Thursday, October 25, 2007

Life and limb



Loss of limb forges former missionary's career as prosthetist
Home News Tribune Online 10/23/07
By CONNIE MIDEYGANNETT NEWS SERVICE
He was in the last month of a two-year church mission in Mexico seven years ago, when, while on foot, he was struck by a car and carried about 300 feet.

The driver who hit him swerved hard to fling Tyler 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," says Ritchey, who now works as a liaison for amputees.
His parents were beside him when he emerged from a coma after several days on life support. But there was no one at his bedside in Mexico 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."

Today, Ritchey's job as a health-care professional for Pongratz Orthotics & Prosthetics in Phoenix is to help others, like Kirsten Witbeck of Tempe, Ariz., adjust to a legless life.
Upon closer inspection of Witbeck's new right leg he says, "that's amazing. It looks just like your other leg. How are you doing with it?"

Witbeck, 26, 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.

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 home 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.

He and Pongratz organized a support group, Limbs 2 Life, to give new and longer-term amputees further opportunities to share stories.

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.

Protect your limbs

  • Practice proper foot hygiene and care, particularly if you are diabetic.

  • Quit smoking, or don't start.

  • Be careful, especially when operating machinery like lawn mowers, wood chippers, etc.

Source: The National Limb Loss Information Center.

On the Web:

Resources for amputees:

www.amputee-coalition.org, Amputee Coalition of America provides education, support, and advocacy for amputees.

www.oandp.org, American Academy of Orthotists & Prosthetists.

www.kidscanplay2.com, Pediatric Prosthetics, Inc., provides information on prosthetic limbs for children.

Spiritual Friendship


An Answer to Prayer
We returned to U of M for an initial fitting of Karim's castings for his prosthetic hands. Again, I wish to compliment Alicia Davis, a key member of the orthotics and prosthetics department. She is definitely a woman who loves her job and has a great way with patients and their guardians. I felt as if I've been a friend of hers for years. She is wonderful! Anyway, the fitting went well and with pictures and hand signals we were able to explain to Karim what we were doing. He is very excited about getting prosthetics. At this time we were still uncertain of where the money would come from to pay for the prosthetics. They are very costly. However, over the weekend I received an e-mail from Alicia, stating that the U of M Charity had agreed to bear the entire cost of the prosthetics. All week I had been praying, "God, if you want Karim to have these prosthetics, you will have to come up with the money." Boy, did He answer this prayer! And in such a timely manner, too. I am extremely thankful to my Lord and King for providing this money so that Karim can have a better life now that his hands will be more useful. We will return this Thursday for another fitting. It is amazing to see all the medical personnel who have come to bat for Karim, not only in Muskegon, but, now in Ann Arbor as well. The above picture is an example of a similar prosthetic. Karim's will be made of a clear plastic material and have plenty of breathing room, as his hands are often burning and itching. He will be able to have some fine motor skills with the pinchers that are attached to the plastic casting. They will rotate, and open and close using a cable attached to a harness-like strap on his shoulders. I will post updated pictures after Thursday's visit.

Tuesday, October 16, 2007

Adjustment to prosthesis hard

Whether lost to a trauma or disease, adjusting to a new limb is a tough task.Connie Midey The Arizona Republic He was in the last month of a two-year church mission in Mexico seven years ago, when, while on foot, he was struck by a car and carried about 300 feet.
The driver who hit him swerved hard to fling Tyler 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," says Ritchey, who now works as a liaison for amputees.
His parents were beside him when he emerged from a coma after several days on life support. But there was no one at his bedside in Mexico 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."

Today, Ritchey's job as a health care professional for Pongratz Orthotics & Prosthetics in Phoenix is to help others, like Kirsten Witbeck of Tempe, Ariz., adjust to a legless life.
Upon closer inspection of Witbeck's new right leg, he says, "that's amazing. It looks just like your other leg. How are you doing with it?"

