1/4 Turn Here, 1/4 Turn There

February 19, 2013     I've been wearing my test socket now for 12 days, including the day of my latest checkup with Dennis. He increased the amount of knee flexion that is built into my socket to allow for a slight knee flexion contracture that I've had for a very long time. This simply means that my knee will not completely extend. So, as I've been walking the prosthesis has been causing my knee to extend beyond the contracture and so has been causing the posterior knee pain. Once again, it's a quirky characteristic of my knee, but after making this adjustment and walking for a couple of days, it feels much better. Dennis also slightly changed the 'toe-out' angle to keep my knee in less of a valgus position through the gait cycle.
So, that was Friday February 8. I was still experiencing some knee discomfort, but I decided that I need to just wear the new socket daily, try to push through the discomfort and see if it will work itself out. The idea being that my knee will slowly feel better with the new adjustments. No good. By Thursday, I am feeling more posterior knee pain. But I am certain we are on the right track. I decide to give my knee a break and wear my old prosthesis on Friday (the day of our Valentine's Day date). I call Dennis and after we discuss these results, he gives me instructions to slightly change the flexion in the socket again, trying to add just a bit more. Duane understands how the turn of the anterior and posterior screws changes the angle of the foot, so I let him do the adjustment using Dennis' instructions. A quarter turn each on the anterior and posterior screws and off I go to give it another try. Saturday and Sunday my knee feels nearly perfect. We are so close. On Tuesday, I have Duane turn the A/P screws 1/8 turn again. I am going to let it ride this way for a couple of days and see how it feels.

Valentine's Day Post Script: As noted above, I was wearing my old prosthesis for our Valentine's Day dinner date, so the red-dress-and-pointy-black-shoes worked just fine. We took a few pictures, and they were all lousy iPhone/Pod shots, but I posted one anyway. I will tell you though that after wearing the new socket with the Venture foot for several days, and then switching back to the Seattle foot, I am amazed at the difference! The old Seattle foot is so clunky and uncomfortable, especially with my dress shoes. The Venture foot is a drastic improvement. Like a Cadillac to a 3/4-ton pickup.

Thought for the Day....

February 13, 2013    Switching from my old type of prosthesis & socket to the new is like switching from Pilates to Boot Camp.  At first it's hard and my muscles are screaming, BUT if I persevere, there will be great benefits.

Roses Are Red.....

February 11, 2013     On Friday I decided that I am just going to wear the new prosthesis without a break (except at night) until my next appointment. If this new prosthesis is going to be mine, I have to use it.

OK, so I'm feeling really good about it. Like I can take on the world....or maybe be an Olympian kick-boxer.   Is that an Olympic sport?










Oh, then I remember that this week contains Valentine's Day. We like to go out for a nice dinner on Valentine's Day. What do I do about that?

Roses are red,
Violets are blue,
My prosthesis isn't finished yet,
So what do I do?

Well, would you go out looking like this?
And...would you wear nylons??


So, here's the thing. I want my prosthesis to be comfortable and functional and that is my priority. Really. But I'm also girly. I like wearing dresses and cute shoes. So, as much as I admire the posters of athletes running with their "blades", well the blade-and-pipe look just doesn't go well with a red dress and pointy black shoes. Maybe I'll take a night off and wear the old prosthesis. What do you think?

Weekend Results...

I wore the new (test) prosthesis all day Friday and all day Saturday. Saturday evening Duane and I took the kids for a family swim at Finn's Swim School pool for some fun. I wore my I'm-not-sure-how-old-it-is swim leg that has been uncomfortable for a number of years - but, I have only the one prosthesis which is OK to wear in the water, so I deal with it. It usually causes me discomfort after wear. We had a really great time swimming with the kids, so it was worth it. Sunday, my knee was sore when I first put on the new prosthesis, but there was no worsening through the day. I was able to wear the new socket all day once again. No posterior knee pain. So, all in all, that's good news.

So, that brings us to another problem we are trying to solve, which is, what to do about a new swim leg. We are leaning towards using my current prosthesis. Why can I not simply swim without one? Well, I could. But then what do I do when I am not in the water and how do I help the kids? It's not practical for me. Using the current prosthesis makes the most sense, but I have to figure out how it will work. The swim leg I have now has holes which allow the water to escape, so that removal is not overly hampered by water-induced suction (that sounds technical, but even with the holes, the silly thing has been stuck on my leg before and it is not fun trying to get it off). Note to self: ask Dennis about that one.

Swim Leg

What's Going on Now?

February 9, 2013     After 2 weeks of trying out both the Echelon foot and the Venture foot, we have determined that the Echelon foot is simply making the prosthesis too long. There is just not enough room for the mechanics. I'm totally OK with that. The Venture foot is an excellent alternative. Getting used to the Echelon foot for me was also a challenge because there were several new sensations happening in my gait. I think in the end, even if the height had not been an issue, I may have still chosen the Venture foot. I love the smoothness of my gait and the extra help it gives me on hills.

We checked in with Dennis yesterday at his office. The 2-week trial revealed 3 main things: 1) there is a spot at the top of the plastic socket that needs to be relieved, it is pushing on my knee and causing discomfort. 2) use of the prosthesis is causing posterior knee pain (after 10 hours or so). 3) when I walk, I feel my knee being pushed into more valgum ( my right knee moving toward my left).

After discussing these issues with Dennis, he is going to slightly shorten the height of trim lines (the top of the plastic socket that goes above my knee) to relieve the pressure. Also, he makes an adjustment which will allow less of an extension moment at my knee during the push-off phase of gait (when my right leg is the back leg). This will hopefully put less pressure on the posterior part of my knee and thus relieve the pain. To fix the knee valgum issue, Dennis uses the adjustment plate at the ankle once more and slides the foot to its maximum medial position (towards center) to give me a varus moment. Hopefully this will be enough to give me the proper balance between inward and outward movement at the knee as I walk. If more adjustment is needed, then at the next appointment, he will have to reattach the adjustment jig. Trying the prosthesis at the office with these new adjustments, everything feels pretty good. So, we'll take it home and give it a real workout.

What am I looking for at this point? When having a new prosthesis fashioned, there is a transition which occurs at some point along the journey of fittings, adjustments and trials. The transition happens when my old prosthesis stops being mine and the new prosthesis takes over; when I no longer want to put the old one on so that I am more comfortable, but I prefer the new one because it feels and functions better. There is an aspect to this which involves physical comfort and improved function, but another aspect which is purely 'psyching' myself into this transition. At some point in our visit with Dennis yesterday when we had discussed several negative points, he looked me in the eye and said something like, "Are you OK with all of this?" I very unequivocally replied that "I am not going back." There is a give and take between the prosthetist and the client. We each have our job to do. Mine right now is to persevere through this phase, to be patient as we try different adjustments, to be aware of whatever might be causing the problems and to communicate these very well to Dennis. His job is to work through possible solutions and execute them. He is very good at explaining the reasons behind each of his adjustments or fixes and gives me confidence that we will get to that point where the new prosthesis is mine.

I have some pictures to post later.....

Super Bowl Sunday

This is all we have to say today!

Ravens are Super Bowl Champions!