the couch, and then he can’t find it in the morning, like, ‘Where’s my arm?’”
At press time, German wasn’t sure if the expense of his new hand or LivingSkin would be covered by insurance, but he said he planned to ‘‘challenge the insurance companies until they pay.’’
‘‘I’ll continue to fight,’’ he said. ‘‘They have to. If they don’t, they’re denying function." ’
Some high-tech prosthetics look as if they'd give athletes an advantage, but perception might not jibe with reality.
By Jeannine Stein, Times Staff WriterJuly 23, 2007
With sleek, curved prosthetic legs that appear straight out of a sci-fi movie, sprinter Oscar Pistorius has been blazing across running tracks, leaving controversy in his wake. At issue is whether those carbon graphite appendages give the 20-year-old South African bilateral amputee an advantage over able-bodied runners, an issue that's yet to be determined as he makes a bid for the 2008 Olympics in Beijing. No, say prosthetic manufacturers, other amputee athletes and researchers. Maybe, says the International Assn. of Athletic Federations, the governing body of world track and field, which continues to study the matter before making a ruling.Although national Olympic committees ultimately select the competitors, technical rules in track and field are enforced by the IAAF. And one of its rules forbids "technical aids that give the competitor an advantage over someone not using them." As prosthetics improve and training techniques advance, such cases are likely to become more common. Even as prosthetic designers try to devise limbs that would be an improvement over biological limbs, many of today's amputees are determined to be as fit and competitive as possible. In doing so, they're going up against the fittest of able-bodied athletes, regardless of the odds. A little more than a week ago, Pistorius placed seventh at a race in England, running the 400 meters before being disqualified for going outside his lane. But he had already garnered attention for holding world records in the Paralympics. Although he's not the first disabled athlete to compete against able-bodied athletes, he is the first bilateral amputee who may make the crossover. The prevailing sentiment among those who work with amputees is this: "I think he has a distinct disadvantage," says Hugh Herr, associate professor of media arts and sciences at MIT. A double amputee himself, Herr is director of the school's Biomechatronics Group. "The prosthetic he's using is completely passive -- it's just a spring." A spring, he adds, that can't possibly compare with the force with which the human leg can propel a foot off the ground. "That comes from the muscles, and he has no muscles," Herr says. "He's just really fast."Amputee athletes must compensate for what they don't have -- muscles, tendons, ligaments, joints, bones -- things that even a state-of-the-art passive prosthetic can't re-create at this stage, researchers say. That compensation varies depending on whether a person is a single or double amputee, how much of the leg is left, and individual biomechanics. Pistorius was born without fibula, or calf bone, in either leg, and at 11 months his legs were amputated below the knee. He began competing in track at 17 and quickly began racking up medals in Paralympic events. He began racing against able-bodied athletes in 2005, coming in sixth in the South African Open Championships. He runs on the Cheetah foot manufactured by Ossur, an Icelandic prosthetic and brace manufacturer. Its J-shaped design, based on an actual cheetah foot, has been available since 2001. But as much as amputee runners favor the artificial running foot, it can't compare to the biological version, say scientists and researchers. In a 1987 study published in Archives of Physical Medical Rehabilitation, researchers evaluated the Flex-Foot, made by Ossur and similar to the Cheetah, against a human foot. Landing on a human foot in a running stride gave a 241% spring efficiency, or energy return, because of the contraction of the calf muscles. In comparison, the Flex-Foot had an 82% spring efficiency. "It's the muscle that will actually help propel you," specifically the calf muscle, says Robert Gailey, associate professor in the University of Miami's department of physical therapy, and director of the Functional Outcomes Rehabilitation and Evaluation Laboratory at the Miami VA Medical Center. The bounce that Pistorius and other amputee athletes have with the Cheetah is created not by actual springs but by the bending of the carbon graphite -- the prostheses don't accelerate the runner like Inspector Gadget. An athlete still has to power his own legs, a force that in Pistorius' case comes from his hips.Also, Pistorius' legs pound into his sockets with every stride, and though suction helps keep them in