Monday, August 13, 2007

Helping hand: Altoonan one of 11 in world to test new bionic limb

By Ashley Gurbal,

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." ’
Mirror Staff Writer
Ashley Gurbal is at 946-7435.

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