Thursday, February 2, 2017

A visit to the prosthetist

The day that I got my
first prosthetic device
I have had my leg for nearly two years, and really for the last year I have not needed to have anything done. My leg has performed extremely well since I got the rush 87 foot, and the new socket. However I have noticed recently that I am beginning to wobble when I walk and it is bad enough that everyone seems to notice. I am notoriously hard headed and a bit of a do it yourself kind of guy. I hate to have to take a car to a mechanic to get it repaired and the same thing applies to my leg. 

One thing to remember is that there is a reason for the division of labor in a civilized society. There are things that some people specialize in. Trash collectors know how to properly dispose of waste, the people in the DMV know how to make people wait, Transportation Managers [me] know how to get the things we need from the manufacturer to the market. The guy that knows how to change my oil and properly store the used waste oil that comes out and darn it, the guy that works on my prosthesis, he knows how to make it work better.

The difference between my sockets after
six months was amazing. 
As an amputee progresses through the first years of an amputation, the residual limb changes shape. First, the swelling goes down as the blood vessels begin to function in their new environment, and then the muscle starts to atrophy a little. The young amputee has a better ability to keep their muscle mass, as does the active adult. In many cases, the amputee may not be as active and the progression of atrophy is very quick, requiring visits more often. In my case, I am active and the progression was pretty slow, and I did not notice it as much. As a matter of fact it took my wife asking me why I was limping to notice. One of my co-workers is a fitness coach, and she was adamant that I take the leg down to get it adjusted.

My normal prosthetist was not available yesterday, but Sean was more than willing to look at it. Turns out I had a 7/8 inch discrepancy between my leg length. Also the socket itself, was far too deep. he had to cut down the wings and drill out a couple of small spots on the front, to help alleviate a couple of rub spots. We talked about the new Rush Rogue foot, and he is going to check and see if I can get a trial to check it out. Not that I am dissatisfied with my Rush 87, but as technology gets better, I would like to be on the leading edge of it.  I am really excited about this new foot, and can't wait until I can get one. 



The bottom line is this: If you are in pain, or discomfort in any way, go back and see the people that know what they are doing. Your prosthetist will do everything they know how to make wearing it a good experience. I wear mine close to 18 hours a day, seldom with any adjustments to how it fits. Talk to them about everything you deal with. They are a great resource. They might tell you something you don't know that will radically change the way you think about it.

Monday, January 30, 2017

How do I remain active with an amputation?

I cannot speak for others. I can only speak for myself. I have chosen to remain active, rather than wallow in a pit of self-despair. Being an amputee can be challenging in so many different ways. There are days that simply wearing my prosthesis causes pain. Other days I have severe phantom sensations, ranging from the twisted ankle syndrome to leg melting into a pit of lava. One thing that I noticed early on was that these sensations got worse when I became less active.

My degree is in physical therapy, even though I abandoned that career path 30 years ago, and haven't kept up with my studies with anything more than a mild interest. Two years ago when amputation was looming ahead, I focused my interests in areas specifically attuned to advances in rehabilitation of below-knee amputations. In almost every case, the recommendation called for  the patient [me] to keep a pain log, along with an activity log. I noticed that in many of the case studies, the writer was focusing on the level of phantom pain decreasing with increased activity. This seemed counter-intuitive at first.

After my amputation, I hit the therapy hard. Attempting to do every exercise that I could as quickly as I could. I didn't have any "phantom" sensations at all. That lasted about a month or so. Then it started, my toes were back... they were getting pinched. My ankle was back and it felt like it was twisted. It always seemed to hit me during times that I was resting, especially at bed time. I dutifully wrote it all down in my log. Funny thing about the phantom pain, medication never seemed to help, in fact it seemed to make it worse. It took me a bit to figure out why. When I took the medication, my activity level decreased, the pain level seemed to get worse.

Once I realized that they were interlinked, I made a decision to push through any minor pain I might have and increase my activity level. Keep walking, hiking, biking and what ever else i could think of. Active massage of the residual limb, making sure that I had a clean liner and clean socks, ensuring that I didn't have any wrinkles or bubbles that might irritate my skin. I had to think about it all the time, and I invested my time in activity, to prove to myself that activity decreased the pain. From my point of view, that is what happened. As a case study, it makes sense. It might be something that someone could prove is normal for others as well. I have a field study of one [me].

