Prosthesis 101

Meet my precioussss.... 

Type: Endoskeletal transtibial prosthesis

Specs:
- Acrylic socket with pelite liner (the fat beige part)
- 3 prong titanium socket adapter
- Aluminum and titanium socket adapter pylon ( (the robocop steel part)
- single axis foot with titanium ankle joint (covered by the shoes)

Donning the prosthetic leg:

1. Clean the stump with soap and warm water
2. Pat dry with a towel
3. Apply Contractubex to scar

       - I apply the ointment to prevent keloids and to increase the elasticity of the skin. I used to have an angry red scar on the area with the remaining bone but has since lightened to kikay pink. The stump doesn't hurt anymore and I have already accidentally banged it several time on various furniture when I forget that it was amputated (my subconcious sometimes thinks that I still have my right leg).


4. Put on socks on stump

       - I am still experimenting with different types of socks since prosthetic supplies are not that readily available in the Philippines. I wrap the stump in an ace bandage when I'm in bed to further promote shrinkage and use a shrinker stocking (the kind used by old people with rheumatism) when wearing the prosthetic. I have a problem with this because the stocking is madulas and I have a bit of pistoning when i walk. Not good, since my gait becomes abnormal. I am trying out now a Puma sport sock without a heel and find it more comfortable although it's mainit.

5. Extend knee and slide in stump, with the leg parallel to the ground.
6. Snap on velcro strap around the thigh. Make sure it's snug but not cutting into the skin.
7. Slowly bend knee and make sure the socket is snug under the knee.

    - there's a little bit of allowance between the socket and the end of the stump and the area around my knee is bearing the weight, so there is no trauma to end of the stump. Since this is just my first prosthesis and I'm a bit on the heavy side, using the vacuum type, which is the most stable and better cosmetically, is not yet advisable. The suspension in the strap type is a bit dodgy but with the right fit, I can regain my normal gait. Probably in a few months :-) I have to return the strap to my prosthetist today because it snaps off when I sit down. Sana wag nya sabihin na papayatin ko na lang hita ko :-(


Standing up and sitting down are production numbers since I'm not yet stable. My supposed "good" leg also has a femoral fracture so I need to grab on to something when I stand and when I sit down. I am using a four-legged walker, which is cumbersome. My physical therapist is training me to use crutches so I can be more mobile and we'll slowly advance to two crutches, then one crutch then just a cane. I'm training myself to take longer strides so I gain more ground. Let's just say I will not run win any walkathon anytime soon. Mas mabilis pa ang marriage ni Kim Kardashian kesa sa lakad ko.  


More updates to come pag nakalakawatsa na ko ng malayo-layo

Whole Again

A journey of a thousand miles begins with a single step

~ Lao Tzu

Well, look who's walking now!

    I picked up my prosthesis this morning after 3 and 1/2 months of waiting for the right time. I had little sleep last night because of the anticipation. Although I'm getting comfortable with the wheelchair, I have to move on to my "new normal". We left at 11am and 20 minutes later, I am back on two feet. 

    I saw the prosthesis as soon as we entered the SGG Orthocare office. My first thought was, ang taba naman. Kuya Raffy explained that this is just a preliminary socket as my stump will still change in the next few weeks. All the excess fat and endema will be gone when my calf muscles rebuild. He also placed a foam liner inside for my comfort, as I mentioned that there's a painful pressure area where the bone ends. And because I have fat thighs. His words, not mine. 

I can't explain the feeling as I walk with two feet again. I have gotten used to the hop-hop system I do when using a walker. The first few steps I took, I forgot I already have another leg and dragged my right leg a bit. I still have to hold on the railings because my balance is shot. My left leg is also still unstable because if the IM nail but nevertheless, I know that I will be walking normally soon. 

As soon as we got home, I was greeted by my and my landlady's family. Now on to the next hurdle: the steps. I live on the 3rd floor of the apartment building and I have to be carried in a chair, princess-style, whenever I have to go down. Good thing my physical therapist is there to guide me up the steps. 

Here is basically how I  climbed 2 flights of stairs:

1. Grab the railing with my left hand and position the crutch on the first step with my right hand. 

2. Put left foot up the first step. 

3. Heave the whole 150 pounds (approximately) of me with my two hands and one leg. 

4. Put right foot up the first step. 

5. Wash, rinse and repeat. 

I didn't mention that I have 4 people behind me waiting to catch me in case I fall down. I have to stop in the landing on the second floor to rest and then grunt my way up on the last flight. All worth it, as I have cake and ice cream waiting for me at home :-)

There's still a long road ahead of me. I still feel wobbly when using my new legn and I have to get used to the feeling that my stump is being choked by the socket. I am more comfortable using a four-legged walker, which is cumbersome, instead of crutches as an assistive device. I have to remove my prosthesis after walking for some time as I feel pain in the stump, which is like a thousand electric currents running up and down my leg. Still more challenges to overcome, but I was never the kind of girl who gives up easily. 

