The Society for Untalented Prosthetists

[John Russell]

One day long ago Wayne replied:
Sorry for the delay but being in New Orleans, and catching up has delayed my
response.

WR> As an amputee, an untalented prosthetist (open to interpretation-but one
who makes me an ill-fitting socket and refuses or is unable to properly
adjust it) also makes me feel faintly. Makes me get faintly and I go
ticky-poo.

The first question was what is the definition of what a Talented Prosthetist
was, would be in first order.

WR> Okay

Am I missing something, as a prosthetist I asked the question of what to do
to be a Talented Prosthetist, so what does Okay mean? Not wanting a negative
definition, but wanting a positive definition. As in prosthetics it is in
the details, and that was what I was looking for.

WR> Does this sentence imply than for whatever reason if I want better
service (such as not being over-charged for product?) I am a
stick-in-the-mud?

NO, I thought that meant or referred to the prosthetist, but pain in the Ass
is also Okay.

The so called experts in this field have stop progression in this field.
WR> I am having difficulty with this idea John. Progress should be halted? I
have gone from a heavy passive foot to a lighter-weight one with energy
storing ability? Should I go back? Maybe I need a SACH foot? I think not.

No you should not go back to a SACH foot, but you should thank people like,
Van, Milo, Childs, and etc. The NIH experts are wasting millions of dollars.

WR> Haha. But how does making Jaipur feet for third-world amputees, most of
whom live in abject poverty

I was not talking about the Jaipur feet(it was first used in India), it was
not invented in this country.  But B/K CAD sockets made in Hanoi, for the
NVA, and the Dr. that comes from Seattle that's wants to make cheaper and
faster limbs with stupid old techniques!

WR> JR> Some of the things that I feel that amputees want.
Sock it to me.
JR> Patient manageable sockets to allow the amputee to change the socket
or interface without changing socks, or putting the leg back on.
Uhhh. Let me see if I have this straight. I am BK. My socket one fine day
gives me grief while I am riding my motorcycle. So I could change out the
socket, keep the same sock, and not put the leg (I assume you mean the
prosthesis?) back on? What do I do then? Ride with one leg?  Uhhh, might be
easier to add or remove a sock, which I do now and then.
No that is not easier than adding or removing socks. We have to get out of
the Box for new ideas. Changing the socket or interface while riding a
motorcycle at sixty mph, with leather on would be the Goal. Not changing
socks! Why do both?  Why do we have to have the socket all solid material?
Why not have parts of the socket that are adjustable at sixty mph.
JR> Adjustable sockets 5 seconds or less, that allow the amputee to
change socket fit according to activity.
WR> A nice idea. Similar to a Ferrier coupler? Or different? And if
different, how?
This is very similar to the first idea, but has a different goal. Have the
posterior wall, adjustable, flexible(1/16") material, that moves as the body
changes. Why not have the amputee adjust the socket when hiking or biking,
to the tightest to compress the soft tissue. This would be uncomfortable for
the ride home in a car, so just push the button and release the pressure. It
can be very simple, but at the same time many details that are out of the
box.
This allowed Dory Selinger to be the only American Track Cycling Gold
Medallist in 1996.
That's all for now.

-----Original Message-----
From:	AMP-L-owner at u.washington.edu [mailto:AMP-L-owner at u.washington.edu] On
Behalf Of RENARDWC at ctrvax.Vanderbilt.Edu
Sent:	Thursday, March 04, 1999 12:17 PM
To:	Amputee Information Network
Subject:	The Society for Untalented Prosthetists

One fine day John Russell, a prosthetist, suggested:

JR> At first this...Institute for the Education of Untalented
    Prosthetists...made me feel uneasy, since I'm a prosthetist.

As an amputee, an untalented prosthetist (open to interpretation--but
one who makes me an ill-fitting socket and refuses or is unable to
properly adjust it) also makes me feel fainty. Makes me get fainty and I
go ticky-poo.

JR> So I thought that before the sit-ins, the definition of what a
    Talented Prosthetist was, would be in first order.

Okay.

JR> While we are doing that I have a point.

OK

JR> If you want CP's to listen, provide better service, and not be a
    stick in the Mud.

I am having difficulty parsing that sentence. What does it mean? Do you
mean that if I as an amputee wish my prosthetist to listen to me then I
should provide him-her with better service? What service? Does this
sentence imply than for whatever reason if I want better service (such
as not being over-charged for product?) I am a stick-in-the-mud? I would
opt for a different metaphor, such as pain-in-the-ass, which I can be.

JR> Then all of the Rules from the Experts have to be changed! The so
    called experts in this field have stop progression in this field.

I am having difficulty with this idea John. Progress should be halted? I
have gone from a heavy passive foot to a lighter-weight one with energy
storing ability? Should I go back? Maybe I need a SACH foot? I think
not.

JR> Only persons or companies have improved this profession by wanting
    to sell improved products, which patient want.

