Getting my prosthesis replaced (2010), part 2: having the socket cast

So, this is a little in retrospect, but here it is!

The new socket is progressing well – a few weeks back I went in for my cast, which is always when things start to feel a bit more real! For me it’s all pretty uninteresting at this stage since it’s been a regular happening from when I was a kid, but I imagine it’d be a bit weird for someone new to being an amputee!

So for the uninitiated, here’s what generally happens – off go the trousers and replace with a weird off-white cotton unitard that goes down your real leg and over the stump. Tie the end off under the stump pirate-style, cut the shoulders on the unitard and tie it like a toga to tighten up on the correct side of the body, stand over some plastic sheeting and have cold, wet plaster wrapped around your stump 😉 Having a good amount of balance helps for this bit, so I’m right at home since I’ve been an amputee since I was a baby.

Anywho, after a bit the wet plaster starts to set and turns from being cold and wet to warm. It’s kinda weird, but I’d hazard a guess it isn’t unlike having a cast put on your arm or leg after breaking a bone or something. Once it’s set, off comes the cast and you clean yourself up by brushing off the plaster. You’ll invariably get plaster seeping through to your underwear, so if you don’t want to ruin your Teenage Mutant Ninja Turtles undies, wear something expendable 😉

Actually, particularly to the guys, I have a piece of golden advice – if you’re being cast over your stump, I’d recommend shaving or waxing your stump in prep, because when that cast comes off, all that hair’s coming with it.

Was it inappropriate to go into that kind of detail? Hopefully not. After all, you’re going to have to deal with it, so not talking about it won’t make it go away or anything 😛

Anywho, so that covers getting the cast done – next time I’ll be talking about the test socket stage. I’ll continue to update as we go, so just keep track of the 2010 New Prosthesis tag for all the posts related to this topic.

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Getting my prosthesis replaced (2010), part 1: starting the process

Those who have been reading up on the blog for a while will know I’ve been struggling the damage to my stump or with my prosthesis for the last 12 months off and on, and I’m pleased to say I’ve finally gotten the ball rolling to have something holistically done about it! Last time I caught up with my specialist was in… June I believe, and back then he mentioned that I was eligible for a new prosthesis since the last one built from the ground up was from 2006-ish (although when we went back to check the paperwork, I’m pretty sure the 2006 job was actually just a socket replacement, as I kept the rest of the leg as part of the build!). I was originally planning to get a move on with this in August, but some unexpected things cropped up, and now we’re in October. So I got there in the end, and it’s proof that it’s not only my training that suffers when life happens, my leg does too 😉

Anywho, I caught up with my specialist and the doctor on Monday last week, and the application has been submitted for processing. I’m told this usually takes a fortnight, and once they’ve been given the green-light, I’ll make an appointment to have a new socket cast to my stump.

I really should have looked into having a new socket put together a while ago – the stump continues to change over time and to its environment, and I have a feeling a lot of the problems I’ve had over the past 12 months have been to do with my stump no longer fitting the mould of my socket as well as it used to. These changes are caused by all sorts of variables from what I understand from a kinaesthetic viewpoint – muscle tone, overall weight of the amputee, usage of the stump, changes in gait, responding to the shape of the socket – so four years on one socket is probably a bit too long.

I think the mentality originates from what I was told as a child – growing up, I’d have a new prosthesis built each year to accommodate the fast pace you grow as a child and adolescent. Back then, I was told that, once an adult, you don’t have new legs built anywhere near as frequently, so that impression still sits with my attitude towards my prosthesis. There’s also the terrible Australian idiom, “She’ll be right”, I have a habit of subscribing to, and that probably hasn’t helped either since I figure any pain is a passing thing and I should just build a bridge and get over it, so to speak 😉

