Friday, July 28, 2017

Dealing with Scoliosis – Caroline’s Story

Scoliosis is an abnormality of the spine that includes a curvature to the side. It occurs most often during the growth spurt just before puberty. Many curvatures resolve on their own, but some progress throughout the growth period and more severe cases may require a brace or even surgery to correct the problem.

We talked to Anne Ewald, whose daughter, Caroline, is a Powell patient undergoing treatment for scoliosis.

“Caroline was diagnosed in 2015, when she was going for her 10th annual checkup with the general practitioner,” Anne recalls. “When she did the typical ‘bend over and touch your toes’ test, the doctor noticed a curve and suggested we get her checked. At that time, she had a mild ‘S Curve’ with a 16-degree curve on top and a 14-degree curve on the bottom. The doctor advised us to come back in four months for a recheck.”

By early 2016, “The top curvature had increased to 21 degrees and the bottom to 16,” Anne continued. “At that point, there had been a 5-degree increase within that short time period, so a brace was prescribed. The physician suggested she start wearing a brace because of her young age and the speed of the progression of curvature.”

After a consultation with Powell, Caroline soon started wearing the Scoliosis TLSO (Thoracic-Lumbar-Sacral Orthosis), sometimes referred to as the Boston Brace. It manages the progression of scoliosis by bending the spine at specific locations. This brace is made by taking over 25 anatomical measurements and using x-rays as well as a CAD/CAM system to accurately place “unbending moments” in brace. It is then made of a flexible, yet rigid lightweight plastic.

Caroline was told that she needed to wear the TLSO brace full time, while she was both awake and asleep. “We were stunned by that,” admitted Anne. “We were thinking that at most, she’d just wear it to bed, so that part was a little shocking.”

Luckily, Anne stated that Caroline is a very even-keeled child – and very practical. “In Caroline’s head,” said Anne, “She’s getting a curve in her spine, so she needs to wear the brace – that’s that.” Anne admitted that even though Caroline wasn’t happy about it, she knew it’s what she needed to do. “It took a little getting used to,” Anne said, “probably more on my end than hers.”

Helping her stay active

Caroline is a gymnast – not exactly something you would think could be continued while wearing a rigid brace for scoliosis treatment. Anne was pleasantly surprised to learn that wasn’t the case.

“Caroline is a competitive gymnast, and we were concerned that she would not be able to continue,” said Anne. “We were so thrilled when the doctor encouraged her to continue gymnastics, and gave her permission to remove the brace during practice.” Anne said the physician explained that gymnastics improves core strength and core strength helps to support the back, and they encouraged physical activity throughout treatment.

Caroline took the treatment well. “Initially, she was wearing the brace probably 20 to 22 hours a day. She was very concerned about making sure it was helping and having it on,” Anne said. “She really adjusted to it crazy quickly.” Anne believes that Caroline’s gymnastics training helped her agility and because of that the brace didn’t inhibit her in any kind of physical activities.

The TLSO is frequently a two-piece plastic clamshell design (it may be a single piece that opens in the front or rear) that extends from the pelvis to just below the collarbones. Anne described the brace “like a hard cast that she gets in sideways, and it circles her body and in the back, there are three Velcro straps that you pull to make it tight around her, like a hard-shell corset …

“It took us awhile to get used to the change in clothing, but most people did not notice that she was wearing the brace.”

Anne said the staff a Powell was especially helpful during Caroline’s treatment. “They have definitely made a difference – by helping us become accustomed to having the back brace there, and being so super nice, friendly and helpful.” Anne mentioned Beth Martin, who designed Caroline’s brace, by saying “Any time we had a question, she was like ‘come on in, we’ll have a chat.’ She was great and still is to this day.”

Anne continued: “They were very encouraging to me, and made Caroline feel like she was normal and this was just a small bump in the road.”

Today, Caroline’s spinal top curve has diminished, but the bottom curve is still being treated. She has graduated from the TLSO brace into a Charleston Bending Brace that she wears at night. “We’re keeping our fingers crossed that it does its job and hoping that we’ll go back in six months and the doctor says ‘It’s better.’”

