I have a small open area on my ankle. What should I do?

Question:

I just received my new brace last week and now I have a small open area on my ankle. What should I do? Sally N.

ANSWER:

Getting a new orthosis or prosthesis is very exciting, but can also present some challenges as your body gets used to the new device. When you get a new device from us it is important to carefully follow the break-in schedule provided to you by your practitioner. Normally we will recommend breaking in your new device over 1-2 weeks until you can work up to a prescribed full-time wear. It can be tempting to wear the new device all day but to avoid causing problems, follow the break-in schedule closely! This can help to stop small problems from becoming big problems.

Something else to look for when using your new device after you have taken it off, is to see if there are any red areas on your skin. Some redness is OK and expected, but if the redness doesn't go away in about 30 minutes and remains, stop using the device and get in touch with our office to schedule a follow-up with your practitioner. 

If you have been following the break-in schedule carefully and monitoring your skin, but still have an open area or some skin breakdown occurs, we normally recommend you stop using your device and contact us for a follow-up appointment. If possible, take a picture so that we can track the problem area together after we make adjustments and as it heals. If your sensation is not completely intact, make sure you have a mirror so that you can inspect your skin visually from all angles if you are not able to feel an area that is rubbing or uncomfortable.

If you have an open area on your skin, do not ignore it, especially if you have circulation problems or diabetes. The area can get larger, or infected if not cared for properly, and this can set you back in achieving your rehabilitation goals. Taking a short break to let a small area heal is more effective and safer than having to take a long break to let a larger area heal. Keep the area covered if it opens up and do your best to keep pressure off of it. Oftentimes, taking a short break from using the device until the wound heals, having an adjustment made, and restarting the wear schedule will alleviate future problems in that area. 

- Nina Bondre, Certified Prosthetist Orthotist

 Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

As a prosthesis wearer, why should I "Check My Foot"?

The start of spring is a good time to review this question…..

Question:

Why should I check my prosthetic foot, and how do I do that? - Carolyn M.

ANSWER:

After a mild winter, spring has arrived in full force. Many of us will start to become a little more active in the warmer months.  We are busy fertilizing yards and mowing grass, preparing our gardens or taking walks in the community.   This means we are on our feet a lot more frequently than in the colder months. 

Spring is a great time to “CHECK YOUR FEET”.    Our feet are our foundation, much like the foundation of a house.  If the house foundation is cracking and in poor condition, the building upon it will not hold up well.  Your prosthetic device is part of your walking foundation and it is a good idea to have your device checked out.

Prosthetic feet wear down from daily use.   Some feet are a completed design, meaning the inner mechanics are enclosed by a foam foot casing.  Other feet have foot shells and protective socks, which can be removed to inspect the carbon foot design.   When your foot begins to wear down, your walking pattern, or gait, may be affected.   You may also hear noises such as a metal “click” or “squeaking”.

Spring is an excellent time to schedule an appointment with your prosthetist.   We will inspect your prosthetic foot for signs of wear or damage and advise you of any recommended repairs or possible replacement.   Sometimes repairs may be completed on the same day you are seen or, may require us to order appropriate parts for your prosthesis.   Either way, it should help you start off your spring on the right foot, or possibly your left!!!

- Mary Reedy, Certified Prosthetist

 Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

Your First Appointment in the New Year

QUESTION:

My next appointment is scheduled in your office after the first of the year.  Do I need to bring anything with me?  Is there anything new I should know before coming to my appointment?

 - Karon M.

ANSWER:

Thank you for the great question!  The first of the year can be tricky for medical offices, as it is when most insurance policies renew. It is also the time of year when brand new insurance plans go into effect.  Unfortunately, a change in insurance can sometimes cause problems for patients since not all medical providers participate with all insurance plans. 

For example, we often see patients who were previously enrolled in traditional Medicare who have signed up for a Medicare Advantage plan during the open enrollment period.  Changing over to a Medicare Advantage plan can potentially affect coverage with your current healthcare providers, as some providers may not participate with a particular Medicare Advantage plan.  This means you would no longer be able to see that provider without having an out of pocket expense.  This is one reason we encourage our patients who have made any change to their insurance to contact our office prior to their appointment to let us know of the change.  At this time, we can also confirm whether or not we are an in-network provider with your new insurance plan. 

