My god it is frustrating trying to find a prosthetist! (see “Not willing to go the extra foot“)  There are loads of them out there, and very limited information about them.  I’ve been searching in just about every way I can think to for a practice that has great experience with traumatic amps that are as active as I am.

I’ve started searching through the list that’s available through my Blue Cross plan, which is extensive.  This is such a laborious process.  God forbid BC put links to the practice’s websites to make info about them a little easier to gain.  Of course, there are plenty of prosthetists (very good ones) that don’t have any web presence at all.  The ones that do, of course say lots of great things about their skills and how much they care.  They really show it by using stock photography from manufacturer websites and other sources (fail).  Many of them make it pretty clear that they’d rather just deal with orthotics, which you can’t blame them for.  That’s far easier and more lucrative than prosthetics.

So this is it.  I’m going just keep plugging through the list and sending e-mails with a link to this blog.  I figure anyone who’s willing to read through this laundry list, and still get in touch with me will likely at least have the ambition, if not the skills to get me rockin again.  If you know a great prosthetist, or know someone who knows one, pass on the link to this page or copy and paste from below!

Seeking Motivated Prosthetist for K4 RBKA PDQ

I am currently searching for a prosthetist that can help me continue with my very active lifestyle.  I have been a RBKA since 2003 as a result of a skiing accident (despite many other rumors the origins of which I am unaware.)  Over the past ten years I have worked with a handful of prosthetists from the very skilled, to those who are best suited for lower activity patients.  My most recent prosthetist changed companies to work in a better environment, which was good for him…  Unfortunately, his new company does not accept my insurance.  Since I have excellent insurance, changing insurance providers is not a realistic option.

My prosthetic needs are a bit more demanding than most amputees I’ve met.  I have been a professional horse trainer for about 20 years.  I have gained national recognition in the sport of carriage driving through competition, judging, feature writing and for developing a national standard of driver proficiency.  This job takes me throughout North America and even a few trips to Europe.

My daily activities as a horse trainer can have me walking 4 to 6 thousand steps a day, primarily on uneven footing.  Beyond simple ambulation, I am constantly stepping on and off moving carriages.  While instructing students I am most often standing on the carriage, providing stability in high speed turns, or standing behind the student to provide physical instruction (talk about a back seat driver!)

Working with horses from the ground, I have to be able to move quickly in any direction while maintaining a position facing the horse.  While using a training modality called long lining, I train horses through the use of 20 foot long reins.  This would be as close to dancing with horses as you could imagine, and requires a very high degree of mobility, coordination and balance.

I use my regular walking leg for the above listed activities.  Having a highly responsive energy responsive foot with multi-axial flexion in addition to a rotational shock pylon means that I can keep up with these activities with ease.  Maintaining excellent suspension allows for higher proprioception for balance and coordination and minimizes shear forces.  Of course, it goes without saying, a great socket is the basis of it all!

Working horses under saddle, I require a riding prosthesis that is specially aligned to match the changes in alignment of a natural leg.  In addition to the alignment, the riding prosthesis socket is significantly different than that of a normal weight bearing walking or running socket.  The specialized socket reflects the difference in forces as the leg is used as a communication aid while riding a horse.  On the ground, that leg is nearly useless, which is ok, since I prefer to stay on the horse’s back once mounted!

While my professional life is very active, my recreational activities are no more sedate.  I  am an avid skier from December well into April.  I put in about 30 ski days in each season locally, and at mountains through New England.  In other words, I know how to ice skate.  I would describe myself as a “most of the mountain” skier, making use of all trails including double black diamond.  I have just begun to find my timing in bumps, and can’t wait to keep building those skills, and eventually apply them to glades.  I enjoy an occasional trip through a terrain park, to the extent that an over 40 skier should.

I ski with regular skis and boots as any other technically able bodied skier on the mountain.  While the prosthetic socket for a ski can be made the same as a for a running or walking leg, the alignment has to be significantly dorsiflexed to match the appropriate body position for skiing.  The foot and ankle need to allow some flexion so the leg can transfer energy into the ski boot.  A stiff cosmesis is needed to allow the appropriate interaction between the leg and the boot.  The most critical component is a jointed brace that lends stability and leverage over the prosthesis.  With a short, 5 ½” residual limb, skiing without a brace is extremely difficult.

When the snow melts I turn my eyes to the sky, because if you want to learn how to swim, you have to get out of the boat, but if you want to learn how to fly, get out of the plane!

I have been skydiving since 2010, accumulating 230 jumps at the time of this writing (in other words, if you are reading this, that number has gone up).  I skydive just about every week that weather, time, and budget allows.  As you can imagine, suspension is the most critical component of a prosthetic leg for skydiving, though perhaps not for the most obvious reason.  While keeping the leg on during freefall and canopy descent is critical, maintaining a tight fit is equally important.

Freefall is essentially a weightless environment, where we use the air to control motion.  This means that a tight fit is necessary to maintain positive proprioception and stability.  If there is a lacking in suspension, the leg will “flag” creating an unpredictable and uncontrollable oscillation.  My skydiving prosthesis must have a cosmesis covering to closely match my sound leg in volume so that both legs have similar interactions with the wind.  Additionally, the ankle most allow for a pointed toe position, similar to swimming, so it can be used as an effective surface to create forward motion.  Finally, the ankle must be able to easily be returned to a normal walking position for landing, since I do not have the necessary ballet training to run out my landings “on point”.  Landings can be as easy and gentle as stepping off your front steps, to high speed sprints to the finish, with the occasional home plate slide, TJ Hooker roll or just plain “Where the eff did the ground come from so fast?”   (Hey, they can’t all be perfect landings!)

If you’ve read this far, you can see I am far from a typical amputee with typical needs.  If you were reading and counting, there are 4 legs in active duty for me.  I’m not sure if I’ve used all of them in one day, but I know I’ve use three in a given day regularly.  While I present many challenges with multiple activities, I also bring to the table 10 years of experience, excellent communications skills and an open mind for solutions that I have tried (as well as being willing to take another shot at something I have tried).  I have excellent coverage from the state’s largest insurer (Blue Cross) who’ve never given me a problem covering any of my prosthetic needs.

My current set of sockets and legs are no longer keeping up with my activities, so they need to be replaced.  I’m searching a creative, energetic prosthetist that will find the projects that I have interesting and stimulating.  I’ve had the most success with prosthetists that have experience in working with traumatic amputees.  If you feel you are, or know a prosthetist who would be excellent for this type of challenge please contact me.  No, really, I mean it… I need better legs!

Thanks for reading and passing this on!