Thanks List! I had over 20 replies.
I’m posting the most helpful below. I received many names of providers/fabricators but few responses from anyone who actually provides the devices as clinicians. The overall consensus I feel from the responses that discussed personal experiences were that the device is :
1. appropriate for patients with very low level involvement as it does not provide a great deal of support. Perhaps appropriate for Drop foot.
2. very expensive and typically costs more than standard reimbursement rates.
I did not call every person recommended to me so there may still be fabricators that provide this device at a lower cost or in a hybrid form to provide an increase in ankle stability but I did not find that person.
————————
Otto Bock in Canada produces silicone products but they are very
expensive and it’s doubtful you would be reimbursed by insurance for
them. I was looking into a zippered SMO and they sent a fabrication
quote of around $2200 including a test unit. For this patient, I ended
up purchasing a flexible laminated AFO from Freedom called 2nd Ankle.
It was $350 and worked very well.
————————
Custom Silicon Fabrication of San Francisco. Great work!! This guy stands firmly behind all his work!! [email protected]
————————
Contact Arthur Graham at Next Step 617-581-6740.
He has fit dozens of those
————————
Andrew at BPM fab in Asheville May be able to help.
The boys at Precision Prosthetics in Memphis do awesome work with laminated silicone for prosthetics, may be able to do an AFO.
For ROLLED silicone, the absolute master is Kevin Molman at Athena Prosthetics in Monrovia, CA.
Call Kevin at Athena. If he can’t do it he’ll tell you who can.
————————
Research was done at NUPOC in regards to these AFO. It was concluded
that they provide no more benefit than current afos on the market.
Also, there is no current billing (Will be private pay), and they are
sometimes difficult to don. I am interested in them as well but at this
time it seems they would be more for comesis than anything. Check out
the following from Smooth-On for in house fabrication. Let me know what
you find out.
http://www.renewmaterials.com/
—————————
Patients will come in all the time with things they saw on U-Tube, a
news article, something a friend told them, and request it. We all use
silicone’s in our orthotics or prosthetics sometimes so perhaps this is
what he means. Let the patient become involved. Be an excited
listener and encourage them to find out more because they are interested
in what they have to do, what they will have to use to get better.
That is probably our most important job is to help them accept these
external appliances we design and dispense. Since you told them you
would put it out to your colleagues and check it out for them you
instilled interest. That was very nice of you. You are active
clinically so your probably not going to miss much. The response I
wanted to give was bit about products, or materials. I think it was
more to everyone who practices O%P that we have to make sure our patient
is secure with what we are providing them. With them knowing they are
receiving as much restorative function as our science can provide them
currently available they will feel confident about the appliance and
start using it. If a patient half heartily accepts an O or P device and
feels they are not getting a real answer for their personal problem
they won’t accept it, or benefit from it.
I tried to write my response to cover all the
patients questioning if what they are receiving form us today is the
best, or is it a waste of time. We do our best, and want our patient to
know it so they can stop all the doubts and do their best.
I am not trying to characterize, or assume that most patients are
like this. Asking questions does show they are interested, but for
patient who has continued doubts perhaps they are close to depression,
and not making the attempt to try. If this is the case in a kindly
manner ask them to seek help. Physical disabilities affect our mental
health. Be the cheerleader for your patient. I may have given too much
a response to your question; but it similar questions come up all the
time on the List and I was responding to the aggregate of them.——————————
