Helping those with limb loss find a prosthetist

Amputees and those with congenital disorders who wear a prosthetic device typically have a long-term relationship with their prosthetist. If you have never worn a prosthesis, we want to provide an outline of what you should expect during your journey.

Are you ready for a prosthesis?

Having a prosthesis can be a lot of work. You need to build strength in your muscles with physical therapy exercises to prepare for your new prosthesis. Having a physical therapist and prosthetist you can communicate with is extremely important for a successful outcome with your prosthetic device.

What is the best way to learn more about getting a prosthesis?

Before you can see a prosthetist, your doctor will need to:

  • Document your current condition
  • Diagnose your K-Level
  • Collaborate among the members of your care team

After your diagnosis, you will want to find a prosthetist to collaborate with on your care team. Your physician will be the one to provide the referral to our facility. The next step is to evaluate which prosthesis will have the fit and function you are looking for.

After the appropriate device has been selected, you will continue your PT while your prosthesis is manufactured. Your prosthetist will fine tune your device and the socket over multiple visits. During the fitting process we will provide education and training so you can get the most out of your new prosthesis.

Step 1: Documenting your current condition

Your doctor will complete an evaluation checklist. This is when you should ask questions. This information will be the basis of the report being sent to your insurance company which ultimately determines the affordability of your prosthetic device.

  • Physical Exam
  • History of Amputation
  • Functional Deficits
  • Functional Level
  • Motivation to use prosthesis
  • Describe the condition of the residual limb
  • Patient’s past experience with prosthesis

If a replacement prosthesis is needed, describe the condition of current prosthesis or component and your recommendation based on your functional level evaluation.

Step 2: Diagnose your K-level

Your doctor will confirm your K-level which determines the type of device your insurance will approve. The K-level is based on your daily activities and current physical condition. it is possible over time that you can graduate to a higher K-Level if you continue to progress in your abilities.

Learn more about K-levels.

Step 3: Team Collaboration = Improved Prosthetic Care

On your first visit, options will be discussed to find the prosthetic configuration that allows you to get back to your daily activities and meet your future goals.

In addition to your doctor, your care team will consist of physical therapists and your prosthetist. Cohesive care during your rehabilitation will help you stay on track with your short and long-term goals to better improve your outcomes.

The team collaboration is a transparent process – the goal is patient education through communication with all members of the team. Collective input creates a clear plan which leads to higher patient satisfaction with improved functional results. After your final fitting, your prosthetic devices will need adjustments over time, so you will likely check in with your prosthetist once or twice a year.

“I believe that providing a prosthesis is just the beginning of my responsibility as a prosthetic provider, I am also involved in the education and follow up care of my patients”, says George. He is always eager to learn new methods and philosophies and share for the benefit of the team as well as the success of the patients’ prosthetic experience.

Read George Villarruel’s Bio here…

Patient Resources

Every patient is unique, physically and psychologically and we have the experience and compassion to guide them through this journey. We have put together a list of resources of organizations and articles to help you and your family members.

Check out our patient and family resources.

Certification Boards

The American Board for Certification in Orthotics, Prosthetics & Pedorthotics (ABC)

abcop.org
info@abcop.org
703-836-7114

The Board of Certification/Accreditation, International (BOC)

bocusa.org

Orthotics and Prosthetics Patient Care – Our offices are open.

Collier Orthotics and Prosthetics in association with Laurence Orthotics and Prosthetics logo

As an essential health care service provider, our offices remain open with a full staff of trained, licensed, bonded and insured practitioners who are ready to provide on-going care for those in need of mobility devices and for in-patient hospital calls 7 days a week, evening and holidays.

Providing Orthotics and Prosthetics care for seniors, pediatric patients, and those with special needs is the heart of what we do.

Our Practitioners and staff can assist those that are in need of orthotic and prosthetic devices to improve or maintain their mobility for all Activities of Daily Living (ADL’s) such as personal care, cooking, walking, exercise, essential transportation to the grocery store and pharmacy, safety, reassurance and especially with those tasks one may have difficulty in accomplishing during this period of Sheltering in Place.

We are here for you. If you need an appointment, please do not hesitate to call. Nothing is more important than the health and safety of our patients and staff. We have taken precautions based on state and federal mandates to provide a safe and comfortable environment for our patients and staff. We follow all social distancing guidelines and ask you to please remain 6 feet from any other patients and staff.

Orthotic and Prosthetic services remain an option to those at risk of mobility and we will do everything in our power to support our patients, staff members and community in every way possible to keep them safe and cared for by continuing services for improved mobility during these times.

Please rest assured that we are monitoring the COVID-19 situation very closely at all our locations.

