Jon D. Wilson, Prosthetic and Orthotic Leader in St. Louis and Beyond

John D. Wilson, CPO, LPO, helped found P & O Care just over six years ago with Jim Weber; since then he has served as its Clinical Director, being both a prosthetist and an orthotist. Jon has a total of over 16 years experience in the field. He graduated from the Certificate Programs in Prosthetics and in Orthotics from the Northwestern University Medical School and then earned his ABC Certification in Prosthetics in 1996.

Later, after working as a prosthetist in St. Louis for a few years, Jon went back to Northwestern for his Orthotics certification and completed his residency in the fall of 2003. Whereas the State of Missouri does not require licensure in the O & P field, Jon is currently a Licensed Prosthetist and Orthotist under the State of Illinois Department of Professional Regulation.

Besides leading P & O Care’s team of nine prosthetists and orthotists here in St. Louis, Jon has been recognized as a national leader in the field of upper and lower extremity prosthetic care. In 2004, he was awarded the prestigious Howard R. Thranhardt Lecture Honorarium for his abstract “A New Concept in Prosthetic Interface Design for Hemicorporectomy Amputees Utilizing ROHO Compression Therapy.” Jon’s new invention, which utilizes a matrix of ROHO cushions inside a custom fabricated “bucket” prosthesis, enables people who have literally been cut in half to float in a seated position. With their weight and body fluid evenly distributed, they are able to lead active, mobile lives without worrying about skin breakdown. Users can get around on their own in a wheel chair (or skateboard!), and some have even driven long distances alone, instead of lying in bed.

Videos about Amputation and Amputees

NYTimes.com: Pistorius Sprints to Gold in First of His Three Races

This page was sent to you by: wmclellan@sbcglobal.net SPORTS / OTHER SPORTS | September 10, 2008 Roundup: Pistorius Sprints to Gold in First of His Three Races By THE ASSOCIATED PRESS One gold medal down and two to go for the sprinter Oscar Pistorius of South Africa at the Beijing Paralympics. 1. Op-Ed Columnist: Hold Your Heads Up 2. Op-Ed Columnist: From the Gut 3. Popularity of a Hallucinogen May Thwart Its Medical Uses 4. Cases: Perhaps Death Is Proud; More Reason to Savor Life 5. Op-Ed Columnist: Palin and McCain’s Shotgun Marriage » Go to Complete List Copyright 2008 The New York Times Company | Privacy Policy

Natalie du Toit Finishes Olympic Marathon Swim

Also See:

Amputee jumps right back in - The Boston Globe

Posted using ShareThis

Amputee inspires in Olympic debut |NBC Olympics.com

By The Associated Press

Posted Tuesday, August 19, 2008 9:44 PM ET

BEIXIAOYING TOWN, China (AP) -- Natalie du Toit pulled herself onto the dock and waited for someone to bring her prosthetic leg. She stretched out the other leg -- the one she didn't lose in that horrendous motorcycle accident -- and chatted with an official about the first open water race in Olympic history.

Du Toit didn't finish where she wanted. Not even close.

But just making it to Beijing was a huge victory for anyone who's ever faced a disability.

Hoping to contend for a medal, the 24-year-old South African amputee fell off the pace toward the end of the grueling 6.2-mile race and finished 16th on Wednesday, more than a minute behind gold medalist Larisa Ilchenko of Russia.

"I tried my best," du Toit said. "I'm not too happy with it, but I'll be back for 2012."

Don't bet against her.

When she walked out with 24 other swimmers to be introduced for the groundbreaking event, it was quickly apparent she wasn't like any of them.

Du Toit hobbled along stiffly on her artificial leg, No. 23 written on her back and both arms. While others bounced up and down to loosen up, she settled for shaking her arms. A couple of times, she walked over to the edge to splash water on her face and goggles, leaning over tenuously with the wooden prosthetic sticking out to the side, keeping her from falling over.

When it was time to race, she walked slowly onto the dock and removed her replacement leg. Someone moved it to the side, and du Toit sat at the edge of the water, her right leg dangling in. When the starter called for everyone to get ready, she pulled herself up, wobbled just a bit and dove in.

She was an Olympian.

"My message isn't just to disabled people," du Toit said. "It's to everyone out there that you have to work hard. I've been through a lot of ups and downs ... but I've seen a lot of good things along the way. I was able to use the negativism in a good light and say after my accident, 'I can still do it if I work hard.'

"You have to set dreams, set goals and never give up."

Videos

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  Watch the 10k

  The 10k marathon swim debuted in Beijing.

Photos

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  Natalie du Toit

  South African swimmer Natalie du Toit, whose left leg was amputated below the knee after a 2001 motor scooter accident, competed in the 10k open water race in Beijing.

• Women's 10k open water

Du Toit, who carried the South African flag in the Opening Ceremony, hung with the lead pack much of the race, but she had a problem with her cap and couldn't keep up when the pace quickened toward the end of the two-hour ordeal. She finished 1 minute, 22.2 seconds behind Ilchenko, who out-sprinted two British swimmers who led most of the way.

Then again, du Toit's time of 2 hours, 49.9 seconds put her ahead of nine others, including 16-year-old American Chloe Sutton, who broke down in tears after finishing, every part of her body cramping and aching.

"I was swimming next to her and she beat me -- and she has one leg," Sutton said. "It's incredible she was able to do that."

