Managing sweat when using your Prosthesis

Managing sweat when using your Prosthesis

Managing sweat in the Warmer months

Managing sweat when using your Prosthesis

With the beginning of Summer and having already experienced a few days of extreme heat, it’s a good time to recall some of the advice or techniques used to help manage perspiration (sweat) when using a prosthesis.After limb loss, the body has lost a significant skin surface area which previously was used to help regulate temperature. Using a prosthesis means the residual limb is now covered by multiple layers – the silicone/gel liner, socks and the socket. Furthermore, walking with a prosthesis requires more energy than for able-bodied counterparts. These factors combine to result in making prosthetic users prone to excess perspiration.

This topic is important because high ambient and skin temperatures with profuse sweating can lead to increased likelihood of skin breakdown, heat rashes or fungal infections.

Skin breakdowns can occur due to increased movement between the residual limb and the socket, which commonly occurs due to a build-up of sweat. Fungal infections are common on the skin and occur regularly in areas that are damp and warm (eg. Athlete’s foot), and this includes the residual limb under the prosthesis. Fungal spores are also likely to live on socks or silicone liners and so hygiene is extra important during the warm weather

Some Common Recommendations

If the hot weather and sweating is becoming a problem for you, please feel free to make an appointment to discuss your options as our advice is best catered for the individual, however some common recommendations we can provide are:

Anti-perspirant treatment

Extra strength treatments can be obtained from a pharmacy without the need for a prescription, or prosthetic use antiperspirants can be obtained from your Prosthetist. Some require the spray or roll-on to be applied on at night, ahead of an expected hot day. Be aware that some skin will be sensitive to antiperspirant, so always test a small section of skin before applying to the whole residual limb.

 

Moisture wicking socks

Some socks have been specifically designed to be worn against the skin, and underneath silicone/gel liners. These socks do not prevent sweating but help to wick away moisture and keep the skin dry. They are popular for below-knee amputees and can work with above-knees however they sometimes reduce the adhesion between the silicone/gel liner and your skin, resulting in excessive movement which can lead to its own problems (or the problem it attempts to correct- excessive movement).

These should be used after discussing with your prosthetist.



Nursing pads

These absorbent pads can be worn on the end of your residual limb with the liner rolled on over the top keeping it in place. The pads absorb sweat and can prevent a pool of sweat under the liner. These can be an option for those who are unable to use the moisture wicking socks, as the pads generally do not impact on the fit of the silicone/gel liner

Silcone/gel liner review (size, type)

Most of you probably wear a silicone or gel liner. There are a number of different types and some may provide you with relief from heat and sweating when compared to another. Most importantly, a liner should be well fitting – which your Prosthetist can check for you. A loose-fitting liner will result in more sweating, more pooling of sweat and more skin irritation.

Remember also to clean your liner daily, and sometimes twice per day in hot weather. This will help keep bacterial or fungal infection away.

Self-management techniques

Good hygiene, being prepared (carrying spare socks, towel, sprays etc), choosing appropriate activities for the temperature, frequent breaks from using the prosthesis (where possible) and regular monitoring of your skin will all help you stay out of trouble this Summer. Please try to develop a habit of making sure you are looking after yourself, your residual limb and your prosthesis.

 Medical referral

For some people, sweating remains an issue despite best efforts to manage it. A review with your local doctor, or our Rehabilitation Consultant could help discuss other options. For example, Botox injections and laser hair removal have been used to help relieve sweating and issues associated.

For any further details or a review of your current options, please contact us to make an appointment on 03 9532 5098

You can read more about how to manage sweat as an amputee, at Limbs 4 Life website.

Introducing Mohammed – An Australia Awards Scholarship recipient

Introducing Mohammed – An Australia Awards Scholarship recipient

At ProMotion Prosthetics, we strive to do all we can to ensure our clients are able to achieve optimal outcomes and achieve their personal goals. However, it is not without the dedication, hard work and positive attitude of our clients that they will be able to reach their full potential. Needless to say, we are extremely proud of each and every one of our clients as we see them reach that potential and are always thrilled to be a part of their journey through rehabilitation and beyond.

