Curious About Prosthetics

PODCAST 237: CURIOUS ABOUT PROSTHETICS

RELEASE DATE: SUNDAY, APRIL 16TH, 2023

D:  HELLO, AND WELCOME BACK TO THE CURIOUS KID PODCAST.  SINCE ALL OF OUR EPISODE TOPICS COME FROM LISTENER SUGGESTIONS, WE FEEL LIKE WE KNOW OUR LISTENERS PRETTY WELL.  ONE THING OUR LISTENERS ARE SUPER CURIOUS ABOUT, SECOND ONLY TO ANIMALS, IS THE HUMAN BODY AND HOW IT WORKS.  IT’S ONLY APRIL, AND WE’VE ALREADY LEARNED ABOUT MUSCLES AND BELLY BUTTONS THIS YEAR.  WHEN IT COMES TO OUR BODIES, ALL OF US ARE UNIQUE AND BEAUTIFUL.  IF YOU THINK ABOUT IT, IT’S OUR DIFFERENCES THAT MAKE US SO INTERESTING.  CAN YOU IMAGINE IF EVERYONE IN THE ENTIRE WORLD LOOKED EXACTLY LIKE YOU WITH NO DIFFERENCES WHATSOEVER?  THAT MIGHT SOUND LIKE FUN AT FIRST, BUT IT WOULD PROBABLY BE SO BORING.  THE DIFFERENCES BETWEEN US ARE WHAT ALLOW EACH OF US TO GO THROUGH LIFE WITH DIFFERENT EXPERIENCES, ALLOWING ALL OF US TO LEAVE OUR MARK ON THE WORLD IN A DIFFERENT WAY.  TODAY, WE ARE GOING TO LEARN ABOUT PEOPLE THAT HAVE BODIES THAT ARE SLIGHTLY DIFFERENT THAN MOST, BUT THOSE DIFFERENCES HELP THEM EXPERIENCE THE WORLD IN A SPECIAL WAY, THANKS TO A LITTLE HELP FROM SOMETHING CALLED PROSTHETICS.

O:  DOUBLE-MAILBAG!

D:  DOUBLE-MAILBAG!

“HELLOOOOOOOO!  THIS IS JUNIPER, AGE 5, FROM SEATTLE, WASHINGTON.  I HAVE TWO SUGGESTIONS FOR PODCAST EPISODES.  FIRST, PLEASE GET CURIOUS ABOUT CURIOUS KID PODCAST.  WHY DID YOU CREATE THE PODCAST AND WHY DO YOU WANT TO GET CURIOUS ABOUT EVERYTHING?  SECOND, I AM CURIOUS ABOUT PROSTHETIC LIMBS.  WHAT KIND OF PROSTHETICS CAN PEOPLE GET?  WHAT ARE THEY MADE OF?  KEEP UP THE GREAT WORK.

-JUNIPER AND HER MOM”

“HI OLIVIA AND JACOB!  I’M AVA FROM SAN ANTONIO, TEXAS.  CAN YOU PLEASE GET CURIOUS ABOUT PROSTHETICS?  I LOOOOOOOOOOOOOOOOOVE (WITH 17 “O”S) YOUR PODCAST!  THANK YOU.

-FROM AVA”

O:  WOWIE.  THOSE WERE TWO AMAZING EMAILS.  WE CAN’T WAIT TO LEARN A TON ABOUT PROSTHETICS THIS WEEK FOR JUNIPER AND AVA.  

D:  THERE IS SO MUCH TO LEARN, AND WE ARE VERY LUCKY TO HAVE A SPECIAL GUEST THAT WILL BE JOINING US IN JUST A COUPLE OF MINUTES.  HER NAME IS LINDSEY, AND SHE WORKS CLOSELY WITH PEOPLE THAT HAVE LIMB LOSS AND LIMB DIFFERENCE.

O:  WHEN WE TALK ABOUT LIMBS, WE ARE TALKING ABOUT PARTS OF THE BODY, MOSTLY ARMS AND LEGS.  THERE ARE MANY PEOPLE THAT HAVE LIMB LOSS, MEANING THAT THEY DON’T HAVE ALL OR PART OF A LIMB OR LIMBS, OR LIMB DIFFERENCE, WHICH MEANS THAT THEIR LIMBS ARE A BIT DIFFERENT.  

