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Tracy Peters has a firm grip on her future thanks to a variety of upper limb prostheses she alternates according to the situation. Whether she’s suspended from a ropes course in a rain forest or evaluating the speech of youngsters, this 33-year-old Houston professional is appropriately equipped.
A patient of Ted Muilenburg, CP, for the past few years, Tracy endured a difficult progression before achieving her present level of dexterity.
She became a right below elbow amputee as a result of a bizarre accident that nearly took her life. On December 22, 1999, Tracy rode in an airport shuttle on her way to catch a flight to Kansas City, Mo., to join family for the Christmas holidays. A construction crane was hoisting a load of rebar that, after becoming unbalanced, dropped onto the passing bus. Crushed under the weight, Tracy sustained massive internal injuries, including extensive nerve damage between her right elbow and wrist.
The arm amputation was one of several operations necessary to stabilize her condition. Placed on a ventilator, she spent months in the hospital. In March of 2000, she made her first visit to Muilenburg Prosthetics, Inc., and by May, Tracy stood up in a wedding, wearing a temporary prosthesis. That October, she returned for more occupational therapy training after receiving her next arm. However, medication she was taking for her injuries prompted substantial weight gain.
“We had to split her socket so that we could keep enlarging it as her weight fluctuated,” explained Ted Muilenburg.
By then, Tracy’s doctors indicated that she’d be a good candidate for a myoelectric prosthesis, particularly since there was concern that the harness of her body-powered arm would irritate her scar tissue. In March of 2001, she needed a surgical revision of the amputation and didn’t wear her arm for weeks due to fears regarding skin breakdown.
In June of 2001, Tracy was working with Dr. William Donovan and Shawn Swanson, OT, at The Institute for Rehabilitation and Research (TIRR) in Houston; she was advised to return to Muilenburg for a myoelectric prosthesis. By then, she was becoming more skilled in using her body-powered and myoelectric arms. Tracy’s options now include a conventional body-powered below elbow prosthesis with both a hand and a hook terminal device, a myoelectric prosthesis with an Otto Bock hand, and a passive, cosmetic arm. The hands of the myoelectric and passive arms feature LIVINGSKIN® silicone gloves for a very natural appearance.
Although Tracy still has some range of motion limitations, she has returned to an active professional and personal life. Employed as a speech pathologist with the Houston school system prior to her accident, Tracy now continues in that role as a consultant with the district.
“I’m primarily testing children who are, on average, three-years-old. In these assessments, I only see the child once — many of them are really young and have severe disabilities,” she explained.
“Some aren’t even aware that I have a prosthetic arm. If they do notice it, I consider that a cognitive marker — that they’ve seen it and make a comment, which is good.”
In addition to her job, Tracy works with a personal trainer to continue to gain strength and agility, and she also travels on missions with members of her church. In all these areas, she is supported by her prosthetic team.
“Muilenburg has really good people who take an interest in helping you through rehabilitation and keeping you happy,” Tracy noted.
Tracy is indebted to her family for ongoing support during her injury and its aftermath. A sister and her family live in Texarcana and her widowed father lives in San Antonio. Strong involvement in Memorial Drive Presbyterian Church has also been important to Tracy’s recovery.
“I’ve gone on several mission trips with my church to Africa and Costa Rica,” she noted. “In Costa Rica, we did a canopy tour of the rain forest, and I was wearing my prosthesis. I speak Spanish, so I could hear how the people who were handling the ropes course were really nervous about my being 100 feet above the floor of the jungle,” she laughed.
“They had me rigged up with a chest harness as well as a waist harness. I did just fine!”
Although Tracy is grateful she’s come so far since the accident, she confesses to occasional twinges about body image.
“Once when I was evaluating a child who was upset about having learning disabilities, I said ‘Joseph, we all have some kind of disability. It’s just that they don’t all show,’” she said softly.
“Now, if I believe that, and I do — then I have to live my life that way. And I intend to!”
Comments Off on Touch Screen Phone Dialing
Recently I was challenged by one of my patients from another country, who lost both his hands, to make one of his myoelectric prosthetic hands work with a touch screen phone. I am sharing this story as what I learned can benefit others who use upper extremity prosthesis.
While shopping in a mall, someone had shown my patient touch pads that could attach to a winter glove enabling phone use without taking the glove off. We ordered the touch pads online but were disappointed to find out they would not work unless the other end of the pad, which is metal, was touching skin under the glove. Attaching the pads to his vinyl glove on his prosthetic hand would not operate his phone because he had no skin under it.
I contacted several people and manufacturers to see if there was anything available to make a prosthetic hand work with a touch screen but they couldn’t help me. I informed my patient of this and he said he knew I could figure out a way to make it work and he was not going home until I did!
Stylus for those who use a Metal Hook
About that time I was informed about a new creation by inventor Gordon Adkins. He designed a inexpensive round, conductive rubber material, called a Smarter Stylus, that stuck to your finger and enabled you to more efficiently operate your phone. He also referred to it a disposable stylus as when it was no longer sticky enough to stick to your finger it could be thrown away.
It was brought to my attention because it would work well for upper limb amputees as they could stick it to their metal hook terminal device and operate their phone also.
Stylus for those who use a Hand
The Smarter Stylus was perfect for those who used a metal hook terminal device but what about those who use a hand. Apparently the metal is what made it work.