Du Toit was an up-and-coming swimmer who just missed qualifying for the 2000 Sydney Games when her life took a tragic turn in 2001. Returning to school on a motorbike after a training session, she collided with a car and sustained massive injuries to her left leg. Doctors tried for a week to save it but finally had to amputate at the knee.

Instead of giving up on her athletic career, du Toit was back in the water six months later. Swimming made her feel whole again, though she wasn't competitive with able-bodied athletes in the pool, where the legs are vital for starts and turns.

Along came open water, which was added to the program for Beijing. There are no flip turns to negotiate in marathon swimming, which is usually held in lakes and oceans, and the upper body is more important than the legs.

"When I take my leg off and I'm completely free in the water," du Toit said, "that's who I am."

She had found her new calling. Du Toit qualified for the Olympics with a fourth-place finish at the World Championships in Spain this year.

"I find it hard, and I'm a completely able-bodied person," said Cassandra Patten, who won bronze in the race held at the Olympic rowing and canoeing course. "She's an amazing role model."

The race didn't go according to plan. Du Toit caught her skintight cap on a buoy and spent much of the time fiddling with it, trying make sure it didn't fall off.

With the cap occupying her attention, she kept skipping the drink stops along the course and wound up getting dehydrated. By the end, her leg was cramping and searing pain ripped through her bulky arms.

"I couldn't even get out of the water," du Toit said. "That showed I gave my best."

After bobbing on the surface in the finish area for a few seconds, she finally hoisted herself onto the deck. The official came over with her artificial leg, which was stuffed with the T-shirt du Toit wore out for the start. She pulled it out, slipped on the prosthesis and walked slowly toward dry land.

Du Toit has put herself out there for everybody to see, and she's eager to share her story.

"Sometimes you feel a bit awkward kind of asking, but she told me everything. She told me about the accident, what happened, the rehab," Patten said. "She's got such courage. Everyone's insecure, everyone has insecurities. To kind of put that in show and be totally fine with that is totally amazing. I'm going to go and give her a big cuddle."

Du Toit was not the first disabled athlete to compete at the Olympics, or even in Beijing. Natalia Partyka, who was born with a right arm that ends just below the elbow, made the Polish team in table tennis.

Both will remain in Beijing after these Games to compete in the Paralympics. Du Toit will be looking to match the five gold medals she won in Athens four years ago.

No disabled Olympian was more successful than American gymnast George Eyser, who won three golds and five medals overall while competing on a wooden leg at the 1904 St. Louis Games. His left leg was amputated after a train accident.

Still, it's quite unusual for someone with a major disability to compete at this level, especially in a sport such as swimming where the legs provide so much power.

Ilchenko praised du Toit for not letting her disability hold her back. She was right in there battling with everyone else in a race that's often called wrestling in the water for its rough tactics.

"I'd even go so far as to award her a separate medal," the winner said through a translator. "I have enormous respect for her. It is exceedingly hard. Just looking at these people inspires you."

Du Toit did receive a special gift from officials at the rowing basin: a traditional Chinese drawing encased in a wooden box. She doesn't want to be treated any different, however.

"I worked hard to get here," she said. "I want to do everything on merit. This is not just a free ride."

Du Toit didn't get a free ride Wednesday.

She was an Olympian, just like everyone else.

NBCOlympics.com - Amputee inspires in Olympic debut

Was an Amputee Gymnast in the 1904 St. Louis Games as Great an Olympian as Michael Phelps?

Tim Dahlberg, a national sports columnist for The Associated Press, agrees that Michael Phelps is certainly the greatest Olympic swimmer ever, but comparing him to dominant athletes in other events and in other eras is more difficult, he says. Carl Lewis, for example, didn't have as many opportunities to medal, but he was still the best in the 100m, the 200m, and the long jump for four Games.

Dahlberg proposes another candidate for best ever: George Eyser, who competed here in St. Louis in the 1904 Olympic Games. "Eyser won six medals in 1904 in gymnastics, despite a left leg made of wood after his original one was run over by a train."

Wikipedia includes this brief entry on Eyser:

George Eyser (born 1871, date of death unknown) was an American gymnast who competed in the 1904 Summer Olympics, earning six medals, including three gold. Eyser competed with a wooden prosthesis for a left leg[1], having lost his real leg after being run over by a train[2]. He is the only person with an artificial leg to have competed at the Olympic Games to date, although Natalie du Toit, an amputee South African swimmer, has qualified to take part in the 2008 Summer Olympics in Beijing.[3]

Exotic animal facility to close after attack

Jacob Barr (left) rests Tuesday while his father keeps him company at Barnes-Jewish Hospital.

( Jordan Wilson/P-D)

by Jordan Wilson

ST. LOUIS POST-DISPATCH

08/06/2008

Jacob Barr awakened slowly, opened his eyes, and pulled off the white sheet covering his legs. "As of Sunday morning, I had a leg," Barr said Tuesday, pointing to his right leg, amputated just below the knee. "Now, there's nothing there."

Barr, 26, of Warrenton, is recovering at Barnes-Jewish Hospital after he was attacked by a tiger Sunday at the Wesa-A-Geh-Ya exotic animal farm near Warrenton. He faces additional surgery today to remove more of the leg to just above the knee.

"I didn't even want to work there, I was just helping a buddy," Barr said.

Because of the mauling, Wesa's founders said Tuesday afternoon they would close their facility after more than 20 years of operation. The facility will give its animals away to three different sanctuaries within the next month.

"It's a number of things, but Jacob was the straw that broke the camel's back," said Ken Smith, 51, who started Wesa with his wife, Sandra, 58. "And I don't think I can fight the fight anymore. I think this has taken the life out of me."

