New Upper Limb Prosthetic Resource for OTs

The fifth edition of  Introduction to Orthotics, by Brenda Coppard, PhD, and Helene Lohman, MA, OTD, OTR/L has just been published by Elsevier. Chapter 20 (co-authored by me; thank you to Shawn Swanson Johnson for recommending me to this project) features upper limb prosthetic technology with resources relevant to training, controls, and functional application.

Different by Design

Check out the Different by Design article in the inaugural edition of WNE! 

https://magazine.wne.edu/2018-winter/05-deb-latour.cfm

If you know me, I have nicknames for my different prostheses. For example, my body-powered prosthesis is "Wonder Woman"! Check out my prototype prosthesis... I covered the forearm and hand with ROCKTAPE. This covering is soft and gives a half-sleeve look.... hence the nickname "Tatoo".

TRS Topic- Debi Latour

TRS - Cutaneous Anchor with Debbie Latour

Is there equal reimbursement of prosthetic technology for individuals with congenital UL deficiency/difference vs. individuals with acquired loss?

And are all cases being treated equitably whether they are 'high-profile' and reported by the media vs the 'average' human being who lives life under the radar?

Well, these are loaded questions. -And deserve 'weigh-in' from my peers in the prosthetic industry as well as my clinical peers and my peers who are fellow consumers.

For starters, let's consider some factors that might heat up the discussion:

1. average life expectancy;

2. benefit of prosthesis use;

3. impact of overuse to the [alleged] intact upper limb;

4. benefit of the provision and use of diverse prosthetic technologies;

5. life span of these diverse prosthetic technologies;

6. cost of insurance (aren't we consumers of this as well?);

7. cost of advocacy;

8. should we even ponder the savings (profit?) accrued by the insurance 'providers'?;

9. are insurance companies truly 'providers' if they withhold reimbursement (how many prosthetic and rehabilitation companies have accounts receivable in excess of 120 days on previously approved devices and/or services? -or have gone out of business because of this?)?

10. are insurance companies truly 'providers' if they are not providing access to such technology?

Let's get this discussion going! I would love to receive your thoughts and will share my own as well.... Stay tuned!!!!

                                     (credit: Rhymes with Orange)

The fight continues: Amputee Coalition update!

The Amputee Coalition is happy to report that the public meeting last week about the recent Medicare proposal on lower limb prosthetics was a great success!
We are thankful to all of the individuals who spoke out against the recent proposal. Those in attendance and on the phone communicated effective, passionate, personal stories and experiences to express their opposition to the draft proposal and without the support of the many amputees and professionals who participated, we wouldn’t have had the impact that we did to show Medicare the depth and breadth of the opposition to their proposal.
After the Medicare Contractors (DME MACs) were forced to expand the meeting space to accommodate the huge number of people that registered, amputees and their families filled the meeting room. In addition, prosthetists, physicians, physical and occupational therapists, and others provided vital comments in opposition to the proposal to ensure their patients are able to receive access to appropriate prosthetic care.
Dan Berschinski, chairman of the board for the Amputee Coalition, presented our serious concerns with the proposal and encouraged the DME MACs to rescind the proposal and make significant changes in accordance with our formal comments.
It was inspiring to see so many members of the limb loss community come together to share their concerns and make sure amputees’ voices were heard. The comments made by the speakers at the hearing overwhelmingly centered on the issues that were identified by the Amputee Coalition shortly after the draft proposal was published:

• Proposed changes to patient functional levels:
  • Concern about eliminating potential in determining an amputee’s functional level
  • Concern that assistive devices like crutches, canes and wheelchairs would automatically limit an amputee’s functional status
  • Concern that amputees would be required to attain a “natural gait” in order to get a prosthetic device
• Proposed changes to the rehab process for new amputees:
  • Concern that the proposal would make new amputees rehab on out-of-date technology before being able to receive an appropriate prosthetic device
• Proposed changes that would limit foot and ankle options for patients
• Proposed changes that would eliminate elevated vacuum socket systems for all amputees
• Proposed changes that could make it more difficult to receive a custom fabricated liner