To learn more about scoliosis braces, please contact us at 804-649-9043.

Tuesday, July 11, 2017

Mentoring a Key to Prosthetic Success

Experiencing an amputation and considering a prosthesis can be an emotionally draining and financially confusing experience.
While prosthetic devices help to get back to life, it helps to have someone to talk to every step of the way.
That’s why Powell offers a mentoring program for both orthotic and prosthetic patients to understand the process from someone who has already worked with Powell.
“We feel education plays a vital role to facilitate positive patient outcomes and progress patients toward community re-entry and independence,” says Joe Sullivan, owner of Powell Orthotics and Prosthetics and himself an amputee. “Our first meeting with the patient could be one of the most important. That meeting should be personable and informative and help to contribute to a more positive outcome.”
Powell’s mentoring program also coordinates an introduction between two similar patients based on ability, disability or disease to help them understand and more quickly adapt to their new situation.
“I encourage physicians to consider early intervention, even pre-surgical, to prepare the patient for what to expect,” Joe says. “Some patients may have an amputation and sit there for three weeks until they’re ready for the prosthetic device. It’s incredibly helpful to be able to have someone to talk to about different levels of amputation, about activities and even what it’s like to deal with insurance.”
Knowing another amputee to talk to is essential, he adds.
“A lot of amputees go through the stages of denial at first,” Joe says. “We help them through that. It’s going to occur. It’s normal to go through that. Having someone to ask questions like how to drive, how to shower and the best way to sleep is so important. Once they get their device they’ll have questions.”
Joe himself offers a treasure trove of advice. He’s the only amputee Certified Prosthetist in Richmond offering mentoring to amputees using his life experiences coupled with over 20 years of experience in the prosthetics field.
He became an amputee at the age of six months due to cancer. He can explain to kids what it’s like to grow up with a prosthetic device. As a retired Paralympian, he can offer advice on how to train and remain active.
“With the mentoring program you get a little of everything depending on your activity and goals,” Joe says. “It’s all about helping people maximize their abilities and putting them on an equal playing field.”
Along with Joe, all of Powell’s mentors are certified through the Amputee Coalition of America.

If you are a new patient interested in being connected to a mentor, or you are an existing patient who would like to join our mentoring, please contact us and ask for, or email our Community Liaison.

Thursday, June 29, 2017

Stay dry and clean this summer

The summer heat and humidity – not to mention the lure of the beach – can wreak havoc for amputees.

“Sweating is the biggest thing, especially in a hot and humid area like Richmond and particularly when you’re active or in the sand and salt water,” says Joe Sullivan, owner of Powell Orthotics and Prosthetics and himself an amputee and Paralympic volleyball champion. “So staying dry and clean is especially important.”
While gel liners typically help to protect your skin from friction, a little extra TLC is needed to keep prosthetics – and yourself -- clean in the sweltering summer. Joe offers some tips:

  • When cleaning your liner, stay away from anti-bacterial soaps or those with dyes or perfumes. Use mild soap instead to combat bacteria that builds up on the gel liners, especially when the gel gets wet. Gel liners take the brunt of sweat, sealing off skin pores. Gel liners take the brunt of sweat, sealing off skin pores. Be sure to clean you liner daily.

  • Wipe gel liner with rubbing alcohol once a week. While soap takes care of the effects of perspiration on your liner, wiping gel liners will reduce bacteria to keep your skin healthier.

  • Wear the right socks. In the summer most people retain fluids due to humidity, which can lead to reduction of socks. However, those who are active in the summer may need more socks because your leg or arm can shrink. See what's best for you.

  • Going into the ocean is OK as long as you take precautions afterward. Carbon-fiber and titanium devices do fine in salt water but salt will corrode aluminum. Be sure to rinse well after a dip in the ocean, preferably soaking your device in a pool or bathtub shortly after.

  • Clean your device daily and lay it down to dry, using your second prosthetic in the meantime.

"Amputees are going to live their lives and they don't slow down for the heat of the summer," Joe says. "Just know how to care for your prosthetic so it lasts longer."