Learning to Walk Again

Today was a big day - it was the day to see all of my hard work come to fruition and hope that the leg I made for Mr. R was going to be one he was able to stand up and successfully (and more importantly, safely and painlessly) walk in.  And...it was a good day!!  After yesterday's lecture example on how to fix someone's gait, I was anxious going into the patient visit today.  I was worried that if my alignment was off by very much or my fit was not right, I was not going to have the knowledge or skills to get it where it needed to be.  I think I lucked out in a couple of areas - first, my fit was pretty great and his first turn down the parallel bars was fairly successful, and two, I actually was able to recall a few things that I was able to do to help correct the issues we were having when he was walking.

 

Erin and I feeling excited and successful after a day of helping people walk.  (Due to patient privacy I was not able to take any pictures of my interactions with Mr. R so I will do my best to just give a quick rundown of the appointment.)

Today was Mr. R's birthday so I brought him a little cake and we all sang to him - I could not tell if he liked it or not, but I think maybe once you have celebrated well over 75 birthdays, you might not really care anymore.  The morning started out with just making sure he could stand up comfortably in my socket.  There had to be some minor adjustments made in the height of the leg, but for the most part, he was feeling steady and looked to be comfortable in the leg.  After making sure his hips were even and the leg was securely on his limb, I had him walk back and forth in the parallel bars to observe his gait.  This is where it gets tough for me and I worry about struggling.  It is easy for anyone to notice a person with a big issue in the way they walk, but detecting very small things (complete toe clearance, driving your heel into the ground, a little foot outset) is extremely difficult.  I know that it is going to just take me doing it over and over again to start being able to see it more naturally.  And I know my alignment was not perfect today, but when Mr. R was able to walk back and forth without any major issues, I was thinking - look at you, a very well done leg!  Then my professor came over...all my bubbles were burst as he was able to quickly point out some alignment issues he was able to spot.  I was able to adjust some things and got to a place where I will be able to go before the entire class and panel of instructors tomorrow in the critique and present a patient with an almost normal gait.

Apparently, the critiques are very intense and people get really stressed about them so it is looking like tomorrow will be another long day.  I am feeling fairly confident going into the day because I feel as though I know a lot about my patient (as much as he was willing to share...including the eulogy from a funeral in 2003) and I can fully explain all of the steps I took in making the leg and then in making different changes and adjustments to the leg throughout the initial fittings and into today's visit.  I think I am more bothered by the fact that I have to iron more clothes than by the idea of being publicly critiqued!

The afternoon was all about the feet.  Tables full of all different kinds and styles of prosthetic feet.  I had no idea how many different ones there are to choose from!  There are feet for all different activity levels, for running or climbing up things, for wearing house slippers and for wearing heels. I knew there were options, I just never knew how many!  It was pretty interesting to learn about the history of prosthetic feet and what goes into choosing which foot is the right one for your patient.  As with all other things in prosthetics, you have to show evidence based reasoning for why you put a certain foot on a particular patient.  So it is crucial to know all of the different feet and what they can or cannot do for someone.

Then came the second best part of the day...the first, of course, being able to see Mr. R walking around in my leg.  We were able to strap on these walking boots (the kind you use for broken feet) that had prosthetic pylons and feet attached to them and walk around to get a feel of what different feet felt like.  It was awesome!!  I think it was such a brilliant idea because, as an able-bodied person, it is impossible for me to relate to an amputee and to explain to them how a component should feel (besides what I know from books).  This gave me a chance to try out actual feet that I will be fitting on patients in my future.  I could have walked around in those things all day!!

I think my favorite thing about them was that I was so tall while wearing them!!  And amazed that this is how Chad views the world every day!

All in all, it was a very good day.  My patient was safe and happy.  I learned a lot and only failed a little.  I was able to put myself in the shoes of an amputee (quite literally), and I did it all on only about 2 hours of sleep.  That being said, I am exhausted and have loads to accomplish tonight before I present to the class tomorrow - there are progress notes to be written and gait sheets to be memorized.  And of course the biggest decision...what to wear for the critique...