Witbeck, 26, 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.

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.

Monday, October 15, 2007

Oregon Health Law News

This blog is dedicated to providing updates on the latest laws and regulations impacting health care in Oregon.

The 2007 Oregon legislature passed a law requiring individual and group insurance policies to cover prosthetic and orthotic devices medically necessary to maintain the ability to complete activities of daily living or essential job-relatedactivities and that are not solely for comfort or convenience.The Oregon Insurance Division recently published a proposed rule that would require those policies to cover the same devices in the Medicare fee schedule. The public may comment on the rule until November 6, 2007.

Orthopaedic rehab centres upgraded

(13-10-2007)

HA NOI — Viet Nam will upgrade its orthopaedic rehabilitation centres, particularly the Vietnamese Training Centre for Orthopaedic Technologists (Vietcot), to meet international standards and supply qualified technologists to the country and the world, according to Dam Huu Dac, deputy minister of Labour, War Invalids and Social Affairs.

Speaking at a ceremony to mark Vietcot’s 10th anniversary in the capital yesterday, Dac also stressed that Viet Nam, home to over 5.3 million people with disabilities, faces an immense problem in rehabilitating its disabled people. A survey conducted by the World Health Organisation (WHO) says that 0.5 per cent of the population of the about 415,000 individuals are in need of technical health care.

Also present at the event, rector of the University of Labour and Social Affairs Professor Dr Nguyen Tiep said Vietcot, set up 10 years ago under a German funded technical co-operation project, aimed to offer professional training and education based on the standards of the International Society for Prosthetics and Orthotics (ISPO) and the WHO.

"Its project objective is to train students and upgrade qualified orthopaedists for work in Orthopaedic Rehabilitation centres," he said.

Tiep also applauded GTZ/Vietcot advisor Wilfried Raab for his assistance and contributions to the centre in the last decade, adding Vietcot was to receive further support from the German Government and Raab himself.

Deputy director of the centre, Dang Xuan Khang, said Vietcot had trained 141 orthopaedic technicians reaching ISPO and WHO Category II, and 45 others on biomechanics, technical drawing and drafting, and physical science.

He said the centre had also been successfully co-operating with and training international technologists from Tanzania, China, Cambodia and Pakistan.

"Vietcot has also been active in consultancy on improving the orthopaedic care system in Viet Nam; conducting clinics introducing new technologies to improve rehabilitation services for patients and providing advice on effective cost calculation to enable the economic management of an orthopaedic laboratory," Khang said.

At the International Rehabilitation Conference in Hong Kong in 2004, Vietcot was lauded as one of three training centres in the world to produce the most qualified orthopaedic technicians. — VNS

Friday, October 12, 2007

102 year old Tribe fan refuses to slow down

CLEVELAND -- Cleveland woman gets prosthetic leg and refuses to miss Indians game.

The oldest Tribe fan in the world lives in South Euclid, Ohio. Annie Barrow, just turned 102 years young.

Poor circulation forced doctors to amputate her right leg. But Annie refuses to slow down.

At the Hanger Prosthetics and Orthotics Clinic Monday she told the staff, "I refuse to complain because I hear people all the time making complaints and I don't know how it does any good".

Prosthetic expert Kevin Carroll and Matthew Manolio helped Annie with the fitting for her new artificial limb.

As Annie took her new leg for a test walk down the hallway, she smiled and said, "Yes, it's lighter than the one I had. This is good!"

Standing nearby, Matthew Manolio said, "she inspires the office staff and Annie inspires me. Just working with somebody who has been around as much as she has and seen as much as she has. She always has a story to tell you."

Born in 1905, Annie moved from a farm in Jackson Gap, Alabama to Cleveland when she was eighteen years old. Over the years she raised 11 foster children.

At her home in South Euclid you won't find any wheelchair ramps. She walks slowly up every step.Annie believes it keeps her young.

