Casting. Photographs courtesy of Bio-Medic Appliances, Essex Junction, Vermont.
Losing weight is often more than simply wanting to look your best for your tenth or 20th high school reunion-it can present a critically important health issue.
Most people who have tried to lose weight know that it can be difficult at best. If you add to that the toll from 17 surgeries, an estimated 70-75 pounds of residual limb lymphedema, and substantial loss of mobility, the task may seem nearly impossible. This was the situation that faced Ken Harvey, owner of K.A. Harvey Manufactured Housing, Morrisville, Vermont, and his prosthetic team at Bio-Medic Appliances, Essex Junction, Vermont.
Since his college days, Harvey has been a husky guy, packing 250-plus pounds on a medium-to-large six-foot frame. However, his health suddenly deteriorated at age 44 when a popliteal aneurysm burst in his right leg, leading to a right transtibial amputation in 1995 and a bypass surgery for an aneurysm in the left leg the same year. And that was just the beginning. Five more aneurysms were found in his right leg-two groin, two pelvic, and one aortic.
Surgeons attempted to repair some of the aneurysms, and “that’s where I got into trouble,” Harvey says. The failed surgeries led to a transfemoral amputation, extreme lymphedema, and severe verrucous hyperplasia, along with continual lymph fluid drainage. Due to edema, Harvey’s residual limb has a distal clearance of only about ten inches, plus his weight climbed to over 467 pounds.
Prosthetic design
A Disappointing Start
In 2007, when Deborah Wilde, MS, CPO, FAAOP, tried fitting Harvey with a custom compression garment to reduce edema, Harvey’s limb circumference at maximum was 46 inches. Compression only succeeded in reducing this to 42 inches. A check socket with a custom gel locking liner was fabricated, but before the fitting, Harvey’s limb edema ballooned so much that the liner and check socket no longer fit. At this point, Harvey decided to forgo additional prosthetic treatment.
Harvey later had a gastric sleeve surgery to reduce his weight, and once his weight was down to 386 pounds, from a previous weight of about 450 pounds, he again sought prosthetic care at Bio-Medic.
“I could only stand on my [contralateral] leg about 30-45 seconds before my knee would start to tremble and I would have to sit down,” Harvey says. He decided to try again to be fit with a prosthesis that would aid him in standing and ambulation.
After fitting
Treatment Plan and Prosthetic Design
Harvey and his prosthetists, Wilde and Sarah Thomas, CPO, who joined Bio-Medic in 2010, tackled the challenge head on and came up with a treatment plan and design. The design includes spinal torso socks stitched at one end, a polyethylene bivalve inner liner with circumferential straps, lanyard suspension with waist belt auxiliary suspension, and a custom composite foot and pylon. This time, the effort was successful.
Harvey says he can now stand for six to eight minutes, which aids greatly in transferring and in more ambulation in general. He also uses a power wheelchair. “I’m pretty independent,” he says.
Harvey still wants to lose more weight and become more active. He tries to be consistent in following the dietary recommendations given at the time of his gastric sleeve surgery. “I’m hoping that as time goes on and I lose some of this lymphedema and the prosthesis becomes easier to use, I’ll be able to get more weight reduction.” Harvey’s goal is to get back into the mid-200-pound range. “I’m comfortable with that,” he says.
Harvey gives much credit to his family and his prosthetists for his prosthetic success. “I can’t say enough positive things about Deb and Sarah, and I’ve been gifted in my family. My wife Debbie has been a wonderful support.” He also mentions his extended family of brothers, nieces, and nephews who are available to help whenever he needs them.
When asked whether or not he has any advice for others with amputations who want to lose weight, Harvey says, “I don’t really have any secrets there. I would say, ‘just don’t give up!'”
Miki Fairley is a freelance writer based in southwest Colorado. She can be reached at