With more than 400 attendees on the teleconference, and a packed room, this was one of the largest attended public comment meetings in recent memory.  This is a testament to how seriously the limb loss community takes this issue and how powerful we are as a community.  We made the point that prosthetic devices are not a luxury and amputees must be able to receive the most appropriate device at the most appropriate time.
After the conclusion of the public hearing, a special meeting was organized by Sharon Lewis, senior disability policy advisor to the secretary of Health and Human Services (HHS) and Administration for Community Living (ACL). Susan Stout (president & CEO), and Jack Richmond (board chair-elect) represented the Amputee Coalition at the meeting. In addition, representatives from AOPA, the Academy, and the O&P Alliance attended to express concerns about the proposal with those at the meeting. From the government, those in attendance included Acting CMS (Centers for Medicare/Medicaid Services) Administrator Andy Slavitt, CMS Deputy Administrator Patrick Conway and Senior HHS Counselor Kevin Thurm. Acting Administrator Slavitt acknowledged that the concerns of the group had been heard loud and clear, and that our views would most assuredly be taken into consideration by CMS. He invited representatives of the groups in attendance to submit further comments about the proposal and provided a mechanism to deliver them directly to the medical director of CMS.
Even with the success of the meeting, it is still vital that everyone submits formal comments to the DME MACs about the concerns you have with this issue by the August 31 deadline. Use the Amputee Coalition’s prepared letter, or create your own and send it to: DAMC_Draft_LCD_Comments@anthem.com.

Want to Learn? Check out this important webinar

The best consumers are informed consumers. Whether you are a clinician, a consumer, a caregiver, or even a citizen, you should be informed! Please check out this very important opportunity... it might just impact your life.
And then get involved, Take a stand about this issue and consider becoming active in the Amputee Coalition.

Attend the Amputee Coalition Webinar on Medicare's Proposed Changes to Amputee Care on Wednesday, August 19, 2015 at 1pm EDT.

The Amputee Coalition invites you to attend this important Webinar to find out more about Medicare’s proposed changes to covering prosthetic care and learn about what you can do to help ensure amputees continue to receive the most appropriate device for their needs. This presentation will last approximately 45 minutes, and will be followed by an open Question & Answer session to address any additional questions that you may have on this issue. If you are not able to attend the Webinar on Wednesday, August 19, 2015, it will be posted on our Web site after the conclusion. Register now! After registering, you will receive a confirmation email containing information about joining the Webinar. View System Requirements We hope that you will join us to discuss this important topic.

A Call to Action: We Need to Enact Change...

Dear All;

As you know, I am an occupational therapist specializing in upper limb prosthetic rehabilitation and in single-handed strategies for those who do not use this technology. I am also a consumer; I have a congenital upper limb deficiency. I have worn and used a prosthesis since I was 14 months of age; at the current age of 59 years, I continue to enjoy the opportunity to wear and use this technology. I truly believe that it has made a difference in my life. Am I able to complete activities without a prosthesis? Yes; but with great cost... cost to efficiency, energy, body integrity, social comfort and even quality of life. Is a prosthesis necessary for all amputees? Maybe not; however we deserve the opportunities to have the choice and to access the technology if desired or needed. These opportunities are currently under threat.

A new proposed coverage policy for lower limb prostheses drafted by Medicare’s contractors has raised significant alarms across the community because of the extremely negative impact it would have on amputees, with some stating it would set prosthetic patient care back four decades to a 1970s standard of care. 

 

As drafted, the proposed Medicare coverage policy could limit and delay access to prosthetics for people with limb loss.

 

Right now the government is listening while the draft policy is in a formal 45-day comment period. This comment period ends at the close of business on August 31, 2015. That’s why now is the time to speak up about concerns.

 

The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has initiated a petition to the White House to completely rescind the draft policy.  The petition needs to reach 100,000 signatures by the end of August to go to the Obama Administration for comment – a critical step to ensure the highest level of government pays attention to this issue.

I urge you, as a consumer, a clinician, a caregiver, a citizen to become involved and to advocate for better services.

 

To sign the petition, please visit:  

https://petitions.whitehouse.gov/petition/rescind-medicare-proposal-restricting-access-prosthetic-limbs-and-returning-amputees-1970s-standards-care. 

 

Immediate steps are being taken across the community to rally with one voice, and every one of us can be a part of this.  Please share this with friends and family and ask for their support!

 

To learn more about this proposal, watch this video at http://www.naaop.org/vid.asp?name=webcast_august-2015.mp4 and visit The Amputee Coalition’s Grassroots Advocacy Center at http://www.amputee-coalition.org/advocacy-awareness/federal-issues/medicare-issue-alert/

 

I thank you for your support!

Single-Handed Solutions...

So, what do you think???!!!

This is my logo for my blog and my company! Can you tell what it is? Right!

It's my handprint and my residual limb print...

I love that my limb print makes a bit of a swirl... it reminds me of the creative thought process! Creativity, clinical reasoning and client-centered care is what I invest in the endeavors of Single-Handed Solutions!



