April 10th, 2019 | Published in Amputee Stories
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.