So how do I remain active? The first thing I do is make sure that I have a good fit in my socket. Stump pain from a bad fit, or careless dressing is a very hard thing to overcome. My liner has to be dry and completely lint free. I wash it using a generic Hibeclense I get from Walgreens. I use a very standard 5 mil sock (I don't have much deviation in stump size any more) I carry both a 1 and a 3 mil sock everywhere I go, just in case anything changes. I can go up or down using one of each sock. I also take my kit with me (small lotion, 2 socks, a 4mm Allen wrench, a metal 14" shoe horn, water and a granola bar) Second, I get up off my butt and go do something. from yard work, to walking to the store or the ball field, maybe riding my bike, or working on some project.

The key ingredient is to find something you can do and do it. Start small and just get after it. Challenge yourself to do a little more every day. You will soon find that you are able to tolerate more and more.

Friday, January 13, 2017

Positive Attitude Matters - Seven Keys to remaining Positive

What we do and what we achieve in life is more often dependent on what we think than any other factor. I have explored this and have found some real nuggets of positive notions regarding what we can do as amputees to work toward a positive outcome. Remaining positive promotes healing according to the American Medical Association. These are all things that we can do to stay positive


Choose Happiness!
Do not wait for good things to happen to you. You need to work towards happiness. You need to create a happy environment around you today to remain happy tomorrow. As amputees we must focus on positive achievement rather than the negative of what we cannot do. If you adopt a positive attitude, life becomes a rewarding game instead of a challenge to ‘get through.’

Clarify and Prioritize
Learn to know what you want. If you know what you expect from yourself, your future becomes clear and your goals become attainable
• Clarify your purpose : A purpose is something you fulfill each moment when you are in balance with your life. (A purpose is a simple, positive statement of why you are here). A purpose isn’t a goal statement, which one can achieve.
• Discover your purpose: by identifying & prioritizing your most important roles in life (at home, at work, community etc) List the positive qualities that you aspire to possess: Honesty, Philanthropic, Accommodating, Tolerant etc.
• Visualize your future, with a clear picture in your mind of what you want to accomplish in your lifetime (you can become what you think you are and what you see). One of the most powerful techniques for achieving life goals is visualization (creating a mental image of something happening in future). Believing in and seeing your dreams can motivate you to become what you want to be.
• Set goals for yourself (To help your dreams for the future become a reality, you need to set short & long term goals) to stay on course.
To provide steady fuel for your energy, create a list of long term goals to be accomplished in life time & break them into several interim short term goals to help you chart your progress.

Be Resilient
Resilient people are those who face setbacks but ultimately, with perseverance, recover from them. Try and be strong and face life’s difficulties as challenges; respond accordingly with action, rather than with fear, self-pity, inferiority or blame. While life as an amputee can be very challenging, an important step in becoming more resilient is to develop the habit of positive self talk and to remind yourself that you are strong and can grow stronger and wiser as you handle life’s challenges.

Self Pep Talk
One’s inner dialogue is one’s biggest strength and critic. Listen to your inner self and talk to it. Motivate yourself rather than getting motivated by others. It is the inner voice that makes us critical of ourselves. Rule your inner voice!



Laugh!
Humor is the best medicine. Make laughter a part of your day. Laughter is known to be a mood elevator. When feeling low, read funny stories or go through a joke book. Allow yourself to open up. See the funny side of things and you will realize, life is a complex, yet funny game.

Carpe Diem!
Seize the day, as the proverb goes. Always enjoy the moment. Do not worry about your past or future. Live for the day. What has happened is irreversible and what will happen is unknown, so try and enjoy what you have. Like someone has rightly said:
“The past is history, the future is mystery. Today is a Gift, That is why we call it the Present”

Be an Optimist

This is the golden rule to maintaining a positive attitude. Always believe in yourself. Being an optimist does not only mean to see the brighter side of life. To be an optimist means to view the surroundings wherein you maximize your strengths and achievements and minimize your weaknesses and apprehensions.

