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Get to Know our Staff: Philip Pitt, Prosthetics & Orthotics

Get to Know our Staff: Philip Pitt, Prosthetics & Orthotics

by | Jul 9, 2024 | Prosthetics & Orthotics

What is your job title/your role at Scottish Rite for Children? My job at Scottish Rite for Children is as an orthotics and prosthetics technician.

What do you do on a daily basis or what sort of duties do you have at work? On a daily basis, I fabricate all types of prosthetic and orthotic devices. I also see patients for repairs of their devices as needed and manage an inventory of supplies used for fabrication.

What was your first job? What path did you take to get here or what led you to Scottish Rite? My first job was a housekeeper at a summer camp in the mountains. After that, I worked at a hospital in Southern California in the orthotic and prosthetics department for seven years before ultimately relocating to Dallas to work at Scottish Rite.

What do you enjoy most about Scottish Rite? The thing I enjoy the most about Scottish Rite is being able to help provide great care and devices for the children that come through the organization. I also think participating in the 2023 Amputee Ski trip to see the work we do in action was an awesome experience.

Tell us something about your job that others might not already know? We have a building next to the parking garage where all our prostheses are fabricated. 

Where is the most interesting place you’ve been? The most interesting place I have visited is a tie between London, England, during a trip to Europe and Vancouver, British Columbia.

What is your favorite game or sport to watch and play? My favorite sport to watch is baseball.

If you could go back in time, what year would you travel to? If time travel was a thing, I would go back to any time in the 90s.

What’s one fun fact about yourself? A fun fact about me is that I am a certified scuba diver.

A Newfound Freedom to Walk

A Newfound Freedom to Walk

by | Nov 6, 2023 | Prosthetics & Orthotics

KaDeyja, of San Antonio, enjoys watching Cocomelon® and listening to her favorite song, “The Wheels on the Bus.” During her physical therapy session at Scottish Rite for Children, this animated music video set the tone, creating a playful atmosphere and soundtrack to a pivotal day in her life. At 16 months old, KaDeyja achieved a milestone that any doting parent would record in a baby book — taking her first step. But for KaDeyja and her parents, this accomplishment was extraordinary.

KaDeyja was born with limb differences affecting her right arm, left hand and both legs. Hand surgeon and Director of the Center for Excellence in Hand, Scott Oishi, M.D., FACS, manages the treatment plan for her hand. Chief of Staff Emeritus J. A. “Tony” Herring, M.D., manages the treatment plan for her legs.
 
“In the beginning, she couldn’t roll over,” Stephanie, her mother, says. Later, she had difficulty sitting up and keeping her balance. “We would prop her up with a Boppy® pillow,” she says. For many months, Stephanie carried her everywhere. Eventually, KaDeyja figured out how to sit up and maneuver on her own by scooting on her bottom.

When KaDeyja was developmentally ready to begin walking, Director of Prosthetics Don Cummings, C.P., L.P., fitted her for two prosthetic legs. And then, the big day arrived. KaDeyja tried out her new legs with assistance from physical therapist Megan Mendoza. Pushing a baby doll in a shopping cart, KaDeyja took one step and then another.
 
“When she took her first step, I was like, ‘Oh my gosh, she’s doing it!’” Stephanie says. “It was very emotional.” With focus and determination, KaDeyja was walking. Every step was a triumph. As the medical team cheered her on, she walked over to each person in the room and gave them a high five.
 
“Scottish Rite for Children has given us hope,” Stephanie says. “It’s a forever kind of journey at Scottish Rite. They are a piece of our family.”
 
Read the full issue.

Ayden the Inspiration – Resilience and Determination Despite Trauma

Ayden the Inspiration – Resilience and Determination Despite Trauma

by | Aug 8, 2023 | Prosthetics & Orthotics

Cover story previously published in Rite Up, 2023 – Issue 2. by Kristi Shewmaker    Ayden, age 13 of Valley View, describes himself as outdoorsy. He learned to ride horses before he could walk. Every day after school, he feeds his flock of sheep that pasture next to the house his father built for the family. When his dad gets home from work, they drive across the highway to feed their horses, ponies, cows, chickens and homing pigeons. Born and raised in the country, Ayden lives with his parents Liz and Sergio and his younger sister and brother on some land they simply call home.   Ayden’s family is close-knit. His grandparents, Liz’s parents, live just across the pasture. Every Sunday, Ayden hops the fence and runs to their house where his grandma makes breakfast for everyone. After their family meal, the guys get to work doing chores around the property.
In February of 2022 while working on the farm, Ayden suffered a traumatic injury with heavy farm equipment and lost his arm. He was transported by CareFlite® to Children’s Medical Center Dallas, a Level 1 Trauma Center, where pediatric orthopedic surgeons Corey S. Gill, M.D., M.A., and Jaysson T. Brooks, M.D., performed an amputation and reconstruction of Ayden’s right arm above the elbow. “I didn’t think anything could be done to save any part of his arm,” Liz says, “but they did an amazing job, and I’m thankful for that.”

