Sept 15 2016 - New socket, Driving, Paralympics.

I spent yesterday at the prosthesis place. They built a new socket. It is a very complicated socket. Slit right down the front, and held closed tight with velcro. The velcro wasn't strong enough, so I added a big hose clamp also.

 The new socket is not as light as you would think with all the holes in it. The remaining part is thick and strong. It is made to be worn with a thick plastic fexible inner liner. Eventually the liner should be permanently attached to the socket.
One major problem we have now is that my skin sticks to the liner. Which is good to keep it on tight, but bad for putting it on. My stump pain is bad when pushing the stump down into anything. So if the liner and the socket are attached, then I would have to push very hard to slide the skin against the liner. That is what we are trying to avoid. Lubrication is a bad idea because then the stump would also slide out of the liner easily.
My previous liner was a flexible silicone sleeve that sort of lived on the stump, and was used to form a vacuum between the liner and the socket. As you can see, it would be hard to form a vacuum with all the holes in the new socket, so the vacuum is between my skin and the plastic liner, then the liner somehow attaches tightly to the socket.

This afternoon, I went for a short shopping walk in the local shop. I needed food. The whole apparatus was very uncomfortable. There was no pain, but the intense desire to remove the leg right there in the store was hard to resist. With no way to securely attach the liner to the socket, the liner was sometimes loose. In the store, reaching for garbage bags, the socket and leg fell off. The liner was still on tight, so I was able to put the socket back on. But it never got on tight enough again to walk on. It was like I had a crutch on my hip. I sort of shuffled the rest of the way through the store to the car. I didn't get some of the stuff I needed.

Tonight I am cutting pieces of foam to fit inside the socket to make it more comfortable

Bradley gave me many types, and thicknesses of foam.
The next big thing is to get the socket and liner to stay together. Some sort of clamp or snap, or something.
I don't see anyway to "not", put the liner on before inserting it into the socket.
My stump didn't pain me today, but right now it is not feeling very pleasant. It is funny to me to be so uncomfortable, without real pain. I fear it takes strain in ways, I hadn't thought about.
 But with all the problems, I was able to do my shopping on my own. A big step for me.

After a few days of playing with the foam to make the socket more comfortable, I think they will build a new socket similar to this one, but with extra thick carbon fiber where I now have the pads.
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The driving school collected me this morning at 04:45.
We went to the Traffic department test center. I was 12th in line. Before they opened at 08:00 there must have been 5 hundred people in the line.
I did my eye test, and then paid lots of money, and got a date to take the learners exam. 28 Sept at 10:00.
 I have 13 days to study. If I pass the learners exam, then the next day I will go and book a date for the driving test.
I talked to some of the guys there. One was going to take his driving test today...for the third time. He booked 3 weeks before. After his flunks, he had to re-book. Once was a wait of 5 weeks between tests. He first booked his learners test in mid June. 3 Months and 6 full days of testing. What a waste of human time.

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I have been watching the Paralympics. One of the largest Prosthetic makers "Otto Bock" does charitable emergency repairs of prosthetics at the Paralympics. So far this year:

Repairs by equipment
Wheelchairs: 2245
Prosthetics: 348
Orthotics: 134
Repairs by Sport
Athletics: 385
Wheelchair Basketball: 258
Wheelchair Tennis: 163
Powerlifting: 140
Swimming: 122
Total Games repairs so far: 2727

They talked about how the Paralympics is becoming all about technology, science, and electronics.

If a prosthesis becomes an essential part of who you are, then it would be part of what makes you, you. Biology alone will no longer define a human being.

Nerves transmit muscle signals at 119 meters per second.
Nerves transmit pain signals at a very slow .6 meters per second.
Nerves transmit touch signals at 76 meters per second.
What if you had a brain interface that detected a thought for a muscle movement, changed that signal into an electric signal, and sent that signal to a muscle via wires at almost the speed of light. You could have reflexes that are thousands of times faster than a normal human. Tennis anyone?

What if you had a system (like a SCUBA system re-breather) that could inject oxygenated blood cells directly into your blood stream. You could hold your breath for hours.

What if your artificial heart had a boost function to speed up the flow of blood throughout the body.

What if you had a helmet that could measure brain functions, and could generate these function. An athlete could then use this to stop pain signals. Professional football players would love that.

A fancy prosthetic electronic knee could evolve into a leg system...into a lower body system, into a complete body system. So a completely paralyzed person could be an athlete...or a super athlete.