It is difficult to change yourself in a day But at least give it a try. A positive attitude in life will help you go places. Just curb that fear in you and move towards the right path!!
Remember, I CAN and I WILL.

Tuesday, January 10, 2017

An open letter to my senators - updated


Once again, we need to address our country's health care system. First it was medicare reform and how that was going to affect the outcome and insurance standards that would effect the entire system, now it is the entire system is being revamped. We must get together with the powers that be and make our voices heard again. I encourage everyone that I know to contact their senators with a similar letter as the one I have posted below. I got this format from the Amp'd Podcast website. Thank you to Peggy Chenoweth and Dave McGill for taking the time to prepare this form of activism.



Dear Senators Boozman & Cotton
My name is Keith Allen, and in 2015 I lost my leg after fighting a yearlong battle with a MRSA infection. I am an active member of my community and enjoy hiking, fishing and working with my daughter’s softball team.
I am writing to you regarding the pending discussion regarding repealing and replacing The Affordable Care Act. Whatever the ultimate outcome of those discussions, there are two potential changes that could hurt people like me who rely on a prosthesis to live a healthy and productive life. I am therefore asking you to continue protecting amputees by (1) ensuring that prosthetics remain classified as an essential health benefit, and (2) prohibiting pre-existing condition exclusions.
As it stands today, virtually every state in the U.S. considers artificial limbs an essential health benefit. This means that insurers cannot set annual or lifetime limitations on the provision of these devices. If this were to change as part of a repeal of current federal law, things would return to the way they were before 2010: insurers will issue policies offering only 1 prosthesis per lifetime, or that have dollar limits on prosthetics so low that amputees like me would either have to try to pay for the entire cost out of pocket or forgo a prosthesis altogether.
Similarly, if repeal of the current law results in insurers being once again able to assert pre-existing condition exclusions, amputees like me will suffer. My need for prosthetic care and treatment is both regular and permanent. If, during a transition from one insurance plan to another, an insurer can refuse to cover any costs associated with my prosthesis, the results could be catastrophic. What happens if my prosthesis breaks? Or if I need modifications to it because I am suffering from pain and tissue breakdown as a result of compromised fit? If we are forced to bear those costs ourselves, I and hundreds of thousands of other amputees who rely on prostheses face the prospect of crippling medical debt or life without a prosthesis.
Thanks to the high-quality care of my prosthetist and modern prosthetic technology, I am able to live a full and complete life. But that can only continue if I have access to these qualified health professionals and the right prosthetic components. The only thing that makes that possible is an insurance industry that covers medically necessary prostheses without being able to assert completely arbitrary annual or lifetime limits and pre-existing condition exclusions.
As you grapple with the ongoing challenges of healthcare in the United States in the 21st century, I am asking that you protect amputees and allow us to continue to have access to the professionals and devices that allow us to live active, healthy and productive lives. Please make sure that prosthetics remain covered as an essential health benefit and that pre-existing condition exclusions cannot be asserted against amputees.
Thank you for taking the time to read my letter. I will closely watch events in Washington over the coming weeks and months and will be extremely interested in your vote(s) on these matters.
Sincerely,
Keith Allen

One thing that we must remember is that no matter who is in office, their primary concern is to balance their spending while providing the best care to the public. Many other organizations have large lobbying groups that speak for them, people like ACLU, NAACP, the NRA, and others that have serious political clout. However, if we all stand up and fight, we can make our voice heard. I encourage each and every one of you to send your senator an email, a tweet, a facebook message, an instagram, what ever platform you use, and make your voice heard!  See other ways you can be active in the fight HERE


********** UPDATE **************
I received the following email from Senator Cotton. To say I am disappointed that he did not even read my email is an understatement.

[RESPONSE BY SEN TOM COTTON] January 11, 2017
Mr. Keith Allen
[address redacted]

Dear Keith:
Thank you for contacting me about Social Security. It's good to hear from you, as always. 

Like you, I believe in the important role that Medicare and Social Security play in protecting the elderly and the disabled from poverty. We must fulfill our promise to current retirees and those who are approaching retirement, while also strengthening these programs for future generations. 