Speaking of out of pocket expenses, since most insurance policies run calendar year (Jan 1 – Dec 31), deductibles and out of pocket costs also renew the first of the year - so there may also be a possibility you will have a share for a service early in the new year.  We will certainly let you know of any financial responsibility you may have prior to providing the service.  Also, please don’t forget to bring any new insurance cards with you to your appointment! 

One last thing, so we may have the option to effectively communicate with you in regards to the care you receive from us, we will be asking for your current email address, as well as your permission to use it as a method of contacting you regarding the medical care you are receiving from us. 

 Happy New Year!

 - Kristin Boswell, Director of Patient Services and Billing

 

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.

What is 3D printing about in O&P?

QUESTION: 

I keep hearing about 3D printing in orthotics and prosthetics. How does that work?  - Paul W.

ANSWER:

Paul, what a great question! This is a very exciting time for 3D printing in Orthotics and Prosthetics and one of our favorite subjects.

The start of 3D printing
Most people think that 3D printing is relatively new. The truth is that it was started in 1980 when Hideo Kodama first described a layer by layer approach to manufacturing. About four years later a French team filed a patent for the stereolithography process (later to be re-named as 3D printing). They later abandoned their efforts, saying they just couldn’t find a viable market for this process. At about the same time, Chuck Hull filed his own patent for a stereolithography fabrication system. Through the ’80s, with much work and experimenting, 3D printing moved from its infancy and childhood to its adolescence. Though there are certainly others, three main printing methods have emerged: SLA - which uses a photo-sensitive liquid polymer; SLS - fuses material in a powder form; and FDM - deposits heated filament on a build plate to create objects layer by layer.

3D printing and prosthetics
One of the things that make 3D printing so appealing is the possibility to design, alter and customize objects. This has led to manufacturers using it to create prototypes in a much more efficient and timely manner. In the world of prosthetics almost everything is custom built for an individual patient - making 3D printing a very useful tool. 

In the last decade, groups like e-NABLE began creating, through open-source collaborations, hands for people who were missing fingers. This has sparked the hope for customizable, lower-cost prosthetic devices.

Often when a prosthetic leg is made, the patient wants a shape that resembles a real leg. This is most often done by encasing the metal tube that connects the foot to the rest of the socket with a foam material and sanding it to a leg shape. It can then be covered with a stocking or an artificial skin. This is known as a cosmetic cover. 3D printing has given rise to a market for personalized cosmetic covers for patients who aren’t as interested in natural-looking devices or really want to have an artistic way to express themselves.  

Dankmeyer’s involvement in 3D printing
Dankmeyer began their adventure in 3D printing in 2013 with the purchase of their first printer. Several people began the process of learning to design 3D objects as well as run the printer. That year also saw a number of staff members participated in an e-NABLE sponsored event where a number of pre-printed hands were assembled. 

If you are interested in seeing a video we made as an introduction to 3D printing, just click on the video link below.


Thank you for your question!  - Art Ross and Shawn Ross, Fabrication Technicians

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com

How often should I follow-up with my practitioner?

QUESTION:

How often should I follow-up with my practitioner?

Nancy W.

ANSWER:

In general, when you have any skin problems (for example, redness that does not go away in 20-30 minutes after using your orthosis or prosthesis) or pain while using your prosthesis or orthosis, you should follow-up with your practitioner. If you notice that your device is not functioning properly (ankle joints not operating well, prosthetic knee is not bending appropriately) we also recommend that you call and follow-up with us.

Prosthetics

If your prosthesis is fitting and working well, it is still a good idea to come in about every 6 months. We can inspect your prosthesis for signs of wear as well as look at your liners, sleeves, and socks to make sure they are in optimal condition for use with your prosthesis. It's a great idea to follow-up with us regularly so we can catch any problems early.  At the beginning of the process, when you first receive your prosthesis, we may see you more regularly for follow-up, as your limb may be changing quickly. However, over time these changes usually slow down and less frequent follow-ups may be more appropriate. We will normally call you to follow-up with you about every 6 months to see how you are doing.

Orthotics

We recommend an annual follow-up for orthoses. This is especially important if you have an orthosis that uses ankle or knee joints that may need maintenance or replacement. We will normally call you once a year to check in and see how you are doing. 

In all cases, if something does not fit or function well, please contact our office at 410-636-8114. We may be able to resolve issues over the phone, and if not we look forward to seeing you in our office!

Thanks for your question! - Nina Bondre, CPO

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.