Stand-Up or Skate Paddling, Anyone???

Are you interested in learning something new this year? Come on; it's the start of a new year! This sport is relatively new. It's conditioning and fun! -Even I want to try it! This company and it's message caught my attention. They have a multi-fold vision and a benevolent mission.  Read on, check out their website- http://skatepaddlesports.com and perhaps consider the crowd-funding opportunity.

Skate Paddle Sports is more than fun and fitness…it’s about changing the WORLD! Starting in our little corner of it – Imperial Beach, CA. Once we realized we were on to something – revolutionizing skate boarding for everyone with an amazing skate paddle – then it was only natural for us to figure out how this skate paddle can create jobs and economic development in our little town of 26,000 people in the 91932, just south of the city of San Diego, and feet from the border of Mexico. We can honestly say…

Our Skate Paddles and Boards WILL BE MADE IN THE USA…barely!

We are also uniquely situated near some of the toughest training sites for the Navy and Marines. We see Wounded Warriors everyday, and are excited to have created prosthetic paddles to allow amputees everywhere the opportunity to have fun too!

Our mission also includes using our profits to build sustainable orphanages in Tijuana, Baja California, Mexico, then working south! Not only sheltering the children who are homeless and live on the streets of Tijuana, but also uncovering and fostering their God-given talents so that they may build up the next generation of Mexico. Our mission really is about changing the world…

Are you in? Do YOU want to help?

Thank you and God Bless!

Footprints Adventures!

 This site was just forwarded to me: what a cool opportunity!!!  Check it out!

http://www.footprintsadventures.org/

 

I was wondering if you know of anyone ages 17-25 who would be interested in our 7 day Young Adult Program?  It is August 6-12 and is $500.  We do have both full ride and partial scholarships for this program.  I thought I would check and see if you know of anyone that would be interested.  

--

Footprints Adventures mission is to promote self-advocacy, personal-reflection, self-confidence, among teens with limb differences and limb loss; and to challenge them to set new physical goals through fun and adventurous activities.

Or simply… FUN EMPOWERING ADVENTURES

Texting and Driving

http://www.youtube.com/watch?v=UzqVFlXDCoIhttp://www.youtube.com/watch?v=UzqVFlXDCoI

 

Check out this movie, "BRAKE"... And share with all you know.... please.

Compelling and true.

I know that I won't be texting and driving.

As many of you know, I am an OT providing  prosthetic rehabilitation services to consumers. This story just came to my attention.... Please read on and be  sure to check out the link:
"This 6 yr old boy was born without part of his arm. He told Santa that he wanted an XBox and fingers to play it. A family friend started fundraising for a prosthetic arm for him because the parents' insurance will not cover a prosthetic arm for the little boy because it is not medically necessary. A little boy doesn't need an arm?Anyway, I thought, well, it is Christmas time. Miracles happen. Maybe someone can help... somehow...Thank you. xo"
http://www.myfoxny.com/story/24198927/long-island-boy-asks-santa-for-prosthetic-arm-and-xbox

Shame on the insurance companies.... and the reviewer who relays this sentiment. How despicable. The argument of the reviewer is that the responsibility of the provider is to prove that the (prosthetic) device(s) requested are medically necessary and that they did not likely submit such necessary evidence. -It is always the fault or the responsibility of someone else. It does not matter that the parents of this child, or any other consumer paying into an insurance policy for that matter; have been paying/contributing to that policy as stakeholders. Talk about being held hostage! We are required to have insurance, to pay into it; yet it provides little to nothing relative to our prosthetic needs. And what has happened to the basics of common sense, not to mention compassion for fellow human beings???? Are we so stupid or so callous that we cannot see the benefits of assistive technology... we have to prove the medical necessity, when the beneficial functional necessity is  apparent?
Please tell me that someone is going to come to their senses and assist ALL of the Christophers of the world...

Last Man Standing...

I would like to share a link to the story of an amazing young man. His website will encourage you;
 please check it out at http://www.nicknewell.tv/ And by the way, Nick fought last night.... and won.
 -No surprise to those of us who are overcomers and positivity-thinkers!

Kudos, Nick! You rock!!

Have I mentioned to you how much I love the articles in Fast Company? Thankfully, I have a brother-in-law who appreciates it as well and shares very cool articles with me.... Here's one that is an amazing and worthy read.... Enjoy! -And thank you John!
www.fastcompany.com/3014622/how-to-be-a-success-at-everything/meet-the-17-year-old-who-created-a-brain-powered-prosthetic-arm

Out on a Limb

You may be interested in this project! Please check this out ....

