Jim Adderson, program manager for assistive technology, checks in with six-year-old Drayden Sweeney, who was born with an absent shin bone and affected foot.
Photo Essay: Behind the scenes of Orthotics and Prosthetics
The mobility centre is a simulated real life environment. “The best learning method is ‘tell me, show me and let me try",
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Drayden Sweeney
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Catherine McPhail
Prosthetist Catherine McPhail has created a plaster mould from Drayden’s affected leg, which will be used to create a clear plastic socket. After trial of the clear diagnostic socket, a permanent one is made.
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Don Locke
Prosthetists and technicians work together to get the right fit and function for each patient. In this case, Catherine teams up with her husband, Don Locke, a prosthetic technician, to fabricate the clear diagnostic socket. Don selects the thermal plastic that will be used to create the socket. The plastic is heated and is then vacuum-sealed around the plaster mould.
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Don - Unique Cases
The diagnostic socket allows the clinician to load areas that can tolerate pressure and unload pressure where they cannot. Don says working with such a collaborative team provides great results for patients. “Because we have so many unique cases, it helps to get different perspectives from people to come up with new solutions. As both a technician and an amputee, I really feel that the team oriented approach gives you the best patient experience.”
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Catherine & Drayden
Catherine began working with Drayden around his first birthday, as he began to pull up to stand and cruise furniture. “You work so closely with patients and families that you get pretty attached. That relationship really helps give a better understanding of what the patient needs and what will work best for them,” Catherine said. Here we see her fitting the clear diagnostic socket that Don fabricated and marking it for adjustments. Patients often have prosthetics for different activities. For example, Drayden also has a swimming prosthesis that he uses for water activities.
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Don & Drayden
Both Don and Drayden are sporting stylish camo-prints on their prostheses. Drayden brainstorms ideas for his next print design. In the past, he’s had Lightening McQueen, Toy Story and Spiderman.
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Stuart Grandy
Stuart Grandy, prosthetic technician, adds a print to the plastic that will be used to create a corrective helmet. The helmet is used to treat plagiocephaly, which is a deformation of the bones of the skull that produces a characteristic assymetrically shaped head.
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Greg Baker & Stuart Grandy
Greg Baker, orthotic technician, assists Stuart as they drape the heated and now pliable plastic over the mould of the child’s head. The plastic begins to cool within 20 to 30 seconds, so four hands are better than two when quick work and precision are needed.
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Stuart - New Helment
Stuart shows off the newly-formed helmet. After some initial adjustments, a clinician will meet with the patient for fitting.
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Geoff Smith
“An orthosis is simply a brace for any part of the body,” explains Geoff Smith, orthotic technician. When fabricating an orthosis, the technician receives measurements and information about specific reinforcements that need to be included. The technician can also assist with making adjustments once the clinician has had an initial fitting with the patient.
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Darlene Jollimore
Darlene Jollimore, Orthotist, trims the edges of a customized lower leg orthosis to maximize comfort and function.
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Thomas Black
Thomas Black, orthotist, uses a torch to heat the plastic edges of an Ankle/Foot orthosis to fine tune the custom fit. “Each brace is completely different depending on the patient’s age and diagnosis, so it’s a very customized process.”
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Greg - Third Generation
Greg is a third generation orthotic technician, following in the footsteps of his father and grandfather. Here, he presents an old brace that would have been used for a polio patient. While metal and leather braces are still used, plastic braces are increasingly popular.
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Darlene with Patricia Mazier
Darlene checks the fit of an ankle foot orthosis on Patricia Mazier. Patricia experiences stiffness and ankle rolling as a result of a stroke she experienced 15 years ago. The brace allows her to be mobile by correcting the foot’s position and offering stability. “I find that going for a walk in the afternoon is a great way to feel refreshed and clear my head, but I couldn’t do that without the brace,” Patricia explains. “Darlene is very meticulous, so she makes sure we have the fit just right before she’ll let me go.”
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Sonya Vardy
Sonya Vardy underwent an above knee amputation in May 2013 due to bone tumors and chronic infection. After 24 years of pain and surgeries, the amputation has meant improved mobility and quality of life to Sonya. “For me, this was hope that I could get back to my life,” she said. “Everyone here is so friendly and accommodating and there’s a very family-centered feel. The team here really anticipates the little things that will make the process easier, like taking the time to answer my husband’s questions and explaining things to both of us. It feels like we’re part of their team, and that our feelings and insights are really listened to and part of this process.”
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Sonya & Kim Parker
Sonya has a gait analysis with rehabilitation engineer, Kim Parker. The gait-right is a carpet that records a person’s footsteps - almost like foot prints in sand. This gives a quick, objective measure of walking speed, as well as insight into where the patient is putting their weight and even a sense of their balance.
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Jenny Billet
Jenny Billet, orthotic resident, is sealing a fibreglass cast in order to fill it up with plaster to make a positive mould. Jenny has completed the academic portion of her training and will work under supervision for two years before writing her board exams. “I always knew I wanted to work in health care, and I was really attracted to the combination of art and science that you get with orthotics and prosthetics. It’s also a nice blend of technical work and patient care. I like that you get to take the time to let a patient open up and tell their story.”
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Dillon MacMillon
Dillon MacMillon, a patient with a spinal cord injury, is having custom braces fabricated for him after using a trial pair. “The exercises we’ve been doing have increased my upper body strength enough that I was able to look into getting braces,” Dillon explains. While braces aren’t practical for Dillon’s every day use, they’ll be great for exercise purposes and special occasions, Jenny says. Dillon, who will be starting a welding program at NSCC in the fall, says he’ll be the first person in a wheelchair to enroll in the program.
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Liz Sepic
Liz Sepic, prosthetic and orthotic technician, works with two layers of leather to create a custom moulded leather protector with padding built inside. “Each patient we’ve encountered has different needs associated with their day-to-day activities, so a one-size-fits-all approach does not work,” Liz explains. “Our goal is to achieve the lightest, strongest, most comfortable product for the patient, keeping in mind their particular risks and needs.”
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Andrew Hoar
Andrew Hoar, pedorthist, spends half of his time in the leg ulcer clinic and the other half here in the workshop. Andrew is a fifth generation orthopedic shoe manufacturer, and is one of the few master shoemakers still practicing, as the process becomes more industrialized. “Since foot wounds are caused by pressure, a large part of what I do is pressure offloading,” he explains. “Once the wounds heal, I can build or modify footwear to prevent further issues.” A significant portion of Andrew’s patients are diabetic, with wounds that could lead to amputation.
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Deborah Stewart
Deborah Stewart, occupational therapy assistant, is responsible for monitoring the inventory of wheelchairs as well as programming those that are motorized. Wheelchairs that aren’t needed are donated or broken down for recycling and repurposing of parts. “We have a great relationship with Easter Seals and Red Cross, so we know which sizes they need and which they already have,” she explains. “If we can’t donate them, we take them apart, recycle the metal and keep any reusable parts.”
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Owen Wright
Owen Wright, wheelchair technician, tests each item to make sure it’s working order and assembles chairs from parts according to specific requests from occupational therapists. "The wheelchairs are customized every step of the way, from the seat cushion needs to power model and size,” explains Stewart.
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Mobility Centre
The mobility centre is a simulated real life environment that includes potholes, corners, curbs, stairs, gravel, sand and a crash mat, which allows patients to try different terrains and scenarios safely while adjusting to a wheelchair. Team members are also encouraged to try these different environments and take place in workshops that allow them to better facilitate learning for patients. “The best learning method in this case is ‘tell me, show me, and let me try,’ so it’s important that those teaching are able to do that,” Deborah explains.