The (Almost Perfect) Storm

I really only used 'storm' for the title of this post because yesterday I called it the calm before the storm. It only then seemed appropriate to refer to today as the storm.  It was a whirlwind, more tornado like than anything else, but I guess a tornado can be a storm if you do not want to get to technical about it all.  I digress....

New patient today!!  How very exciting!!  I love my new patient, I will refer to him as Buddy in the blog (for some reason that name suits him in my opinion).  I was ready to go bright and early this morning, standing eagerly by the door of the school, ready to greet Buddy at 8:00am.  Every other student's patient came through the doors (I greeted each one in anticipation) and Buddy did not show.  The panic set in...I thought maybe I was cursed and something about me caused my patients to be no-shows.  Luckily, Buddy was just running behind and came to school around 8:30 profusely apologizing.  I think I can count on him to show up for all his scheduled appointments.  Buddy is a super nice guy - he is very interesting, very chatty and has been a student volunteer for many years...so frankly, the man knows more than I do when it comes to these sessions.  He was even giving me tips on how to fool the professors into thinking my cast was perfect even if it happened to not be!  He said he would walk and just not grimace even if he did not like the socket.  I am glad that I charmed Buddy, but little does he know I am a perfectionist and extremely determined - if my professors say it is not good enough, I am going to do it over again.  Sorry, Buddy.

The first thing we were looking for in this visit was finding the right silicone or gel liner for our patient.  We were all instructed to try three or four on each patient to see which one they liked best.  I, of course, chose an Ossur liner for my patient (let me be honest, I tried on three or four different liners - they just all happened to be Ossur branded).  I think if I chose another brand, it would be like going against my religion...it might actually cost me friendships :)  I am nothing if not brand loyal!  It actually worked out really well, Buddy, who is typically very opposed to these fancy liners, said he felt really comfortable in this one and really liked it.  Buddy is going to be a tough patient because he sits in his wheelchair most of the day and says at this point he is only walking about half an hour a day.  This means almost any leg I put on him is probably not going to be that comfortable or easy for him to walk in, not because of the design (although, if the design and fit are off that certainly will be a factor), but mainly because he does not ever use his body to walk in any leg.  When walking is not something you do regularly, you lose the muscles it takes to do so without pain and you lose the ease and regularity of it.  He really wants to be a regular walker, he just has yet to have a socket or leg made for him that he feels comfortable enough in to be able to walk for long periods of time.  Maybe my leg will be the one that makes getting out of his chair worthwhile!!

We were supposed to make two casts on our patients today.  I found the right liner and took all of Buddy's measurements and set about casting him.  As you can see in the top picture, I was clearly focused and working very hard.  And as you can see in this picture, I was also laughing and having a pretty good time.  This alone is a big step for me - feeling comfortable enough to laugh and have a conversation while casting means I have come a long way.  I used to feel like no one could talk to me or distract me or I was going to ruin what I was working on.  Today, I felt like I knew what I was doing and was really comfortable working with the plaster.  Buddy was also making the experience much more relaxed because he was very patient and very helpful.  A willing and accommodating patient definitely makes a big difference.  I took my first cast to show my instructor and he said my casting technique had come a long way and he could really see a big difference and made a point to comment on how far I had come...yea for me!!  And, in other amazing news - my first cast passed all of the measurements and looked so great that I did not have to do a second one!  I would not have minded doing a second one for the practice and the fact that I was not so stressed out about it, but I had a lot of work to get done (and Buddy was dying for a smoke break), so having a short casting session really worked out well for the both of this morning :)

The next step was filling the cast with plaster and making one of those molds I am always talking about.  I was able to get this done before lunch and take my lunch break while the plaster was setting and hardening in my cast.  I came back from lunch and pulled my mold out and was left with this beautiful looking residual limb.  If you have read any of my other posts, you know what comes next.  Modification!!  Supposedly this was an easy modification and in the future (when we are official and have been at this for more than 4 weeks), we will be able to do this one in about 15 minutes.  For those of us who have only modified a couple of times, it was more like 2 hours.  That is okay though because I think I made a really really good cast and a nice mold and was able to modify it in a way that made me happy and feeling confident that it is going to become a great check socket.  I got approved and checked off to go pull my plastic for my check socket about an hour before the end of the day.  I was feeling a bit of a time crunch, but made the decision early this morning to not let the time constraints stress me out today and to know that I would rather have a better socket than to be done an hour earlier.

So, I was able to go and pull my plastic for my check socket and this is where I ended the day.  This is why it was an almost perfect day.  I would have liked to have gotten a little further - this was where we were told to be by the end of day, but of course you can always go beyond that.  I would have liked to have gotten to make my trim lines and cut it out and have even worked on grinding a little bit, but I think I will be able to get it all done tomorrow.  Every time I make one of these I learn a few new tricks that help me do better the next time so I am hoping to use some of that knowledge tomorrow and knock it out in a few hours.  I have lecture the entire morning and then we have three hours in the afternoon to get from the point I am now to attaching the pylon and the foot.  Tomorrow will be grinding and gunking and aligning to get this ready to try on Buddy next week.  It was a great day and so wonderful to not feel the stress and to have more confidence in what I am doing - at least in order to be more relaxed and to really enjoy the process.  I am feeling really really good about where I am and what I have gotten done and I am excited to post a picture of my second completed leg tomorrow!!