For amputees who use prosthetic limbs, winter weather can pose a range of challenges.
But changing technologies and new strategies are making winter easier for Granite Staters who use the devices.
Therese Willkomm just returned from a trip to India, and a visit to a company there called Dham Innovations. She brought back a ceramic tile a little bigger than a Scrabble piece, set in a sort of fingerless glove that Velcros onto the wearer's hand.
With a battery-powered control, she's able to heat the tile – and the wearer's previously icy hand – in about a second. A second later, she can also make it very cold.
Willkomm is the Director of Assistive Technology in New Hampshire, or ATinNH, and Clinical Assistant Professor in the University of New Hampshire's Department of Occupational Therapy.
She's particularly excited about using this technology to help farmers who are also amputees with prosthetic limbs – her specialty. Farmers, and others who do physical labor, can ask a lot of a prosthetic limb, working outside in all kinds of weather. “One of the challenges, of course, this time of year, with individuals using prosthetic devices,” Willkomm explains, is that “that terminal device is often made of stainless steel, it gets very cold, it transmits through a hard socket...” The same happens during the summer, when metal components can get very hot.
So Willkomm is excited about this ceramic tile technology, as a new way to regulate the temperature of a prosthetic limb.
Of course, here in New Hampshire, and especially at this time of year, you don't have to work outside to frequently find yourself in adverse weather conditions.
Jason Lalla is a certified practitioner at Next Step Bionics & Prosthetics in Manchester, which provides and customizes prosthetic limbs for amputees of all ages, and in every profession.
He agrees one of the biggest challenges for a Granite Stater with a prosthetic limb is winter cold. Newer prostheses are generally made of temperature-conducting materials, often metals, that are left uncovered. “The metal components are exposed to the weather,” he explains, “and the metal is acting kind of like a cold sink.”
There are some new heat-regulating innovations in the works – like Willkomm's ceramic tile – but Lalla says a lot can be done with insulation.
One of his clients, Leo Havlan, whose right leg was amputated two years ago, says insulation does the trick for him. He drives a concrete truck for construction down in Boston, and recalls one day not too long ago when that city was well below freezing. “My left leg and my foot were cold,” he says, “but my right leg didn't feel a thing.”
Ice is another problem. Lalla says not being able to feel the ice underfoot is one challenge. Another is that most prosthetic ankles don't really bend. “Humans generally have learned that when you step on ice and icy conditions you walk very flat-footed,” he explains, “and you can take almost a full stride, because you can angle your foot so it still comes down kind of flat. With a prosthesis, when you take a stride it's coming down on the very tip of the heel, basically, and it'll just slide away from you really easily.”
Lalla says a bending, bionic ankle is available, and has made winter a lot easier for some of his clients.
But the advancement he most wants to see has less to do with dealing with winter weather, and more to do with enjoying it.
Lalla's leg was amputated above the knee when he was 18, and soon after he got into skiing. Really into skiing: he eventually joined the U.S. Disabled Ski Team, winning gold medals at the 1998 Winter Paralympics, and at the World Championships in 2000.
Back then, Lalla says above-the-knee amputees like him skied on one leg, without a prosthesis, using a pair of crutches called “outriggers” that have short little skis on the ends. That's because a prosthetic knee that could bend and rotate the right way for skiing just didn't exist yet.
Now it does, but a special prosthesis for skiing costs many thousands of dollars – and is often not covered by insurance.
Lalla, who now coaches disabled skiers, says he wants to see sports-specific prostheses made available to more amputees. “As a society, are we trying to get people back to where they can just do the bare minimum,” he asks, “or are we trying to restore their lifestyles?”
Prosthetic technology is advancing at a rapid pace, and practitioners like Lalla, and assistive technology innovators like Therese Willkomm, are doing all they can to help amputees deal with winter weather –
– And get to enjoy it.