A few weeks after surgery, Ayden and his family reunited with Dr. Gill at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. They also met the multidisciplinary team of experts who would care for Ayden, including pediatric psychologist Emily Gale, Ph.D., prosthetist Dwight Putnam, C.P., L.P., and occupational therapist Lindsey Williams, O.T.R., C.H.T. “When you lose a limb, the family goes through a process of grief,” Dr. Gill says. “So, it’s really important for our Psychology team to work with them early on.” During his recovery, Ayden and his family toured the Prosthetics Lab at the Dallas campus to learn about the possibility of wearing a prosthetic arm and how it could be customized for him. “It was important for Ayden to know that whether he has a prosthesis or not, it does not define him,” Dr. Gill says. “He could do things with it or without it, but he was going to be great regardless.” Ayden decided to move forward with the arm. After his limb had time to heal, he would return for an evaluation with Dwight. In the meantime, Ayden began occupational therapy with Lindsey twice a week. Initially, she focused on caring for his residual limb, including massaging his scar to desensitize the limb in preparation for wearing a prosthesis. “The day I met Ayden, he was very quiet,” Lindsey says. “He was trying his best, but he didn’t yet know the potential that he had. We were just trying to get rid of his phantom limb pain, trying to cope in that way.” Phantom limb pain occurs when the brain perceives tingling and painful sensations in the limb that is no longer there. To resolve the pain, Lindsey used mirror therapy to trick his brain into thinking his right hand was there. Because Ayden lost his right arm, and he was righthanded, they also focused on dominance retraining, or training his left hand to become the dominant hand. They worked on strengthening the grip of his left hand, as well as coordination, fine motor skills and handwriting.
After the swelling subsided in Ayden’s limb, Dwight recommended a body-powered prosthetic arm. Built specifically for Ayden, the arm attaches to a prosthetic socket that fits onto his residual limb. The prosthesis is worn with a harness that loops around his left arm. The movement of his shoulder creates tension in the harness that is transferred to a cable system, which moves a terminal device in the form of a hand or a hook. Initially, Ayden chose the hand so that it would look like his fingers. The hand has a tripod grasp, meaning the first two fingers and thumb pinch together to grab objects.

For many months, Ayden worked with Lindsey on completing tasks with his left hand as well as learning how to use his prosthesis. They problem-solved daily activities, like how to get dressed, button buttons and zip zippers. In one session, he learned to tie his shoes with one hand. They also worked on two-handed tasks, like scooping ice cream, opening a sauce packet, and cutting apples and avocados.   “Ayden has grown so much,” Lindsey says. “He comes to appointments prepared with a list of things he wants to work on. Early on, he wanted to help his mom. He brought in clothes to fold and hang. He wanted to be able to take out the trash.”
After a year, Ayden decided to try the hook on the end of his prosthetic arm. He wanted to use it to feed his sheep. The pinch on a hook is stronger and can grasp heavier items. Before his injury, Ayden fed his sheep by pouring grain out of a five-gallon bucket into a trough. Lindsey taught him to use the hook to hold the handle while his left hand tilted the bucket. “Almost instantaneously after we added the hook,” Dwight says, “it has increased his abilities to do the things he used to do and contribute to his family.”

“I think he will continue to explore and find things he wants to do with his prosthesis,” Dr. Gill says. “Whether it is for things around the farm or adaptive sports, it’s our job to help him succeed in whatever he wants to do, and I think he will.”   Now, Lindsey is preparing Ayden for high school. She is teaching him one-handed typing using a Dvorak keyboard, which locates the important letters directly under your hand. They just put new stickers on the keys. “Lindsey has really been a blessing to us,” Liz says.   The best part of his care journey, Ayden says, has been getting help from Lindsey. “I’ve learned that I can still do everything the same,” he says. Liz adds that Ayden says he wants to be Dwight, and later in his life, he wants to build prosthetic limbs.
 “At Scottish Rite, they care more about the kids than anything else,” Sergio says. “They actually take care of you. They don’t care if you’re Hispanic, White, Black — whatever color you are — they treat everybody the same.”   In a recent session, Ayden and Lindsey played Jenga®. Ayden grasped a block with his hook. As he wiggled it, it looked like the tower might fall. “But, he got it out,” Lindsey says, “and when it didn’t fall, he had the biggest smile on his face.”

“Nothing is off the table for Ayden,” she says. “The injury was so traumatic for him. It could’ve defeated him, but he has just soared.”

