Getting Hooked on Upper Extremity

Well, when we started working on arms, all I could think was - I am running a "leg only" clinic!!  I just keep getting comfortable with one part of the body and having the tables turned on me and the feeling of helplessness makes me want to run back to what I know...which is a whole 13 weeks of lower extremities :)

Onto the important stuff - the fitting of my arm prosthesis.  My biggest fear in these fittings became my biggest reality...my socket would not go on my patient's arm.  Not even with lotion and coaxing.  I thought I was going to have to bag this project and chalk it up to a rookie mistake and hope for a better result next time.  Oh, no no no, not in prosthetic school...we are "failing forward" and there is no chalking anything up and turning the page.  There is only figuring it out in the following four hours!!  

So, that is what I did.  I heated up my socket, I flared it out, I trimmed it down and I magically got it on my patient.  Phew, one thing down.  It was not easy and not quick, but it had to happen in order to keep moving forward with my fitting.  I was so relieved when my patient was able to get this arm on that I was not too worried about operating the hook and working out the harness fit.  

The harness is easily adjustable so that was no big deal, the hook and cable and all of that was another source of drama and stress for the day.  I was cutting my cable over and over to get it the right length...repositioning my hook and adding rubber bands.  Long story short - it took a LOT of work, but at the end of the four hour fitting, my patient was able to wear the prosthesis and fully operate the hook to complete all the tasks required by my professor's check-out standards.  I was then able to chalk this one up to a successful project...and that made me very happy and very relieved.  Maybe upper extremity isn't so awful :)

As always, the day is never short and our reward for completing a project is the introduction to our next project.  In upper extremity, our next project is to create a myoelectric arm.  This was the second cast and mold that I worked on the day after finishing my arm with the hook.  The myoelectric arm is the one that is controlled by sensors on the muscles of forearm of the patient - these sensors are used to open or close or rotate a hand/hook.  

So, our afternoon was spent learning the ins and outs of myoelectrics that we will be fitting our patients with in the morning.  We learned the computer programs that go with the sensors and how to use the sensors and find the exact right muscle spots to get the most out of the sensors.  We actually got to put them on our own arms and hold the myoelectric hands in our hands and operate them - opening and closing - to see what our patients would be experiencing.  Per usual, I love the real life application that we were given in getting to use the sensors.  It is much harder than you think to control only one muscle group at a time.  In order for the sensors to work best, you have to flex with one group to close the hand and extend an other muscle group to open the hand - working on this control and fine tuning it to open slowly or close halfway is really difficult.  Most of the time, patients are sent home with sensors and computer programs that include games in order to get their muscles used to functioning the right way so the will be able to get the most out of their future myoelectric device.  

I was staring at this suitcase full of hands all during the lecture...it was a little creepy so I thought I would share :)

Tomorrow we fit our myoelectric sockets and then hopefully get our patients working on the sensors and able to make these arms fully functional!!