The Calm Before the Storm

This is what an empty training room, set up for casting looks like.  Gentle, clean and no chaos.  Tomorrow at 8am, this room will be the complete opposite state.  It will be full of 10 patients, 20 students and 4 instructors...and about 100 rolls of plaster.  Buckets of water everywhere, tools being tossed about, and lots and lots of cups of coffee.  Measuring tape and scissors, progress notes and casting socks.  Tomorrow we are casting our (new) patients for a transtibial prosthesis.  Remember the 3-stage casting technique we learned the other day?  Well, tomorrow are going to be applying casts using two of the three stages that we used a couple of days ago on our classmates.  Per usual, I am not really sure of the reason for using or not using the third stage, but I figure, it is one less stage to have to worry about and thus, I am very happy with just my two stages.  I am really looking forward to meeting my new patient tomorrow and to have another chance to expand my casting skills.  Again, we will make two casts for the patient, regardless of how well the first cast turns out.  I really like that we do this because I need all the practice I can get.  Plus, it makes the casting session feel a little less like a do or die situation.

Today was a day full of lectures and demonstrations.  Truth be told, these usually make for long days that are often hard to stay focused and awake during, but after yesterday, I was perfectly content staying relatively still all day.  The morning was spent talking about why we cast in certain ways and all of the different types of liners (what goes on a patient's leg before their socket) are on the market and the pros and cons to each different type.  Like all of the other aspects of this industry, it is unbelievable to see all of the countless options for liners out there.  It is just another area of preference and trial and error to see which one works best for your patient.  I have a feeling I could easily spend hours just trying on liners with someone!  In our casts tomorrow, we will be casting the patients with a gel liner on.  This will help make our patients more comfortable in the sockets we make.  Gel liners are a wonderful invention because it takes a lot of the pressure off the bony areas in a residual limb and just provides general, overall total contact and comfort for the amputee.  The downside is that they are tough to cast on because it makes the limb into more of a cylindrical shape (my professor says the "coffee can") as opposed to being able to distinguish all of the bones and landmarks like you can when the skin is bare.  Apparently this means you just have to squeeze down much harder when casting to try and feel these landmarks through the gel liner.  I am really interested to see what the difference feels like tomorrow when I am working with my patient.

This is what the chalkboard looked like today in reference to what we are trying to capture when we are casting tomorrow.  We have these drawings done for us multiple times a week - I can only imagine how many lower limbs and different socket drawings my professors have done over the years.  They are very proficient at it :)

And this gives you a good idea of what about 4 hours of my day looked like...I think it makes it look more inviting if I write in pink :)  Note taking is my strong suit, I can memorize these things all day long.  A day full of this definitely does not have me rushing home mentally and physically exhausted.  So, as sleep-inducing as they may be at the time, they are a nice mental break from all of the modifying and grinding.  It is also nice to leave school in clean clothes.

Big day tomorrow - we are expected to have wrapped two casts, fill the best of the two and do all of our modifications AND pull the plastic over the molds by the end of the day.  No more three weeks to get these things done, we are down to a mere few hours from start to finish.  Cross your fingers that in tomorrow's post you see a completed project because we are supposed to be attaching the pylon and foot by Friday.  My patient is supposed to be walking on this leg next Tuesday.  Nothing like the deadline of giving someone the option to walk or not to get you motivated to move faster!!