Dias Dos

In many ways, day 2 went really well. Just like the week should be it was extremely busy but productive and fairly smooth. Aquipa Azul molded some 24 limbs. As part of the the prosthetic trifecta; that means approx 72 prosthetic patients were seen today.

Forgive me. Over some recent years our team has really become more diverse. We have portions of the team that focus exclusively on pediatric PT, while others focus on physical rehabilitation, speech therapy, neurosurgery,...etc. It is difficult for me to comment on their activities as I really know very little about them and the curiosities of their activities. I can only truly speak from the prosthetic perspective as I am close to that.

Today, I got to see Adrianno again. I don't know how to express how great it was to see him and also to see that he was using the device we had made last year.

Adrianno lost his limb about 4 years ago in a car accident. Sadly, motor vehicles accidents are the number 1 cause of amputation in Peru. I had the leisure of fitting Adrianno in 2017.

While it was great to see Adrianno using our old prosthesis, it also did not fit. For he, as all creatures do, grew. While Adrianno finds his current prosthesis to be too short, he has also grown up and out of his current socket by about 1".

I don't get to see a lot of kids in my practice at home. In fact, I really only have one that I can say I have direct prosthetic charge of. Still, more than most any other patient, I am steely focused on the nuances of their fit. I need to see when they subtly shift their weight away. I need to see that they don't really attend to putting on the leg as was instructed. I need to quickly see how they compensate with awkward motions things that the prosthesis should easily do for them. I need to see the grimace, slight though it may be, that indicates some discomfort that Adrianno himself is trying to dismiss simply because he doesn't like....and is nowhere near present of mind to know that, not only do I want to know but that I might be able to do something about it.

Why? You say.

They will never focus on fit and function the way an adult will. All kids have ADD. Molding and fitting them is akin to fitting a cat. Before you can ask them how something feels they have either 1) Bolted out of site 2) Wriggled out of it to go play with something or 3) Broken it and rendered it useless. Beyond that it only gets deeper. With adults it is easier to get a sense of where we are going and what the patient is going to be capable of. With kids, you have to naturally assume that they are always going to either push the limits of the prosthesis to its edge or find a way to do without it. I know and am very close to the impish demeanor that makes most kids, kids. When they are in my charge I fully embrace the responsibility to enable them to do their job to the best of their ability.

My wishes for Adrianno are not any different than what I wish for my own kids. I want them to have the opportunity to succeed in whatever is driving them. If there is a way to make the prosthesis less of a distraction or inconvenience and more of a benefit to Adrianno then that is what we must dream and work toward.

Buenos noches
Pablo