Cancer is a terrifying diagnosis for anyone to receive. A million thoughts race through your mind as you try process what you just heard. In 2008, when Steve learned that he had stage 1 colon cancer, he had a plan. Take care of it via surgery. The surgery, at first, seemed to be a success, but a little over a year later, Steve began having pain in his shoulder. Doctors soon learned that, the colon cancer had traveled all the way up Steve's body and reappeared as a mass on his shoulder and spots on his lungs. This absolutely stunned the medical professionals. Steve suddenly went from having Stage 1 cancer to having Stage IV terminal cancer. He then began a 6 ½ year journey of chemo treatments and surgeries, and while there were marked improvements in some areas, the cancer was stubborn and was not able to be fully eradicated. Finally when the cancer started manifesting on his skin and moving to the bones of his shoulder, Steve was faced with a difficult decision. The best chance and hope he had to be cancer-free would be to amputate his entire arm and shoulder (what is known as a forequarter amputation).

"It was very devastating when I first heard it." Steve went and got a second and then a third opinion, and the doctor's all said basically the same thing. If Steve wanted the best chance to be cancer-free, then amputation was really his only option. One of the conversations that helped to put Steve at ease was with a nurse practitioner named Levi that Steve knew well. Levi sat down with Steve and Steve's wife and had a very open and honest conversation with Steve. Levi happened to be about the age of Steve's oldest son, and as Steve tells it, "He [Levi] just sat down and talked to me like I was his dad and he was my son. I had known him long enough that I trusted his sincerity, and he told me 'You only have about a 5% chance of being here [survival of cancer] right now, and now you have a shot at being cancer-free, to me, it is a no brainer.'" This helped to put Steve's mind at ease, and he made the decision to move forward with the amputation surgery.

After researching his options about what different types of prostheses were available, Steve ran across some information about an innovative new surgical procedure called TMR (Targeted Muscle Re-Innervation). This procedure held the promise and potential of allowing Steve to use a myo-electric prosthesis. Through further research, he also learned that there was a doctor locally (at OSU) who performed this surgery, Dr. Ian Valerio.  This path was an answer to his prayers and the starting point for Steve's new journey.  Steve had the TMR surgery, and soon after, was cleared to begin the fitting process for his prosthesis.

Steve's prosthesis is designed to pick up on the electrical signals from the nerves and muscles of Steve's residual pectoral muscle. He uses contractions in his muscle to trigger his prosthetic elbow, wrist, and hand. None of us will ever forget the look of utter amazement and joy on Steve's face when he tried on his prosthesis for the first time fully hooked up (all electrodes connected). He stared incredulously as he was able to make his arm move with just muscle contractions. He was so happy he even laughed out loud when he saw his new wrist do a 360 degree turn. As time has gone on, the electrical signals from his TMR procedure will continue to get stronger and stronger as the brain and body recover and the newly "re-wired" sections of nerve and muscle learn their new functions. It is truly absolutely amazing.

Throughout Steve's incredible journey, he has learned so much about himself and about life in general. "Your views about the things in life that you thought were important before, maybe in your youth or even in your middle aged years, changes. What it really boils down to is faith, family, and friends. Those three things have gotten me through all of this. If you are going through a cancer battle like I was, you learn that you must get up in the morning and put one foot in front of the other no matter what. No matter how tired you are, no matter how sick you feel, you have to get up and get yourself out of bed and keep moving forward. Take little steps, but never stop. And always realize that it is ok to have down moments sometimes, but never ever stay there.  That is where your faith, your family, and your friends come in. They can help you."  

Steve addressed one of the common concerns that amputees face when out and about in public, people staring. He offers this unique perspective, "I do wish that people (and I do catch people glancing over or staring at me), when they make eye contact with me after I 'caught' them staring, wouldn't look away in embarrassment. I wish that they would just give me a quick smile." This small gesture of acknowledgment and support goes a long way and turns an awkward moment into one of mutual encouragement.

 

We are truly thankful and genuinely enjoy working with Steve, and we are so incredibly proud of the progress he has made. Steve also, is so glad that he found Optimus. As he tells it, "I would absolutely recommend Optimus. Believe it or not, I did look around because I could choose places where I wanted to go [for prosthetic care]. I appreciated everybody here [at Optimus] immediately. Everybody listens intently to me. What was offered here was something that was not offered other places with regards to advanced types of electronic prosthetics. That was a big deal to me and will always be a big deal to me. I enjoy how positive everybody was right from the very beginning. Taking the time to ask me, 'What do you really want to do [my goals]?' That level of focus on me and my care gave me hope."

We could not have said it better ourselves. At Optimus, our passion, what drives us each and every day, is getting our patients back to living their lives and accomplishing their goals by providing compassionate care and superior solutions. 

 

Several columns in the past have talked about the pelvic driver series. It's a great way to teach proper prosthetic weight shifting and establish or re-establish the body's ability to control the center of mass (which is their trunk), over the base of support (which is their feet).  But sometimes they struggle to use their pelvis correctly with the drivers and other drills, so this month we are going to discuss the concept of the pelvic bucket.

 

 

First, I like to find out if the patient even knows what their pelvis is. You would be surprised how many people don't have any idea what their pelvis is or where it is found. I will show pictures or use a model to help educate them. Once the patient understands what a pelvis is and where it is located, I tell them:   "Imagine that I have a bucket full of water (I hold my hands out in front holding the imaginary bucket of water). Now in a couple of seconds I am going to hand you the bucket of water and I want you to keep it level and don't spill any of it. If you tilt the bucket of water forward you will spill the water out of the front, if you tilt the bucket of water backward you will spill the water out of the back, if you tilt the bucket of water sideways you will spill the water out of the side and so on. When I hand you this imaginary bucket of water, you are to place it inside your pelvis. Now hold the bucket of water still with your pelvis and don't spill any water out of it." Another benefit of this is they now have a good position to establish their neutral spine position.

 

 

Another tip that I learned long ago at an awesome continuing education course is "the blue marble." Have the patient imagine or visualize a blue marble in the middle or center of that pelvic bucket. To help the patient find their blue marble, tell them, "I want you to use your finger and find your belly button. Now drop your finger about 2 inches and in the middle is your blue marble." The purpose of this is so the patient can get an idea of their center of mass which will help with balance.