1001 Ways to Bend a Leg

This was my view at 7am this morning.  The time change may make staying at school until it is dark a bit tough, but it makes my apartment light up at 6am (making sleeping past that almost impossible), but making it easier to get to school earlier and work on my leg.  I was pleased to see that the plastics room looked exactly as I had left it 14 hours previously - my leg in position on the vacuum ready to go.  All I had to do was turn the oven on and wait for it to reach 360 degrees.  (This happens much slower when you can see the oven digitally counting up the degrees).  The slow warm up was probably a good thing for me, gave me a chance to wake up and get ready for a long day of work.  Well, apparently it did not give me long enough to wake up fully - I messed up my first pull of plastic.  Cue the sad violin music.  It was slightly disappointing - mainly because I was geared up and beat the crowd to the plastics room and was ready to get a head start on the day.  This is a really big leg and I took too long pulling the plastic down over the leg.  The plastic began to harden before I could get vacuum suction around the bottom edge (really the top of the leg) sitting down on the wooden wheel.  It is a very sad realization when you have suffered through burning metal on your hands and sculpting this piece of plastic over your mold to find out that you have to redo it.

Alas, I kept a positive attitude and put a new piece of plastic in the oven and began the melting process again.  No coffee needed for this girl, messing up your plastic mold will quickly wake you up and really realign your focus.  There was no way the plastic was getting the best of me today - I had a leg to finish by the end of the day and I was going to finish it!!  Notice in the picture that the end of the residual limb is about the same size in circumference as my head :)

After getting the plastic done right (yes, the second time was the charm), it meant cutting and trimming and grinding.  The cast saw is now my friend and I use it with great confidence.  The sanders and grinders, while we have yet to reach friendship status, we are definitely good acquaintances and I do not mind visiting them every now and then ;)  It is not even that I am intimidated or bothered by the grinding anymore, it is just that I am not a huge fan of doing it.  It is a necessary evil and because of that I am happy to spend half an hour eating plastic dust, but of all the things that come with making legs, this is on the lower end of the totem pole for me.  This picture is what I call "grinding success!"  I used to take the pretty socket and get really excited about how nice it looked...take it to my desk and admire it.  Now I just go ahead and rough up the bottom (it has to be done before the gunking process) and do not leave the grinding room until there is no more grinding to be done.  It does not look that pretty, but the edges feel fabulously smooth and my valve looks and works perfectly.  Grinding is the step before aligning and gunking - I managed to get this much done before noon...time was on my side today.

After lunch, I spent some quality time putting all of my components together.  Although I did not get a fancy microprocessor knee for my patient like I was hoping, I did go ahead and use another Ossur knee we had at the school.  What can I say?  I am brand loyal :)  I actually think I picked a great knee for my patient, he does very very little walking and I think a fancy knee would have been too much for him and he would not have used it to its full potential.  I used an Ossur foot that I have never used before so I am excited to see it in action.  Using these fancier knees (we used really basic ones on the last leg) makes the leg look so much cooler and much more like the prostheses you see out in the real world.  That was exciting for me.

I aligned, I gunked and I fiberglassed.  I then reattached my knee and foot and the result is this beautiful limb you see here before you.  Is that not a nice looking leg?  It is going to be even nicer looking in a week when we make an inner liner for it and laminate the socket - there will be no grinding marks or messy stuff at the bottom.  I am still working on a fun pattern to put on it...I selfishly keep looking for one that pleases me and not really considering what my patient might enjoy.  Hmmm, I might need to factor that in...

It is just that I picture this sitting on my mantle...he will wear it for 15 minutes for critique and move back to his real prosthesis.  I think that allows me some artistic freedom when picking out the fabric pattern to use.  Besides...real mean love pink, right??

Today was a great day - I worked hard, I was very productive and I accomplished the set goal of having a completed leg by the end of the day.  I was even able to get out of school a couple of hours early (totally worth going in early this morning for).  I have a huge pile of school work to do tonight and have been plugging away at it since I got home - the blog is my break for the moment.  Tomorrow we have our patient fittings and, per usual, there is always the fear that my patient will not get into the socket.  I am hoping my beginner's luck does not run out by the morning and I am able to get Paul up and walking - you just never know which way a fitting is going to go.

Did I mention that my favorite part of making trans femoral legs is that it is really cool to see the knee bend?  I do not know why this amazes me so much, but I just love that I have created a leg that moves!!