We will continue to keep our Management, Practitioners, and Office Staff Employees well-informed on a daily basis about the virus and best practices to ensure the health and safety of all of our clients and employees. The following precautions are being taken to combat this changing situation:

  • Limiting the number of people in our facility at any given time. If you require assistance, we ask that you limit caregivers/companions to one support person only for your visit.
  • Reducing patient appointments to comply with social distancing in waiting rooms
  • All patients, caregivers/companions, and staff are required to wear a mask. The mask must remain over your nose and mouth throughout your entire visit to our office.
  • We ask that patient family members remain in vehicle at the time of patient appointment
  • Pediatric patient can be accompanied by an adult during their appointment
  • All patients entering the clinic will sanitize or wash their hands on the way in and out.
  • We will continue to disinfect all equipment and surfaces after each treatment.
  • We will be modifying treatment to accommodate your specific needs.
  • We ask you to help our efforts by staying home if you feel sick or are at risk.

Those defined as at risk are:

· The elderly
· Those with heart or lung disorders
– Diabetes
– Immunocompromised

We are doing our best to take the proper precautions and modifications to meet the needs of our patients under these unusual circumstances. Make sure you are doing your best to protect yourself, and if you have any questions or concerns, please visit www.cdc.gov/coronavirus.

Our compassionate and professional staff and practitioners have been serving the community since 1988 for Collier and 1946 for Laurence. We are committed to offering the same legendary service which we are known for, especially during this unprecedented COVID-19 crisis.

If you have any questions, or are in need of services, please contact us by email below or call 916-979-9729.

Ian McLaughlin: Rising to the Challenges of Post-Stroke Recovery

Ian’s latest achievement: The Rise Paralysis Recovery 5k Wheel & Walk

Ian, what’s most important to you about your experience with Collier?

As a person recovering from multiple serious strokes and complete hemiplegia, I needed to assemble a team of dedicated professionals I can rely on in my recovery effort for their support and expertise. The Collier team is like a family and is an invaluable part of my recovery team. The single most important thing to me is their dependability. I use an AFO to walk and as I recover motor functions over time my orthotic needs constantly are changing. I have been able to work with the Collier team on a regular basis to make the adjustments to my AFO as my needs have changed.

When you think back to your first evaluation with Collier, how did you feel when that was complete?

My initial evaluation with Collier occurred in November 2016 when I was in an acute inpatient rehab facility – only two months post-strokes. I was still cognitively very impaired and not walking very much and I had no idea what my orthotic needs were or what they would ultimately be. Collier orthotist, Dennis “DJ” Johnston, BOCO, CPA, fit me for my AFO (ankle foot orthosis) at that time. I have used the same AFO for three years now with numerous modifications as I become more ambulatory. In 2018, I wore that same AFO when I walked a 5K Turkey Trot in my local community.

If there were things that concern you about the future of your care, what would they be?

My concerns have nothing to do with Collier and their services. I am working very hard to control my post-stroke spasticity that causes me to need to wear an AFO and I hope to not need one someday. My concern is that I will never regain the ability to walk without an assistive device. I know that as I go through the process I will be able to work with the Collier team to fit me with progressively less cumbersome braces as my skills and abilities develop further.

Dennis Johnston, Collier Practitioner

A Board Certified Orthotist, Dennis fits custom orthoses for orthotic patients of all ages.
— Patient Care Specialist
— Specializing in Proprietary R-Wrap™ AFO’s since 2003
— Expert in Spasticity Management

 

Looking for a solution or second opinion? Contact one of our orthotic specialists at 916-979-9729 or contact us with the form below.

How to treat Scoliosis with the Chéneau-Gensingen Brace

This gold standard of scoliosis bracing treatment is the result of three generations of development.

The 3D Chéneau-Gensingen brace utilizes the latest bracing technology for the best possible outcome:

  • CAD/CAM is used for the creation of each curve-pattern specific brace for a three-dimensional treatment addressing all three planes
  • Treats mild, moderate and severe scoliosis
  • A viable option even for patients with 40°+ curves
  • Custom fabricated with voids and pressure zones to work in conjunction with Schroth Method Best Practices
  • Front closing design and less material for more comfortable fit and ease of application

Dr. Chéneau was the first brace developer in 1979 in an effort to advance and improve scoliosis bracing an to work in conjunction with the Schroth corrective breathing method developed by Katharina Schroth, and the classification system being developed by Christa Lemert-Scroth. In the 90’s, Dr. Hans-Rudolf Weiss (Christa’s grandson) hosted courses at the clinic demonstrating Dr. Chéneau’s bracing concepts. At the time, braces were still being fabricated from a mold of the patient’s torso through casting. Dr. Weiss went on to develop the ‘Chéneau Light®’ brace. It had a record of improved patient outcomes and reducing the need for scoliosis surgery.