While millions of Americans rely on these programs, unfortunately, politicians have put them on a path towards insolvency. The most recent report from the Social Security trustees confirmed that 2014 was the fifth consecutive year in which the program paid out more than it took in from with a $39 billion deficit for the year. Not to mention, our national debt is expected to grow nearly 50% to $27 trillion and consume more than 100% of our total economy. 

If we are to maintain our promises to both current and future retirees and save future generations from the crushing burden of repaying our debt, we must implement reforms that make Social Security and Medicare stronger and more affordable in the long term. 

We must reform these programs so current retirees can continue to receive the benefits on which they rely and so future beneficiaries can plan effectively for their retirement. As I evaluate proposals to change entitlement programs in the future, I will keep three principles in the forefront of my thinking: (1) opposition to tax increases; (2) changes should not impact those who are retired or approaching retirement; and (3) reforms should expand, not limit, patient choice in health care. Rather than ignore the problem now and face painful consequences down the road, I believe we must enact reforms now to guarantee the integrity of these programs.
I'm truly honored to serve as your Senator; please know that your interests and affairs have my unceasing attention. Always feel free to call my office at (202) 224-2353 or visit www.cotton.senate.gov.
Sincerely,

Tom Cotton 

United States Senator
*****************  UPDATE *******************

I just received a second letter from the Senior Senator from Arkansas, and while this is still not what I wanted to hear, at least it appears that the Senator or his staff actually read my letter before replying. This response was better than the last and hopefully, Senator Boozman will have a little more influence than his junior partner.
[Reply from Sen John Boozman (R) AR] 1/23/2017


Thank you for contacting me to share your thoughts on the current state of healthcare in our country. It is good to hear from you. 
Like most Americans, I believe our healthcare system needs substantive reform. While there are well-intended goals that I support in President Obama's healthcare law, such as ensuring those with pre-existing conditions have access to coverage, the fact remains that accessibility and affordability are still serious problems that elected officials, community health advocates, hospitals and providers must work hard to address.  
President Trump, Speaker Ryan and Chairman Lamar Alexander (R-TN) of the Senate Committee on Health, Education, Labor and Pensions have all said that Congress should repeal and replace Obamacare simultaneously. I agree with my colleagues in their commitment to a careful and orderly transition to a patient-centered health care system that truly is affordable, not just in name but in practice, and that actually works for the American people.  
I believe we must embrace market-based reforms that lower healthcare costs. From cross-state insurance purchases and healthcare co-operatives to medical malpractice reform and medical record modernization initiatives, it is critical that we implement responsible reforms. Moreover, we must preserve and protect the role of patients, providers and physicians as the principle healthcare decision-makers, not the federal government.  
It is time for us to come together and find commonsense solutions to our challenges. America functions best when we work through our differences and tackle our country's problems. Moving forward, I am committed to working with colleagues on both sides of the aisle to reform our healthcare system so it makes sense for all Americans. Please be assured that I will take your thoughts into consideration as we continue this discussion.  
Again, thank you for contacting me to share your views. Please visit www.boozman.senate.gov to sign up for my e-newsletter, request assistance with a federal agency, or learn more about my efforts on behalf of the people of Arkansas. I look forward to hearing from you in the future.
Sincerely,
John Boozman
U.S. Senator




Monday, January 9, 2017

Assumptions and Ability

Some things came to me this weekend that got me thinking. First is that not all disabilities are easily discerned; the second would be that even with my disability, I am far more mobile than the average person.

I guess that having a blue tag gives me an advantage. Yes, I use it when parking at work, sometimes at the local stores and malls. I don't really need to, but I like to have the freedom to open my door completely to get out of my car without fear that I will bump the car next to me. But some of the scowls I get from other people are withering. I have been lectured, with fingers pointed squarely at my nose. Honestly, I cannot wait for summer when I can wear shorts again. I never get those looks when my disability is easily seen. Since I walk with a barely discernible limp, and can walk faster than a lot of people, owning to my 6 foot 6 inch frame, people tend to not notice that I have anything wrong with me.

