Wednesday, July 18, 2012

How Artificial Limbs Have Changed Amputees' Lives

It was an average, muggy August morning when Ann Kornhauser went out of the house to walk her Golden Retriever. The 50-something Hicksville, NY resident heard a snap in her foot and felt the bones break. It turned out that Kornhauser had a rare tumor in her foot and it was amputated.
She received a prosthetic foot which caused her constant pain. Kornhauser recalls crying in her car after trips to the grocery store because she would have to carry the bags in the house. Her prosthetist offered a solution: Artificial limbs have made vast improvements in the past few years and she would be a good candidate to try one of the new high-tech versions. However, her leg would have to be amputated below the knee.
It was a frightening and scary prospect to Kornhauser, whose leg was healthy. But after two years of discomfort, she decided to try it. "All my family said was, 'You're going to be sitting there without a leg.' But they didn't know what I knew. I knew it was going to look like a leg and that people ran marathons on them. I knew that I would have a life."
The mechanical leg has a realistic appearance, with a custom flesh colored silicon skin, and an ankle that adjusts for different heel heights. The toes even have a pedicure.
Over 2 million Americans live with amputations, according to the Amputee Coalition. With the advent of higher quality artificial limbs, many amputees are making the same choice Kornhauser made: amputate healthy limbs to regain more normal function.
Artificial limbs like Kornhausers are replacing older, outdated models. New bionic prosthetics now have custom skins, motors, and microchips that replicate natural human function. South African runner Oscar Pistorius, a double amputee, has been accused of an unfair advantage because he runs with J-shaped carbon fiber blades.
Amy Palmiero-Winters, 39, says "Amputees are realizing they can do everything that they did before. They look at people today and see the different things that they're doing and how it's more out in the open and accepted." Palmiero-Winters is a ultramarathon runner who lost her left leg in a motorcycle accident when she was 24. She works at A Step Ahead, a Long Island prosthetics clinic.
The loss of a limb is still a medical trauma, but more amputees are embracing artificial limbs. "Many have little desire for the artificial limb to look human. They want it to look interesting and have a machine beauty," says Hugh Herr, head of the biomechanics research group at Massachusetts Institute of Technology, which is developing wearable robotic devices.
Army captain David Rozelle lay outside a Baghdad hospital the summer of 2003, his right foot mangled by a land mine. The foot was amputated above the ankle. Captain Rozelle, who lives in Boulder, CO, has been able with an artificial foot to compete in triathlons and even returned to duty in Iraq. Two and a half years later he told his doctor that he wanted to amputate the remaining nine inches of his right leg so he could get a new below-the-knee prosthesis. His doctor was horrified.
"The medical community is focused completely on salvaging limbs. There's actually a disadvantage to having extra limb length, because you can't fit correctly into prosthetic devices," says Major Rozelle. Rozelle now owns several robotic legs.
Tom White was just 21 when he was run over by a truck while riding his motorcycle. His left foot was amputated and then reattached, something he begged his doctors to do. But it turned out to be a painful decision that was not the best for him. White had 19 operations and spent 2 years on crutches and lived a fairly pain-free life going on backpacking trips, running marathons, and keeping in shape.
But arthritis attacked his fused joints, he walked with a limp, and there were new sharp pangs when he ran. "The last couple of years, boy, my life started closing in on me because I couldn't run anymore. It got so that doing something like taking a hike wasn't fun anymore because it hurt too much," said Dr. White, now 51, a family physician in Buena Vista, CO.
Like Rozelle and Kornhauser, White had his left leg amputated just below the knee so he could get a carbon-fiber foot. "I made the decision to have an elective amputation so that I could have a chance to get back to my life. It just dawned on me- the technology is amazing, and I would be better off."
Technology for artificial limbs is advancing rapidly. Dr. Herr founded iWalk, which is devoted to making the next generation of prosthetics. Their first product is a bionic foot and ankle, modeled after muscles, tendons, and spinal reflexes used in human walking. The foot senses the actions of the wearer and terrain on which they are walking and adjusts accordingly. The robotics simulate the actions of the missing calf muscles and Achilles tendon.
In the future, we will see artificial limbs that resemble human limbs in dexterity, strength, size, and weight, all while being controlled by your brain. A small array of electrodes would be planted in the brain's cortex. This is still several years away, but the technology we have today has provided one excellent benefit: "I don't feel ugly anymore. I feel like a normal guy," says Dr. White.
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