When Ralph was hit by an IED in November of 2008 while serving in the Army as a Field Artillery Platoon Sergeant in Iraq, he was met with one of the biggest challenges he had yet faced in life. His injuries were severe, and now he was left with the question of "What now?" He had lost the sight in his right eye, had severe trauma and injury to his arm, and both of his legs had to be amputated below his knees. A lot of people would have been tempted to give up, but Ralph (or Stew as he likes to be called) is not like a lot of people.
We have had the privilege of working with Stew since 2011, and in the 5 years we have known him, his positive attitude, sense of humor, and dogged determination challenge and inspire all those that he comes in contact with. Stew's motto is "Never give up! You have to find it deep within yourself to push harder, and no matter how bad you have it, someone else out there has it worse than you do." Keeping this perspective has helped to motivate Stew and keep him focused.
Here at Optimus seeing our patients get back to doing what they love and achieve their goals is the driving force behind why we do what we do. As Stew put it, "Optimus was highly recommended [to me]. They take the time to get to know you as a person." We all will never forget the day in late 2013 when we got to see Stew run for the first time since he was injured. The look of sheer joy and triumph on his face cannot be put into words. The power of that moment combined with the humbling honor of being able to share this moment with Stew brought tears to our eyes.
"It's a very humbling experience [going through limb loss]. I never really thought about it until it happened to me." One of the soldiers who was also injured in the same IED explosion as Stew is amazed at how much better Stew is able to get around now using his prostheses. "Sometimes, a leg that is no good [not functional anymore] can hinder your progress." One of the biggest worries Stew had after amputation was that he would lose his independence. However, having his prostheses allows him to walk and run, but most importantly, they allow him to retain his independence and live the active, outdoor lifestyle he loves.
In late December of this last year, like many of us, Stew realized that he had gained more holiday weight than he planned. "I was at my heaviest at 263 lbs, and I knew it was time to do something." Last April, Stew participated in our first annual Optimus 5K, but he was not able to run in it. This year, he has made it his goal to get into shape and RUN at least 1 mile of the 5K. In the months leading up to the 5K, Stew has been hitting the gym at least once a day and working on getting in shape. In fact, he has lost 45 lbs since the beginning of the year! We are all excited to be there right alongside Stew to cheer him on in this year's 5K and see him reach his goal.
Sylar Combs: Life as an Amputee in 1st Grade
"Through the eyes of a child, you will see the world just as it ought to be." - Author: unknown.
In 2008, Sylar was born missing his right arm below the elbow. His limb difference was not seen in any of the ultrasounds performed before his birth and his doctors have never given a reason why this happened.
At the age of 1, Sylar received his first prosthesis and has since received three difference prosthetic arms featuring a claw/hook attachment. His most recent prosthesis, however, is adorned with his favorite superhero sign and a lifelike hand which includes a lock for keeping the hand in place; open or closed.
Now, Sylar experiences life like any other first grader. He plays soccer and loves video games. In fact, his favorite game is Lego Avengers which he plays on his Playstation 2. Sylar also loves watching YouTube videos on his laptop.
He says he's never had any issues with his prosthesis, and his biggest challenge has been to become better at using a scissors. When asked if kids at school have ever teased him, he said "no." He went on to describe that if kids ask him about his amputation or prosthesis, he simply tells them, "I was born this way."
With his new prosthesis, Sylar has been most excited that he can now help out more in class such as carrying items for his teacher. He has even been given the opportunity to write to a pen pal in high school, and the local pen pal is even an amputee just like him! They have written to each other a few times, but the topics are usually about sports or video games.
When it comes to advice for other amputees, Sylar offers these words of wisdom: "Never give up!"
|Get Up Stand Up 5K - April 9th|
|Optimus Yoga Event: April 29th|
|Jim Scharf, PTA|
The goal of "Jim's Corner" is to provide helpful information and be a resource for those helping patients fitted with prosthetics learn to use them correctly in order to enjoy a better quality of life as an amputee.
Before we jump into this month's column, I do want to take a moment and thank everybody who has attended the free CEU courses that we are offering here at Optimus Prosthetics in Dayton. Because we now offer outpatient physical therapy exclusively for the amputee patient here in the Dayton Clinic, I can no longer go out to all of the facilities as I have in the past, so I now have to do them in house. I am quite impressed with the clinicians who have traveled from as far as Hillsboro, Sidney, Chillicothe & Columbus to name a few! Thanks again!!!
Several months ago I was presenting one of our CEU courses to an inpatient hospital therapy group and afterward I was asked a very good question - "I work in acute inpatient and we only get to see the patient maybe 4 to 6 days then the patient is discharged to a SNF, what should I focus on?" "Patient education and contracture prevention" was my answer. As I have mentioned before "contractures are the most common preventable complication that can impact outcome!"
In my opinion the importance of therapy for an amputee patient does start right after surgery. One factor in the amount of success for the patient does relate to their residual limb range of motion. I was at a CUE course recently and I was reminded that:
"Collagen starts to lay down within 72 hours post-surgery. When the collagen starts to lay down you run the risk of potential contracture development. So a contracture can start to develop 72 hours post-surgery." Yikes!
Another thing that works against us in therapy is that the position of comfort is generally favorable to the development of contractures. So with patient education:
- Educate the patient on what a contracture is and how to prevent one.
- Educate the patient on why contracture will affect their gait negatively when they get their prosthesis.
- Educate them in terms that are easy for the patient to understand.
- Teach the patient how to prevent a contracture with a bedside/HEP within their abilities.
- Teach the patient a bedside/HEP working on contracture prevention and residual limb strengthening (especially extension) so when they are discharged and go to the SNF or wherever they are discharged to, they will have the "tools" to continue to work on that.
At this stage full AROM is far more important than strength, if the patient has full AROM we can always gain strength. For example remember that 10°-20° of hip extension is required for normal gait and proper opposite step/stride length (another can of worms for another day). So try to think of:
Jim Scharf, PTA, Prosthetic Assistant/Gait Specialist
Jim has been a Licensed Physical Therapist Assistant since 1988. Jim has worked with lower extremity amputee patients throughout his career. He serves as a Gait Specialist and Liaison when prosthetic patients are meeting with their therapists. Feel free to contact Jim if he can assist you in any way at:firstname.lastname@example.org.
4/19 Health South Rehab- Drake at 12:15 PM
4/20 Blackstone-Hamilton Co. at 8:00 AM
4/21 UC Drake Outpatient Rehab at 12:15 PM
4/7 Mill Run Gardens & Care Center at 12:00 PM
4/21 Arbors East at 12:00 PM
4/29 Isabelle Ridgeway Care Center at 12:00 PM
4/19 The Forum of Knightsbridge at 12:30 PM
Our new Cincinnati office will open its doors April 11th. It is located at:
4623 Wesley Avenue, Suite B
Cincinnati, OH 45212