I went back to the original product I had ordered, the Digits, invented by Brian Shy. Through trial and error I found that I could solder about a 14-inch or longer wire to the inner metal part of the touch pad (Figure 4) and it would then operate the touch screen phone. It could then be attach it to the thumb of the prosthetic glove in the same way it was designed to be attached to a winter glove, then installed on the myoelectric hand . The Digit Stylus and wire didnâ€™t interfere with other hand functions and the wire could be wrapped around the wrist, out of site.
My patient with the myoelectric hands could now use his touch screen phone as he desired and he could return home happy.
Comments Off on Ronald H.
Electrician Reacts To Double Amputation: “I’ll Make It Work.”
On a typical utility pole, a power distribution wire will have a standard voltage of 7,200 volts. Surviving a 7,200-volt shock is almost unheard of.
It was 2004, and Livingston, Texas native Ronnie Hindsman was doing what he’d done a thousand times before – a simple job out of a bucket truck for the Sam Houston Electric Cooperative where he’d been working for the last 23 years. It was a job he’d done so many times that he didn’t bother wearing the rubber gloves.
Ronnie can’t clearly remember the electrical shock that changed the rest of his life. “There are things some people just get too comfortable working on. I only remember some of the accident,” he said. “I didn’t know anything for five days.” The high-voltage accident cost him both of his arms above the elbow, and he spent 45 days in the hospital, followed by two weeks of additional rehabilitation and surgery on his shoulder.
When he was ready to receive one of his two prostheses, his rehabilitation specialist, Dr. William Donovan, referred him to Ted Muilenburg, CP, FAAOP.
“I saw Ronnie three times in December 2004, and almost thirty times in 2005,” Ted said. “I spent a lot of time with him in order to build the prostheses that would suit his needs.”
At first, they went back and forth on all the electric options because, Ted said, you hear so much about the high tech prostheses. “I sat down for a few hours and put together a long detailed list on what types of electric components I would build for him if he wanted it,” Ted said.
Initially, Ted fit Ronnie with a sophisticated electric wrist on the left side, and a conventional (body powered) prosthesis on the right with a custom harness that enabled him to lock and unlock the wrist rotation unit.
“The electric wrist was just a little heavier,” Ted explained. “He looks at me, and he says, ‘It’s just too heavy.’”
Many patients come to Ted looking for a miracle. “They really drive you to try everything that you possibly can to help them,” he said. “I put myself in their situation and ask, what would I do? We’re trying to make the impossible work.”
Having no electric components is unusual for someone with amputations to both arms. According to Ted, when Ronnie decided he didn’t want to use the electric wrist but two conventional ones, “I told him he couldn’t do it, and he said he would. And he did. He said, ‘I’ll make it work.’ Even though he could barely do it at first, he was able to make it work well enough for him, so that it was better than an electric wrist.”
On his right side, Ronnie uses a standard style five hook made of titanium and a Texas Assistive Device (TAD) Five-Function Wrist (its functions are flexion, extension, supination, pronation, and a disk connect feature for the hook). He has an internal locking elbow with a locking humeral rotator and flexible frame socket.
On the left, he has a 555 hook, the Five-Function Wrist, an internal locking elbow with a locking liner, and a flexible frame socket.
“It is the most functional wrist flexion rotation, light weight unit available. It suited him,” Ted said.
There were many fittings, many adjustments over the course of the year. “The length was determined after a lot of work meeting his specifications – we spent a lot of time shortening the prostheses to suit his needs.”
It took Ronnie a few weeks to learn the motions with the prostheses. “After I got both of them, I just had to work with them,” Ronnie said. Nevertheless, he’ll be the first to say that he still has a lot to figure out.
It was on December 8, 2005 that Ronnie returned to work, where he is limited on how much weight he can pick up. “No more than 50 pounds,” he said, and then laughed. “But I would forget and try to pick it up. Ted saw plenty of me.” For a while, Ronnie would go in to see Ted every week.
In 2009, he has only gone to see Ted nine times, mostly for repairs. Ted said, “When someone loses both their arms, they’re using the prostheses pretty much from the moment they get up until they go to bed, because they can’t do much without them. The wrist units have a lot of little parts that go out over a period of time. Just from consistent use, they need maintenance.”
He added, “There are so many details involved in fitting a patient with these wrists.”
As backup, Ronnie received a new pair of prostheses this year too, and he has extra parts. “If I break a cable or break a strap, I have repair stuff now. I can try to repair it myself, or get someone to help.”
But if he can avoid getting help, he will. He’s been married more than 11 years, and asked his wife to stop helping with every little thing. “Lots of ladies here at work try to help, but I don’t let them. If I don’t learn to do it, I’ll never be able to do it. I like being independent.”
Even after the accident, “I didn’t ever think I’d lose my independence,” he said. “For a while, I always had to have people with me, and it was frustrating – I couldn’t drive, couldn’t go anywhere. It was hard on me and on my wife.”
Every day, Ronnie works to be self-sufficient, and he continues to improve. “Nothing’s really kept me down,” he said. “I try to do anything I did before. Usually I don’t ask for help unless I really need it.”
Today, Ronnie works mainly in the safety and training department of the electrical cooperative, doing a lot of new-hire training. In March 2009, Ronnie was honored with the “Unsung Hero” award from Texas Electric Cooperatives for his many years as an instructor and his contributions to the success of Loss Control line technician schools.
