New Arm- Part 3 (Building the Arm)

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

I facilitated a three-hour leadership seminar recently in Auburn, Alabama. Community leaders were seated behind tables arranged in a “U.” For a full hour and thirty minutes I spoke in the center, moving about and interacting with the 35 participants. Just before I dismissed the group for a 15-minute break, I told a personal story about being born with one arm to help illustrate a point. During the break, a woman approached me.

“Until you mentioned your prosthetic arm, I had not noticed it!” she said. “I had checked out your cute outfit and even your shoes. But I did not see your arm!”

This happens to me quite often. Half of the credit goes to the great prosthetics people who help me so much. The other half of the credit goes to the slick operator with 54 years of experience.

6/20/16- The lower arm was made when I arrived. It was very thin and had no outer lamination. Adan (Prosthetist), Caitlin (Prosthetic Resident), and Brad (Fabrication Manager) worked diligently with me for seven hours.

  • We concentrated on positioning and mounting the elbow. Two separate pieces were involved—the locking unit on the inner side next to my body and the joint unit on the outer side. These connected the upper arm to the lower arm. Once again, I had to make sure the angle of the lower arm when bent was where I wanted it (left to right).

Elbow 1Elbow Joint 2Elbow 3

  • We decided how much to cut out on the top side of the lower arm at the elbow to allow for flexion (how far up I can bend the arm).
  • The gap between the upper arm socket and the inner elbow unit will be filled in with foam and laminated over. This will make the shape and size of the upper arm match my real right upper arm.

7/1/16- The inner and outer elbow units were laminated in when I arrived and the gap between the upper arm socket and the inner elbow unit had been filled in and laminated over. For eight hours, Adan, Caitlin, and I worked on suspension and line-of-pull. These are difficult to explain, but I am going to try.

Suspension & Line of Pull 1Suspension & Line of Pull 2

  • Suspension is how the prosthesis is held onto the body. Straps attach the prosthesis to a harness. The harness goes across my back and under my right arm. Line-of-pull involves attaching additional straps to cables that operate the elbow and hand.
  • The straps, harness, and cables have to be positioned in exactly the right places and at exactly the right angles for me to be able to operate the prosthesis smoothly. A slight change in a position or angle can make a huge difference in the ease or difficulty of operation. I’d put on the arm, I’d attempt to operate the arm, they’d evaluate, I’d take it off, they’d make a slight adjustment, I’d put on the arm, and repeat the cycle—all day.

Suspension & Line of Pull 3Suspension & Line of Pull 5Suspension & Line of Pull 4

  • We made progress, but we didn’t yet find that sweet spot. When we do, I will be able to use shoulder and upper left arm movements to raise and lower the forearm, lock and unlock the elbow, and open and close the hand.

7/15/16- I hung out with my friends at Fourroux Prosthetics for eight more hours.

  • We finalized suspension and line-of-pull.
  • Adan sewed padding on the harness in spots that were uncomfortable.
  • I decided exactly where I wanted the hand positioned most of the time. (I’ll still be able to manually rotate it at the wrist slightly to type.) They drilled a hole just above the wrist unit, fed the hand cable through it to hide it, and brought it back out near the elbow.

  • I “took delivery” of the arm (paid my portion) for insurance purposes so I could take it home and wear it for a few days. I will make sure it works like I want it to before they do the outer lamination.

8/31/16- I dropped off the arm to Adan. I was not able to test it as originally planned because the hand made a noise like fingernails on a chalkboard when I opened it. I couldn’t stand it! We are not sure what is going on. He will have the team get on it right away. No rush on my part though. I am going to be speaking several places and leading tours over the next two months. I won’t be able to return until November.

Thanks for walking with me through this process. What are your thoughts about the building phase?

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“It is God who arms me with strength and keeps my way secure.” (Psalm 18:32 NIV)

 

Read “New Arm- Part 1 (Picking Out Body Parts)” here:
https://onesmileonearm.wordpress.com/2016/05/04/new-arm-part-1-picking-out-body-parts/

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

New Arm- Part 2 (Designing the Arm)

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

I know my life motto is “Never Say I Can’t,” but I’m going to open up and be totally honest with you right now. There are two things I can’t do. First, I can’t clap. I wish I could clap. I can put my hands together and pretend to clap with others in an audience, but it doesn’t make a sound. Sometimes I clap my right hand on my leg or borrow a family member’s hand to clap against. And second, I can’t scratch my right arm. Rubbing up against a door jamb works pretty well, or directing my husband where to scratch. But thanks to prosthetics, I can do everything else.