One particular client whom we must acknowledge and owe a great deal of credit to for coming so far to achieve his goals is Mohammed. In early 2017, Mohammed arrived in Australia from his hometown of Malang, Indonesia to begin studying a Master degree in Law at the University of Melbourne. It wasn’t long after his arrival that we had the pleasure of being introduced to him.

Four years prior to this, he had undergone an amputation of his left leg above the knee after sustaining serious injuries in a road accident. Unfortunately, he was never fitted with a prosthesis in Indonesia, nor had he ever met a prosthetist. Unlike in Australia, Indonesia does not have in place the same level of funding for prosthetic or amputee rehabilitation services, creating a financial barrier to accessing such services for a large number of amputees. For those four years, Mohammed relied solely on a pair of crutches to ambulate.

Australia Awards Scholarship

The Australia Awards Scholarship is a fully funded scholarship from the Australian Department of Foreign Affairs and Trade awarded to students from low and middle-income countries. Mohammed was a recipient of this scholarship, and not only were his tuition fees covered but his necessary health expenses, including prosthetic management, were also supported. Mohammed was given the opportunity to be fitted with his first prosthesis.

Being fitted with a prosthesis for the first time can be an unusual and quite often challenging experience. In almost every case it requires significant amounts of time and practice in order to develop an ability to control the prosthesis and restore as much function as possible post-amputation. For Mohammed, learning to walk again posed an even more significant challenge given that his residual limb presented with marked weakness having not been used for the four years prior. Furthermore, he was simultaneously juggling full-time study in his second language and was also adapting to a new culture.

Nevertheless, Mohammed rose to the challenges always with a smile on his face and great gratitude for the opportunity which he had been offered. Over the course of a 10 months period, he received gait and strength training under the guidance of physiotherapist Jemma Keeves and his prosthesis was adjusted accordingly as his ability to ambulate with the prosthesis continually developed.

This concerted effort put into his prosthetic training has gone a long way and is a great example of how far strong will and persistence can take a person. On every occasion Mohammed came into ProMotion, there was an obvious improvement in his strength and mobility. From using a pair of crutches upon first prosthetic fitting to only a single-point stick for walking long distances and even climbing jungle gyms for a bit of fun, we were always thoroughly impressed. These improvements allowed Mohammed not only the ability to walk from class to class all over Melbourne Uni but also opened up opportunities to see more of Australia while he was here, enjoying visits to Adelaide and especially Tasmania along the way (look at that smile!).

Mohammed has now completed his studies, passing with flying colours. We must offer our greatest congratulations to him and all of his achievements over the past year. It has no doubt been a challenging road he has travelled but has done so always with great diligence and resilience.

Yet at the same time it was with some sadness that we also had to say farewell to Mohammed in February as returned home to Indonesia. We are sure his family would have been so proud to see him walk off the plane without crutches for the first time and also as a Master of Law. He has since let us know that life is
going very well now that he is back home and is pursuing work as a lawyer in either Surabaya or Jakarta, where he will have easier access to continuing prosthetic services.

Mohammed you have been an absolute pleasure to work with. All of us at ProMotion and your physiotherapist Jemma wish you all the very best success in your future career. You’re a shining example of the impact that a positive attitude and determination can have on a person and everyone around them.  Hopefully we will have the chance to see you again someday.

For more information on the Australia Awards Program. 

Mitch Farrar – Prosthetist, ProMotion Prosthetics

How much water can your microprocessor knee handle?

How much water can your microprocessor knee handle?

In today’s climate of advancing prosthetic technology, the range of knees, feet, hands and other componentry that are available for amputees is ever-growing. With such large numbers of these products, it can be difficult to distinguish which activities each individual one is suitable for. As we described in our January 2016 blog Making a Splash with your Prosthetic Limbs, prostheses with specific components can be manufactured and fitted with some of these activities in mind.

Going to the beach or local pool, camping, fishing and taking the boat out are just some of the many recreational activities which many amputees may wish to enjoy in their spare time. It is for this reason that many prosthetic components are now classified as being either waterproof or water-resistant. Amazingly, this even includes most microprocessor knees technology.

