Practitioner Ray Diaz recently cared for Mr. Harrell, a 50-year-old diabetic. He presented with a very unstable gait and had been previously diagnosed with left foot drop secondary to a stroke and leaving him with left side paralysis. Mr. Harrell would his arms for balance while ambulating, and had experienced a number of falls.
Certified Orthotist Ray Diaz
Ray fabricated a left double upright Ankle Foot Orthosis with extra depth shoes and custom accommodative inserts for Mr. Harrell. The AFO is used to control the instability in his lower limb by maintaining proper alignment and controlling motion and drop foot. The double upright AFO will be attached to the diabetic shoe which allows for edema and protects the diabetic foot from any shear forces. His chronic diabetic neuropathic condition requires extra depth shoes and custom diabetic inserts to accommodate his deformed feet. The AFO will also protect his de-sensitized feet from repetitive stress and irritation – something his current shoes were not providing.
Mr. Harrell has been wearing the double upright AFO for a few weeks now and it has boosted his confidence. He has been very satisfied with the progress he has made toward resuming his normal walking routine.
Mr. Harrell had a few words to describe his patient experience at Collier:
“Ray Diaz treated me with professionalism and was very kind to me. I can walk a lot better! Everything was done in a timely manner and he made me feel at home. I love my new shoes and brace! I am very happy I was referred to Collier.”
On a recent Monday afternoon, Harmony was meeting with practitioner George Villarruel for her final fitting for the new prosthesis she will wear.
Harmony was born as a congenital right trans radial amputee. Now that she was getting older, her parents wanted to give her an opportunity for bi manual function.
Laura Kendall (left), Harmony (right) without devices and wearing their prosthesis.
Over about 5 visits, George has been working with Harmony for fittings and preparing her for some of the challenges when adapting to a prosthesis. In fact, George thought it could be helpful to Harmony and her parents to speak with someone who has lived as an amputee since birth. Laura Kendall, a long-time congenital left trans radial patient, came to the office to meet the family. Harmony’s parents were thrilled to connect with someone who really understood their daughter’s challenges – and Laura had such a happy, positive attitude that reinforces with Harmony that life is not about what you don’t have, it is about what you can achieve.
George Villarruel has trained our team in all aspects of care for young patients and their families. His psychology background helps him understand patient care and help our patients heal on the outside and the inside. If you have a question you can contact George here.
When treating pediatric prosthetic patients, working with the family ensures patient success.
Colin’s Mom expressed her thanks: “It always seemed that George presented a wealth of information regarding the options for my son’s care — with the goal of helping my husband and I decide what would be best for our son as well as practical for our lifestyle.” Maria Haugseth, Sacramento, CA; Colin’s Mom
Colin needed to be fit for his first prosthesis. His long-term treatment plan was developed with his team of caregivers and his mom. Colin was treated by George Villarruel, one of our pediatric and upper extremity prosthetic specialist practitioners. He customized the prosthesis and educated Colin and his mom over a period of about a year during treatment.
Colin’s Mom was with him every step of the way and she deserves a lot of credit for her positive outlook and supportive encouragement. Over the many visits and with a lot of hard work, Colin is now successfully doing more activities with his new arm prosthesis and is not letting anything hold him back.
Colin is ecstatic to be riding his bike!
With the support of his family, and a prosthetic device from Collier O and P, Colin is ready to tackle his next goal.
Extensive experience working with pediatric patients
Veterans are welcome to come for a consultation about problems or challenges with their current prosthesis
Our bilingual practitioners can converse with patients in their chosen language
Our lead prosthetist spent many years with Shriners Hospitals for Children. The volume of patients seen in this inpatient setting established him as a specialist in upper and lower extremity prosthetic care for children and their growing needs. Our philosophy is that we want to treat the family first, and then the patient will have the understanding and guidance they need to be self-reliant.
Collier Orthotics and Prosthetics has offices in Sacramento and the Bay Area Region. Please call 916-979-9729 and we can answer your questions and set an appointment at the location most convenient for you.
Mikhaila Rutherford is 26 years old and, and with her new prosthesis, she is more ambulatory and ready to enjoy her new career in nursing without the hassles and limitations of her old and worn out prosthetic device.
Four years ago, Mikhaila came to our lead prosthetic practitioner with some challenges:
She would be challenging to fit due to multiple surgeries to resolve her subluxating patella (knee cap).
A short trans tibial residual limb.
Her current foot did not allow for any flexibility when walking on slopes of any kind.
George was able to get approval through the insurance for the best possible device for Mickhaila. Watch the video to see how Mickhaila demonstrates her new prosthesis with an articulating ankle.
She was fit with an Alps AKDT locking liner and Patellar Tendon Bearing Supra Patellar Supra Condylar (PTB SCSP) socket design to help stabilize her knee in the medial lateral plane. For her last fitting, she was provided a foot with an articulating hydraulic ankle which can accommodate going up and down sloped terrain.
Mickhaila can now get back to daily living with a lot more mobility when hiking and being outdoors. We look forward to hearing about her new career as a nurse when she comes back for a check up.
Mickhaila has been a patient of George Villarruel at Collier O and P for the last 4 years. If you would like to see more of our patient success stories, visit our patient outcomes page.
Rick Todd COF, managing partner at Collier Orthotics & Prosthetics, has many great things to say about JR when interviewed by BOC, and the positive impact he had on their growing business.
Why does JR deserve this award?