So, new leg, new opportunities? My specialist is looking at introducing some tweaks to the design to allow more flexibility for the stump whilst in the socket, but also with greater suction. We’ll also be looking at adding a more robust knee to the arrangement, though it’ll still be pneumatic as I prefer the practicality of the pneumatic knees in the same price bracket as the hydraulics – higher end of the cost scale I reckon I’d slide over to hydraulic units that offer more sophisticated features, but I’m limited by what’s provisioned under local medical schemes as there’s no way we could afford to spend $1000s on my prosthesis when Wifey and I have a Gen-Y mortgage to maintain. Mind, the support these days is significantly improved from when I was a kid, so I’m not complaining about the existing government support for amputees, just pointing out that I can’t afford or justify the cost of going outside those boundaries given everything else.

I’ll continue to update as we go, just keep track of the 2010 New Prosthesis tag for all the posts related to this topic.

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On spontaneously walking up to fellow amputees and saying “Hi”

I’m sure this isn’t unique to myself, but I thought I’d share anyways.

The other week I was taking Wifey out shopping (because I’m an awesome husband), and when out we walked into a video game store (because I’m also proficient in nerdisms) I noticed another guy who looked in his late teens or early 20s in crutches. Since I’m a bit nosey by nature, I instinctively looked to his feet, and noticed he only had one leg. I couldn’t tell if he was an above-knee or below-knee amputee, but still, it was there (or rather, it wasn’t :P).

My first instinct was to walk up to him and say “Hi” and see how he was going, purely on the basis of him being an amputee, but I hesitated… I mean, I’m pretty comfortable with having only one leg and talking to people about it, but I know not all amputees feel this way. What if the loss of his limb and talking about it upset him? What if he misinterpreted my good intentions and thought I was poking fun at him or drawing unnecessary attention? What if he’s actually been a long-term amputee and his stump was knackered, and the reason he was getting around the place on crutches was because of that and thought I was being condesecending? I was wearing shorts that day with the titanium pole exposed so he would have easily been able to see I was a fellow amputee, but still, I was worried.

So I didn’t say anything, because I was concerned about coming off without the good intentions that I had.

The question I’m asking myself aloud is – is it cool to go up to a fellow amputee and just say “Hi” and ask how they’re doing?

It’s weird, whenever I see another amputee out and about I always have that urge. I know it must be human instinct, but still – that little voice of hesitation is always there.

One of the few times I’ve acted on it was a feew years ago when I was walking to catch a train home after Uni finished for the day – I was walking with Wifey (well, she wasn’t Wifey back then since we weren’t married :P) and came to a stop along the footpath where one of gates for bike/vehicle access to the Uni was located. As I was standing there or walking up to it, I noticed a guy on his bike had one leg. So, being the person I am, I stopped for a chat. I was also my usual subtle self, pointing to his leg and stating, “Hey, I have one of those too”. The guy looked at me with this kind of inquisitive look (possibly verging on delivering a headbutt) so I reached down and pulled up the leg on my jeans, revealing my prosthesis like the shining symbol of awesome gimpyness that it is.

And that was it – I reckon we stood and chatted for about 20 minutes, exchanging stories and experiences, before I realised I wasn’t going to catch the train on time if I didn’t hustle. While I did catch the train on time, I didn’t have enough of a buffer to grab a couple of freshly fried cinnamon doughnuts from the doughnut place. Bummer. Would have been a perfect afternoon then 🙂

Going back to my original story – owing to this happening, I’m looking at ways that maybe I can get involved in the wider amputee community. I’m not sure in what capacity at this stage, but I’ve been meaning to join the forums over at the excellent Limbs 4 Life website, which I’ve mentioned previously and currently have links setup on the blog’s sidebar so people can easily access the site from here. I’m not such how else I want to involve myself in the community at this stage (there’s ultimately only so much time free during the week), though Wifey’s been really supportive and has encouraged me to get more involved and help other people out due to my positive attitude towards my leg.

amplified cover - Autumn 2010

Autumn 2010 cover of amplified

For those who haven’t checked out their site before, I’d encourage you to stop by and check it out – they’ve also recently released the latest edition of amplified, a quarterly magazine published via their website as a high quality PDF. I took the time to read through the latest issue in full (thanks Wifey 🙂 ), and there were some great articles and personal experiences therein. There’s also (as of next issue) going to be the chance for amputees to write in and ask questions. Best of all is that it’s free, so no cost for access to an extremely professional publication on a niche topic. Brilliant work.