Just like the latest smartphones and your GoPro camera, each microprocessor knee will be labelled with what is referred to as an Ingress Protection, or IP rating. This IP rating is important in defining just how protected a microprocessor knee is against water and dust getting into its electrical circuitry and potentially causing damage to its operation. It is most commonly made up of two numbers. The first number can range from 0 to 6, indicating the level of protection against dust and foreign objects, while the second digit can range from 0 to 8, indicating just how protected the knee is from water penetrating into its inner workings. With a few exceptions, the higher the number, the greater the level of protection.

Here are just a few examples of different microprocessor knee joints with varying levels of protection against penetration of water and dust:

Ossur Rheo Knee 3 and Rheo Knee XC: IP34

Ossur Rheo XC and Rheo3

The new Rheo Knee 3 and Rheo Knee XC both have been classified with an IP34 rating. This rating indicates that both knees are protected against foreign objects thicker than 2.5mm and also against splashing water coming from any direction. This means that you shouldn’t be too concerned if you got stuck in the rain with your Rheo Knee 3 or Rheo knee XC for a few minutes. That being said, showering with the Rheo Knee 3 or Rheo Knee XC is not recommended. Soapy, chlorinated and saltwater could still potentially cause harm and should be avoided. Should your Rheo be exposed to any conditions outside the IP rating, it must be reviewed by your prosthetist.

Otto Bock C-Leg 4 and Freedom Innovations Plié 3: IP67

Freedom Innovations Plie3

Otto Bock Cleg4

The Ottobock C-Leg 4 and Freedom Innovations Plié 3 both have a high level of protection against both foreign objects and water, with an IP67 rating. They have complete protection against dust particles for up to 8 hours of heavy exposure and can even be temporarily (no more than 30 minutes) submerged in fresh water up to 15cm deep. As such, an incidental splash of water while playing with your kids at the lake is nothing to be too worried about. However, like the Rheo Knee 3 and Rheo Knee XC, they are not designed to be routinely used whilst showering with soapy water or around salt or chlorinated water. If it is exposed to saltwater or chlorinated water, it should be rinsed off with fresh water straight away. It is also important to note that just because they may be submersible, it does not guarantee that they are protected against water jets, such as those projected from a powerful hose. Once again should these knees be exposed to any conditions outside this IP rating, you should inform your prosthetist quickly.

Ottobock Genium: IP54

Otto Bock Genium

The Ottobock Genium is also considered weatherproof, but not completely waterproof. It has an IP54 rating, which indicates that it is for the most part protected against penetration of dust, however, large quantities of dust may trigger complications. It also indicates that it is protected against splashing water, as is the Rheo Knee 3 and Rheo Knee XC. A bit of rain is nothing to worry about, but the Genium will be at risk of damage if it is submerged or sprayed with any hose or jet and most certainly should not come into contact with any soapy, salty or chlorinated water. If it does, it should gently be rinsed with fresh water, but may also need to be inspected by Ottobock technicians in Germany to make sure everything is still running smoothly.

Ottobock Genium X3: IP68

Otto Bock Genium X3

The Ottobock Genium X3 microprocessor knee unit offers functions very similar to that of the Genium, yet has the highest possible level of resistance to both dust and saltwater with an IP68 rating. This means it can is 100% protected from penetration of dust and can be submerged in water at least 1m deep for over 30 minutes and still remain operational at the same time. Furthermore, unlike other microprocessor knees, its parts have been designed with a corrosion-resistant coating which allows it to be used in saltwater and chlorinated water as well as freshwater, making it perhaps the most versatile of microprocessor knee units. However, it is still always recommended that the knee be rinsed off with fresh water after being exposed to saltwater or chlorinated water. It also must be recognised that while this IP rating permits the knee unit to be submerged in water, it does not guarantee that water will not be able to penetrate into the inner workings of the knee unit when projected in powerful jets or hoses.

