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.....