Jan 8 - Walking at last

08:00
I slept well, and am ready to get my prosthesis today :-)
First coffee and an egg.
The Prosthesis company just called to remind me to bring a left shoe to match the right shoe.
I slept in the silicone liner which is not normal, but we want the stump as shrunk as possible. He made everything assuming the stump will shrink more in the next few weeks.
I quickly removed the liner, and washed everything with water only, then put the liner back on.

--
18:30
A long, tiring, wonderful, day.
I arrived at the prosthetic place just before 10:00. We went into the training room. It has a set of parallel bars bolted to the floor, and quite a few roll around chairs.
There was Bradley, the prosthetic fundi, and his Serbian assistant, and through out the session different people that work there came in to watch. They say that working there is good because they change so many lives for the better. Lots of job satisfaction.
Bradley is amazing. If you ask any prosthetic related question, he doesn't just know the answer, he is actually an expert on that topic. Cool Dude. He has run 4 Comrades Marathons and I have run 2 so we have something in common.

First was to try on the socket. Bradley didn't like the strength of the plastic socket, so he wrapped a layer of fiberglass around it. He assembled the leg, and put on the foot, silicon fake foot cover, then a kevlar sock, then my shoe.
Shoes are important because the angle of the foot is quite important. A shoe with a higher heel will change the locking dynamics of the knee. Bradley said that after a week or so he will show me how to do the different adjustments for different shoes. Most prosthetic people just have one pair of shoes, so they don't have to adjust the knee so often.

He showed me how to put the socket on. It takes almost my full body weight to force the stump into the socket. He sprayed a lubricant inside the socket before trying it on. We rested the socket bottom on a box, so it was the right height, then I pushed down hard. He then tried to pull it of. No way would that socket budge on the stump. As the stump went into the socket, it pushed out all the air, forming a strong vacuum between the stump and the socket. My silicone liner has a movable ring that acts like a one way valve. It lets air out of the socket, but won't let any air in.
The only way to get the socket off the stump is to let air in. There is a small push button on the side of the socket to let air in. When you press that button the air whooshes in and the feeling inside the socket is funny. The whole stump shrinks in a second.

You can see the push button vacuum release.

I had with me my small video camera (like a cheap GoPro). It usually lives in the front of my bicycle in the states. Now I set it up to show me when I walk. Most of the video is the back of Bradley's head :-) I took a total of 2 gigs of video. It is a good thing, because I have a record of everything Bradley talked about during the 3 hours of instruction.

Next Bradley attached the rest of the leg to the socket.
Now we worked on standing straight, and getting the pelvis level. He then took the leg and adjusted the pylon length, and other things, then brought back the leg, and we adjusted it again and again. Finally I could stand up straight.

Standing on my own two feet. First time for 77 days.

My amputation operation was on 23 October. Now was 8 January. 77 days.

This knee has different modes. In the normal walking mode, the leg is never locked straight. I must use muscles to keep the leg from collapsing. When the weigh is on the heel AND the knee is all the way straight, it is a very tiny bit over center, and therefore "locked"..
Try this at home. Stand with your back to a wall, and your heels against the wall. Now push one heel back hard against the wall. Hold the pressure. I bet that is a muscle you seldom have used. That force is what keeps the leg from collapsing. I would find that a difficult action to NEVER forget. Like if I am standing and a pretty girl walks past, my concentration would wander, and the knee would collapse.

Now I worked on shifting weight between legs. Then I worked on the action to break the leg stance. If I have the knee hard in a straight "locked" position, and weight on the heel, it is actually very strong, and does not give. If I relax, or move the knee forward, then either the weight comes off the heel, or the leg gets over center and collapses. These are two separate actions, with two very different results.

With a straight leg, and weight on the heel, the leg is locked. If weight shifts off the heel onto the toe, ( like your good leg has just moved forward.) then the leg thinks you are walking and it swings back, then forward with little resistance. Hopefully the leg swings far enough forward to have the heel strike the ground and now if you pull back on the knee, the leg will lock. Just before you put weight on it. Lots to do in a short time.

Again...With a straight leg, and weight on the heel, the leg is locked. if the knee is pushed forward while weight is still on the heel, then the leg gives a slow collapse. Maybe 2 seconds. The knee thinks you are sitting down in a chair, and it lowers you into a sitting position. This is also handy if you stumble. It give a slow descent to the ground, and maybe even time to catch your self.

The different adjustments take some getting used to. He let me play around and some felt bad. I decided that A4 was the best setting. It turns out that he sets beginners at A3. I am set at A3.

I did a lot of back and forth on the parallel bars, then we walked out to the main lounge and up and down the halls We went into the one office to practice on carpet. When we were all done and leaving I did something wrong and fell. Riaan caught me. He said my heel caught the carpet and the toe came down and released the leg. Scary. I did not like having the knee collapse on me.

Bradley gave me some of the solution to put on the socket before putting it onto the stump. I'll buy some this weekend. Then we went out to the car and he showed me how to get in and out.
 I then drove home. At home I walked a bit, but I was tired. There was little food in the house, so I went to the local shop.
I tried pushing a trolley around, but that was a disaster because my swing forward on the prosthesis kept hitting the trolley and not extending so I could get the heel down to lock the knee.
I asked for a cashier lady to help me. She was very nice. I was using crutches in case I fell. I was doing very good, then the lady asked which margarine I wanted, and I looked and the knee collapsed. I caught myself with my crutches. Scary.
Then we went to the yogurt area, and she asked me what yogurt I wanted. I was checking prices, and the knee collapsed.
Then we walked far over to the deli and I bought some pizza slices. The lady behind the counter asked me which ones I wanted. I looked, and the knee collapsed.
I have to stay concentrating on the forces required to keep the knee locked. A small distraction and the knee collapses.
So I think tomorrow will be a day of trying to get confidence in the knee.
To be honest, the whole prosthesis thing right now feels like a party trick. "Hey guys! Watch this." And I walk 10 meters.
But It seems impractical till the locking becomes second nature and instinctive.
--