place, Gailey points out, he still has to create stability as he makes contact with the ground. Stability issues and centrifugal forces may make it more difficult for him to maneuver around a curved track. Whereas able-bodied runners are fast out of the starting blocks, a lack of ankles and Achilles tendons give Pistorius a far slower start. But the IAAF still has some questions to answer before it determines if Pistorius can compete (no date is set for that ruling). According to spokesman Nick Davies, the organization would like to measure his VO2 max (the maximum amount of oxygen, in milliliters, that the body uses in one minute, per kilogram of body weight) and measure the mechanical efficiency of Pistorius' running style using force plates, 3-D kinematics and other techniques. All results would be compared with those of able-bodied runners. His running has already been filmed so that his stride length and speed over various parts of the track can be analyzed. Part of what may frustrate IAAF officials is the lack of research done on amputee athletes. That, says Gailey and others say, is due to the small pool of elite athletes available for study, and the fact that research money is used primarily to develop prosthetics to help people walk better.That's changing. Today, bionics and robotics are two main areas of prosthetic research. Herr has developed the first powered, computer-controlled robotic ankle that allows a faster and more natural gait. It will be available to consumers in about a year, he says. He also developed Ossur's Rheo Knee, which contains a microprocessor that adapts to changes in speed, load and terrain. At Northwestern University's Prosthetic Research Laboratory and Rehabilitation Engineering Research Program, director Steven Gard says his lab is working on a foot and ankle mechanism that will better adapt to changing terrains and walking speeds. Erik Schaffer, a certified prosthetist and owner of A Step Ahead, a prosthetics and orthotics company in New York, says he's inspired by the athletes he works with to develop new and better prosthetics "as athletes push the boundaries." But prostheses are still not as strong and powerful as biological limbs. Nor are they linked to the nervous system, Herr says, which would allow a person to "think and have the limb respond, so it behaves automatically in an appropriate way." Yet he and others working on improving prosthetics are sure that one day the devices will be more integrated with the human body. And here's where the debate about amputee versus able-bodied athletes gets even thornier: "Our goal is to design a running prosthetic that would actually give an amputee an advantage" over an able-bodied person, Herr says.The artificial leg would actually save energy as it propels someone along. So as Pistorius narrows the gap between disabled and able-bodied athletes, technology could eventually split them apart again. "If there are no constraints placed on what technology can be used," Herr says, "at some point there will be an advantage the amputee athlete has. In the future, Paralympic running times will be faster than the Olympics."
APL News Story Armed with Ideas - APL Leads Prosthesis Development Team
A team of APL scientists and engineers has embarked on one of the Lab's most ambitious projects: to develop a next-generation mechanical arm that will look, feel, perform and be controlled like a natural limb. The work is being done as part of the Defense Advanced Research Projects Agency (DARPA) Revolutionizing Prosthetics program, a bold effort to provide the most advanced medical and rehabilitative technologies for military personnel injured in the line of duty. APL has been awarded a $30.4 million contract to start the first phase of Revolutionizing Prosthetics 2009, a four-year $55 million program that aims to develop an advanced prosthetic arm that will allow a user to button a shirt, tune a radio, feel the warmth of a loved one's hand, or even return to active duty in their previous capacity. APL's Stuart Harshbarger, along with a core group of engineers, scientists and medical professionals from APL, the Johns Hopkins School of Medicine, the Whiting School of Engineering, and the Bloomberg School of Public Health, will lead an interdisciplinary team of government agencies, universities and private firms to implement DARPA's vision. Harshbarger is quick to downplay the media's characterization of the end-product as similar to the one Luke Skywalker gets in Empire Strikes Back, after Darth Vadar severs his hand. "We want to be careful not to overstate expectations," he says, though he's no stranger to engineering solutions to seemingly insurmountable tasks. At the Lab, and in prior positions, Harshbarger has established a track record of developing, managing and delivering high