His personal story comes up at work, as respecting safety rules is an important part of the training he does. His hooks serve as a reminder to anyone he finds not using a hardhat or rubber gloves.
For the work computer, he uses a special mouse pad that he can operate with his hook. He also has steering knobs for driving in his work truck, his personal truck, and even his boat. He owned the boat before the accident and is glad he can continue fishing. “Mostly I do fishing in spring. I have rods made up that go in where I take out my left hook – so the rod stays in my left arm and I reel it in with my right hook.”
Year round, he continues one of his favorite pastimes – cooking. “I love to cook on the grill and the barbecue pit. My wife tries to help, and I tell her no. If I let someone help me do it, then I’ll never do it,” he said. Although he isn’t baking yet, he grills everything from steaks and chicken to pork chops and ribs on the pit.
In the fall, he hunts deer and hogs. Currently, he has devices that allow him to use the guns, but he’d like to find a way to hold the guns and pull the trigger instead of using adaptive devices. “I have crossbows, rifles, and shotguns,” he said. “It sits on a swivel chair, and when I move, it moves with me.”
While the idea of hunting alone appeals to him – and he thinks he’d be able to do it – he hunts with friends. “But I’m always thinking ahead,” he said. “Sometimes I’m by myself.” He does have a knife attachment, as well as rope in his truck for loading up his deer. “Most times, there’s someone to help me out with taking care of the animal.”
He said, “I’ve got some really good friends. And the company I work for has been really good, too.”
It might take him longer to do things that used to be simple, but he said the important part is that he’s getting them done.
At home, he and his wife have settled back into the routine – though it is a different routine from before the accident. After the initial adjustment period, he no longer needs her help with getting dressed. But some things he is still trying to find a way to do himself – like applying the roll-on gel pads. “I can put the arms on and the T-shirt on, but I can’t put the roll-on on my arms. I just haven’t figured it out yet.”
For Ronnie, the process is ongoing. “I’m always thinking about how to do things,” he said. “I figure it out.”
Comments Off on Rick M.
Muilenburg Prosthetics, Inc. slogan, “Partners for Life,” is especially true when it comes to Rick Melcher. An MPI patient since 1973, Rick, who went by the nickname Ricky back then, became an amputee as the result of an accident that sent 26,000 volts of electricity through his body. It happened the day before his high school graduation. After a long recovery, he donned his first pair of bilateral, below-knee prostheses in 1974 as a patient of MPI founder Al Muilenburg, CPO.
Rick recalls how he came to work with MPI. “I wasn’t expected to survive the accident,” he said. “When I woke up, I was sent to TIRR for rehabilitation and everyone I met there recommended Mr. Muilenburg. I still remember meeting him and waiting for my turn to be cast for the first time.” Family members of Rick had also been MPI patients in the past.
It wasn’t long before a young and motivated Rick was back on his feet and studying at Texas A&M University. Over the years, he has worked as a professional photographer and for nearly 15 years has been working in public relations and as the PR manager for a water and wastewater utility near Port Lavaca.
Rick’s first prostheses were exoskeletal with cuff suspension straps and SACH feet. After almost 40 years wearing prostheses, he has observed a lot of changes and is amazed and grateful for how prosthetic components have advanced. “The changes I’ve seen over time are tremendous,” he said. “Today’s legs allow me so much more mobility and the ability to stay on my feet all day long! That’s a big improvement.”
Rick is also impressed with the improved technology in the feet he wears. “The SACH foot was ‘mushy,’” Rick said. “When I put on the Flex-Foot® Feet it was like going from a pirate’s peg leg to a bionic foot.”
Another advancement is the development of gel roll-on cushion liners, which act as the main interface between the wearer’s residual limb and prosthesis. Today’s liners are made of materials that improve fit and cushion the limb, provide for easy donning and doffing, and help maintain skin health. Liners also provide protection against friction between the residual limb and the prosthesis, distributing pressure to maintain adequate fit and comfort.
Because of the nature of his injury, Rick’s residual limbs were left badly scarred and highly sensitive. His first prosthesis fit with only wool socks, which were extremely uncomfortable and caused a lot of discomfort and skin breakdown. They later made me custom silicone socket inserts that improved the fit a lot but they could not be replaced when worn out without compromising the fit. “The cushion liners I wear now are so much more forgiving on the skin,” he commented. “They allow me to stay active throughout the day.”
For Rick, staying active means spending time on the ocean, exploring and fishing. Rick fishes the waters of Madagora Bay frequently. His favorite place to fish is off the coast of Belize in Central America. “I love the blue-green water there,” he said. “It’s my favorite place!” He also enjoys spending time with his 25-year-old daughter, Jaydee.
Rick has been working with Ted Muilenburg, CP, FAAOP, since 1987 and was recently fit for new prostheses, which feature custom sockets and Modular III Flex-FootÒ Feet. He still uses the simple and durable cuff suspension straps. According to Ted, Rick’s legs are made in two sections, an especially challenging design. The top half of each is completely finished with hard durable custom laminates. The shape of each had to match each other yet blend anatomically into the lower, foam covered, endoskeletal section that could not be added until later. This interface allows Rick’s Flex-Foot Feet to move and provide energy storing capabilities.
“The trick was to end up with well-shaped left and right prosthesis that matched each other — blue with stars on the top, laminated sections and white on the lower soft ankle sections,” Ted said. “They turned out great, finished with Rick’s legs signature American Stars and Stripes design.”
