No, but seriously, he does. And I expect to be successful at it - because that is the attitude I am going to have going into it. I am so ready to see patients, so ready to give this plaster casting business another go and I know I can only get better the more I keep practicing. Luckily, we get two chances tomorrow. Even if our first cast is the most perfect piece of casting in the history of transtibial casting, we have to do a second one. Frankly, I am relieved - I think the pressure will be a lot less if I know that I get a second chance without even having to ask for one.
Today we spent the morning in lecture, learning the different types of transtibial amputations we will encounter in our careers and the appropriate way to cast them and what the best devices for these patients will be. It was all very informative and the options for different legs for these patients is overwhelming. There are apparently about 120,000 amputations done in the US each year and with diabetes on the rise, I am sure that number will not be decreasing for at least the next decade. The history of where all of these prosthetic legs and feet and liners come from is fascinating and essentially all boils down to about 5 men. Everyone just keeps building off of everyone else's ideas. If I can come up with some great new prosthetic invention, I can probably just give my services away for free in some third world country :)
We also were able to watch the video of the transtibial (apparently this is the more correct way to say 'below the knee') amputation. Wow. I have seen surgeries before, but it never ceases to amaze me at how rough the surgeons are with the human body. The surgery we watched was a man who was having crazy nerve pain and elected the amputation in order to improve his quality of life. These surgeons can perform this surgery in about 45 minutes. Is that not insane? This man probably toiled with this decisions for days and weeks and months and then in 45 minutes, bam, it is done. I know that his quality of life probably improved greatly because I have learned that many amputees have very little limitations put on their lives due to all the advances in the industry. It is pretty amazing. I am attaching the link for the website if you want to see a surgery for yourself. These are not for the faint of heart, but I thought it would be something my dad might really enjoy.
http://www.ampsurg.org/html/amplevels.html
The afternoon was entirely devoted to learning how to do a patient visit and casting. We learned how to get the patient history and what measurements and things we were looking to obtain in the first casting of the patient. Then we observed Scott performing this on a patient. There are lots of forms to fill out with lots of information to get before you can even begin to think about wetting your roll of plaster. We have four hours with our patients tomorrow so clearly they aware that this is going to be a slow moving process. Apparently I can look forward to being able to do these appointments in 45 minutes to an hour once I become a pro :)
I am so ready for tomorrow - we get to meet our patients and get going first thing in the morning. I am definitely nervous about a poor innocent patient volunteer being subjected to my inadequate knowledge of exactly what I am doing, but thankfully, these guys are repeat customers and have been volunteering to be tortured by the hands of unknowing students for years. The nerves mainly come from the fact that once you get the plaster on the patient, you have a tiny window of about 60 seconds to make all of the necessary markings and reliefs in the cast before it becomes hard and sets. There are a lot of things to remember and do in that 60 seconds. Regardless of the nerves or worries, tomorrow is going to actually mean something because it will be my first amputee casting and appointment and a chance to really feel like I am a prosthetist! It is very exciting!! I must iron my professional attire (I have yet to grasp the concept of wearing nice clothes that you know are going to be covered in plaster), but I do dig the lab coat. After lunch we don our safety goggles and start modifying our molds from the morning casting. By tomorrow afternoon, I might actually pass for a prosthetist...watch out!
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