"They say using the steps is good exercise", she told Channel 3's Mike O'Mara, "so I take the stairs about four times a day." You can understand why the staff at the Hanger Prosthetics clinic celebrates her annual visit.

She's just that special.Said Hanger Vice President, Kevin Carroll, "Annie has been a great inspiration to me and also to other patients. I tell everybody all over the country about her all the time.Added Carroll, "if somebody is complaining that they are feeling old at 60, I make sure they hear about Annie's story. I tell them you're only a kid compared to her.

"Annie attended her first Cleveland Indians game at League Park back in 1925 and remains a devoted fan. Said Annie, "I used to go see the Indians every time they were playing at home in Cleveland.

I was there to cheer them on, even if I had to borrow the money to attend the game!"When asked about the playoffs with the New York Yankees, Annie paused and said quietly, "you know if they had won last night I would have been very happy. But they can always do it tonight.

"Annie added, "I'm 102 years old and there are times in these playoff games that are just too much for my heart to take. I have to turn off the TV and say a prayer."
Video

Play Video for Mike O'Mara's story

Click here for more video clips

Annie Barrow, 102, on 4th artificial leg, is a real inspiration to us all'

Prosthesis patient, 102, a real inspiration to us all'

Tuesday, October 09, 2007

Mary VanacPlain Dealer Reporter

After 102 years of walking, Annie Barrow isn't ready to sit down, even if she is on her fourth leg.
At age 98, Barrow lost part of her right leg and was fitted with an artificial one.
Four years later, Barrow is still on the go. On Monday, she was fitted with a new, lighter prosthesis.

Visit this link to read her whole story!

Cuban-Americans Help Ukrainian Children


By LAURA WIDES-MUNOZ – 3 days ago

MIAMI (AP) — Sometimes large-scale international diplomacy is about small-scale gestures.

On Monday, it was nine Ukrainian children playing with dolphins at the Miami Seaquarium while waiting to be fitted with free prosthetic limbs. Their visit and treatment are courtesy of Ukrainian first lady Kateryna Yushchenko, members of South Florida's Cuban-American community and others.

The nonprofit Cuba Democracy Advocates wants to build solidarity with Ukraine's fledgling democratic government by helping to pay for prosthetics for about 30 low-income children from the former communist nation and by increasing medical exchanges.

Many Cuban-Americans see Ukraine as a model for peaceful political change and want to support its government and recent criticism of political repression on the communist island.
U.S. Rep. Lincoln Diaz-Balart, R-Fla., has worked with the State Department to send doctors to Ukraine and most recently to bring the children to Florida.

"The countries that most understand the Cuban people — besides the U.S. — are the countries of Central and Eastern Europe," said Diaz-Balart, who is Cuban-American. "When I go there, I feel so well. The people there get it."

The Cuban-American community and the U.S. government are keenly aware of the decades of medical treatment that Cuba provided for Ukrainians before pro-Western Viktor Yushchenko became president two years ago. Cuba treated thousands of Ukrainian children after the 1986 explosion at the Chernobyl nuclear plant.

Since 2005, much of that aid has dried up, and relations between the two countries have cooled.
"The U.S. was concerned that Cuba would cut out medical support for the Ukraine, and there was a push to say, `If you take a stronger stance on Cuba, there are still ways to get that support,'" said Carlos Pascual, vice president and head of foreign policy for the Brookings Institution in Washington. Pascual served as U.S. ambassador to Ukraine from 2000 to 2003 and is also Cuban-American.

He called the treatment for the children a good gesture but symbolic, considering Ukraine has a population of about 47 million people.

Yushchenko won his country's 2004 election after more than a million Ukrainians took to the streets to protest voter fraud in favor of the Russian-backed presidential candidate. Not surprisingly, he has been critical of Cuba's repression of political dissidents.