MPI created the stars motif; Rick will paint the stripes on the lower white soft sections himself. He has been wearing his prostheses this way since 1975!
Rick has another plan for spending his free time later in 2011. Inspired by young servicemen and women who are returning from overseas tours after experiencing limb loss, this summer he plans to start visiting with these vets to show them how they can get out and be active. He hopes to get them on the water fishing.
His high-energy approach to life makes him an inspiration to others as well. “Rick has never let his amputations bring him down. He is energetic, cheerful, and creative in everything he does – his hobbies, his sports and his work,” Ted said. “And he always brings us great fishing tips and photos of his catch!”
Rick is grateful for his long relationship with the MPI team. “My experience has always been tremendous,” he said. “It’s great to see Ted follow in his father’s business, expanding it, and keeping it going strong.”
Comments Off on Pam P.
Myoelectric signals are no mystery to Pam Progule. Her career is based on radio signals and electronic communication. But familiarity didn’t make it any easier for her to master an upper extremity prosthesis when an accident caused the loss of her right hand.
Practice, practice, and more practice. Her postamputation adjustment also included analyzing situations involving manual skills and exchanging “Why can’t I do this?” with “How can I do this better?” A determined lady, Pam moved on from mastery of a body-powered below elbow prosthesis to taking on the challenge of a myoelectric terminal device, a multi-function wrist, and retraining her left brain/right brain dexterity and coordination.
Turning a hobby into a learning experience is just part of the drill. As part of her fine motor coordination exercises, Pam is soldering tiny parts of a model car kit. She is assembling the voice-activated, radio-controlled model car under the guidance of her rehabilitation team as a way to fine-tune her use of adaptive terminal devices designed as tools. For Pam, rehab is all part of the job.
For more than 19 years, Pam has been responsible for maintaining two-way radio systems and other electronic communication systems, including pipeline controls at Equistar Chemicals, LP, a petrochemical company. She began her radio communications career in 1985 after obtaining her Federal Communications Commission license.
On a mid-November Sunday evening in 1999, she was returning from a visit to a Galveston beach when she encountered dense fog. While driving her motorcycle through the thick fog, she missed a curve in the road and was catapulted off into a field. Later inspection of the accident site revealed that Pam’s flying body had sheared off a vertical metal pole.
“I must have hit it with my right arm. When I saw my hand lying in the field, I knew things weren’t good,” she recalled. A volunteer emergency medical technician, she knew her condition was extremely serious.
The impact had also severely shattered her left leg. Pam’s calls for help were finally heard by a young man who lived nearby. The fog was so heavy that the rescue helicopter was grounded and she had to be driven to the nearest medical facility instead.
She spent four days in intensive care and a month in Methodist Hospital, followed by two weeks at The Institute for Rehabilitation and Research (TIRR) in Houston.
“I almost lost my left leg, too. It took repeat surgeries and two external fixator rods to save it,” she noted. “My right elbow was fractured and held by pins, so I couldn’t do anything about a prosthesis until it had healed up.”
In the spring of 2000, Pam came to Muilenburg’s where she was fit for a body-powered below elbow prosthesis by Ted Muilenburg, CP. It had a hook terminal device which Pam felt was far more versatile in picking up objects than a prosthetic hand. To gain mastery of her prosthesis, Pam enrolled in a “work hardening program” offered by TIRR. Participants spent five days a week for six weeks gaining coordination skills. The valuable training also helped Pam learn to use a series of tool terminal devices purchased for her by the Texas Rehabilitation Commission. Those tools, designed by Texas Assistive Devices, included vise grips, a crescent wrench, a socket wrench, and a filet knife, Pam explained.
Her prosthesis and its interchangeable terminal devices enabled her to return to work, and she wore it for more than two years. Eventually, however, the shoulder harness, which secures a body-powered BE prosthesis, was aggravating an old shoulder separation injury she’d experienced before the motorcycle crash. Her physician at TIRR recommended she be fit with a myoelectric prosthesis.
“At first I was worried about the increase in weight because a myo is heavier than a body-powered prosthesis,” Pam said. “But I did some weight training and that helped make the end of my radial bone less tender.”
Ted fit Pam’s myoelectric prosthesis to be interchangeable with either of two terminal devices depending on the job at hand. She may choose the Electric Terminal Device (ETD) from Motion Control for precision tasks. Its narrow profile permits good visibility and it can easily access tight spaces. Her prosthesis also accepts the N-Abler II terminal device from Texas Assistive Devices (TAD), which is designed for use with a number of specialty tools that Pam needs for her job. The interchangeable tools are ideal for a wide variety of mechanical and household tasks.
“When I want the tools, I just turn the myo battery off, detach the electric hook, and insert the N-Abler II terminal device that holds the tool I need,” she reported.
What’s missing from her prosthetic wardrobe is a cosmetic hand.
“I was never worried about looking pretty,” Pam laughed. “I’m all about getting the job done. A cosmetic hand is just heavy – I wore one for a picture once. It’s really very limiting.”
As a right-handed person who is now a right BE amputee, Pam had grave concerns about maintaining her manual skills. “In the type of work I do — setting up and maintaining electronic systems — I’ve always had to use both hands. So it felt kind of natural to be using my left hand more, but I still had to retrain my brain to do things from the left, rather than the right side. I have to stand back and analyze a job — it’s a challenge, especially since I’m in such a technical field,” she added.