The doctors gave me the blue tag about a year before my amputation, primarily to keep me from walking too much. I use it to garner extra space to open my doors. I have no problem walking in across the parking lot. I used to get upset when I would see someone that I did not expect to need a tag. This attitude changed when I saw a young, blond girl pop out of a nice new car and run into the store. I was pretty upset at first, and was planning on saying something. I assumed that she was simply using someone else's blue tag. Suddenly I realized who it was.

Her name is Patience Beard. She is an University of Arkansas cheerleader. Her story is amazing, Click the link on her name to read an article I found on her. She was wearing leggings that covered her leg and I suddenly got the whole picture of why people get so angry when they see me parking there. Not to say I am a beautiful young college student and athlete, but I am relatively young and healthy compared to many that need a blue tag. I can easily walk in from a regular parking spot.

As a matter of fact brings me about to my second point, I am a lot more active than many of my peers. Some of whom are 10-15 years younger than I am. I hike, I fish, I ride my bike. I walk for exercise and occasionally I can jog. i still don't like to run, but mostly because my prosthetic leg is so much lighter than my remaining limb, and that throws me off balance during the run. I am getting better at it and learning to trust my residual limb and prosthetic. One thing that makes this easy is the Rush™ Foot 87 that I have. It is rated out more than 100 lbs heavier than I am, I hop over mountain creeks, I can hop off short ledges and onto uneven terrain without thinking about it. It is still a bit stiff and does tend to want to push my leg into the resting position, but I can overcome this with little thought. I absolutely love my rush foot.

What really amazes me is how slow some people walk, Kind of like walking through a casting for the zombie apocalypse. I constantly pass people several times when grocery shopping. It might just be me being impatient, but I honestly believe that I am out here to have my second chance at life... I want to take it by the horns and get every last little bit of it. It helps me find my happy place.


Friday, January 6, 2017

A year and more on a Rush 87 foot

OK, a little over a year ago I wrote a couple of posts about my new Rush 87™ foot. As you remember, I was super jazzed that my insurance company paid for a new foot for me and I was amazed at how well it was working. You can see the post here.

Now, more than a year later, what do I have to say about it? Well, it is still here. I still use it, and overall I can not see any way to make it better (other than the fact that the foot shell is still rather pale) It resides at the bottom of my left leg and I hardly think about it. I adapted well to how it works and I don't have to make any adjustments in the way I walk, hike, bike or even jog on it. I don't worry that it is suddenly going to fracture if I accidentally step off the second rung of the ladder, or hop over a mountain stream. Some of you remember that I broke my first carbon fiber foot pretty quickly, and had to have the ankle replaced because it couldn't handle my weight.  None of that nonsense with my Rush™ foot.

I have been out and about, between Christmas shopping, hiking, biking and even to the beach. In every circumstance the Rush™ foot just took the abuse. The top of it is getting a little darker and I actually have tan lines on the foot shell, which is actually starting to crack a little on the bottom, but the foot itself is rock solid. As a matter of fact, most people don't even notice that I have anything wrong with my left leg at all. My gait is very natural while wearing it.

One of my co-workers asked why I favored the leg, wondering if I had injured myself, I had been sitting for about three hours and my leg was numb. I looked at him like he was a little crazy, but I realized he was serious. I had never told him I had an amputation. When I pulled up my pant leg, he was shocked.   He was amazed that I walked as well as i could.

Overall, I believe the Rush™ foot has really been a factor in how well I have adapted to my amputation. Without it, I feel certain that I would not be as mobile as I am.

Continued activity is vital

One thing I've learned is that you must remain active as an amputee.  I  allowed myself to slip back in to a life of sedentary slothism.  I gained 25 pounds and that means I put more weight on my residual limb every step.  That's one reason I haven't posted for so long.  So with the new year, we are getting back after it. I am resolved to get back to a reasonable weight. Right now, my goal is back to 240 and below. I am at 265 and that is not working for me. Each day I stay at this weight I am causing damage to my 'meat' leg as well as the residual limb. 

Some easy fixes will be to start with the walking, hiking and biking. Back to fishing and other activities. I may be beginning a new phase in my professional career that will open other opportunities for me. Overall, I am hoping that 2017 will be a great year! What are you going to do this year? Set a goal, and pursue it with everything you have!!