technology solutions on multi-million dollar programs for DARPA and the Department of Defense. Still, he treads lightly when making promises about this project. "This is truly a ‘DARPA hard,' high-risk, high reward project," Harshbarger says. "We are going to need breakthrough research in neural control, sensory input, advanced mechanics and actuators, and prosthesis design and integration to pull this off in four years, when DARPA is expecting us to deliver the product, ready for clinical trials. When it happens, it's literally going to revolutionize the prosthetics field and, more importantly, transform the lives of patients who have suffered limb losses." Because of advances in body armor, soldiers are surviving wounds that would have been fatal in past conflicts; but these soldiers often have massive injuries that require the amputation of an extremity. According to DARPA, more than 300 soldiers from the War in Iraq alone have returned home with major amputations. Harshbarger says there have been significant improvements in upper extremity prosthetics in recent years. The state-of-the-art myoelectric arm, for example, allows users to control hand and arm movements by deliberately flexing a muscle or through mechanical movement. Still, he says, "these devices have relatively limited degrees of motion and can generally allow control of only one motion at a time." Technically speaking, existing technology allows for about three degrees of freedom of movement; Harshbarger's team is aiming for a device able to perform at strengths, speeds and angles with 22 degrees of freedom (including shoulder) to match the performance of the human arm while maintaining the person's ability to control the arm. "Our guiding philosophy is that the patient's brain is more likely to be able to learn to use the prosthetic limb if its mechanics and controls behave similarly to the system that the brain learned initially," Harshbarger says. However, he concedes, understanding the body's signals may be the most daunting task of all for engineers. "Our challenge is to advance the base of scientific understanding related to neural control mechanisms and physiological function of the human limb, while at the same time developing innovative engineering solutions that can be successfully implemented," he adds. "DARPA is very clear on this; they will not tolerate delivery of a box of parts," Harshbarger states. In fact, the defense research agency is looking for his team to deliver usable improvements on existing technology at the end of each of the first two years of the project and they want the technology ready for clinical trials in only four years."There is no time for us to recreate the wheel," he says. So, he has pulled expertise from across the Lab and the broader Hopkins enterprise and assembled a formidable array of brainpower from several disciplines to tackle the technical challenges while addressing real patient needs."We have handpicked a team that has decades of experience in prosthetics and related areas," he says. "We are literally standing on the shoulders of giants in their respective fields. This team is comprised of the best folks who've been pushing the envelope and are poised with many of their most recent advances finally ready to be implemented." The APL team includes investigators from several top-tier universities and includes Otto Bock Health Care of Austria, one of the world's leading manufacturers of prosthetic devices. A complete list of subcontractors is available online at http://www.jhuapl.edu/newscenter/pressreleases/2006/060209.asp. "Developing this broad consortium and providing both the technical and managerial leadership for the design and systems integration of this advanced limb is an example of what APL does best," says Dexter Smith, APL's business area executive for Biomedicine. "We focus on programs where we can make critical contributions to our nation's critical challenges. I can think of no better example of a critical contribution than having a positive impact on the quality of life and future opportunities for our injured soldiers."
Juan Arredondo can pick up a plastic cup with his left hand without crushing it. That's a big deal for the 27-year-old retired U.S. Army Sergeant who lost his hand to a roadside bomb in Iraq in 2004.
He's among the very first veterans to be fitted with the iLimb, billed as the world's first bionic hand with independently moving fingers.
“Everything is meant for a hand to grab it. You go for a door and it's meant for your hand to grab it fully and wrap around that handle and grab it. [The iLimb] just provides a lot of natural feeling. I go for something and I’ll be like, ‘wow that's how I'd grab it with my right hand, so that's the biggest thing for me. It’s almost having my hand back,” Arredondo said.
