Diane Koepnick:  The Strength to Go On
Written by:  Diane Koepnick
I had been battling with an infection in my foot since September 2014.  In March, 2015, we thought it was all cleared up and went ahead with the first skin graft.  On Friday, April 24, 2015, I woke up from a very restless night.  My foot had been hurting all night.  My daughter came into my room after she woke up. I told her about it and so she looked at my foot.  Along the right side of my foot there was a place that looked like a bone was sticking out of my foot.  I honestly thought I had broken it again. (I previously had Charcot foot).   We decided to head to the emergency room.  I really didn't think it was anything more than a broken bone.

They took me right back to a room when we got there and within a couple of minutes; the doctor was in checking it out.  He looked at it....poked at it...messed with it....and then he looked at me and told me it wasn't a broken bone, but a puss pocket.  The infection evidently had not cleared up completely and was now coming out the side of my foot.  The doctor had me admitted and immediately started IV antibiotics.  I wasn't happy at all!!  I couldn't understand why this was all happening to me!  I was so sure that the infection had been cleared up!

I got up to my room and early in the afternoon my Orthopedic Doctor came up to see me.   He sat down and said that now was the time to make some important decisions.  I had two choices:
  1. He could "filet" my leg open from my knee down and pretty much start scraping to get all the infection he could out.  Then he would implant these little packets of antibiotics, sort of like a dishwasher packet, and leave those in there to slowly dissolve the antibiotics directly at the source.  If this is what we decided to do, there was no guarantee that he would get it all and I probably wouldn't be able to ever walk again.
  2. We could go to the operating room and he could amputate my leg.  He said he was pretty confident that it would be below the knee and he guaranteed me he would only take as much as he needed to.  I asked him if I had until Monday to make the decision and he told me "no".  He said that I had until the end of the day, because the infection was spreading.
He left my daughter and me to talk about the options.  I decided that the amputation was the thing to do.  I wanted my life back and this seemed the best way for that to happen.  So, I told the nurse and she called the doctor.  The surgery was scheduled for the next day, Saturday, April 25, 2015.  But, because of some mix ups with medication, my surgery had to be postponed until the following day. At 7:30 a.m. on Sunday, April 26, 2015, they wheeled me back to the surgery prep area.

I had no idea what was happening...what was going to happen or how I was going to survive!

My first glimpse of hope was a couple days after surgery when Aimee from Optimus Prosthetics stopped by to see me.  After spending some time talking and her answering some questions for me, she told me that she too was an amputee.  I had no idea!  You couldn't tell by how she walked.  I finally had some hope!
"Courage is not having the strength to go on; it is going on when you don't have the strength." -Theodore Roosevelt

It's been a long 2 ½ years and a lot of things have happened, but through it all, the people at Optimus have always been there for me.  I did some hard core therapy with Jim & Andrea and because of them can walk with no assistive devices...quite well actually.  Most people can't even tell that I have a prosthetic leg if I don't tell them.  I've had some other health problems to deal with along the way, but with each victory I get stronger and get another piece of my life back!  I'm not going to tell you that it's all sunshine & roses, 'cause it's not!  It's hard work and sometimes depression and sometimes loneliness and sometime s anger, but you can't let those things take root and fester!  You have to pick yourself back up and move on! 

My grandmother used to tell us, "can't never could do nothin'".  Well, that's very true!  You don't know what you can do until you do it!  Don't give up and if you get stuck, there are lots of people at Optimus that care and will be there to help you get back up and take the next step!  More importantly, we're there for each other.  If you need someone to just lend an ear or understand who you know has been there, ask someone at Optimus to hook you up with someone from the Peer Visit Program.

As Teddy Roosevelt once said, " Courage is not having the strength to go on; it is going on when you don't have the strength."

Steven Huff: Faith, Family, and Friends 

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. 
Physical  Therapy Quick Tips
Activities for Prosthetic Training
Residual Limb Extension Exercise
The goal of "Quick Tips" is to provide helpful information and be a resource for those individuals helping patients fit with prosthesis learn to use them correctly in order to enjoy a better quality of life as an amputee.
Andrea Kinsinger, PT


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.


Andrea Kinsinger, PT
Andrea Kinsinger  has been a licensed Physical Therapist  since 1986.  Andrea has worked with lower extremity amputee patients throughout her career. She enjoys offering her expertise, advice, and support throughout the patient's rehabilitation. Feel free to contact Andrea if she can assist you in any way at: akinsinger@optimusprosthetics.com.

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