D:  LIMB LOSS AND LIMB DIFFERENCE ACTUALLY IMPACTS MILLIONS OF PEOPLE AROUND THE WORLD.  IT CAN OCCUR BECAUSE SOMEONE MAY BE BORN WITH LIMB LOSS OR LIMB DIFFERENCE, OR THERE MAY BE AN ACCIDENT OR DISEASE THAT RESULTS IN LIMB LOSS OR LIMB DIFFERENCE.  THOSE WITHOUT THE NORMAL USE OF THEIR ARMS AND LEGS CAN STRUGGLE TO DO EVERY DAY ACTIVITIES THAT MANY OF US TAKE FOR GRANTED.

O:  FOR MANY YEARS, THE OPTIONS FOR PEOPLE WITH LIMB LOSS AND LIMB DIFFERENCE WERE LIMITED.  THANKFULLY, THERE ARE LOTS OF OPTIONS AVAILABLE TODAY, INCLUDING THE USE OF ADVANCED PROSTHETICS.  

D:  A PROSTHETIC DEVICE IS SOMETHING THAT TAKES PLACE OF A MISSING OR DIFFERENT LIMB, AND OFTEN HELPS PLAY THE SAME ROLE AS THAT LIMB.  

O:  THE WORD PROSTHETIC COMES FROM GREEK.  WHEN TRANSLATED TO ENGLISH, IT MEANS “ADDITION”.  THAT DEFINITION TOTALLY MAKES SENSE.  

D:  THERE IS EVIDENCE OF PROSTHETICS BEING USED AS MANY AS 3,000 YEARS AGO, ALTHOUGH PROSTHETICS BACK THEN WERE VERY DIFFERENT THAN THE AMAZING PROSTHETIC DEVICES BEING USED TODAY.  OLIVIA, WHAT’S THE QUESTION OF THE WEEK?

O:  THE QUESTION OF THE WEEK IS, THE EARLIEST EVIDENCE OF A PROSTHETIC WAS FOUND ON AN EGYPTIAN MUMMY.  THE PROSTHETIC WAS MADE OF LEATHER AND WOOD.  CAN YOU GUESS WHICH BODY PART THE PROSTHETIC WAS USED TO REPLACE?

D:  WHILE YOU’RE THINKING OF THE ANSWER, LET’S LEARN A BIT MORE ABOUT THE HISTORY OF PROSTHETICS.  IN ANCIENT ROME, THERE ARE ACCOUNTS OF WARRIORS WHO USED PROSTHETICS MADE OF IRON AND WOOD TO MAKE ARTIFICIAL ARMS AND LEGS.

O:  EVEN THOUGH PROSTHETICS WERE BEING USED THOUSANDS OF YEARS AGO, THEY WERE BASICALLY USED FOR COSMETIC REASONS ONLY.  IN OTHER WORDS, THEY WOULD SIMPLY REPLACE A MISSING LIMB, BUT THEY WEREN’T ABLE TO PROVIDE ANY OF THE FUNCTION OF THAT MISSING LIMB.  

D:  THAT ALL CHANGED, STARTING IN THE 1500’S, WITH THE FRENCH RENAISSANCE.  THAT’S WHEN PROSTHETICS BECAME FOR FUNCTIONAL.  AMBROISE PARE, WHO WAS A FRENCH SURGEON, MADE PROSTHETICS WITH HARNESSES AND KNEE LOCK CONTROLS SO THAT THEY FUNCTIONED MORE LIKE ACTUAL LIMBS.  HE ALSO USED MATERIALS THAT WERE LIGHTER AND SOFTER, SUCH AS LEATHER AND PAPER, LEADING TO MORE COMFORT AS WELL.  HE EVEN MADE OCULAR PROSTHESES, CREATING ARTIFICIAL EYES USING THINGS LIKE GLASS, PORCELAIN, GOLD, AND SILVER.  