It is important to recognise that the above information only applies to the microprocessor knee units mentioned and not necessarily other components that may be fitted to your prosthesis. As such although your knee may be used in or around water, it is possible that your foot or connecting components should not be. For this reason, it is always essential that you check with your Prosthetist what type of activities are safe to take part in if they potentially involve getting wet or simply being around water or dusty environments. If your current prosthesis is not suitable to use when heading to the pool or launching the dinghy, speak with them about different options that can keep you doing the things you love.

If you’re interested in learning more about the IP ratings and how they are determined, take a look at the link below:

http://www.webcitation.org/6DGYoRMwp?url=http://www.ce-mag.com/archive/06/ARG/bisenius.htm

Written by Mitch Farrar
Prosthetist, ProMotion Prosthetics 

Terry Fox – the legacy that keeps on running

Terry Fox – the legacy that keeps on running

“I want to try the impossible to show it can be done”

“I want to try the impossible to show it can be done” Terry Fox

These are just some of the inspiring words spoken by the incredible Terry Fox as he embarked on his mission to run across Canada, all the while wearing a prosthetic leg.

Terry Fox was a young, athletic and tenacious student from Winnipeg in Canada when at the age of only 21, he was diagnosed with a malignant tumour in his right knee. Unfortunately, his leg was required to be amputated above the knee as the only life-saving procedure available at the time (1977).

However, his tenacity and love of sport were never lost. Less than two years after his amputation, Terry began training for his Marathon of Hope – a run from the east coast to the west coast of Canada in an effort to raise money for cancer research and awareness. Despite the lack of availability of componentry used in modern running prostheses, Terry was inspired to take on such a challenge when reading about another running amputee the night before undergoing an amputation himself. Indeed his drive came not only from his dreams to be as active as possible and to challenge the common perception of limitations imposed on amputees, but also to do everything he could to reduce the impact of cancer

that so many others had experienced:

“It’s one thing to run across Canada, but now, people are really going to know what cancer is.”

“I’m not a dreamer, and I’m not saying this will initiate any kind of definitive answer or cure to cancer, but I believe in miracles. I have to.”

Terry Fox running the Marathon of Hope, 1981

On the 12th of April, 1980, at the age of 22, he dipped his prosthetic leg into the Atlantic Ocean before embarking on his quest. Through brutal summer heat, ice storms and strong winds, he ran nearly 42km per day – that’s a marathon every day with a prosthetic leg – for 143 days, covering 5373km. Amazing is an understatement.

Over this time, waves of public support grew and grew as did the funds raised for cancer research and awareness. Despite pain, exhaustion and wear and tear on his prosthetic leg, he continued day by day, continually being encouraged by this overwhelming support.

On the 1st of September, 1980, the pain became too much. Doctors had confirmed that his primary cancer had returned and had spread to his lungs. He could no longer continue on his odyssey to run across Canada, yet the public support did not wane. Donations continued to stream into for the Marathon of Hope, totalling $24.17 million by February, 1981 – Terry’s dream to raise $1 for every Canadian is realised.

Then on June 28th, 1981, Terry sadly lost his battle with cancer.

Terry Fox's prosthesis with which he ran the Marathon of Hope (1981)

Terry Fox’s prosthesis with which he ran the Marathon of Hope (1981)

However, the world was not about to forget Terry Fox. The first Terry Fox Run was held in his memory only 3 months after his passing, with 300 000 people taking part at multiple sites around the world and a further $3.5 million being raised. These runs are now held annually at sites spanning multiple countries with all proceeds going towards the Terry Fox Foundation, which continues to contribute to cancer research, including through the Terry Fox Research Institute. To date $715 million has been raised.

Needless to say, the world listened to Terry when he said:

“Even if I don’t finish, we need others to continue, it’s got to keep going without me.”

In addition to his contribution to cancer research and awareness, Terry’s run has also inspired the development of more advanced prosthetic design. While on his run, he met with prosthetist Guy Martel to discuss the issues he experienced whilst running. Martel then went on to lead a team in the development of the Terry Fox Running Prosthesis which included an improved polycentric knee mechanism as well as a spring-loaded and pneumatic shock absorber. Although Terry was never able to trial this design before he passed away, it undoubtedly has contributed toward the development of modern designs of prosthetic componentry for both every day and recreational use.

