New Arm- Part 1 (Picking Out Body Parts)

For those who might be interested, I invite you to walk with me through the tedious process of getting a new prosthetic arm. I’ll journal the steps and my experiences along the way. You can interact with me by sharing thoughts and comments, if you wish.

There are some advantages to having one arm. I only need one mitten—if I lose one, I have a spare. Manicures are fifty percent off. I can remove my arm before stepping on the scales. I get to pick out my own body parts.

Though I got a new prosthetic arm in 2012, it has become uncomfortable and even painful in the past five months. (This has never happened to me before!) An ill-fitting socket, the part that my existing upper arm slips into, can cause pain in the arm, shoulder, neck, and/or back. A socket’s fit can change over time with variances in muscle, skin, or weight. Perhaps I’m gaining muscle tone because of my new treadmill (or perhaps things are shifting because I’m 55). Whatever the reason, I find myself by evening wanting to shout, “GET IT OFF!” Again, this is a first for me. I have always worn my prosthetic arm from morning to bedtime with little thought about it all day long.

On 3/3/16, I went to “the body shop.” That’s what I like to call it. I met with Adan, one of the great prosthetists at Fourroux Prosthetics in Huntsville, Alabama. We talked about my need for a new arm and looked online at options available for upper-arm sockets, elbows, forearms, wrists, and hands. We discussed ways to decrease the weight of an arm, as the pounds hanging on my shoulder seem to bother me more now than when I was younger. We crafted a design that I feel will give me relief and offer improvements over my present prosthesis.

Arm made in 2012

UPPER ARM SOCKET:

• Lamination on the exterior of the socket gives it a skin color. The lamination can “bury” cables to provide a nice appearance when wearing short sleeves and to eliminate “bumps” under clothes when wearing long sleeves. The down side to lamination is that it holds in heat and adds weight. I have to decide if I want the cosmetic advantage of buried cables or the cooler and lighter advantage without.
• An added option would be to put a hard plastic liner inside the socket and do “cut outs” in the lamination to release heat and reduce weight. The cut outs could be placed where least noticeable, such as on the side where the arm hangs next to the body.

ELBOW/ FOREARM/ WRIST:

• In 2012 I chose an Ergo Elbow. It came as a unit with an interior balance system inside a standard forearm. The elbow mounted to the bottom of the socket adding two inches to the length of the upper arm. Swinging the forearm slightly forward activated the balance system to help raise the forearm.
• In 2016 I am choosing a side-mount elbow for several reasons. First, it is small and light-weight. The Ergo Elbow, standard forearm, and internal balance system were much heavier. Yes, I will lose the help of the balancer, but I don’t really like it anyway. When I am standing on a stage and speaking to an audience, I like to move naturally and use my hands when I talk. I find it difficult to raise my forearm using my regular cabling system and shoulder movements—because the forearm is so heavy—and the balancer doesn’t kick in to help unless I am walking and swinging my forearm. This makes my movements a bit awkward.
• Second, because the side-mount elbow attaches to the side of the socket, my prosthetic left upper arm will lose two inches and better match the length of my unaffected right upper arm. This will look and feel more natural. Also when I place my elbows on chair armrests, the left side won’t push up on my shoulder as much, possibly alleviating some of my shoulder and back pain!
• Third, the side-mount elbow allows Fourroux to make a custom forearm. It will match the size and shape of my right forearm. (The Ergo Elbow came with a standard forearm that was much wider than my real forearm.) Fourroux will incorporate an oval wrist. (The Ergo Elbow required a circular wrist. Real wrists are not circular—they are oval!) Fourroux will use carbon fiber to make the forearm ultra-light. (As I mentioned earlier, the Ergo Elbow standard forearm was heavy.)

HAND:

• Adan and I decided upon a Hosmer hand like I presently have rather than an Otto Bock hand. I like a tight grip and the Hosmer hand allows for adjustment of grip strength. I use the “voluntary opening” version, meaning the hand remains closed until I exert effort to open it. Some people prefer the “voluntary closing” version, meaning the hand remains open until they exert effort to close it.

• Fourroux will order a cosmetic silicone glove to cover the mechanics of the hand from a company in Sweden called Centri. They will specify FEMALE, LEFT, and COLOR 03 (the color that is the closest match to my skin color).

On 3/10/16, Fourroux obtained pre-certification from my insurance company and called to give me the cost details. After a $500 deductible, insurance will cover 80%. The total cost of the arm will be $6400 and my portion will be $1700. That’s a chunk, for sure, but less expensive than my 2012 arm by almost $4000! I asked Fourroux to give me a few weeks to figure out the financing. Then on 4/27/16, I called to give them the green light. They will order my body parts and notify me when they arrive.

Thanks for walking with me through this process. What are your thoughts so far?

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“But in fact God has placed the parts in the body, every one of them, just as he wanted them to be” (1 Corinthians 12:18 NIV).

 

Read “New Arm- Part 2 (Designing the Arm)” here:
https://onesmileonearm.wordpress.com/2016/06/18/new-arm-part-2-designing-the-arm/