Surf or Shower

Richard Riley's low-cost swim/shower prosthesis has opened up a new world for him-not to mention his shower door. If anything can be said for amputees who also work in the trenches of their own private O&P practice, it may be this: they can fabricate, fit, and deliver any type of prosthesis they want for themselves. And for Richard L. Riley, CP, owner of Prosthetic Consulting Technologies, Washoe Valley, Nevada, the most effective ancillary prosthesis he has made for himself is a swim/shower prosthesis. "It expanded my world more than my handball leg, my backpacking leg, my skiing legs (both downhill and cross country), and even my pirate peg leg-which is a really good time at Halloween," Riley says. "It is the one I use when I have to get up in the middle of the night as well. It is easily donned and doffed." It was the beach, something that separated him from his wife and children while on vacation, that motivated him to fabricate the swim leg to his specifications. Riley's everyday prosthesis utilizes a shuttle lock suspension system and a multiaxial graphite foot that will not stand up to the wet, salty, sandy environment. The swim/shower prosthesis has everyday practical and safety aspects as well. One of the most dangerous things an amputee can do, besides walking on icy surfaces and rough, wooded trails, is to use the shower. "The two worst falls I have taken in my adult life were on shower stools," Riley says. "All shower stools have four legs on them. Shower stalls have to drain, and no shower floors are flat. The same can be said for bathtubs. If you put a shower stool on a surface like that, chances are the stool will be wobbly. Besides that, it's made of plastic and aluminum, and when those materials break down, it will collapse on you. Shower stools are not a great answer for safety." While most amputees have already outfitted their bathrooms with grab bars for convenience, practicality, and safety, the ancillary shower prosthesis is almost a necessity when it comes to stepping into the tub or over the floor rim and onto the shower floor. If the tub has sliding glass doors, the prosthesis is almost indispensable, as the track for the door negates the use of one's knee to get into the tub. Whether grab bars or shower stools, it becomes a moot point when the user is on the road or when he or she may want to use a Jacuzzi at a hotel. Like most swim/shower legs, Riley's is small enough to pack up on business trips or vacations. One of the few difficulties with a swim/shower leg has nothing to do with its purpose, but rather with the bottom line-getting reimbursed for its fabrication, fitting, and delivery. According to sources close to the matter, a prosthetic business owner will sometimes offer to make such an ancillary device for a client for the amount of the insurance deductible or co-pay-a difficult proposition for many. Components for a good swim/shower prosthesis such as Riley's may include a Safe II or Kingsley Wayfarer foot, carbon and fiberglass socket lay-up, a lower-end but effective suspension device, acrylic resin, rigid foam, pelite or soft thermoplastic for a socket liner, a pylon, and carbon graphite ankle block. The only expense that is eaten is the labor. Unless more expensive componentry is used, it is a fairly inexpensive investment for a prosthetist to make in the life of a motivated client, and it will improve the patient's lifestyle. In turn the patient becomes a loyal customer who, once accustomed to its convenience, practicality, and safety, will see it more as an essential, rather than ancillary, device. For more information about Riley's design and fabrication techniques, rickjillriley@hotmail.com ; www.prostheticconsulting.com Gordon Zernich, CP, BOCP, is employed at the Veteran Affairs (VA) Medical Center in Miami, Florida.

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