That’s why Hanger Prosthetics & Orthotics Inc., which fit Arrendondo with the hand, insists the Scottish-made device is much more than just an incremental improvement over previous models.
“Each finger moves independently, where every finger has a motor in it and the transmission. In the back, there's a computer that controls the whole thing. So what happens is, as the user makes a contraction, it sends a signal to that computer and then it grabs an object very naturally, just like you and I would. Previous hand designs were limited in how they grabbed objects, and so the user had to compensate, they couldn't use the prosthesis for all their activities. The old ones relied on using excessive force, and so. They crushed objects all the time,” Troy Farnsworth of Hanger Prosthetics & Orthotics Inc. said.
There’s one downside to the hand. Like most high-tech devices, it can't get wet, but developers say they are working on a waterproof model.
Other than water though, it seems just about anything goes, from lifting a baby to lifting weights at the gym.
“It doesn't quite have as much power, but absolutely you could lock on and hold something. The limit is now going to be more the rest of the prosthesis. I don't think the hand is going to be the limit. So, for example, the way it fits to the patient might be the limiting factor,” Farnsworth said.
Arrendondo said he does workout with it and tries to test just how far it'll go, within reason. He does fear destroying his iLimb, however, which at close to $18,000, costs as much as two to three times that of other prosthetic hands.
They are working on a waterproof model.
Other than water though, it seems just about anything goes, from lifting a baby to lifting weights at the gym.
“It doesn't quite have as much power, but absolutely you could lock on and hold something. The limit is now going to be more the rest of the prosthesis. I don't think the hand is going to be the limit. So, for example, the way it fits to the patient might be the limiting factor,” Farnsworth said.
Arrendondo said he does workout with it and tries to test just how far it'll go, within reason. He does fear destroying his iLimb, however, which at close to $18,000, costs as much as two to three times that of other prosthetic hands.
Landing the fish is easy for a self-proclaimed Yazoo City outdoorsman.
Taking his squirmy catch off the hook is the tricky part.
Small things, simple things, just aren't that easy anymore for 25-year-old Anthony McCool.
Try pushing a wheelbarrow with one hand.
Try buttoning a shirt, zipping pants or tying shoes.
Try hammering a nail or using a measuring tape.
McCool, who lost his entire right arm, shoulder and part of his collarbone in an accident at work, has help, though, and is on the cutting edge of technology for amputees. Earlier this year he became the third civilian in the world to be fitted with a $120,000 Otto Bock Myoelectric arm, one of the most innovative prostheses available for upper-extremity losses.
"There are some people out there that will say, 'Well, what do you need it for?' " McCool said.
"They're not me. They don't know. People that don't know are the ones that have two hands."
The device contains carbon fiber, copolymer and silicone, and electric power, not the patient's muscle strength, operates it, said Dr. Rick Psonak, a certified prosthetist in the Department of Orthopedic Surgery's Division of Orthotics and Prosthetics at the University of Mississippi Medical Center. A microprocessor, rechargeable battery and motor supply the power.
McCool must contract his pectoral and rhomboid muscle in his back to turn the device on and switch between three modes: raising and lowering the forearm, rotating the wrist and opening and closing the hand.
The prosthesis is strapped across his torso, and electrodes detect contractions of the two muscles.
"The electrode is like a radio," Psonak said. "It is trying to get a good signal. Then the microprocessor will send power to the battery and motor."
The speed at which the arm moves is proportional to the strength of McCool's muscle contractions.
"Every time he does it, he's working that pectoral muscle. It's almost the same as if you're doing bench presses."
Psonak said improvements to prosthetics and new products spring up about every six months, but the technology is 10 years behind.
"Prosthetics is pretty slow to get the drop down. Electrical engineers make computers. Other engineers work at plastics companies, things like that."
"A lot of this stuff is a spin-off of other things," said Martin Buckner, a certified prosthetist and orthotist in Jackson.