O:  I WANT TO TELL EVERYONE ABOUT THE AMAZING STORY OF JAMES EDWARD HANGER.  HE WAS BORN IN VIRGINIA IN 1843, AND HE WAS STUDYING ENGINEERING IN COLLEGE WHEN THE CIVIL WAR STARTED.  HE WAS SERIOUSLY INJURED IN THE OPENING DAYS OF THE CIVIL WAR WHEN HE WAS HIT IN THE LEFT LEG BY A SIX POUND BALL THAT MAKE IMPACT CLOSE TO HIS KNEE.  THE INJURY WAS SO BAD THAT THE SURGEONS THAT WERE TREATING HIM THOUGHT THAT AN AMPUTATION WAS NECESSARY.  AN AMPUTATION IS WHEN A LIMB IS REMOVED BY SURGERY.  THE SURGEONS REMOVED JAMES EDWARD HANGER’S LEFT LEG STARTING AT SEVEN INCHES BELOW THE HIP BONE.  AT THE TIME, PROSTHETICS WERE VERY EXPENSIVE, THEY WERE EXTREMELY UNCOMFORTABLE, AND THEY OFTEN DIDN’T HELP PERFORM TASKS ANY EASIER.  HE FELT HELPLESS WHEN HE SAID THESE WORDS:

D:  “I CANNOT LOOK BACK UPON THOSE DAYS IN THE HOSPITAL WITHOUT A SHUDDER.  NO ONE CAN KNOW WHAT SUCH A LOSS MEANS UNLESS HE HAS SUFFERED A SIMILAR CATASTROPHE.  IN THE TWINKLING OF AN EYE, LIFE’S FONDEST HOPES SEEMED DEAD.  I WAS THE PREY OF DESPAIR.  WHAT COULD THE WORLD HOLD FOR A MAIMED, CRIPPLED MAN?”

O:  HANGER TRIED HARD TO FIND A JOB, BUT DIDN’T HAVE SUCCESS.  HE TRIED TO BECOME A JEWELER AND A TEACHER, BUT NOTHING STUCK.  HE WAS GIVEN A PROSTHETIC AFTER HIS INJURY, BUT IT WAS PAINFUL AND USELESS.  WITH HIS KNOWLEDGE OF ENGINEERING, HE DECIDED THAT HE SHOULD DO SOMETHING ABOUT THE SAD STATE OF PROSTHETICS AT THE TIME.  HE CREATED A BETTER PROSTHETIC LIMB USING OAK BARREL STAVES, BUMPERS MADE OF RUBBER, AND NAILS.  HIS PROSTHETIC, CALLED THE “HANGER LIMB”, WAS ABLE TO BEND AT THE KNEE AND AT THE ANKLE.  HE OPENED A STORE IN VIRGINIA WITH HIS BROTHER, SELLING PROSTHETICS TO OTHER SOLDIERS WOUNDED DURING THE CIVIL WAR.  IN ADDITION TO BEING MORE FUNCTIONAL THAN  PREVIOUS PROSTHETICS, THE “HANGER LIMB” WAS AFFORDABLE FOR MANY, COSTING ANYWHERE FROM $150 TO $200 PER LIMB.  HANGER’S PROSTHETIC COMPANY GREW IN THE YEARS FOLLOWING THE CIVIL WAR, TO MAJOR CITIES LIKE WASHINGTON D.C., ATLANTA, BALTIMORE, PHILADELPHIA, AND ST. LOUIS.  MANY YEARS AFTER THE CIVIL WAR, WHEN WORLD WAR ONE BROKE OUT, JAMES EDWARD HANGER TRAVELED TO EUROPE TO ASSIST WOUNDED SOLDIERS THERE AND OBSERVE HOW PROSTHETICS IN EUROPE COMPARED TO THOSE USED IN THE UNITED STATES.  MAKING THAT TRIP ALLOWED HIM TO GROW THE INFLUENCE OF HIS COMPANY OUTSIDE OF THE UNITED STATES, TO MAJOR CITIES LIKE LONDON AND PARIS.