Sandra Smith said the attack was the first time an animal mauled a volunteer. Wesa-A-Geh-Ya means "cat lady" in her native Cherokee language.

Wesa, which houses more than 50 lions and tigers along with other abandoned animals, has come under government scrutiny and criticism by animal rights groups in recent years. It was open to the public until the Smiths surrendered their exhibitors license to the USDA in late 2003 in the midst of a federal investigation. Both have been placed on probation for violations that included failing to keep cages properly locked and failing to register some animals.

The Smiths blame some neighbors and former volunteers for much of their trouble. Because of constant complaints and allegations of abuse, the Smiths say they were unable to add on to their animals' cages because the Warren County planning and zoning board denied their requests.

Sandra Smith said they wanted to add tops to their cages, which could have prevented the mauling, but were denied by planning and zoning.

Officials at the Warren County Commission could not be reached Tuesday but issued a statement saying that since 1995, the commission has "no record of any conditional use permit for cages or perimeter fence" from the Smiths.

Sandra Smith said as soon as Wesa finds its animals new homes, she and her husband will also leave town.

"Warrenton citizens won. We've thrown the towel in," she said. "I've got animals out there I love as much as some of my grandkids, probably."

Jim Barr said his son has that same love of animals. But for some reason, Barr said, animals never seemed to return the love to Jacob.

One time, Barr said Jacob's brothers were playing roughly with a golden retriever. Jacob was on the other side of the room, but the agitated dog bolted past his brothers and bit Jacob instead. He needed more than a dozen stitches.

Sunday was Jacob Barr's first trip to Wesa-A-Geh-Ya. He was helping a friend who was a volunteer, his father said. While Barr and another worker were cleaning a tiger's cage, the animal jumped a 12-foot fence and got hold of Barr. The 800-pound tiger "tossed Jacob around like a dish rag," his father said. The tiger was shot and killed to end the attack.

Initially, Wesa workers told authorities Barr was attacked by a pit bull. Warren County Sheriff Kevin Harrison said the story changed, though, when Barr's father told the department a tiger attacked his son, not a dog. Then, Wesa workers described the attack, Harrison said. Sandra Smith said the cover-up was done to keep her animals.

Jim Barr says his son never would have gone to Wesa if he would have known the conditions of the cages.

The Smiths remain horrified at the attack.

"I'd kill every animal out there if Jacob could have his legs back," Ken Smith said.

Could You Play Baseball with One Leg? Adam Bender Might Inspire You!

Check out video of Adam playing baseball and read the Lexington Herald-Leader's story about him.

Times Of India: Spreading Awareness on Leg Attacks

Check This Out!!! Log on to : http://www.timesofindia.com

Man's leg amputated after tiger attack

Jordan Wilson
St. Louis Post-Dispatch

WARREN COUNTY, MO. -- A volunteer at an exotic animal farm had his lower leg amputated Monday after a tiger attacked him Sunday on his first day of work.

Authorities said an 800-pound tiger attacked Jacob Barr, 26, of Warrenton, about 11 a.m. Sunday while he was helping clean cages at the Wesa-A-Geh-Ya facility near Warrenton.

Barr was listed in satisfactory condition at Barnes-Jewish Hospital in St. Louis after surgery to amputate his leg below the knee.

Barr's father's roommate and longtime friend, Chris Bryant, said Barr seemed to be in good spirits Monday afternoon after the surgery.

''When I talked to Jacob, he said he was so scared he thought he was going to die,'' Bryant said. ''He said, 'When the tiger started biting me, I kept punching it in the head.' ''

The tiger, named Tony, was shot by the owners during the attack.

Sandra Smith, 58, one of Wesa's owners, said Monday the attack was a ''freak accident.''

Smith said Barr was a first-time volunteer, and was being trained on how to care for the animals when the attack happened.

While Barr and another worker were cleaning the cage, Smith said the tiger jumped a 12-foot fence and got hold of him. The other volunteer screamed for help, she said, and Smith ran out with her gun and shot the tiger. Smith said her husband, Ken, 51, later shot and killed the tiger.

''When I shot that animal, my heart just died,'' Sandra Smith said outside her home, which is adjacent to Wesa. ''I knew it had to be done.''

In an interview Sunday with the Post-Dispatch, Smith said she would let authorities take and euthanize the roughly 60 animals at her facility.

But Monday, she said she wasn't sure if she was ready to give up. The Smiths have operated Wesa-A-Geh-Ya, which means ''cat lady'' in Sandra Smith's native Cherokee language, for more than 20 years, and she said this was the first time an animal mauled a volunteer.

Over the years, the facility has come under government scrutiny and criticism by animal rights groups.

Wesa was open to the public until the Smiths surrendered their exhibitors license to the USDA in late 2003 in the midst of a federal investigation. Allegations included not providing proper veterinary care and lacking adequately trained employees. Sandra Smith says they surrendered the license in order to keep the animals.

In 2003, she received probation for failing to keep cages properly locked. This past May, Ken Smith was placed on probation for failing to register some animals.

Sandra Smith says Wesa is the best chance the animals have at surviving since many of them have been abandoned. And as long as they are registered, it is legal to own exotic animals in Missouri.

Warren County Sheriff Kevin Harrison said his department will have to pay more attention to Wesa.

''The law may allow them to operate, but at some point we have to take initiative to regulate them beyond what the state of Missouri does,'' Harrison said.