Martel's Terry Fox Running Prosthesis (1984)

Martel’s Terry Fox Running Prosthesis (1984)

If you’re interested in learning more about Terry Fox and his legacy, or even if you are interested in starting your own Terry Fox run in your local neighbourhood, take a look at the Terry Fox Foundation website:

And remember…

“Anything’s possible if you try”.

Written by Mitch Farrar
Prosthetist, ProMotion Prosthetics

The Long Road to Rio – we’ve finally arrived!

The Long Road to Rio – we’ve finally arrived!

With less than a week to go before the world’s elite Paralympic athletes take their mark to compete in the 2016 Rio Paralympics.

When all of their hard work and training in the lead up to this huge event is put to the test… it’s time for all of us, as supporters of these Superhumans to get excited.

To help get you fired up for what is going to be 12 days worth of inspiring grit and determination, here are some links to get you prepared:

* The Paralympic torch relay will begin on 1 September and will visit five cities around Brazil on its way to Rio de Janeiro.
Paralympic torch

* The IPC selects Dailymotion to live stream 680 hours from Rio 2016 Paralympics. 15 HD Dailymotion channels will show 13 live sports, highlights of all 22 sports and Opening and Closing Ceremonies on paralympic.org

* Syrian refugee, Ibrahim Al Hussein who lost his leg will compete as part of Independent Paralympic Athletes Team at Rio 2016.

Ibrahim

Here are just some of the athletes I’m looking forward to cheering on during the games:

Ahmed Kelly – going for gold in the pool

Monique Murphy – going for gold in the pool

Brant Garvey will be up there with the best of them in the Triathlon

Ellie Cole – going for gold in the pool
Ellie Cole

* The Australian Paralympic Committee website is full of useful information for you:
Athletes profiles
Paralympic Events
Classifications

Here are some interesting facts about the Aussie Team:
facts

And don’t forget you can follow all of the live results for our Aussie team and cheer them on via Twitter by using #AUSParalympics !

GO AUSSIES!

Lance Anderson – The Rodeo Stuntman

Lance Anderson – The Rodeo Stuntman

Name:  Lance Anderson

Background information:

Lance Anderson, the ‘Rodeo Stuntman’ first qualified as a Stunt Performer in 1989, and brought with him over 10 years professional Rodeo experience. Competing extensively throughout Australia, Canada and the United States. Lance went on to win the 1978 World Bull Riding Title, proving himself to be a man dedicated to pushing the boundaries and earning a formidable reputation in all areas of stock work including Bull Riding, Bareback, Roping, Whip Cracking, Camel Wrangling as well as in practical skills such as welding and oxy cutting and operating heavy machinery.

Rodeo Lance Since that time, Lance has gone on to demonstrate that the commitment and versatility that served him so well in the professional Rodeo Circuit, has provided a strong basis from which to build his subsequent career as a Safety Supervisor & Stunt Performer. From precision and stunt driving to animal wrangling, rigging & wire work, high falls to body torches, street fighting and beyond, Lance has proved himself to be an asset both in front of the camera and behind the scenes. Sunrise feature a fantastic story on Lance recently… you can watch the video here:

https://twitter.com/i/status/1018276795295002624

 

Lance out for a ride

Testimonial from Lance…

“When I became an above knee amputee I was very apprehensive about what lay ahead for me. My fears were soon put at ease when I met Monique and David from Promotion Prosthetics. Their professional and knowledgeable approach to my problems made my transition to walking again a great experience. Their understanding of what I needed and the best way for me to achieve my goals, made every trip to Promotion Prosthetics enjoyable and when I left I felt confident with my prosthetic and what I could do, everything was explained and shown in detail and nothing was a problem for them. From horse riding to exercising, and a comfortable fitting prosthesis, I would not hesitate to recommend Promotion Prosthetics to anyone needing to get moving again. Great company and people to deal with.”