   

Warning: This is a morbid post

       Today is my stump's 3rd monthsary. My nephew nicknamed it Cobra, because it looks like a snake ready to strike when I lift it up. I found this picture while browsing through my photo albums. Surprisingly, I have tons of shots of my right leg. I didn't realize that I have a habit of taking photos of my feet whenever I arrive in a new place.  I figured enough time has passed that making fun of what happened to me is no longer disrespectful to those who have suffered the same misfortune

       This was taken in Palawan the summer of '09, also the year I started my 3/3 rule - 3 Philippine provinces and 3 countries visited every year.

        This was my longest vacation (1 week) and also my first time in Boracay. My ex-roommate Buena just resigned from her Malaysian gig and I am on the brink of resigning because of burnout, so we decided to do some island soul-searching. It was adventure-packed and our stay also got extended because all flights were cancelled on the day we were to go home and we can't get a flight until 2 days after. The summer of 2010 also started my love affair with Boracay and I returned thrice in the same year after this trip.

       This was taken during my 1st camping trip, at a ripe old age of 30. I always managed to avoid camping even when I was in elementary because I was deathly afraid of having no clean bathrooms when nature calls. I was just a sabit to a friend's getaway with her high school barkada but I didn't feel out of place as her friends also brought their own sabits. We thought that Anawangin will be deserted because it is Good Friday, but alas, everybody else has the same idea. I can't say that this trip changed my mind about camping but it was sure a lot of fun, clean bathroom or without.

      Sadly, that was the end of my right foot travel series. Sure, I can always take pictures of my left leg but it wasn't as sexy as Cobra's departed half. Here's hoping my prosthetic foot (coming really soon!)  is photogenic.

I may be bent but I'll never be broken

It's ironic now when I read my blog banner.

It was a Fight Club quote. I used to pretend (still do) I am Edward Norton's character, a corporate slave by day but really Tyler Durden in my head. I fulfill this Tyler Durden fantasy when I travel: everything in life gets the volume turned down. All the work stress, the family drama, heart woes, nothing mattered but what I am experiencing and seeing at the moment. The grittier the experience, the better. It makes me feel alive, connected. I wanted to touch everything, eat everything, smell everything. Anything but my real-life sanitized environment where the closest relationship I have is with my keyboard. 

Now it has come true, I will never be perfect and I will never be complete again.. And despite everything that happened, I'm still grateful.

I left Prey Veng, Cambodia on the dawn of July 31st a broken woman.  At approximately 4am, my old life ended with a bang. Literally. When I opened my eyes, I expected to be dead already. The news reports surrounding my accident has already rehashed how I kept my wits and checked myself for injuries, reciting the alphabet in my head and did some complex multiplication to make sure I'm not bleeding from my brains . How I stashed a copy of my passport in my bra in case the police needed to identify my corpse.What people doesn't know is that for the 2 hours that I was stuck in there, I was scared and I wanted my daddy. And I want the crying woman in front of me, who is hugging her dying son and whose other two daughters are bleeding beside me, to stop because it breaks my heart. How I longed for someone to make eye contact with me so I can tell them to please be careful with my mangled body. And that when I was finally loaded into an ambulance and got to see the extent of my injuries, I laughed. I laughed at the absurdity of my situation, laughed at the thought that I will not be an inspirational disabled person, laughed at the thought na masamang damo talaga ko, I'm still alive.

I am now entering my 3rd month without my leg, or an RBKA (Right below knee amputee)  in amputee parlance. And life's both a bitch and a breeze. I live with pain everyday but I have my family's love and support 24/7. I'm officially bionic because of the hardware in my left leg and I am 130 pounds of pure upper body strength. I am shopping for a new leg like I'm shopping for a new car: I think of suspension, how much mileage I can get out of it, what accessories will fit my lifesyle. I have an entourage: an orthopedist, a physical therapist, a prosthetist and my brother as my personal nurse. I never expected it, but a lot of people has come into my life and further enriched it. Strangers, fellow victims, friends I've reconnected with, acquaintances I have long ignored.

I can say I am a changed woman, in more ways than one. But my journey has just begun.
May I never be complete. May I never be content. May I never be perfect. Deliver me from being perfect and complete

This is one of the articles written by an organization sister and journalist, Lhen Paredes.

Having just one leg doesn’t change everything

The amazing optimism of a travel enthusiast who survived a bus crash in Cambodia

By: Arlene Paredes
Philippine Daily Inquirer 1:27 am | Saturday, August 6th, 2011