D:  TODAY, HIS COMPANY HELPS MILLIONS OF PEOPLE ACROSS 900 LOCATIONS IN THE UNITED STATES AND MANY MORE WORLDWIDE.  WE ARE SO LUCKY TO HAVE LINDSEY, A CERTIFIED PROSTHETIC/ORTHOTIC CLINICIAN WITH HANGER CLINIC JOIN US TO ANSWER A FEW QUESTIONS.  OLIVIA, TAKE IT AWAY.

O:  LINDSEY, THANK YOU SO MUCH FOR JOINING US ON CURIOUS KID PODCAST.  CAN YOU TELL US A LITTLE ABOUT YOURSELF AND HOW YOU DECIDED TO GET INVOLVED WITH PROSTHETICS?

L:  My name is Lindsey Prasse, and I am a certified prosthetic/orthotic clinician with Hanger Clinic in the Philadelphia area. Every day people in the limb loss and limb difference community, and help determine how we can help them with their daily goals and activities. I became interested in prosthetics when I was in college and learned about the field during my time at a physical therapy clinic. I love interacting with the limb loss and limb difference community and helping them continue to live fulfilling lives. It is exciting to be a part of their journey and cheer them on as we help them navigate through something they may have not experienced before.

O:  WHAT IS LIMB LOSS?

L:  Important question Olivia. Some of the ways people may experience limb loss could be due to a disease (like cancer or diabetes) or an accident, and sometimes, people are born without a body part (such as an arm or a leg). Limb loss can occur in anything from a finger or toe, to an arm or leg, or even multiple body parts. There are more than 2 million people in the world who live with limb loss.

O:  WHAT IS A PROSTHETIC AND WHAT DOES A PROSTHETIC HELP YOU DO?

L:  A prosthetic is a device that provides support in place of a missing body part. Whether an arm or a leg, a prosthetic device helps a person do daily activities such as walking, opening a door, holding a fork, playing with legos and more! In my job as a clinician, I help by making sure the person gets fit with the best prosthetic device for what they like to do. I see patients in the office, at a hospital, or even at their house to provide services as they learn to use their prosthetic device. 

We work closely with surgeons, doctors and physical therapists as a team to help patients recover and use their prosthetic devices safely while doing things like eating, walking, and writing or driving. With the help of the prosthesis, some people also continue doing their favorite hobbies, like playing sports, hiking, swimming and running – there are even the Paralympics and professional teams for these athletes. You may notice that a kid who has a prosthetic device may do something a little differently than you, but that doesn’t make it wrong - especially if it allows them to continue playing with their friends and doing what they love! 

O:  HOW IS A PROSTHETIC DEVICE MADE?

L:  Great question Olivia. A prosthetic is made according to what body part a person is missing; How it looks and the material it’s made with can change depending on the person. Typically the first step for getting a prosthetic device is being measured for it. Measurements are taken with a tape measure and then a casting or scan is done to start making the mold for the prosthetic device. This mold allows us to have a copy of an arm or leg to help create the prosthesis. The mold is shaped to make sure it will be comfortable for the patient. For example with your arm or leg, you can sometimes feel pointy bones, so we make sure there isn’t pressure on those areas. 

Next, a clear socket is made that we can test with the patient to make sure they can move around comfortably with it – this test part is important so adjustments can be made before making the final prosthetic device. It’s similar to when we are trying on shoes and we pick the pair that fits best - not too tight, not too loose! Because the test socket is clear, it allows us to be able to see inside of the socket and how it fits. 

A fun part of creating a prosthetic device is that the patient gets to choose the pattern or color. Some people prefer it to match their skin color - others like to have their favorite color, sports team, super hero, cartoon character or even sparkles! Once the fitting appointments are complete and we have the right fit, the patient will take home the prosthesis and have training that teaches them how to use the device. Examples can include walking, using the stairs and doing things around the house, school, and their community. We continue to work with the patient and make sure they are happy with their prosthesis and able to do the things they want to in their life. As a patient uses their prosthetic device through the years, if a new one is needed or an update needs to be made, we can help with these changes. Sometimes we start working with a child who may need a prosthetic device and we support them as they grow up and need new, bigger prosthetic devices!