Learn more in this Research Study: A Prospective Cohort Study of AIS Patients with 40° and More Treated with a Gensingen Brace (GBW): Preliminary Results

The newest Chéneau-Gensingen brace design has evolved to a higher standard with the advent of CAD/CAM technology and many years of documenting and researching in-brace results. The unusual features of the brace work to reduce spinal rotation in all three planes. Openings positioned at the spinal concavities and corrective pressure points are plotted with CAD/CAM and fabricated to have a built-in correction effect according to a patient’s individual curve pattern. This exacting fit is much more tolerable for the patient which contributes to improved corrections and happier patient. As a treatment solution, this brace can be 90% effective for avoiding surgery with full patient compliance. In some cases, patients have been able to partial reimbursement through their insurance.

Cheneau-Gensingen Brace Providers. From left to right: Marc Moramarco, DC; Amy Heller, OTR/L; Brian Lee BOCPO; Calli Clark, CPO; Ray Diaz, BOCO.

Our practitioners trained with Dr. Marc Moramarco, the most experienced Schroth Method practitioner in the United States. In the video, Dr. Marc Moramarco visited Dr. Weiss at his facility in Germany and they discuss the benefits of Cheneau bracing over other bracing methods.

The Schroth physcial therapy method is used in conjunction with brace therapy for best possible outcome.

Best practices for Schroth Therapy from our friends at Scoliosis3DC.

Learn about the history of the Gensingen brace development and how they set the standards for better scoliosis patient outcomes.

Seeking the Scoliosis Treatment Secret – A Personal Journey

Read about Dr. Moramarco’s healing journey with his daughter after she was diagnosed with scoliosis.

Contact us if you would like to learn more!

Collier Orthotics Hospital On-Call Services

Collier O&P is committed to having a practitioner available for after hours, weekends, and Holiday services. For our team to serve you effectively and timely please consider the time frames below for our practitioners to provide superior patient care.

Hospital on-call services for orthotic patients.

1. Early morning orders received by phone before 12:00pm will be serviced from 11:30 to 1:00pm.

2. Orders received by phone after 12:00pm will be serviced by end of business day.

We can fit your patients for any of the following off-the-shelf products with same day service:

  • Spine
  • Hip
  • Knee Orthoses
  • Minerva CTO
  • Cervical Post-Op Management
  • AFO
  • Helmets
  • Fracture Management

Custom TLSO’s: Our team is committed to a 24 hour turn around on TLSO devices.

For us to be successful and meet your expectations, orders are to be called in by 3:00pm. This will allow a 3-hour window to get the patient evaluated, casted/measured and their device manufactured for guaranteed next day delivery. For after hours care please call 510-502-3515.

 

Arthritis knee pain flaring up with the change in weather?

An unloader knee brace is specifically designed for treating arthritis knee pain.

Do your bones ache when the weather changes?  Does your osteoarthritis knee pain prevent you from enjoying your daily activities? Studies show that cold, wet weather negatively affects people with rheumatoid and osteoarthritis. 

For osteoarthritis knee pain relief, you need a prescription from your doctor for an unloader-style knee brace. A custom-fitted unloader knee orthosis (brace) has a range of settings to dial in to make the brace as comfortable as possible. Your practitioner should be able to show you how to use the different settings.

Osteoarthritis Knee Pain Solutions

An OA brace can relieve bone-on-bone joint pain and slow down the degenerative process. Dynamic OA braces open the joint only when the leg is extended and the most pain relief is needed. No pressure is applied when the leg is bent. With dynamic unloading, these braces are comfortable to wear for extended periods of time.

Treatment with the correct knee brace can relieve most osteoarthritis symptoms:

  • Pain, after overuse or after long periods of inactivity
  • Aching and soreness of the joints
  • Stiffness after periods of rest, swelling of the joints.

Cold weather brings on aches and pains – it is not your imagination. Most common in weight-bearing joints, the pain can settle into your knees, hips and ankles. It is important to remember that stiffness is one of your body’s early warning signs. If the symptoms persist, be sure to check in with your doctor. If stiffness and joint pain persist it might be a sign that you have arthritis, and you want to address the issue as soon as possible with your doctor to prevent further progression.

The Collier-Laurence Orthotic Team works with your doctor and other care providers to find the correct knee orthosis (brace) for your diagnosis. We have these tips for those who might be shopping for an osteoarthritis knee brace:

1)     How many patients does the facility see monthly? The busiest clinics tend to have the more experienced practitioners.

2)     Look for an orthosis (brace) recommended by your doctor for your specific condition. How many different OA braces do they offer to patients?

a.     Pittet style

b.     Large styles

c.     Valgus / varus

d.     Custom / off the shelf

e.     Hand Dexterity problems

f.      Sports related

3)     Do they have a return policy on braces that don’t provide pain relief? Will they provide other options?