“I have a huge service monitor that involves flipping knobs and switches and testing systems. It had been set up for my right hand. After the accident, I had to set up my whole work bench to be left dominant. It took a while, but I’m getting used to it.
“Sometimes, I have to take a deep breath and study the situation — analyze how I can approach something better. But I’m thankful for what I have left, and for the help and encouragement I’ve gotten from Dr. Donovan at TIRR and from Ted Muilenburg.”
As to her fateful motorcycle, she gave it to the boy who heard her cries for help on that foggy night in 1999.
Comments Off on Michelle A.
Teenager Michelle Alcorn once envisioned a glamorous career as a high fashion designer. Illness wasn’t part of her plans. However, now the clothing she intends to design will be for people like her — people who wear prostheses.
A potentially lethal case of bacterial meningitis in June of 1999 left the then 15-year-old Texas 10th grader in critical condition at Memorial Hermann Hospital in Houston. The infection attacked her vascular system, particularly her hands and feet. Soon after the disease was diagnosed, her family was told that Michelle’s extremities would have to be amputated. By the end of July, the surgeries were complete; Michelle’s hands were amputated at the wrist and her legs just below the knee.
Despite prompt intervention, Michelle’s medical condition didn’t improve. A secondary infection ravaged her body; doctors induced a coma to slow down her systems and promote healing. Several times during the following weeks, her family feared for the teen’s life.
Her mother Tammy recalled that a few days before Michelle’s 16th birthday, her daughter had to be resuscitated and put on a ventilator; doctors questioned whether to continue aggressive treatment. Then three days later, she woke with no serious damage to her brain or organs. It was time to begin life as an amputee.
After transfer to The Institute for Rehabilitation and Research (TIRR) at the Texas Medical Center, Michelle was introduced to the Amputee Program and to Houston Children’s Charity, an organization of more than 75 agencies that provide assistance to disabled and underprivileged youngsters. She was also referred to Ted Muilenburg, CP, for prosthetic evaluation and fitting.
Initially, Ted fit Michelle with conventional control, wrist disarticulation prostheses with mechanical hands in October of 1999. These were replaced with Otto Bock myoelectric hands the following January. It was necessary to wait before providing her with below knee prostheses until the scar tissue and grafts covering her limb had healed sufficiently.
Last June, her prosthetist fit her with bilateral below knee prostheses with custom TEC locking liners for enhanced comfort and security. Seattle Light Feet completed the limbs.
“Michelle really pushes herself,” Ted stressed. “She has great determination.”
“The day her legs were fit, Michelle stood up and walked across the room. She amazed all of us!” Mrs. Alcorn recalled. “We were astounded to see her just stand up and walk.”
Ted continues to work with Michelle to fine-tune the Myoelectric control of her right hand.
Michelle enjoys shopping and going to restaurants with family and friends. Home schooled through her local school district, she uses a computer equipped with a voice dictation device for her homework.
“I’m not ready to go back to school yet,” she volunteered. “I don’t think I would be comfortable. People think I’m different now, but I’m not really. I’m even stronger than I was before I got sick, and I don’t let this get to me.”
Next semester, Michelle’s teachers will modify her schedule, with some classes at school. Her physical therapy sessions will count for high school physical education credits, and occupational therapy will fulfill her home economics requirements.
Michelle spends much of her free time with her brothers and sisters and their large circle of friends. Her mom characterizes Michelle as independent, fun loving, and funny, noting that her daughter’s experience has brought their family even closer together and made them all stronger.
This October, Houston Children’s Charity honored Michelle at its fourth annual gala at the Hyatt Regency in Houston. Recognizing her courage and determination, the banquet speaker noted, “This young lady has the spirit to triumph over her tragedy. Houston Children’s Charity is proud to know Michelle and to have played even a small part in helping her to reclaim her life.”
“That was really a lovely evening for Michelle,” Mrs. Alcorn said. “Everyone has been so great to us. The people from Muilenburg and from Houston Children’s Charity are helping us get through this.”
The teen’s family credits Michelle’s recovery to her tremendous spirit. “She is a ray of sunshine in our lives,” her mom emphasized. “And she always will be. She’s even more special now.”
Comments Off on Megan H.
Wife, mother, physical fitness buff, community volunteer, and business professional, Megan H. has plenty on her plate – and she loves it.
“I’m extremely active and I’m constantly on the go. I don’t like to say I can’t do something because of my leg,” said Megan, a below-knee amputee. “Like anything else in life, being an amputee is what you make of it. Drawing on your personal strength and the strength of those around you, you can do everything and anything you want to do.”
Megan became an amputee at 16, after a car accident. Right from the beginning, even though it was very difficult, Megan took a positive approach to her situation.
“I remember the surgeons were looking at options to rebuild my leg, but weren’t optimistic about my mobility. I told them to do whatever would allow me to run,” she said of her pastime then. “They said amputation was my best bet.”
Standing Strong with Family and Friends
“It’s a huge thing for anybody to experience that kind of trauma, but my parents didn’t lend it as much power as other people would,” Megan said. “I have people tell me even today, ‘I don’t know how you do what you do; I would have just wanted to die.’ That’s a weird thing to tell somebody. I didn’t think it was that bad. You can get through it, but respect it with the gravity it deserves.”
Megan said she was blessed to have supportive family and friends.