Hmmm, I think I got sidetracked there, sorry about that!

Anywho, just wanted to share the irrational side of my personality when it comes to seeing other amputees. Hopefully I’m not the only one 😛

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Should amputees be allowed to compete with other martial artists?

I got an e-mail over the weekend from Eric Dexheimer, a reporter over at The Statesman, who was doing some research for an interesting article about an above-knee amputee MMA fighter, Jorge De Leon. The twist to the story is that despite covering his prosthesis with a protective foam and being physically fit for the event, the Texas Department of Licensing and Regulation fined the event organiser $5,500 and disqualified the event. To quote from Eric’s piece:

The official crime was that De Leon had broken a rule prohibiting fighters from wearing “metal, straps, buckles, necklaces, jewelry or other objects (including piercings) that may cause injury to either fighter.” “The leg would fall under ‘other object,’ ” explained Susan Stanford, a spokeswoman for the agency.

So, the question I rolled around in my head was – should amputees be allowed to compete with other martial artists?

The above is an interesting scenario – on the one hand, I think it’s awesome that he’s gone ahead and participated in an MMA match despite his disability, and feel quite strongly that he shouldn’t have been disqualified. On the other hand, knowing how much potential damage a prostheesis can inflict on a person, particularly some of the edges and parts relating to the knee, supporting titanium pole and so forth, I can see that there may be grounds in terms of safety of the prosthesis during a match.

In some ways, I’d argue that there simply being a prosthesis isn’t unsafe per se. The prosthesis is merely a tool that can used and manipulated as a weapon, no different to a knee, fist, elbow, etc. In fact, due to the greater degree of movement and kinetic energy that can be harnessed, it could be argued that these natural extensions of the body are no less safe than a prosthesis, it all comes down to the use thereof. For example, if I were to strike with a roundhouse kick, my prosthesis would likely cause a significant impact – however, due to the way kinetic energy can be manipulated via muscle and hard bone, I imagine that a roundhouse kick by a seasoned martial artist would arguably have greater impact. I have compared my kicking techniques to my instructors and other experienced martial artists I have trained with, and I would actually believe their strikes are actually more powerful than something I can generate. This is reflected in Eric’s article, noting that experienced athletic prosthetist Jan Stokosa found that while sparring with below-amputee Ron Mann, it was his real leg that caused greater impact compared to his prosthesis.

One of the disadvantages of a prosthesis compared to fully-functional limbs is that we don’t have the same degree of control compared to a physical leg owing to the lack of muscles, and this lack of control could well be grounds for arguing issues against its use (i.e. unintentional damage or injury due to the relative instability of the leg). Mind, contrary to that, I’ve seen some pretty scrappy MMA bouts, and I don’t think controlled striking is necessarily a universal component that all participants believe in; this does make sense in the spirit of MMA though, given its potential to simulate “real” combat, rather than point-based or light contact sparring quite common amongst “traditional” martial arts styles in the West. Mind, I certainly wouldn’t have the balls to compete in an MMA match, looks too full-on for my sensibilities!

As a point of comparison, if it’s relevant, whenever I spar with other martial artists I do two things – first up, I give them advanced warning to watch how they strike in case they unintentionally hurt themselves on the prosthesis. Secondly, I make it a habit not to actually strike using my prosthesis during sparring – this is more in line with my philosophy that I don’t believe I can control the leg to such a degree that I can guarantee there won’t be unnecessary impact to my sparring partner.