Because he is knowledgeable in Orthotics and Prosthetics, BOC accreditation standards, Medicare standards and his outstanding service with patients. He has the ability to give of himself and teach in the area of Orthotics and Prosthetics as well as everyday life. JR has the ability to communicate with physicians and physical therapists on difficult cases. He works for the overall interest of the business and outcome as a whole, not income alone. Follow up is assured in all of the above areas. JR is an amazing family man and great friend, even if I didn’t always want to hear what he had to say.
How did you meet JR, and what has been the impact of his service throughout your career?
I originally met JR in 1992 when I was a Bledsoe sales representative in Northern California. JR ran the Shriners Orthotic and Prosthetic practice in both San Francisco and then in Sacramento. When dealing with JR in regards to product purchases he was very respectful of my position even though I was just a salesman peddling products to Shriners. He always treated me with the utmost respect and every time I saw him he had some funny story to tell me, as well he was full of information and willing to teach.
I did not see JR for many years except at an occasional trade show. When I would bump into him it was just like I had seen him in the past. He was friendly, great to talk with and like a long lost friend and always full of knowledge.
In 2012 I was in the midst of growing my first orthotic practice. I started to work with Jim Hewlett in regards to accreditation through BOC and applying for my first Medicare license. At that time I found out that JR was working with BOC as well as Jim Hewlett and doing site surveys. We rekindled our relationship. Jim let me know that JR was interested in getting back to seeing patients again, and that he would like to do patient care. I then hired JR as the director of Orthotics for my company.
JR was an open book and not only was he a fantastic practitioner; he is very accomplished in our field.
Watch the presentation, JR says Thank You.
He was helpful in all the Medicare and accreditation rules, and if he didn’t have the answer he has a relationship with someone who did. He was also very helpful in the setup of our second Orthotic and Prosthetic facility. He understood from his Shriner days, the function of utilizing space in a manufacturing area. He was also helpful in finding the appropriate products and tools to set up a state of the art manufacturing facility. In the early days of this new business he had the ability to streamline systems, bring employees together, and communicate with physicians about patients and product philosophy, as well as the biomechanics that went along with this. JR has the ability and interest to get the best outcome of all situations, and give of himself as a mentor and a teacher to my staff.
Not a day goes by without thinking how he is doing in his present situation. JR was diagnosed with Acute Lymphoblastic Leukemia on September 4th 2016 and underwent seven rounds of intense chemotherapy. He was a candidate for a Bone Marrow Transplant at Stanford University Hospital and after an exhausting international search a 10/10 donor was located. On March 30th JR received his transplant and after 100 days of living at Stanford he is finally home recovering and in remission. He still has a long road to go in recovering his blood counts, energy and general wellbeing but he is as always in good spirits and we at Collier continue to wish him and his family well.
His smile and jovialness is missed by all at Collier Orthotics and Prosthetics and we hope to be able to see him soon.
Certain pediatric orthopedic conditions require the knowledge and skill of a specialized pediatric orthotic specialist.
We address the concerns of the family as we care for our young patients and make sure they are fully informed about the care their child receives.
Our specialist care includes both injuries and congenital birth disorders which can include fractures, bone and joint disorders, spinal disorders, and neuromuscular disorders.
Brian holds clinics at 4 different California Children’s Services locations throughout the Bay Area.
“Working with kids is my favorite, probably because of their positive attitudes and almost constant smiles! Another benefit of working with CCS is the open communication. Being able to discuss treatment plans with each child’s PT creates a huge advantage for each patient’s progress. From TLSOs to arch supports I feel like I can make a positive difference in their little lives.” Brian Lee, CPO
Although this is a dramatic depiction of a transfemoral patient with a significant hip flexion contracture, it is something many above knee amputees and their prosthetist deal with to various degrees. A Thomas test would show that this patient has a contracture of approximately 35 to 40 degrees.
The picture on the left shows the weight line or TKA line, bisecting the socket with the center of his mechanical knee so far in front of the line that weight bearing on this alignment would certainly cause the patient to feel unstable and possibly collapse. Even if the patient could stand on this alignment it would create a lordosis or arching of his lower back. He would be in pain in no time as his lordosis compensates for the lack of hip flexion aligned onto this prosthesis.
By simply adding a flexion plate to his existing alignment (purple arrow) the patient can now stand on his prosthesis with greater stability and confidence.
The weight line on the picture on the right shows it bisecting the socket and going slightly anterior to the center of his mechanical knee and down to the middle of his foot creating an inherently stable alignment from which the patient can feel safe ambulating on.
George is an American Board Certified Prosthetist with over 25 years of experience focused solely in the practice of prosthetics. As the Director of Prosthetics for Collier, he is responsible for lower and upper extremity prosthetic patient care. His experience ranges from infancy to geriatrics.
We have put together some links which you may want to explore to learn more about your child’s condition or find support for your child with a prosthesis. Please remember Collier is not affiliated with these websites, and that there is no substitute for a practitioner who listens to your needs.
Collier practitioners make themselves available for questions of any kind regarding your child’s prosthesis. Many patients have come to us, and with a few corrections to their prosthesis, are thrilled to have options that were not offered with their previous practitioner.
Association of Children’s Prosthetic-Orthotic Clinics
The Collier practitioner team work with you and your care team to ensure the most successful outcome for your goals. With offices in Sacramento and Pleasant Hill, we serve patients throughout Northern California. If you are frustrated with your prosthetic, do’t hesitate to ask one of our practitioners – there may be options available to reduce pain and get you back to your daily activities.