“My family told me it was another stepping stone and we’ll get through it. That’s how I was raised. My aunt is a Pilates instructor and right away she was working with me on core strength. The approach was that we are not going to let this thing take over. I also had support that helped at school. They arranged for me to have all my classes on the main floor. My classmates at St. Agnes Academy were wonderful and my boyfriend at the time was not fazed by it. St. Agnes Academy (all girls) had a few “brother schools.” St. Thomas High School was one and their student body was extremely supportive as well. I was very happy and surprised to be elected their homecoming queen!”
A Foot to Fit a Busy Life
Megan’s surgeon, Dr. Richard Haynes, recommended Megan see the clinicians at MPI for her prosthesis. She has been a patient for more than 10 years.
“MPI is so wonderful. Right after my amputation they tried to get me my (prosthetic) leg as soon as possible because they knew I was going back to school. They’ve just always worked for me,” she said.
Andre Martinez, CP, LP, is Megan’s prosthetist. “Megan is a very good patient and easy to work with,” Andre said. “She knows how to communicate about the fit of her prosthesis and what is working for her and what isn’t. That makes it easy for me to make sure she stays comfortable and active.”
The prosthesis Andre recently fit to her is held in place on her limb with a locking liner, finished out with a custom-shaped cover and a durable custom-painted protective covering. “Megan is really into working out so I gave her the Renegade® foot. It’s good for young, active individuals like Megan. She does very well with it,” he said.
A typical day for Megan begins at 5:30 a.m. when she heads to the gym for a rotation of fitness boot camp, plyometrics (exercises to increase muscle power), Pilates, spinning, and jumping rope. Then she is back at home caring for two daughters, toddler Grace and baby Caroline. “I’m a full-time mom but I also work part time as an account executive at Marie Flanigan Interiors. Grace is in school two days a week and I’m the room mother for her classroom.”
Megan also is the volunteer chair for the 2012 Pink Ribbon House, Membership Training Chairman at The Junior League of Houston, and served as vice president of Young Professionals Group for The Women’s Home.
“I volunteer a ton of my time, more than my husband would probably like, but I love filling my days; I love being busy.”
Sharing Experiences and Encouraging Others
A graduate of Texas A&M, Megan majored in early childhood education with a business minor. “I love being around children because they really enjoy life and that’s how I like to live. They are so innocent and fun and carefree,” she said.
Megan put her education and her experiences as an amputee to use as a development associate at Shriners Hospital. “That was wonderful because I got to be around kids in a similar situation. I loved working there. I’ve always wanted to be involved as an advocate to offer support to those who are going through a traumatic amputation,” she said. “I like reaching out to people who have stories like mine who might need some sort of connection.”
Don’t Stop Believing
Megan draws on her own experiences to encourage others.
“Being an amputee does not define or limit me as a person. I look back and often reflect on the sometimes painful steps that brought me where I am today,” she said. “If you want something badly enough, don’t stop taking those steps. There are modifications to just about every activity on this Earth and there are people who will hold your hand as you figure out what those modifications are. Believe in yourself and what you’re capable of – not as an amputee, but as a person. Limbs are there to help us grasp things more easily and to help us get places more quickly. Those of us missing limbs may be forced to work harder, but in the end, we are more than capable of doing what we set our minds to. Never stop believing in yourself. Don’t be afraid to challenge yourself and never consider failure as an option. Sometimes, all we need is a slight modification and before we know it, success is ours.”
Happily Ever After
After leaving her position at Shriners, Megan became the marketing services coordinator at Baylor College of Medicine in 2007, which was a very eventful year for her as she married Luke H. after a six-year courtship. Their destination wedding included nuptials in the Vatican at St. Peter’s Basilica’s Chapel of the Choirs. A reception for the 70 family and friends who attended was held at Rome’s fashionable 175-year-old Casina Valadier. For those who couldn’t travel abroad, another reception was held a few weeks later at the Petroleum Club. The couple honeymooned in Costa Rica where, typical of Megan, she zip-lined, kayaked, and took full advantage of the outdoor activities that beautiful country offers.
A year later, Megan and Luke were delighted to learn they would be parents.
“I got married November 23, 2007 and on November 23, 2008, I found out I was pregnant with Grace – so no wine at our anniversary dinner,” she exclaimed.
However, as an amputee, Megan had some concerns. “I was scared being pregnant and having children would be too difficult for me. That’s a lot of load bearing during pregnancy and then the question of how accessible I would be to my children once they’ve arrived,” she said. “Those questions answered themselves in time and I didn’t allow myself to be afraid of those new experiences. I have two beautiful baby girls and never once have I allowed my ‘disability’ to get in the way of my care and love for them. If Mommy needs to stay off of her leg for a day, we make it work. They are the primary reason I’m so glad that I’ve chosen to live with no fear. If I had chosen fear, I may never have allowed myself to be loved by my amazing husband and wouldn’t have Grace and Caroline here making me the happiest woman on Earth!”
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Lourdes Mueller isn’t a firefighter or a soldier. She doesn’t run marathons. But she does have an important and demanding job.
“She’s a school teacher and a typical mom, and she does everything a mother of three little kids has to do,” her prosthetist said.
Thanks to the new Rheo Knee® by Ossur, Lourdes’ job has been made a little easier. She’s only had the Rheo for a short time and already, “I’m pretty psyched about it,” said Lourdes. This is good news, considering that for a while she thought her life was essentially over.
In 1988, she went water skiing while on vacation from college. When the boat turned, Lourdes went into the water, and another boat ran over her, severing her right leg just above the knee and severely injuring her left leg.