 Now blind people "drive" to the shops in driver-less cars. Putting the same electronics on the head, could allow a blind person to walk to the store unaided.

Soon a blind, paralyzed person will be able to kick ass in ping pong.
Pure biological people will be severely disadvantaged in the near future.

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Sep 05-09 2016 - Pipe legs and Driving

Sept 05 2016
I have been trying to find a way of standing to do dishes, that does not entail balancing on one leg. I came up with a piece of PVC piping that my stump fits into, and I flared the top. You can laugh, :-) but I can stand for hours now.

I also have been working on designing a socket that allows for stump volume variations. By being able to vary the volume, I can keep it tight all the time. I built this.

Again, you can laugh, BUT,... it does not hurt. No Pain. Next is to get both together, and then make a way for the pipe not to fall off when I take a step.

Online I found a socket that looks like it would work, but they want house prices for these things.

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Sep 06 2016
I went to the prosthetic place today. I told Bradley (my prosthesist) That I want a pain free walking leg by the end of the month. We discussed many, many options.
He made another cast to make another socket. It should be ready by Friday.
We plan on making this socket like a normal solid socket, but without an end on it, so the bottom is open, and also put a slit down the side, and use clamps to tighten it on tight.
I think the best clamps/straps will be similar to ski boot bindings.

My stump pain seems to be increasing, not decreasing. I think the stump is shrinking in length, which put all the muscles, scars, and skin at the end more forceful against the bone end.
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Sep 08 2016
I spent a few hours with the surgeon today. He thinks we might somehow "pull" the stump end to stretch the muscles and skin to relieve some of the force on the end of the bone.
We need to think on that.

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Sep 09 2016
I'm just back from a few hours with Bradley, the prosthesist. We tried on the new socket. It is similar to the old , hard sockets, but is split down the side to allow adjusting it's volume.
He left the bottom end closed, but wide enough that the stump never touches the bottom part. That way we can still apply a vacuum to the bottom of the stump if needed.
The socket was very tight at the top, and floppy at the bottom. Just like it should be. It caused no pain. He had made this one out of very transparent plastic, to allow seeing where it is tight and where loose by noting skin color.
Hopefully I'll walk away on the new socket next Wednesday.

This whole cancer/amputation thing has resulted in me staying away from Texas for so long that my Texas drivers licence is expiring. It will be cheaper for me to get a South African license, than to travel to the states to get a new Texas one.
I now get to experience the South African bureaucracy first hand. 100% bureaucratic bullshit. It should take a month or two. depending on how many times I flunk the driving test. Without bribing, it usually take a few flunks. Flunks pump up the stats for the inspectors to prove how hard they work, and how many tests they have to do each month.
I just chatted with a lady that flunked her driving test 7 times. Seven is a lot even for South Africa. Three seems to be about average.
I have to first get a learners permit, then I can apply to take the driving test.
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I just had coffee with a friend at a local restaurant. It was nice to get out and interact a bit.

I have been looking at the paralympics. I look at all the people competing, and find someone worse off than me. Then I look more, and find someone worse off than that person.  Then look some more, and find someone even worse off than that person. It seems there is always someone worse off than someone else. Which I guess really means that I am MUCH better off than so many others.

I read some good observations regarding the Paralympics:

 We could see blind runners taking a course unaided thanks to headsets which can watch for hurdles as well as providing left and right instructions.
(The step from driverless cars, to blind people walking, is not a large step.)

Actually our wheel chairs are like Formula One cars; they're the absolute cutting edge of technology. Thanks to carbon-fibre chairs and precise engineering, the wheel chair weight is down to just 2kg. 
(Mine weighs 18kg.)

The Paralympics is wedded to science and technology. In the paralympics charter, science is a huge part of it. It’s all about enhancement, it’s all about making people better. 
(Able bodied people will soon need body enhancements, or get left behind by disabled people.)

The ‘Brain Sled’ was designed by engineering students at Imperial college, and uses electrical signals in the brain to ‘steer’ a sled in a bobsleigh event. Now we can have totally paralyzed people competing in sports. 
(Is this still an "athletic" competition?)

The current exoskeleton can only walk slowly, and the expensive, computer-controlled hydraulic machines is used to deliver the health benefits of walking to paralysed patients. 
(Isn't an exoskeleton just a step up from a fancy prosthetic knee?)

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