''Now the thought has to be any time a cat wants to hop the fence and get to you, he can.''

Harrison said the facility has been mostly cooperative throughout the years, but workers tried to cover up the attack Sunday.

Initially, Wesa workers told authorities Barr was attacked by a pit bull. Harrison said the story changed, though, when Barr's father told the department a tiger attacked his son, not a dog.

Then, Wesa workers described the attack, Harrison said. The cover-up, which Smith says was done to keep her animals, is a major concern, Harrison said.

''If they're going to operate that kind of facility, they have a moral and ethical responsibility to the citizens to be honest,'' Harrison said. ''Especially when it could jeopardize other people's safety.''

Debbie Leahy, a director for the People for the Ethical Treatment of Animals, said she wasn't surprised to hear about the attack. She said she toured the facility about five years ago, and was shocked at the conditions of the cages. PETA sent a letter Monday urging federal wildlife authorities to investigate the attack.

''This was clearly an accident waiting to happen,'' Leahy said. ''We had received a number of complaints about this facility.''

Tiger attack near Branson

A worker at Predator World near Branson was critically injured in a tiger attack on Monday.

Stone County Sheriff Richard Hill said a 16-year-old worker entered a pen to take a photo for a customer and was attacked by three tigers. One of the animals knocked the teenager to the ground, while two others dragged the boy into a water pool.

Employees pulled the teen from the cage before emergency responders arrived. The teen was airlifted to a Springfield hospital and was in critical condition, with injuries including punctures to his neck. His name was not released.

The Associated Press provided information for this report.

Homemade Pipe-Bomb Leaves 11-Year-Old with an Amputated Leg

The following page from the "Daily Herald" web site has been sent to you by Bill ( bmclellan@pandocare.com ).

You can access it at the following URL:
http://www.heraldextra.com/content/view/274764/

Could Wash. U.'s Treatment for Obesity Lead to Fewer Amputations?

First U.S. incision-free procedure for obesity performed at Washington University



By Jim Dryden

July 24, 2008 -- Doctors at Washington University School of Medicine in St. Louis have performed the first non-surgical procedure in the United States that restricts the size of the stomach to treat obesity. The investigational procedure was performed under direct endoscopic visualization with specialized instruments passed into the stomach through the mouth. The first U.S. patient received the treatment on July 23 at Barnes-Jewish Hospital in St. Louis.

Photo by Tim Parker

Sreenivasa Jonnalagadda, M.D., and J. Christopher Eagon, M.D., performing the first TOGA procedure in the United States.

The procedure was performed as part of the TOGA Pivotal Trial, a multi-center study evaluating an incision-free procedure using the TOGA® System (transoral gastroplasty). Like surgery to treat obesity, the TOGA procedure is designed to alter a patient's anatomy to give a feeling of fullness after a small meal. The difference is that the investigational technique delivers the treatment through the mouth, without any incisions.

"This is a shift in the way we approach the surgical treatment of obesity," says Washington University bariatric surgeon J. Christopher Eagon, M.D., who is an assistant professor of surgery and local co-principal investigator for the study. "If this technique provides results close to those achieved with more traditional surgery, it may be an option for people who need to lose a great deal of weight but don't want to have surgery."

In the TOGA procedure, the physician introduces a set of flexible stapling devices through the mouth into the stomach, and then uses the staplers to create a restrictive pouch. The pouch catches food as it enters the stomach, giving patients the feeling of fullness after eating less. This study is evaluating the safety and effectiveness of the investigational procedure.

Between February 2006 and July 2007, 47 subjects had the TOGA procedure in a pilot study at medical centers in Mexico and Belgium. They weighed an average of almost 120 pounds over their ideal body weight. Six months after the procedure, subjects had lost more than a third of their excess body weight. By 12 months, their excess weight loss averaged almost 40 percent.

"That's not as great a loss as we see with gastric bypass surgery, which is still the 'gold standard' for weight-loss procedures," says Washington University gastroenterologist Sreenivasa Jonnalagadda, M.D., who is an associate professor of medicine and co-principal investigator at the St. Louis study site. "The key benefits from an endoscopic procedure as compared to laparoscopic or open surgery are quicker recovery period, shortened hospital stay, decreased risk of complications and an incision-free procedure. And if the restrictive pouch becomes bigger over time, as has been the experience with some obesity surgery patients, it may be possible in the future to further decrease the size of the pouch with this new generation of devices."

Carrie Williamson of Granite City, Ill., was the first U.S. patient. She was given general anesthesia when receiving the TOGA procedure and stayed overnight at Barnes-Jewish Hospital for observation.

Both Eagon and Jonnalagadda expect the TOGA procedure eventually could be performed on an outpatient basis with sedation rather than general anesthesia, depending on the study's results.

Subjects will be evaluated regularly for at least one year. All study-related medical care is provided at no charge, and patients receive medically supervised nutrition counseling. Because she was the first, Williamson knew she was getting the actual treatment, but during this study, one of every three volunteers will be a control patient, receiving anesthesia and an endoscopic evaluation of the stomach, without the TOGA procedure, for comparison purposes.

These control patients will be offered the TOGA procedure after 12 months if the procedure proves to be effective. Investigators will evaluate weight loss and monitor obesity-related health problems such as type 2 diabetes, cholesterol levels and hypertension.

"In patients undergoing gastric bypass surgery, it's common to see blood lipids and blood glucose levels normalize in the days after surgery, even before they lose any weight," Eagon says. "We may see similar benefits from this procedure, but we need to test that hypothesis."