Still, improvements in size, speed and weight of prostheses components in the last 20 years have meant the difference between patients who use them and those who don't.
Batteries are much lighter, smaller and hold their charge longer. They were once as heavy as the arm - 4 or 5 pounds. Microchips are smaller and faster. Motors are smaller and lighter. Even the design of the prosthesis and the way it fits the patient's body has changed. In the past, a shoulder cap would have been used with McCool's prosthesis, making the weight of the device uncomfortable.
"It would feel like somebody is pushing down on your shoulder the entire time," Psonak said. Injuries from military service have been the driving force behind the expanded use of the Myoelectric arm, Psonak said. The government has stepped in to help service men and women returning from Iraq acquire the expensive equipment.
"We see the soldiers are fit with this technology, and they put it through the rigors." In turn, some insurance companies are slowly beginning to offer coverage of prosthetics to policy-holders, Psonak said.
The number of young adults needing prostheses also has pushed the need for advancements, Psonak said.
"Generally, amputations happen from diabetes, which afflicts mainly the older population, folks who are just proud to get from A to B," Psonak said.
"But you get a guy like Anthony. He doesn't want to just get from A to B. He wants to run. He wants to fish. He wants to play with his kids."
Improvements in the works for the Myoelectric arm are fingers and shoulders that move and wrists that turn in different directions. Electrodes are embedded on the muscle inside the arm instead of on the skin's surface, allowing for better control of the device.
Advances in lower-limb prosthetics come at an even faster rate because of higher demand for these devices, Buckner said.
"People don't want to use a wheelchair," Buckner said. "They want to walk. But people will reject upper extremity prosthetics because they can be uncomfortable or too expensive."
The electronic knee is a breakthrough in prosthetics for lower-extremity amputees. The knee measures the patient's activity and can adjust itself for how fast the person is walking and for uneven surfaces and will correct itself if it senses the patient begins to stumble, Buckner said. Osseointegration is a new technique where metal pins are implanted into the bone at the point of amputation, Buckner said. The prosthesis connects to the pin. Weight is distributed up the prosthesis and into the bone of the leg, which is a more natural distribution of weight. However the risk of infection is extremely high.
The procedure is not offered in the United States, but Buckner said he believes it eventually will be.
Joni McCool said surgeons thought her husband would never be able to wear a prosthesis. "I guess they weren't aware of the development because he didn't have a shoulder, so they said there's nothing to attach it to," she said.
And if McCool had lost his arm 20 years ago, his best prosthetic alternative would have been a cable and pulley system.
"There's so much movement he has to achieve through gross body movement with that type that it wears and tears on the joint," Psonak said.
The rejection rate of prosthetics was very high 20 years ago, Buckner said. The devices were too uncomfortable or had too little functionality.
"I'd hate for him (McCool) to come to me and say, 'I wear it when I don't do anything, and whenever I do something, that's when I take it off,' " Psonak said.
But McCool has adjusted well to his prosthesis, and now it has helped him return to a near-normal life. He has returned to work, and he hunts, fishes and plays with his two young sons. "I think Anthony had a new family to live for - two children and a wife," Psonak said. "Being depressed just wasn't an option."
McCool worked at a fertilizer company in Yazoo City. When a machine malfunctioned, he tried to check it out but lost his balance and fell off an observation platform. His hand got caught in the conveyor belt, and he was pulled about 200 feet. He dangled about 3 feet above the floor for an hour before he was freed from the machine by coworkers.
Part of his arm might have been saved, but gangrene set in.
"The big misconception, I think, is folks think, 'Well, this is a permanent arm,' " Psonak said. "This is equipment. It's like having a permanent car or a permanent pair of shoes."
McCool probably will have 20 prostheses in his lifetime.
"Occasionally, you'll have to come in and say something isn't responding that well, so we'll do a service check," Psonak said.
"The part I like is that this is a spiritual thing," Psonak said. "Patients can recover, and I can be there to watch them do it."