Uhhhh, yes. Progress, no? I do not expect companies to engage in R&D for
nothing. Should I? I was at a prosthetics shop the other day where I met
Chris Burke, a CPO. Chris is a youngish (maybe late 20s) amputee (lawn
mower when he was eight) who went to prosthetics school in New England
and who recently moved to Nashville. He works for Chuck Dillard, who has
made my BK prosthesis since about 1980. Chris is a golfer, and he would
like a foot with more torque, (for swinging a club) but lacks the
engineering wherewithal to figure out how to make it variable. He's
tried them all and is wearing a VeriFlex now. He told me he would also
like to have the ability to remove the enhanced torque feature when he
is not golfing. "Ahhhhh," I glorked to Chris. "I will put you in touch
with a buddy who does R&D for College Park and maybe you guys can work
something out. After all, if R&D folks do not get ideas, nothing much
happens." Maybe it will happen. Maybe it will not, but try....

JR> The experts have (In my Opinion) slowed the whole process.

Who are they? The experts to whom you refer? A bit unclear.

JR> Rx's for a leg makes that person a patient.

Aha...yes. For myself, I agree. I do not need to go to my primary care
physician to obtain a scrip for a new leg. A waste of both our times. I
know what I want. I recently had to obtain a scrip for eight new stump
socks and six J.R. Smith suspensions, which is ludicrous. He had to fax
it to a prosthetist, tho there is a web site (not honored by my
insurance provider) that will sell direct.

JR> Better socket interfaces, stop the research money going to Hanoi by
    some Dr. wanting to make cheaper and faster limbs with stupid old
    techniques!

The ultimate goal for me---a perfect interface. Indeed. Haha. But how
does making Jaipur feet for third-world amputees, most of whom live in
abject poverty (I live like a king compared to 99% of them and my petty
problem pale in comparison), follow from a better socket for me? The
fact impoverished amps have at least something has no bearing on a your
ability to make me a better socket, does it?

JR> It is not so much the Institute for EUP but the certify board for
    the Prosthetists, if you did things on that test that patient
    wanted then that person would fail the test.

I assume here you refer to the board that certifies CPOs--the one that
requires a 4-year college degree, an apprenticeship, and passing written
tests? Ahhh yes. Well now, this is open to much debate. Do I care, if my
prosthetist makes me a great socket and aligns the pylon-foot correctly,
if that person can quote Shakespeare or discuss the poetry of Milton? Of
course not. Do I care if they can read? Probably not. I happen to know
some very bright people who cannot. I do care about product.

Does the fact someone has spent years in a university make them a better
person or prosthetist? Not always. Some of the most incompetent people
in the world, including criminals, have advanced degrees.

You have seen here discussed the idea of a Master Craftsman (MC), an
idea that is wonderful on the surface but which I once debated with
George Boyer on another list the following notion:

Let's say we have an MC. This MC can make me a socket that is perfect.
You go to this MC. Your stump differs from mine and since this MC does
not know it all (haha who does?) they make you a socket that, wheeew, is
not so good. It hurts. Is this possible? Yes it is. Unless that MC is so
well versed in every type of prosthesis (including BK, AK (all of the
different AK types), BE, AE, etc. the chances of them being an MC for
every amputee is, well, their apprenticeship would take 30 years. And
who could afford their service? A brain-surgeon would be cheaper.

JR> The laws of Florida would not allow that person to do anything for
    amputees.

Tony Barr was one of leaders pushing for those laws. There are good
prosthetists in Florida, so I hear. There are also criminals selling
prosthetics. What specific laws prevent YOU, a prosthetist, from making
a Florida amputee a 'decent' prosthesis? BTW, I had my first prosthesis
made in Lakeland, Florida in 1970.

JR> Some of the things that I feel that amputees want.

Sock it to me.

JR> Patient manageable sockets to allow the amputee to change the socket
    or interface without changing socks, or putting the leg back on.

Uhhh. Let me see if I have this straight. I am BK. My socket one fine
day gives me grief while I am riding my motorcycle. So I could change
out the socket, keep the same sock, and not put the leg (I assume you
mean the prosthesis?) back on? What do I do then? Ride with one leg?
Uhhh, might be easier to add or remove a sock, which I do now and then.

JR> Adjustable sockets 5 seconds or less, that allow the amputee to
    change socket fit according to activity.

A nice idea. Similar to a Ferrier coupler? Or different? And if
different, how?

JR> That's all for now.

Yeah...I agree. This has worn everyone out.

GB> Michael - I want you to carte blanche me to the quick, and promptly.
    God only knows we desperately NEED manifestos of perfect clarity and
    rousing rousingness. Clenched fists, torchlight marches....multiple
    sit-ins at the, ....

Power to the People. Take it to the streets. Let our phreak flags fly.
And damn it George, please stop bogarting that joint.


Wayne Renardson