The TOGA study will investigate the technique in at least 275 patients at centers across the United States. Investigators at the Washington University Medical Center site are planning to enroll at least 27 volunteers into the trial. Volunteers must be 18 to 60 years old and 100 pounds or more overweight. Some lighter patients may be considered if they have type 2 diabetes or high blood pressure. Patients with a recent heart attack, stroke, chest pain or severe reflux disease are not eligible.

Obesity affects more than 300 million people worldwide according to the World Health Organization. In the United States, the American Society for Metabolic and Bariatric Surgery estimates 205,000 patients had weight-loss surgery in 2007, but that number is estimated to be less than 2 percent of the eligible patient population.

"The TOGA procedure could provide another option for treating obesity," says Jonnalagadda. "Most of the common treatments — such as diet, exercise and drug therapy — have limited success in this population, and not everyone wants to have surgery, so this may help some patients who haven't had success with those more traditional treatments."

For more information about the TOGA study, patients or their families may call Volunteer for Health at 1-866-362-5656 or visit https://vfh.wustl.edu.

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Manufactured by Satiety, Inc., the TOGA System is not currently approved by the U.S. Food and Drug Administration.

The TOGA Pivotal Trial is funded by Satiety, Inc.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's Hospitals. The School of Medicine is one of the leading medical research, teaching, and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's Hospitals, the School of Medicine is linked to BJC HealthCare.

Although a common indicator of PAD is extreme leg or buttock pain caused by walking or exercising, as many as 40 percent of people with PAD never complain of this symptom.

Peripheral Arterial Disease (PAD) Affects One in Three People with Diabetes

Michael Jaff, MD, Medical Director of the Vascular Diagnostic Laboratory at Massachusetts General Hospital, Boston, Mass.
17 July 2008

This press release is an announcement submitted by Massachusetts General Hospital, Boston, Mass, and was not written by Diabetes Health.

Peripheral arterial disease (PAD), a condition commonly correlated with diabetes, affects at least one in every three diabetics over the age of 501 and approximately eight million Americans over the age of 40. Although PAD is common among diabetic and senior populations, current data show that public and physician knowledge of the disease is startlingly low, with only 25 percent of the affected population seeking treatment.2

People with diabetes are at the greatest risk for developing severe PAD and experiencing complications from the disease, as they have difficulty properly processing the sugar they ingest. As a result, plaque (fatty deposits) accumulates in the arteries, triggering changes in internal blood vessel size and elasticity that cause subsequent circulation problems.

Plaque buildup causes a narrowing and hardening of the arteries and can eventually decrease the blood flow to the lower extremities. When blood flow to the legs becomes limited or restricted, the propensity for developing infections, chronic foot ulcers, gangrene and leg lesions dramatically increases. Not only that, but these foot wounds have difficulty healing. In severe cases, the affected limb is so damaged that amputation is required if other treatments fail. Problems with the feet are one of the most common causes of diabetes-related hospitalizations. In fact, people with diabetes are up to 15 times more likely to endure lower limb amputation than those without diabetes.3 Fortunately, new medical devices and drugs are being developed, and in many cases amputation can be avoided or limited.

Although a common indicator of PAD is extreme leg or buttock pain caused by walking or exercising, as many as 40 percent of people with PAD never complain of this symptom4 – and those who do commonly mistake the discomfort for aging pains and fail to seek treatment, allowing the condition to worsen. PAD is highly treatable in its early stages, but as the disease remains undiagnosed, the likelihood of complications greatly increases, as does the probability of heart attack or stroke.

The following are risk factors for PAD:

* Being older than 50 years old (1 in 20 Americans over the age of 50 has PAD)
* Being a current or former smoker (both have an up to four times greater risk of developing PAD)
* Having high blood pressure (high blood pressure increases the likelihood of plaque build-up in the arteries)
* Having a history of heart disease (chances of contracting PAD increase to one in three patients suffering from heart disease)
* Having high cholesterol (excess cholesterol and fat in the blood contribute to the formation of plaque in the arteries)
* Being African American (African Americans, for reasons not yet fully understood, are twice as likely to have PAD as their Caucasian counterparts)

Individuals who have PAD may also have plaques in the arteries to the brain and heart, which could cause stroke or heart attack, respectively. Early detection and treatment of PAD is essential to improve quality of life and reduce the risk of heart attack, stroke, and amputation among diabetics with the condition.

Several symptoms are warning signs and potential indicators of PAD, including:

* Fatigue or cramping in the leg muscles (known as claudication) when walking
* Pain in the legs and/or feet that disturbs sleep
* Wounds on toes, feet or legs that heal slowly, poorly, or not at all
* Color changes in the skin of the feet (paleness or blueness)
* A lower temperature in one leg compared to the other leg
* Poor nail growth and decreased hair growth on toes and legs

Physicians can quickly and easily test for peripheral arterial disease, which can allow patients to undergo treatment for the condition and effectively arrest the progression of the disease. The most common test is the ankle-brachial index (ABI), a noninvasive process that compares the blood pressure in the ankles with the blood pressure in the arms. An ABI can help determine if someone has PAD, but it cannot identify the location and degree of the obstruction in the artery. A Doppler test, which is also noninvasive, can check a specific artery for blockage. The Doppler test uses ultrasound waves to measure blood flow in arteries within the lower extremities.