OUT ON A LIMB is a documentary about advances in prosthetics for amputees and their transformative impact on so many lives. It won the “BEST DOCUMENTARY AWARD” at the 2013 Boston International Film Festival. Please forward to your friends and colleagues.

 

This coming fall, to coincide with Veteran’s Day, the documentary will debut on KRCB, a PBS-member station -- and we have been offered national distribution by NETA, the National Educational Telecommunications Association, which specializes in the distributuion of one-of-a-kind documentaries to 350 public television stations across the country. This is a huge audience!  But we need a little more help.

 

There are many expenses in accepting this offer from NETA, and we’re happy to say some foundations and companies have already come in as Underwriters of the Program.  We just need a little more – and we just have another few weeks -- to make it over the hump. That’s why we've just launched a Crowd-Funding Campaign. Check it out at:

http://igg.me/at/out-on-a-limb-Broadcast/

 

But we’re not just asking, we’re giving too. You can receive “PERKS” such as the OUT ON A LIMB DVD with 30 Bonus Minutes of Stories and Interviews. What’s more, your donations are Tax-Deductible-- because OUT ON A LIMB is fiscally sponsored by the International Documentary Association, a 501(c)(3) nonprofit organization.

 

For more information about OUT ON A LIMB, visit www.outonalimbdocumentary.com

If you have questions, please contact Daria Price at: OutonaLimb68@gmail.com

 

 "Out On A Limb is a compelling look at the evolution of prosthetics and the exciting advancements being made in the prosthetics field at the intersection of neuroscience, engineering, and robotics. This is an inspiring and informative chronicle of human spirit and ingenuity.”  Stan Marvin, KRCB, Director of Broadcast

“A compelling documentary, Out On A Limb explores the incredible advances being made in the field of prosthetics and shows their potential impact on so many lives-- from the thousands of amputees wounded in wars to the millions of civilians at risk from such common diseases as diabetes” 

Peter Rosenstein, Exec. Director, American Academy of Orthotists & Prosthetists

Greetings from AC National Conference!

Today we arrived in Orlando, FL for the National Conference of the Amputee Coalition. This will be a well-attended event, with resources, courses, vendors, and loads of activities for attendees. The event opened today with peer mentoring seminars, an instructional semiar for therapists and meetings. The conference is being held at the Renaissance Orlando Sea World. -It's a beautiful venue with friendly accommodating staff. Speaking of accommodating, the hotel has pools and hot tubs.... all equipped with lifts to make these amenities accessible. Poolside this afternoon, I enjoyed the comraderie and networking. It's not too late to register for this conference, which runs through Sunday. The exhibit hall  opens Thursday at 5:30 p.m. -I will be found there through Saturday helping at the Handsprng/POA table. -Please come by and say 'hello'!    

 

 

http://www.amputee-coalition.org

 

Inventing a Life

I hope that you will enjoy this publication; please read the article on consumer-inspired and -developed prosthetic technology. I'm sure that you will recognize a familiar name or two! -And please contact me if you have questions about my harness-less body-powered technology!

 

http://www.amputee-coalition.org/inmotion_online/inmotion-23-03-web/index.html#/1/

 

 

Check this out!

Newly crowned Miss Iowa hopes to advocate for people with disabilities

By Mike Krumboltz | The Upbeat – 5 hrs ago

•  

Miss Iowa Nicole Kelly (MissIowa.com)

Nicole Kelly, the newly crowned Miss Iowa, plans to use her title to help advocate for people with disabilities, reports the DesMoines Register.
Kelly, 23, was born without her left forearm, according to her biography at MissIowa.com (note: site has been intermittently down). Photos can be viewed at the Miss Iowa Facebook page.
After winning the title, Kelly spoke with CBS-4 News. "It was shocking and overwhelming—just like that your life changes," she said.
"As I grew up I learned to counterbalance the initial stares I received from people with an outgoing personality that would not give into 'no,'" Kelly wrote on the pageant site. "This means that I tried everything. From baseball, to dance, to diving—there's nothing I would not try. I found my passion within a world where I was giving people permission to stare: the stage."
According to Kelly's biography, she's currently studying directing and theater management at the University of Nebraska at Lincoln. She hopes to work on Broadway.
"If you would have told me a year ago that 'pageant queen' was in my future I would have laughed," she wrote. "Giving voice to a platform is a great honor and I am excited to continue my adventure of speaking out and touching lives."
Kelly will compete in the Miss America pageant on Sept. 15 in Atlantic City, N.J.