“I woke up five days later in the ICU without one leg and with the other in a cast,” Lourdes said. “I thought I’d never go back to school. I thought I’d never get married.”
Then her orthopedic surgeon referred her to Muilenburg Prosthetics, Inc. and she had an initial consultation. Her prosthetist made her feel “comfortable in a difficult situation,” she said.
Her worries about not graduating or marrying would soon be forgotten. She soon went back to school where she met her future husband Chris.
“At first, I didn’t think I’d be able to do anything. Well, I knew I was going to walk because I was determined to do so. However, I didn’t know that I’d be able to do any other activities. But my husband was always saying, ‘You’re going to do everything.’”
A year later, Lourdes and Chris were snow skiing in Colorado. Lourdes went on to graduate with a degree in community health education, become a social worker, and then a kindergarten teacher. She took time off this year because she just had a third child. Lourdes and Chris have two sons, Christopher, Jr., and Luis, and a daughter, Marisa.
Since the accident, Lourdes has had four different prosthetic legs. The most recent one utilized a Mauch SNS Knee. It was adequate, but Lourdes thought it was time for a change.
When asked why, she said, “Stairs.”
“I hated stairs because you have to go down them one stair at a time. And when you have little kids like I do and have to chase after them, it really helps to be able to do that faster.”
Then Ossur introduced the Rheo Knee, which adjusts to the user’s gait one-thousand times per second and offers the ability to walk on inclines. She was one of the first people in Texas to get a Rheo Knee, but she came close to not getting one at all.
“I supposedly wasn’t the ideal candidate for this knee because of my short height and long residual limb. I have about ½ inch of a pole to attach the foot. So, at first they weren’t going to consider me.” Thanks to the efforts of her prosthetist, she was considered. “I appreciate it so much. Otherwise, I wouldn’t have been able to try it for another year or so,” Lourdes said.
Lourdes has had her new Rheo Knee for two days and already she’s walking down stairs foot over foot.
“I haven’t done that in years,” she said. “I have a lot of stairs at home, so it’s really nice. Also, quick turns are a lot easier. And everyday walking requires less effort. It’s a lot easier. I’m more stable. I used to have to go sideways down a steep incline. Now I don’t have to. The Rheo Knee will definitely change lifestyles.”
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Jamie White wears a prosthesis, but she is not an amputee. Nor is her condition common. Jamie was born with proximal focal femoral deficiency (PFFD), a condition that occurs in one in 50,000 to one in 200,000 births. PFFD is a congenital anomaly of the pelvis and proximal femur, which causes hip deformity and shortening and altered function of one or both lower extremities.
There are several degrees of PFFD, where the femur is shortened, flexed, abducted or externally rotated. Some patients opt for leg-lengthening, rotationplasty, or an amputation. Every case is unique and for Jamie’s situation, her parents opted not to have surgery.
Jamie was accepted as a patient at Shriners Hospital for Children – Houston when she was four months old. Her condition was initially treated with shoes built up with a vertical lift.
“I started with shoes but as I got my balance, I was fitted with a prosthesis when I was six years old by Muilenburg practitioner Ben Chadwell, CP, through Shriners Hospital. I have a fully-formed foot, but I don’t have a lot of motion. My bones are fused at my hip,” Jamie said.
“When I was little it took me longer to walk but I didn’t feel limited. I had good family support. In school, I was able to do everything in physical education classes except run.”
When Jamie turned 18, she left the Shriners system and continued as a patient of Muilenburg Prosthetics, Inc. After graduating from Texas State University in San Marcos, she switched her prosthetic care to a facility in Austin, where she has lived the past six years. But she found that the care was not satisfactory. “I didn’t have a positive experience,” she said. “I was dissatisfied overall with the service. I wasn’t comfortable and when I went in for adjustments, they basically blew me off. Then my parents received a letter about the free clinic Muilenburg offered in October.”
Shortly after Jamie attended the clinic, she became a patient of Richard Brunner, CP, who used his skill and creativity to create a prosthesis for Jamie that gives her leg extension, comfort, and mobility.
“The prosthesis she is wearing is an extension of her natural foot,” Richard said. “After casting her foot, I fabricated a hard socket built up with an acrylic laminate and light-weight components. Her foot fits straight down into the socket and is supported from the back of her leg. It is held into place with Velcro straps. Her prosthetic foot is a College Park Tru-Step. Jamie has expressed how the foot has helped her to walk better in normal situations around town, on stairs and slopes, as well as having a smoother gait from heel to toe. The College Park foot is a multi-axial foot and ankle combination that gives back what was lost or never there for the patient – ankle motion in all directions. Although her left leg is shorter than her right by almost five inches, with the prosthesis, the legs are of almost equal length.”
“Jamie’s prosthesis is customized to meet her unique needs,” said Richard. “But it provides her ambulation and stability.”
Jamie works as a manager for The ARC of the Capital Area, an organization that provides services to adults and children with developmental disabilities, and is happy she returned to MPI.
“Going to Muilenburg for care is a trip for me, but it is worth it for so many reasons,” she said. “Many of the people working there I still remember from my first visit after Shriners. And Richard was able to help me feel more comfortable.”
“My other prosthesis was dated and didn’t have shock absorption, flexibility, or give me the mobility I needed. Richard was able to correct that.”
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Motivated is a word that describes Jade (Yook-Hiam) Lai perfectly.