O:  CAN PROSTHETICS HELP ANIMALS?

L:  Yes Olivia, animals can also use prosthetic devices! You may have heard about a dolphin with a prosthetic tail named Winter. Winter was injured in 2005 after getting caught in a crab trap that resulted in the loss of her tail. Two clinicians I work with at Hanger Clinic helped make Winter’s prosthetic tails so she was able to keep swimming, and she wore them for over 15 years! There is a movie called Dolphin Tale you can watch that tells Winter’s story and shows how the prosthetic tail helped her.

O:  HOW DO DIFFERENCES MAKE US UNIQUE?

L:  Love your thought Olivia. Well today we have been talking about people with limb loss that can look different than us, and the prosthetic devices that help them move around a little differently than we do. As you said, differences make us each unique and special in our own way, which is wonderful! For example, someone without a leg may use a prosthetic to help them walk, someone who cannot hear may use sign language to communicate, and someone without their eyesight may use braille to read. They can still enjoy doing the same things you do, and may even show you a new way of playing or doing something. For example, someone with limb loss may learn to ride a bike differently, but they still enjoy being outside and riding with friends like you. 

Also, just as you may enjoy camp during summer vacation, there is a camp called Camp No Limits that takes place across the United States, where kids with limb loss and limb difference, and their families, go to enjoy all sorts of fun adventures like zip lining, rock climbing, kayaking, and swimming. There are other prosthetic clinicians like me at these camps that help to make sure the kids are safely learning how to take part in all these activities. There are a number of other groups, like Camp No Limits, that help show people with disabilities that they are able to participate in activities and sports just like everyone else. This helps build confidence and lets those with limb loss or other disabilities feel included in some of their favorite things!

D:  WOW, THAT WAS AMAZING.  A BIG THANKS TO LINDSEY FOR GIVING US A FEW MINUTES OF HER TIME TO ANSWER QUESTIONS ABOUT PROSTHETICS FOR US.  BEFORE WE SIGN OFF FOR THE WEEK, LET’S ANSWER THE QUESTION OF THE WEEK.  THE EARLIEST EVIDENCE OF PROSTHETICS WAS DISCOVERED ON A 3,000 YEAR OLD EGYPTIAN MUMMY.  WHICH BODY PART WAS THE PROSTHETIC DESIGNED TO REPLACE?

O:  IT WAS A PROSTHETIC TOE MADE OF WOOD AND LEATHER.  IN THE THOUSANDS OF YEARS SINCE, PROSTHETICS HAVE REALLY COME A LONG WAY, HELPING MILLIONS OF PEOPLE AROUND THE WORLD LIVE BETTER LIVES.  

D:  THE GREAT PEOPLE AT HANGER CLINIC AND CAMP NO LIMITS ARE HELPING TO MAKE SURE THAT PEOPLE LIVING WITH LIMB LOSS AND LIMB DIFFERENCE GET TO DO ANYTHING AND EVERYTHING.  

O:  I LOVE GOING TO CAMP EVERY SUMMER, SO I LOVE THE MISSION BEHIND CAMP NO LIMITS.  WE SHOULD SUPPORT THEM IN ANY WAY WE CAN.  

D:  WE ARE GOING TO SUPPORT THEM, AND WE’VE ALSO PROVIDED A LINK TO THE CAMP NO LIMITS WEBSITE IN OUR EPISODE NOTES.  YOU CAN CLICK ON THE LINK TO MAKE A DONATION TO CAMP NO LIMITS.  WELL, THAT’S A WRAP FOR THIS WEEK’S EPISODE.

O:  237 - PROSTHETICS.

D:  GREAT JOB OLIVIA, AND GREAT JOB JUNIPER AND AVA FOR A VERY SPECIAL EPISODE TOPIC SUGGESTION.  JOIN US NEXT WEEK, WHEN WE WILL GET CURIOUS ABOUT AXOLOTLS FOR LISTENERS IN ONTARIO, CANADA, MISSOURI, AND WASHINGTON.  AS ALWAYS, THANK YOU SO MUCH FOR LISTENING AND GETTING CURIOUS WITH US.