Politics were far from the minds of the Ukrainian children who arrived last week. They looked alternately thrilled and terrified as the dolphins leapt out of the water for kisses and high-fives.
When asked what he knew about Cuba or Cuban-Americans before he came to the U.S., Paul Satsuk, 17, of Polonne, Ukraine, grinned.

He mimed smoking a cigar and drinking coffee.

Satsuk couldn't explain why Cuban-Americans would feel a special connection with his country.
"These are very good people, with big hearts," said Satsuk, who lost half his right arm in an industrial accident when he was 6.

Vladimir Hynedka, 49, accompanied his young son Stepha on the trip. He asked his Cuban-American host family if they were Christians because he couldn't think of another reason why they would try so hard to help his son.

The connection between Ukrainians and Cuban-Americans is understandable, said Taras Tkachuk, 30, a Ukrainian doctor who works with Kateryna Yushchenko's charity, Ukraine 3000 Fund, which helped sponsor the group along with Hanger Prosthetics and Orthotics in Orlando.
"It's difficult to have a democracy after totalitarianism. Our parents were born under that system. But these kids, they look forward. They feel life in a different way. They are able to use choices," Tkachuk said. "The same will one day be in Cuba."


Copyright © 2007 The Associated Press. All rights reserved.

For amputee, a big step


Posted by the Asbury Park Press on 10/10/07

BY SHANNON MULLENSTAFF WRITER

In almost all respects, Brian Hansen thinks he's got great health insurance.

He's got a $15 co-pay for doctor's visits and medications. He's got 100 percent coverage for hospital visits.

He had no complaints, really — that is, until he needed a prosthetic leg and learned the maximum lifetime allowance was $1,000, with a $200 co-pay.

A thousand dollars? A basic prosthesis costs 10 times that much. You can't buy a wooden peg for $1,000 today.

Hansen, 50, of Keyport, a diabetic since childhood, lost his job as a hazardous materials training technician after he tore off a toenail and developed a dangerous infection that led to the amputation of his toe. Subsequent amputations of his other toes, half his foot and finally his left leg, above his knee, had wiped out his life savings and driven him into debt. He and his wife, Fran, didn't know how they'd come up with $10,000, even if that was his only shot at ever walking again.

But Tuesday he did walk. Just a few, tentative steps — but after all he's been through, it felt like reaching the surface of a very deep, dark sea after a long time underwater, and seeing the sun again.

"It's amazing," an ecstatic Hansen said afterward. "It felt great to be standing and to put weight on my two legs again. I haven't done that in two years."

At Hansen's side was Robert Manfredi Sr., look-ing equally pleased. It was Manfredi's charity, Angels with Limbs, that made the moment possible.

Manfredi, 70, of Rumson, is the co-founder of Manfredi Orthotic & Prosthetic, a company that's been a fixture in downtown Long Branch for the past 50 years. Three years ago, in an ironic twist, Manfredi himself wound up needing a prosthetic leg after a diabetic-related amputation; he says he's one of only 10 people in the world right now with a computerized ankle joint.

Manfredi retired at the time, handing the business over to his son, Robert Manfredi Jr. Eager to remain active, the elder Manfredi founded Angels with Limbs, a nonprofit organization that uses parts of donated prostheses to fabricate new limbs for New Jersey residents who are underinsured or don't have health insurance.

The charity helps about a dozen people per year. Among its recent projects was fitting an Ocean County man with a state-of-the-art, $50,000 computerized prosthetic knee that the previous owner had bequeathed to the charity. The man has returned to work and participated this summer in the Manfredi company's annual tennis clinic for its prosthesis-wearing clients.
Campaign for fairness

The Hansens' insurance problems aren't unusual, according to the Amputee Coalition of America.

The advocacy organization says coverage for limb loss varies widely among insurance companies, which sometimes evaluate coverage on a case-by-case basis. For example, the ACA found at least eight different companies in New York that are restricting or eliminating coverage for prosthetics. The restrictions vary from financial caps of $1,000 or $2,500 to excluding repairs or even limiting a person's benefit to one prosthesis per lifetime.