A short vacation has gone horribly wrong, and now a young woman determined to bounce back from a tragedy needs our help.
On board Kampuchea Angkor Express, a double-decker bus in Cambodia, 30-year-old Nina Kristine Abad was asleep. It was a Monday, about 4 o’clock in the morning, and her bus was in Peam Ro District, Prey Veng, en route to Vietnam. She was seated on the right side, second row at the top deck.
Nina’s peaceful slumber was interrupted by a massive impact from outside the right side of the bus. Jolted to wakefulness, she knew right away the bus was in an accident, and it was not a minor one.
Over the phone, Nina calmly recounted how she went through the ordeal. She said, “The first thing I did, I checked my teeth, my collarbone, and my eyes.” She felt lucky that her head was resting on a pillow by the window, which cushioned the impact somehow.
Lucid
It quickly occurred to her to check how lucid she was, so Nina did a few multiplications and even recited the alphabet in her head. She felt sure she would come out of the accident alive—except she could not move from her seat, as her legs were pinned down by a steel part of the bus.
An Indonesian guy in the first row was not as lucky. His side heavily absorbed the collision, causing him to suffer head injuries.
Not losing clarity and courage, Nina took comfort in knowing that she could think straight and she was “okay” from head to waist. She then pulled out her cell phone from her sling bag and texted her father and brother. “I told them I was in a crash, and they should let the embassy know.”
It would later be reported that the bus had careened to the right and hit a huge truck filled with corn. It took over an hour before the passengers were removed from the wreckage, with about seven of them suffering major injuries, two of whom did not survive.
The first hospital Nina was brought to was only about 20 minutes away, but did not have the facilities to completely attend to her injuries. She was then rushed to Calmette Hospital in Phnom Penh, where she is now confined.
“I am receiving the best medical attention,” Nina said, noting that a doctor once politely asked if she had any idea how she’d pay for all the expenses. She told him with a smile, “I’ll worry about it later.” She was sure she will get all the help she would need.
Nina is the only girl and the eldest among four siblings. She lives in Quezon City with a 16-year-old brother whom she is supporting through college, while her only surviving parent, her father, is based in Laguna, where he works as  a quality manager.
Asked if she had travel insurance, Nina said that is one of the things she would like to tell other travelers—get insurance before traveling. “I always thought that if the plane crashed, I’d die, anyway,” Nina mused, chuckling, realizing that she did not consider road accidents. It was Nina’s first solo trip.
Driver at large
There were 34 passengers on the bus. Other foreign tourists came from South Korea, Spain, and Ireland. The accident is still under investigation, while the driver, who reportedly fled the scene, is still at large as of press time. An online news article quoted Peam Ro District Police Chief Seng Ponlok as saying, “We think that it was caused by the driver being sleepy.”
Asked if she has some advice to give to travel enthusiasts like her, Nina said, “Don’t ride the night bus.”  Nina realized that the night driver could have also driven during the day and was probably tired.
Bubbly and buoyant despite the tragedy, Nina has been an inspiration to the Filipinos who have been visiting her since Day 1.  “I’m in high spirits” was the first thing she said to this writer when asked how she is doing.
The Philippine Consulate in Cambodia was quick to offer assistance to Nina. They transferred her to a more convenient room and hired a Cambodian to look after her.
The day after the accident, the condition of her legs were explained to her. Bones in her right leg had been badly crushed. “I already had a feeling since the accident that I may have to lose a leg,” Nina said, turning serious for a second without a hint of remorse or regret in her voice. When she was pulled from the wreckage, Nina saw that her left leg looked broken, but her right leg had it worse.
Lawyer Norman Corneros, the Philippine Embassy’s representative, explained to Nina, with the assistance of a Cambodian interpreter, the content of the consent form that she was asked to sign prior to the amputation.
A true optimist, Nina said, “They cut below the knee, and I know there are prosthetics available so I know I’ll be all right.” Her doctor said she could be ready for a skin grafting in 10 days, after which her wound will be closed up and she could be ready to travel via an air ambulance. Nina needs help in making arrangements for that, and she needs good orthopedics for her rehabilitation and further medical procedures.
Never alone
Filipinos living in Cambodia who read about the accident on The Cambodian Daily have flocked to visit Nina and cheer her up.   “I was never alone. I love the people here. I love Cambodia. I’m not traumatized or anything, I’ll definitely come back to Cambodia.”
Support quickly poured from friends and loved ones. Friends from UPLB Development Communicators’ Society (DevComSoc) rallied online after having learned of her situation. Using social networks Facebook and Twitter, Benjamin Delos Santos sought help from friends to call on the media and reach out to friends and connections in Cambodia to report on Nina’s condition and visit her at the hospital.
Mylene Malabanan, a Filipina based in Cambodia, says in her email, “Ang tapang nya!”
Short overseas trips usually mean relaxing pleasures. After a break, things generally go “back to normal” upon landing home. How will it be for Nina?
“I don’t see any change happening other than I may have to use prosthetics to walk again,” Nina said decisively, with her hopes set on seeing her friends and family again. “Gala ka kasi ng gala,” a friend joked, to which she replied, “Hindi ako titigil, no? If I could walk again, the next destination is The Great Wall of China.”
Even after the tragedy, things will go back to normal for Nina, who has the tenacity of a true fighter and a beyond-normal zest for life. But financially, she needs as much help as she can get.
As Nina has her ATM in Cambodia, she has requested her trusted friend Sheena Padilla to take care of all the help she can get.

E-mail the author at lhenparedes@gmail.com.