On 5/30/16, Fourroux Prosthetics called to tell me my body parts had arrived. Normally shipment doesn’t take a month, but a merger between two major prosthetics manufacturers (Hosmer and Fillauer) slowed the delivery.

On 6/8/16, I met with Adan (Prosthetist) and Caitlin (Prosthetic Resident) to design my new arm. Eli (Intern) and Brad (Fabrication Manager) were also on hand to help. (These are the people I am referring to throughout this post when I say “they.”) It was a long seven-hour appointment, but it was the best day I’ve ever experienced in a prosthetics facility. They allowed me to hang out in the lab and watch the entire process! I’ve worn a prosthesis for 54 years and this is the first time I’ve gotten to see how one is made.

UPPER ARM:

  • Adan made a plaster cast of my upper left arm.

Cast

  • They poured plaster in it to create a mold.

Mold 1Mold 2

  • They heated a heavy plastic sheet in an oven and laid it over the mold to create the test socket.

                           6-17-16 138Plastic

  • Once cooled, Eli removed the plaster mold from inside the test socket.

Remove Mold

  • Adan worked with me to get the test socket to fit just right. He heated problem spots with a propane torch to make them flexible. Then he reshaped them with his hands. He cooled the spots with an air compressor before having me retry the test socket. They cut back areas of the test socket from under my arm and from the “wings” on the top front and top back until it was comfortable. They flared out the edges to prevent skin contact with blunt edges. This tweaking endeavor took approximately twenty tries. This part of the arm design is stressful for me because I have to decide when it is just right. Then it gets laminated and I am locked in forever! 🙂

                           Test Socket 1Test Socket 2Test Socket 3

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Bionic Woman- Part 1 (The Options)

I am getting a new prosthetic arm! I thought some of you might find it interesting to follow the process with me…

My initial “casting” visit to BioTech in Birmingham, Alabama, was on Friday, April 20th. The prosthetist made a cast on my existing upper left arm, just like casts are made on broken bones. Next he slipped the cast off my arm to use as a mold to size my new prosthesis. He will create a socket (kind of like a removable cast) for my upper arm to slide down in. Then the elbow, forearm, and hand will be attached to that.

Much thought, prayer, and research had preceded that day. In fact, I’d been exploring prosthesis options for almost two years. I went to that appointment with my mind finally made up, but left with a head full of new options to consider. It’s just such a big decision! I will have to live with it for many years. (My present prosthesis is nine years old.) And it’s a huge financial investment.

Here are my options…

I can get an arm like I have now, which is called BODY-POWERED or cable-operated. The prosthesis is held on by a harness across my back with a loop under my “good” right arm. Cables run from the elbow and hand to the harness. When I move my shoulders and upper body certain ways, it pulls the cables to manually lock or unlock the elbow and open or close the hand. The movements are hardly noticeable because I am slick at it.

Or I can get a MYOELECTRIC arm. My upper arm would slide into a socket held on by suction, eliminating the need for a harness. Within the socket would be electrodes, strategically placed to pick up signals from muscle contractions. By flexing various muscles, I could control the actions of the electric elbow and hand.

Here is my dilemma…

I am used to the BODY-POWERED arm; it is second-nature to me as I’ve worn this type since I was one year old. It is less expensive—$10,000 as compared to $25,000. The mechanical parts tend to break down less than myoelectric parts and the parts cost less. Improvements have been implemented since my present arm was built. Now cables, housings, and bolts can be flesh-colored rather than silver; some can be buried out of sight, too.

But with the MYOELECTRIC arm, I could get rid of the harness across my back. That would be nothing short of life-changing. Obviously, it would feel amazing. Not so obviously, I could wear clothes that I’ve never been able to wear before. The myoelectric would also offer increased function, though the learning curve would be a killer. I’d have to relearn even the simplest tasks. And one final thought—what if I don’t like it? I’ll be stuck with my old arm for several more years.

So…I need to make a decision right away. Help! What should I do?

 

We humans keep brainstorming options and plans, but God’s purpose prevails. Proverbs 19:21 (MSG)

My present arm is on the left