Once a clogged artery is identified, patients can consider several treatment options with their physician. Angioplasty is a nonsurgical procedure that is used to widen arteries with constricted or blocked blood flow. During the procedure, a catheter with a balloon on its tip is inserted into the narrowed artery and inflated. Once the artery widens, the balloon is deflated and the catheter is withdrawn, often restoring blood flow.

Another option in certain arteries such as the iliac is a stenting procedure. In this process, a stent (a wire mesh tube) is inserted into the artery, where it is expanded to act as a “scaffold” to hold the artery open and allow blood flow to resume. The procedure is minimally invasive, as the stent is guided into the restricted artery with a catheter inserted through a small opening in the artery. Drug-eluting stents, which are coated with medicine that is slowly released into the artery, were created to prevent plaque from growing around the stent due to inflammation and forming scar tissue, a process called restenosis. These devices have shown clinical effectiveness in treating coronary artery disease.

An investigational device for PAD with this characteristic is the new Zilver PTX Drug-Eluting Stent (www.zilverptxtrial.com) from Cook Medical. Currently in clinical trial for use in the superficial femoral artery (SFA), the largest artery in the leg, the Zilver stent is coated with paclitaxel, a drug used as an anti-cancer agent and used successfully with coronary stents to reduce the recurrence of narrowing in the coronary arteries. The Zilver PTX stent was created to reduce arterial reblockage in the nearly 40 percent of patients who now must endure repeat procedures when arteries renarrow. The Zilver PTX Trial is currently enrolling patients having PAD in the artery between the groin and knee in clinical trial locations around the world, and has commercial approval in New Zealand, Singapore and Hong Kong. Future PAD studies will be conducted to examine the effectiveness of treating obstructions in arteries below the knee to the foot with this technology.

In situations where large sections of an artery are narrowed, arterial bypass is a surgical option. During leg bypass surgery, a vein from another part of the body or a fabricated blood vessel is sewn above and below the clogged area of the artery to detour blood flow around the blockage. Bypass surgery is a largely successful treatment option, but can be risky for patients who suffer from other disorders such as diabetes or high blood pressure.

People who have experienced any of the aforementioned symptoms or are at increased risk for PAD, especially those with diabetes, should speak to their healthcare professional immediately to schedule testing. Identification and diagnosis of peripheral arterial disease is critical, as early treatment can ultimately save a life.

Wii-Hab for Seniors

I found this story at KFMB in San Diego. You can also watch the video.

Video games are generally reserved for grandkids, not grandparents. But not anymore - a nursing home in Escondido is using the Nintendo Wii game system to rehabilitate its patients. It's called "Wii-hab" and it's changing lives.

Shirley Fisher is getting magical results with the wave of her hand. At 73 years old, Shirley is Wii-habbing her hip.

"Oh this is very cute… it's nice," she said.

On the screen, a younger video game version of Shirley struts her stuff. But in real life, Shirley is pitching away the pain. And it's not just baseball. Therapists are using bowling, and even tennis to motivate patients.

"First they just kind of 'I don't want to do that', well, let's try it and pretty soon after three or four treatments they ask us when can we do this," Gene Craven of Life Care of Escondido said.

It's 79-year-old Alejandro Gallegos' turn to take the mound. Up and out of a wheelchair, Alejandro is recovering from a lower leg amputation.

"Alejandro had a hard time. He wasn't too happy about things. He stayed in his room, now he comes out more and every time he sees it he just lights up," occupational therapist Rachel Solis-Hoover said.

Wii is working to help Alejandro grow stronger one Fountain of Youth fastball at a time.

"It's like when he was young. He feels strong, he feels good," Solis-Hoover said.

We want to wish Alejandro a happy birthday today and wish him well as he works his way towards a prosthetic leg.

The Care Digest Volume 2 Issue 2

The Care Digest Vol 2 Issue 2 (6-26-08) - Upload a Document to Scribd

Read this document on Scribd: The Care Digest Vol 2 Issue 2 (6-26-08)

Molly the Amazing Amputee Pony

LSU School of Veterinary Medicine Performed Rare Surgery on Hurricane Survivor Pony
Just north of New Orleans, in the quiet community of St. Rose, Louisiana, Kaye Harris provides a haven for small ponies. She takes them to birthday parties and celebratory events throughout the south, making a business and a life for herself and her horses.

But as it did for many residents in the New Orleans area, Hurricane Katrina changed all of that. In spite of her own trials, Harris ventured out in the days following the storm and effectively turned her small farm – "Pony Paradise" – into a rescue facility for a number of animals in need of shelter.

In the months following Hurricanes Katrina and Rita, Kaye Harris returned home one day to find her rescued pony, Molly, being attacked by a rescued pit bull. Molly’s wounds were extensive and, for a time, Harris seriously doubted whether the 15-year-old, gray, Pony of the Americas would survive at all.

"The dog had shown no signs of aggression at all and had been with us for some time," Harris said. "I was absolutely shocked."

After contacting her local veterinarian, Dr. Allison Denny-Barca, the two immediately worked to save Molly. Her wounds were grave. Lacerations were found on her head and neck, across her abdomen, and down to the bone on her leg. Over time, all of her wounds healed except the ones on her right front leg. It became apparent that the lower part of the limb had lost its blood supply and was severely compromised.

After contacting Dr. Rustin Moore, director of the Equine Health Studies Program at the LSU School of Veterinary Medicine, Harris and Barca brought Molly in for evaluation and consideration as a candidate for surgery. It would be a surgery that LSU veterinarians had never performed on a horse – amputation and the fitting of a prosthetic leg.