But MMA is arguably quite different to a lot of sparring I would do in class – if your body has a natural advantage (athletic, muscular, experience), does the presence of a prosthesis make much of a difference to the spirit of a match if it’s considered simply a function of the body, akin to the aforementioned attributes? When grappling arts like Brazilian Jujutsu were introduced into MMA competitions and proved an effective (and arguably essential) part of a combatants’ repertoire, the style wasn’t banned – rather, participants had to learn how the system worked and how to counter it. In that sense, is the presence of a prosthesis any different?

As an amputee, I can assure you that whilst there may be advantages to having a prosthesis during such a match, there are also a huge amount of disadvantages – balance, limited control, lactic acid buildup in the stump, incredible amount of energy expenditure to move/use the limb compared to an able-bodied competitor. The question is – do the disadvantages even out the advantages?

There’s also the fact that there aren’t many opportunities for amputee martial artists to be recognised and compete if they wish – I would be absolutely thrilled if karate or something similar would get introduced at a Paralympic level, as the only martial art currently available is judo, and participation is based on the basis of your eyesight-related disability. There is no avenue for amputees to compete.

I’m pretty on the fence with this one, hence why I’ve jumped back and forth on either side of the argument… I know it may be a little convoluted, but hopefully I’ve helped stimulate some discussion on the situation.

On a final note, for those interested in reading more about Ron Mann, check out the following sites:

He has also run some workshops and competitions at the Extremity Games – according to the website, the next one is happening next month in Texas. It’s definitely an event I’d love to go to, but putting aside the money factor (gotta love those Australian mortgages!), I’d want to get into more shape before thinking about heading over there to compete 😉

Huge props to Eric on his excellent report on this issue and for getting in touch – I just wish I checked my mail a little earlier so my response could have been more useful! I highly recommend you check it out to get the full story, it makes for a great read:

Not going down without a fight on his prosthetic leg: Agency says war vet’s bout broke law as technology and martial arts converge.

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Taking a (forced) break over x-mas

Sorry for the lack of updates of late 😛 Last week ran away before I knew it!

So, update on how I’m going – erm, leg’s not holding up too well 😛 The issues that cropped up a week or two back have come back again, so it’s out with the walking stick again to keep me company 🙂 I’m not sure why the stump’s not healing up as quickly as it normally does, I suspect it’s to do with the location of where the split skin currently is and the fact it’s in constant pressure, whether it be wearing the prosthesis or not.

So, I have to exercise something I’m not all that good at – patience 😉

So, I’ll be taking an extended break, longer than I first thought when I took a week or two off in November. I’ll have to make sure I don’t indulge too much over the break as well, since I won’t be able to exercise as much! 😉

This does raise a couple of questions though – how do I exercise whilst trying to minimise excess physical impact to my stump? I want to use the next month and a half until classes start again in January to get back into weight training, and I reckon this might be able to float the balance between being able to have a good workout, but do it without excess pressure on the rear of the stump since I can do a slew of different exercises on the bench, rather than standing.

The other thing I’m considering doing is working on adapting some of my core techniques to being able to do them standing on one leg. Taking a note out of Jesse’s (of the Martial Explorer) book and his interest in practical application of martial to real-world scenarios, I thought this is something I should be looking at. While I’m generally wearing my leg while I’m awake and out and about, there will be times where I’m going to be without my prosthesis, whether it be because I’ve mangled my stump or damaged my leg. So, I’m conscious that, in the spirit of trying to be a well-rounded martial artist, it’s important that I consider broadening my skillset to cope with performing at least a handful of upper-body techniques if ever I need them. So, I figure while I’m a bit mangled, it may not be such a bad idea to roll in an exploration of some of these techniques with my condition.

So, while there are definitely some negatives with where things are at, there are also some opportunities in there as well. I’ll update as I go 🙂 I’m actually a bit excited about exploring what techniques can be transferred to training on a single leg, hopefully the resultant posts won’t be too convoluted!

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