4)     Your brace can’t help you if you don’t wear it regularly. If your brace is uncomfortable or pinching, contact the provider and they should be able to make adjustments for a better fit.

 

Additional Reading:

Unfortunately, there is no cure for arthritis, but there are ways to manage the pain and slow down the progression of arthritis. Although it maybe difficult, staying active is important. Make sure to check with your doctor or physical therapist for appropriate exercises for your condition.

What causes so much pain in my knees?

The stages of Osteoarthritis

Practitioner Paul Easterwood – Certified Orthotic Assistant & Certified Pedorthist

From creative baker to creating orthoses

Paul’s journey from orthotic tech to his dream job of helping patients at Laurence and Collier O and P.

Paul was a full time assistant baker and head cake decorator in 2002. The hours were early — he remembers the alarm clock going off at 3am and thinking, is this what I want to do with my life?

In the summer of 2002, I met Bob Jensen and he hired me as an orthotic technician. The work was part time at first – after I finished my day at the bakery I would drive to Laurence Orthopedic and begin my shift modifying and fabricating custom arch supports. My background in art made this a pretty natural transition for me, and I found the job challenging but fun. After a few months, I was hired full time as an orthotic and prosthetic technician and left my job at the bakery.

I would study foot anatomy books and ask questions about everything. I really wanted to understand why I was doing what I was doing, what function did this modification serve? How does this affect how the foot orthotic feels on the patient’s foot?

Over the next few years I worked with the technicians at Laurence, learning how to fabricate AFO’s, knee braces, spine braces and prosthetics of all kinds.

I was constantly learning something new and developing my own techniques for fabricating devices. Our fabrication was pretty efficient in those days but I still thought we could to better, I created a workflow board and job tracking to get the lab more organized. With fabricating knowledge, I started shadowing the clinicians at Laurence helping with patient care. I found this was what I truly loved to do. I took a certified fitter course, took my board certification exam and became a certified orthotic fitter.

I continued to fabricate as well as see patients. Most of my time was spent seeing patients and overseeing fabrication as the lab supervisor. I still wanted more so I went back to college. Nights and weekends were spent going to class and falling asleep with books. I then went on to take my boards in 2008 to become a Certified Orthotic Assistant to further my patient care scope of practice.

At this point my focus was almost all on patient care, casting, fitting and follow up of my patients, going to clinics and assisting in the formulation of design for the devices I was providing. I was seeing a lot of people with ankle and foot dis-function — it is something that is complex and challenging. It is satisfying to me if I can help someone regain a function or reduce some pain with their daily activities.

With a lot of my focus on the foot and ankle I attended the Francis Tuttle Pedorthic Program.

In 2017 I took my board certification and became a Certified Pedorthist. I still like to fabricate but my heart is for helping people by making a small difference in someone’s life and seeing how it affects them is what drives me. I have patients that were once active; hikers, runners and even some marathon runners they have come in, now dragging their foot as they walk, hoping that anything will help. I talk to them about their goals, “What do you want this brace to do for you?” most of the time the answer is walk without stumbling. Some of those people have returned to their active lifestyle, as much as they tell me I’ve helped them it’s gratifying for me to see how much it helps them.

I look forward to working tougher cases in ankle and foot orthotics. I love to teach people what I know, so ultimately having a bigger team to teach and learn from is what I look forward to over the next few years.

You can contact Paul Easterwood at our Oakland Office at 510-658-2062.
Collier Family of Companies
Sacramento, Pleasant Hill, Oakland

Now part of the Collier Family – Laurence Orthotics and Prosthetics

Laurence Orthopedic is now associated with Collier Orthotics and Prosthetics.

Laurence Orthopedic was established by Matt Laurence in 1946 and has been providing prosthetic and orthotic patient care services to the Oakland and the East Bay communities for over 70 years.
Laurence Orthopedic specializes in orthotic treatment for scoliosis and clubfoot and state-of-the-art prosthetic services for veterans with limb loss.

Director of Prosthetics George Villarruel talks about the Collier-Laurence transition.

My name is George Villarruel, Director of Prosthetics at Collier-Laurence Orthotics and Prosthetics. I want to speak about the additions-acquisition of Laurence Orthotics and Prosthetics into the Collier Family. This will allow us to service new accounts and to spread our philosophy of compassion and service to the orthotics and prosthetics communities. We feel we can provide excellent service to the pediatric and adult populations in need of an orthotic or prosthetic device.

Continue to our website for help with your orthosis or prosthesis.

Double Upright AFO helps diabetic patient get back on his feet

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, custom afo

Certified Orthotist Ray Diaz. Click his picture to read his bio.

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.”

Do you have a question about a current health issue?

Please contact us below or call 916-979-9729. We have offices in Sacramento, Pleasant Hill and Oakland, you can get directions here.

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