"Amputation is not commonly done on a horse or pony," said Moore. "The main reason is that adult horses are not very good at living on three legs because the opposite leg of the one missing usually fails."

Considering the wounds the right foreleg had sustained, it was the only option remaining. On January 16, Molly’s right front leg was amputated just below the knee. Initially, LSU doctors fitted her with a cast that included a built-in temporary prosthetic. As the hours passed, Molly continually rested herself, alternating sides and agreeably undergoing each evaluation.

"She made it obvious she understood she was in trouble," said Moore. "Her relatively small size and her attitude, intelligence, and courage were the biggest factors that led us to believe that, for this type of procedure, she was as ideal a candidate as we could ever hope for. The other important factor is having a truly committed owner who is dedicated to providing the daily care required for Molly."

As LSU surgeons worked to rid Molly of infection, Barca was busy trying to locate a company that could build Molly a permanent prosthetic. She and Harris contacted Dwayne Mara, Clinical Perfusionist with Bayou Orthotic and Prosthetic Center in New Orleans, Louisiana.

Molly was one of his first clients when the business relocated and reopened following the storm. She was also his first equine client.

"I was overwhelmed; I really didn’t know what to think," said Mara, who had designed artificial limbs for people for eight years but had no experience with horses. After developing Molly’s first permanent prosthetic, however, he was so captivated by his experience that he is currently crafting the fourth rendition of her new artificial leg, each one continually increasing in fit and comfort.

"Every time I see her, knowing she’s walking and getting around, I just love it. I’m really interested in it and really more than I thought I would be," Mara said.

Molly walked out of surgery on a temporary cast. By the time she received the first edition of her permanent prosthesis on Valentine’s Day, she was moving about, even jogging occasionally and cantering as if she had no disability at all.

"The prosthetic device is amazing. Even without it, Molly does really well, but the prosthetic has given her a whole new life,” said Barca. “And she asks for it. She’s amazing. She will put her little limb out and come to you and let you know that she wants you to put it on. Sometimes she wants you to take it off, too."

Currently, Molly spends her days at Pony Paradise and visits Barca’s stable regularly on the Mississippi River levee for a physical check up and minor prosthetic adjustments.

"While out on the levee, she usually doesn’t try to get away from me," Barca said. "But occasionally she will drag your butt down the levee ... she’ll tow you! It can be pretty bad when you can’t catch a three-legged horse."

As Molly’s condition continues to progress, she has been able to continue her influence as an ambassador to children who have had life-altering illnesses or injuries themselves. Molly has begun to make visitations to children’s hospitals as a therapeutic friend to offer hope and comfort, and to continue to inspire those around her.

"To me, she is a symbol of New Orleans. You know, if you ask me, New Orleans had its leg chopped off, but it can survive," said Harris. "Maybe we’ll need a prosthetic for New Orleans for a while but you know what, we can survive. That is the spirit of New Orleans, and this city can come back. Molly has come back, and she’s going on to bigger and better things. She’s not back to normal; she’s gonna be better."

Amputee Coalition of America Calls for Prosthetic Parity

From O&P Business News, Online Exclusive
April 15, 2008

In the face of drastically reduced health insurance coverage for prosthetic care, the Amputee Coalition of America (ACA), a national non-profit educational and advocacy organization representing amputees, is calling for federal legislation requiring health insurance companies to cover prosthetic care on par with other essential medical care.

A bill creating the Prosthetic Parity Act, HR 5615, has been introduced in the House. The bill was authored by Rep. Robert Andrews (D-NJ), with Reps. George Miller (D-CA), Todd Platts (R-PA), Mario Diaz-Balart (R-FL), and Lincoln Diaz-Balart (R-FL) signing on as original co-sponsors.

“The introduction in the House of Representatives of the Prosthetic Parity Act is a tremendous positive development. Many of the two million amputees in the United States are deprived of meaningful coverage for prosthetic care by their health insurers, which potentially places a greater burden on society. This proposed legislation would require health insurers to cover prosthetic care on par with their coverage of other essential medical care,” said Paddy Rossbach, president and chief executive officer of the ACA.

“Increasingly we’ve seen health insurers drastically limit coverage for prosthetic care by imposing unrealistically low dollar caps and restrictions, even limiting coverage to one prosthesis per lifetime,” Rossbach added. “Federal legislation is needed to close the insurance coverage gap.”

There are an estimated two million individuals living with limb differences or loss in the United States, including 70,000 under the age of 18.

According to a recent poll by the ACA, among respondents with private health insurance, 24% had experienced a reduction in prosthetic coverage over the past three years. Four percent had their coverage eliminated entirely.

“For less than 25 cents per month in health insurance premiums, amputees will get the care they need to get back to work and live independent, productive lives. The cost to the health care system if this is not done far exceeds that of providing prosthetic care, and places a huge burden on society,” Rossbach concluded.

Prosthetic Parity Hearings a Huge Success!

Members of the Limb Loss Coalition and amputees from across the great state of Missouri showed up in Jefferson City Tuesday to support the Prosthetic Parity Bill before House and Senate Committees. Representing P&O Care were Jon Wilson, Clinical Director, Mark Woodson, Director of Fabrication, Bill McLellan, Director of Sales, and Suzi Schumacher, a young working amputee and active member of the Coalition.

