Wednesday, February 10, 2010

The Real Carbon Footprint

This is a very exciting post (!) about my current foot, my prosthetic foot that is, and the suspension system components I am using. This is my third socket, which has been by far the best fitting. As the residual volume changes it's been easy to adjust the fit back to near-optimal comfort with the addition of prosthetic socks. When the socket was new it was several weeks before I needed to add any socks in the morning, but lately I start with 8 plies of socks. I will be getting a new socket soon so I thought I'd write this history of this old friend.

Here is the socket with the Otto Bock Derma ProFlex sleeve rolled down over the socket and the gaiter (light color) above. I'll explain more about these later. Also shown is the actual prosthetic foot, a Freedom Innovations Renegade LP (low profile). This is a high activity foot and you can see the similarity to running blades in the shape. To the right is the creepy foot shell. Why anyone thinks this is pleasing is beyond me. It is c-r-e-e-p-y. The carbon fiber foot is a work of industrial art, why hide it in the C-R-E-E-P-Y foot shell? Okay, enough of that. In the background is an optional cat, known as Cutie. I had the foot taken apart for cleaning after surfing through a deep puddle at the Charlie Post 5k.

Here is a close-up of the carbon fiber (CF) foot. My guess is this will remain my everyday foot for the next couple of years. It is obvious a prosthetic foot needs a foot shell to properly fit in a shoe, but I would rather see a transparent, non-anatomical model that did not hide the CF foot. In an ideal design in Richard Wayne's World, the prosthetic foot would stand alone, no foot shell and no shoe required. Form follows function. Architects learned this about one hundred years ago. Just sayin'. This is the case with the running blade and it rocks.

At left is the plastic socket showing the sleeve and gaiter. My residual limb is already in an Ossur Comfort Cushioned liner with the socks pulled over it. By late in the day I sometimes have to add a one ply half sock; this has been my usual setup for my running. When I get my running blade I will probably want a sport liner like this one.

At right I've slipped my residual into the plastic socket and I'm ready to pull it all together. Many days I wear my prosthesis just like this under my dress pants as I don't really require the sleeve to keep the leg on. This leaves more skin exposed which I like and reduces the chance of blistering at the top of the sleeve. It's also just more comfortable.

This pic shows the gaiter rolled up over the socket. The purpose of the gaiter seems to be two-fold to me. First it serves to seal the socket so you get good suction on the residual limb. Secondly it softens the hard trim line (edge) at the top of the socket. The socket edge trim line has cut every sleeve I have in a couple of weeks; this Otto Bock sleeve has no such problem. It is made from better quality materials than the simple neoprene sleeves I have been using.

At right I've rolled the sleeve up over the gaiter and up my thigh and voila the prosthetic leg is ready for a run. Now imagine you're out running along and all is sweetness and light when you feel sweat collecting inside the liner in this get-up. At some point if enough perspiration gathers inside the liner the leg could lose suction and fall off; it gives plenty of warning with a sort of mushy feeling. Sooner or later the leg has to be taken off and the sweat dried off the residual limb and the liner. This is why I carry the infamous ShamWow as it does a great job soaking up the moisture. Using Drysol or Certain-Dri helps retard perspiration, but these products can be very uncomfortable to apply and I can't imagine long-term use is good for the skin.

You can also see why I have railed about sweating in the prosthesis in the past. In a warm distance race taking the leg off has a decidedly adverse effect on finishing time. A NASCAR type pit stop will likely lose me at least a minute's time, maybe longer. In the meantime my able-bodied pals will be passing me on their way to the hardware store for the top deals.

Every active amputee and some who are just naturally heavy sweaters could benefit from this problem being solved by the prosthetic industry. I am hoping it will be resolved in the next few years as I could sure use some help in our subtropical heat. If any prosthetic companies need a guinea pig to test new technology for this problem, by all means contact me.

Next leg review will likely be about my running blade, so stay tuned for details. We're also talking about a simple biking leg too, but first thing first.

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