A hard-working woman with many skills and abilities, Jade speaks a half-dozen languages (including English and her native Mandarin); works full time for the Chinese Community Center (CCC) in Houston as a receptionist and translator; and owns a transportation company that provides taxi services around the area.
Jade also wears two prosthetic arms fit and fabricated by Ted Muilenburg, CP, LP, FAAOP, of Muilenburg Prosthetics, Inc.
Jade became an amputee in 1962. At the age of 18, she was riding in the city bus to school from her home in Kuala Lumpur, Malaysia. Jade remembers the bus swerving on a road under construction. The accident resulted in her arms being amputated.
“The Malaysian government sent me to England to get my prostheses,” Jade said. “They (her prosthetic arms) came from Germany, so I waited a long time to get them. I also went to occupational therapy to learn how to use my arms.”
She returned to Malaysia two years later to finish high school. After graduating, she attended Northern Arizona University in Flagstaff, where she met her husband. The couple married and returned to their native country following the birth of their oldest son and eventually raised three more children in Malaysia. Jade moved to the U.S. permanently in 1993 and settled in Houston to be near her oldest son and his family. Today, all three sons reside nearby; her daughter lives in Indonesia.
Her family also includes a brother, Bernard Lai, his wife, Ann, and their three children, who live in Sydney, Australia. Jade sees Bernard as her number one supporter, the one who treats her to an airline ticket each year so they can visit in Malaysia or Australia.
“We were very close when we grew up because we lost our father when I was seven years old and he was 18 months old,” Jade said. “Our mother and my sister, who is one year younger than me, brought us up. Their job was to wash and iron clothing using only their two hands. (They) worked for a few dollars each until 4 a.m. every day. It was when (we) saw their bitter, hard life that we learned to be strong and never give up in life.”
She added, “I wouldn’t be who I am today if not (for) my brother and my childhood.”
Jade met the team at MPI 17 years ago. Initially, Ted repaired her original arms and hands, which she wore for 26 years. When new prostheses were absolutely required, he fit her with another pair of conventional control arms. Her latest pair was delivered earlier this fall.
“She learned to do everything without fancy components such as flexion wrist and assistive devices,” said Ted. “When I met her initially, it was only to see if I could get parts for the imported German components in her prosthesis. She had her son with her and a tool box of Weed Eater® line, connectors, and rubber bands. He could fix her hook and elbow control cables himself. I remember getting her in contact with the Department of Assistive and Rehabilitative Services (DARS), which helps pay for prostheses and vocational training. At our next appointment, she told me they would help her if she got a job. When I saw her again, it was very exciting as she was the happiest I had ever seen her. She told me about her job as a school crossing guard and showed me how she used her prosthesis to raise and lower the stop sign she held. The rest is history. She continues to utilize this prosthetic design incorporated with ultralight materials and extra thin laminations that meet her special requirements. We also made hers with the European style of cabling system where the control cables that operate the elbow and hooks run on the opposite side of the arms.”
Because Jade is small in stature, and wanted them lighter, Ted switched her to medium or adolescent-sized components that are lighter but left the adult-sized hooks for her hands to enable her to grasp large objects. According to Ted, she opted for two hooks. Her previous prosthesis had a mechanical hand on the left but, to keep her arms as light as possible, she switched to a lightweight aluminum hook.
Unique socket designs include holes for comfort and to help keep her residual limbs cool. “She wears a split socket design on her right side with step-up joints and a split housing cable system that allows her to flex her arm up to her mouth for eating,” Ted said.
“I always wear the same kind (of arms),” Jade added. “But Ted makes them much lighter than the original pair. The sockets feel much better and I use less energy and strength to open and close my hands with the newest design.”
Jade’s case does present a few challenges. Her residual limbs are varied lengths with a short, below elbow on the right side, and short, mid-length above the elbow on the left. “Ted figures out exactly what I need,” she said. “He knows my hands are very special because I have such a short elbow. But he is very skilled and makes two joints and two cups so I can use my hands.”
Ted has also developed a few custom options for Jade, including a special watchband that enables her to wear her watch on her arm, and currently he is creating a new hand grip that will fit the paddle for Pickle-Ball, an activity she enjoys!
“Ted is a great problem solver,” Jade added. “If I want something special he figures it out and fixes it for me!”
Ted said, “Her nature is self-motivating. She’s not afraid to do what she has to do to be independent. I enjoy hearing her stories about some of the awkward situations she has gotten herself into and what she had to do to get out of them. She is always on the go.”
Looking toward her future, she set up her transportation business a year ago. Jade Transportation provides rides for people at a nominal charge in the evenings and on weekends. She has a friend who answers the phone and sets up jobs while she is at work and one of her sons is the driver.
Jade refers to this job as her “security” in case she ever has to retire. She understands the value and results of hard work and uses the Chinese numbers that represent “making prosperity every day” (11 and 68) as part of her website’s address, jade1168.com.
While she is very busy with work, she does find time to participate in activities at the CCC such as Pickle-Ball and walking around the track. She also enjoys meeting and talking to people through her work at the center and her taxi service.
She offers this advice for new amputees. “Don’t be sad and don’t give up!” she said. “I never think my life is over. Be happy and help others, too. Ask for help if you need it.” Jade added, “People are kind and always help me!”
“I am really proud of her for being a hard-working person who wants to be independent,” Ted said. “She is a person who never gives up!”