The organization is leading a national campaign in support of state legislation that would bar such practices and create parity among insurance providers. Seven states have adopted such laws, and bills are pending in another 24 states, including New Jersey.

In the meantime, Angels with Limbs has provided the Hansens with a lifeline they desperately needed.

Brian Hansen's toenail injury in 2005 sent them on a two-year downward spiral. Despite the amputations of his toes and foot, and heavy doses of OxyContin, Hansen was in excruciating pain because of recurrent infections and circulatory problems.

"All I did was sleep, wake up in pain, sleep, wake up in pain. It was no way to live," Hansen said. "I sat there at night screaming, I was in so much pain. . . . It was rough on my daughter (Isabella), a 12-year-old, seeing all that."
prognosis was bleak: Hansen was told he'd need to keep having amputations to deal with the problem. When he asked if there were any alternatives, one doctor presented him with four options. Hansen chose the only one guaranteed to end his pain: pre-emptive amputation of his leg above the knee. He had the surgery at Jersey Shore University Medical Center, Neptune, on July 17.

"They gave me my life back the day they amputated my leg," Hansen said.

Next step: rehab

Hansen said he erred in not checking his coverage for a prosthesis before he had the amputation. After his wife found out about the $1,000 maximum, she called around and discovered the prosthesis her husband needed would cost between $10,000 and $12,000. Her last call was to Manfredi Orthotic & Prosthetic. At the other end of the line, Jean Manfredi, who is Robert Jr.'s wife and an employee of the company, assured Fran that the company and her father-in-law's charity would do whatever they could to help.

On Tuesday, they made good on that promise, fitting Hansen with a moderately sophisticated prosthesis with a titanium pylon and a socket that will allow him to pivot on his foot, once he learns how.

"It's just been a nightmare, and now we're finally seeing a light at the end of the tunnel," Fran Hansen said after watching her husband take his first steps. "Thank God for Angels with Limbs."

Hansen's HMO will pay for a week's stay at Riverview Medical Center's rehabilitation hospital in Red Bank so he can learn how to use the very prosthesis that the company wouldn't cover in the first place. Hansen is too grateful right now to dwell on the irony of that.

"It's like a whole new beginning for me," said Hansen, who is hoping to return to work, eventually. "I'm looking forward to walking out of the hospital."

Shannon Mullen: (732) 643-4278 or shannon@app.com

Monday, October 08, 2007

Welcome to The Cambodia Trust Blog

Stay up to date with the news from our projects.

Sometimes Saying Goodbye To Someone Dosn’t Always Mean Goodbye

Cambodia trust


Working for equal rights for disabled people in an inclusive barrier-free society
Cambodia Trust is committed to assisting people with disabilities re-gain mobility and live equally within society. Our help extends to people affected by polio, landmine/unexploded ordnance, cerebral palsy and clubfoot. We opened our first rehabilitation centre in 1992 and now have three centers operating in Sihanoukville, Kampong Chhnang and Phnom Penh. In each of the centers, we provide physiotherapy, prosthetic limbs and orthopedic braces, and wheelchairs and other assistive devices.

Our activities include an extensive community-based rehabilitation program, which identifies people with disabilities who would benefit from our services. We support disabled children from poor families to attend school and provide schoolbooks, uniforms and bicycles. Further support includes assisting people into small business and establishing self-help groups so people have the opportunity to exchange ideas and advocate for themselves, and working with other partners including the government.

We also run an education centre - the Cambodian School of Prosthetics and Orthotics (CSPO) - where people learn to make and fit prosthetic limbs and orthopedic braces. The aim of the School is to create a foundation of physical rehabilitation services by producing specialists with skills and knowledge to support people with disabilities. The training program takes three years and students come to Cambodia from many different countries.\

~ by feelcool on October 7, 2007.