Around 2:00 p.m., four witnesses testified before the Senate Small Business and Insurance Committee, chaired by Senator Lowden. Dr. John Rush, Medical Director for Hanger Orthopedic and a national expert on prosthetic parity, flew in to testify on many of the more technical issues. Then Mark Wilson, President of Prosthetic and Orthotic Design, Inc., in St. Louis testified that as a small business owner, he was not given the option of purchasing health insurance that did not include ridiculously low caps on prosthetic coverage. Next, Jeff Damerral, Chairman of the Missouri Coalition for People with Limb Loss, testified about his personal experience loosing both his legs below the knee to meningitis while a freshman at Truman State University. Damerral said that while he had good insurance through his father at the time, he is fighting for everyone who doesn't. Now that he is on his own and working as a lawyer for a small firm, Damerral must pay approximately $16,000 every 3-5 years to have his two legs replaced.

Finally, AK amputee and Secretary of the Coalition Jean Freeman brought the whole room to the verge of tears, telling how caps on her prosthetic coverage force her to hope that the various parts of her prosthesis don't wear out at once. "As an amputee, I am being discriminated against," she said.

Several registered lobbyists for the insurance companies spoke briefly against the bill, saying they opposed prosthetic parity for the same reason they have always opposed every other "mandate" the state has passed, such as those insuring coverage for mental health, women's health screenings, and wigs for children with cancer. They believe on principle that policies should be able to exclude coverage for any condition, provided that policy can be sold to a customer or employer. On being questioned by Senator Day, one gentleman did not know that some plans include once-in-a-lifetime clauses for prosthetic devices. "Do you mean that a person is expected to wear the same leg at 18 months as 18 years?" she asked incredulously. "I'll have to get back to you with that information," he replied.

The hearing in the House of Representatives began around 7:00 p.m., and since it was after business hours, many more supporters showed up. The bill sponsor, Rep. Dr. Wayne Cooper, introduced it to the committee, and Dr. Rush, Jeff, and Jean testified again. This time Jon Wilson, Clinical Director of Prosthetic and Orthotic Care, Inc., represented the state's prosthetists. "Surgeons often ask me to speak with patients before they loose their limbs, often to convince them that it's worth an amputation to save their life. I tell them I can help them walk again," Wilson said. "But later, when they're ready for the prosthesis, I have to be the one to tell them that their insurance won't pay for it. When they need health insurance the most, it isn't there."

Wrapping things up was Bill Brannan. He told how good health insurance has enabled him to live a productive life for ten years since he lost his leg at age 65; but he also told about meeting a young mother in a grocery store, juggling her kids and her cart and trying to get along in a wheelchair because her husband's insurance would not pay for her to get a prosthesis. The fine individuals who had to get up and represent the insurance companies after Bill sat down seemed like they were just going through the motions, stating rather plainly that they always oppose mandates, even inexpensive ones that seem to make all the sense in the world like ours does.

The representatives seemed to understand our case, and members from both parties told us the hearing had gone extremely well. It's always dangerous to get over confident, but here is what Dr. Rush thought comparing the parity effort in Missouri with other states where he has testified: he said that whereas elsewhere most of the real work gets done behind the scenes and hearings are just window dressing, we could have actually won our case in one day on hearings alone! We'll wait and see just where things go from here.

Video of Above-Knee (AK) Amputation

This video is not for the faint of heart--and on the other hand, probably not that interesting for those just looking to be shocked--but it should give amputees and others who work with them a better picture of what they go through under the knife.

Arm Amputee offers Inside Look at Life without His Limb

Here is an excellent blogger who has posted stories about his experience loosing his arm, waiting on it to heal, and then getting fit with an upper-extremity prosthesis. You can even watch a slide show of his arm through the healing process, but I warn you: it is not for the squeamish.

Below you can read his own welcome:

Welcome to my blog, here you can read about my life after I lost my left hand in a near fatal accident whilst paragliding in Colombia, (South America), back in February 2006. You can read about the accident in one of my first posts here, and see how I've recovered by checking out the posts under the recovery category. As is normal for blogs everything is in reverse chronological order, so go the bottom if you want to read in time order.

I try and post about once a week on things I experience in life, some related to being an amputee and others not. I've also started to do some product reviews of things I've found useful when you only have one hand. You can see details of my coverage in the media, something that started with an article in the San Francisco Chronicle. I hope you find your reading enjoyable, interesting and perhaps informative. Please leave a comment on a post or two, it's always nice to hear from people that have come to visit.

How Media Shapes the Way the World Sees Amputees

Jeniffer Hoydicz has an excellent article in the newest issue of O&P Business News that looks at images of amputation in the media, particularly Hollywood. Here are some of her fascinating conclusions, interacting with Raphael Raphael, MA, a professor of film studies at the University of Oregon, and David Serlin, PhD, associate professor of communication and science studies at the University of California at San Diego.

This will hopefully pique your interest in the whole article.

“The disabled body seems to be perceived as a challenge to … independence and self-sufficiency, especially challenging our – largely mythological – notions of masculinity,” he said.

To overcome these perceptions, the public needs to be challenged to evaluate its own prejudices and value systems, Serlin explained. Additionally, more attention needs to be paid to “ordinary” people with amputations rather than individuals who are often identified critically as “super crips” by the disability rights advocates.

“Why does someone have to exhibit super abilities in order to be recognized as productive or ‘normal’? That I think is frustrating,” Serlin said. “Part of the goal for those within the disability rights community or people who work with orthotics or prosthetics organizations should be able to make non-disabled people aware that disability can be an ordinary phenomenon that does not define who a person is. People who use prosthetic devices or deal with amputation should not have to be superheroes in order to get respect.”