“We can’t thank everyone at Scottish Rite enough,” Liz says. “Something that has been horrible and tragic is turning out to be something wonderful and positive for our child.”

Read the full issue.

American Society of Hand Therapists – Prosthetics Series: Pediatric Upper Extremity Prosthetics

American Society of Hand Therapists – Prosthetics Series: Pediatric Upper Extremity Prosthetics

by | Apr 21, 2023 | Press Coverage, Prosthetics & Orthotics

On this episode, we are joined by Dwight Putnam, a certified prosthetist who works at a pediatric hospital in Texas. He brings a unique perspective to his job as a prosthetist as he previously worked as a professional sculptor. In his job, Dwight works with kids born with congenital hand differences and he builds terminal devices that allow them to participate in the activities that are meaningful to them.

Listen to the podcast.

Limb Loss and Limb Differences: Terms You Need to Know

Limb Loss and Limb Differences: Terms You Need to Know

by | Apr 19, 2023 | Prosthetics & Orthotics

There are many different words that are used to describe limb loss and limb differences. These medical terms allow patients and their families to effectively communicate with their health care provider. This glossary of words and phrases will help you learn some of the terms used to describe limb differences and limb loss. 

Acquired amputation: The surgical removal of a limb(s) due to complications associated with disease or trauma.

Alignment: The position of the prosthetic socket in relation to the foot and knee.

Amputation: The surgical removal of all or part of a limb due to disease or injury.

Atrophy: A wasting away of a body part, or the decrease in size of a normally developed extremity or organ, due to a decrease in function and/or use.  After amputation, for example, some of the muscles in the remaining (residual) limb often atrophy over time since they are not being used as actively as before. 

Bilateral: Occurring on both sides, as in loss of both arms or both legs.

Check or test socket: A temporary socket, often transparent, made over the plaster model to aid in obtaining proper fit and function of the prosthesis.

Congenital limb deficiency: An absent, shortened or abnormal limb present at birth.

Custom fit: Fitting an individual with a device that is made from a scan or cast of the individual’s unique anatomy and fabricated according to the needs of that individual.

Extremity: A limb of the body, as in upper or lower extremity.

Gait: Referring to the manner or style of walking.

Gait training: Part of ambulatory rehabilitation, or learning how to walk, with your prosthesis or prostheses.

Lower extremity (LE): Relating to the leg.

Nylon sheath: A shear nylon interface worn close to the skin on the residual limb to reduce friction and to help wick away perspiration from the surface of the skin.

Orthosis: A external device that is used to protect, support or improve function of parts of the body that move, i.e., braces, splints, slings, etc. It can include anything from an arch support to a spinal orthosis. Orthoses is plural.  

Orthotics: The profession of providing devices to support and straighten the body (orthoses).

Orthotist: A skilled professional who designs, fabricates, fits and maintains orthotic devices that are prescribed by a physician, generally as a collaboration regarding the biomechanical goals of the orthosis and the patient’s needs.

Proximal Femoral Focal Deficiency (PFFD): Proximal Femoral Focal Deficiency is a complex congenital difference in which the femur (thigh bone) is short or even mostly absent, making that leg significantly shorter than normal. PFFD includes a wide range of severity and multiple treatment options based on how big the length difference is, the child’s age and development and whether other parts of the limb or other extremities are involved.

Prosthesis/prosthetic device: An artificial limb, usually an arm or a leg, that provides a replacement for the amputated or missing limb. Prostheses is plural. Generally, the word prosthetic should be used as an adjective. If referring to an individual’s replacement artificial limb, it should be called a prosthesis not just a prosthetic.

Prosthetics: The profession of providing those with limb loss or with a limb difference (congenital anomaly) a functional and/or cosmetic restoration of missing or underdeveloped human parts.

Prosthetist: A person involved in the science and art of prosthetics; one who designs and fits artificial limbs.

Pylon: A structural part, usually a metal alloy or composite tube, that provides a relatively light weight support structure between other components of the prosthesis such as between the socket or knee unit and the foot.

Residual limb: The portion of the arm or leg remaining after an amputation, sometimes referred to as a stump or residuum.

Revision: Surgical modification of the residual limb.

Socket: Part of the prosthesis that fits around the residual limb.

Symes: a type of surgery for amputation through the ankle joint, generally retaining the heel pad so that the residual limb can tolerate more loading through that area.

Upper extremity (UE): Relating to the arm.

Van Nes (Rotationplasty): Rotationplasty is a surgical reconstruction occasionally indicated for bone tumors near the knee or for PFFD.  There are many variations of this surgery, but in general the limb is shortened, and the anatomical ankle and foot are moved up to about knee level and rotated around so the heel faces forward.  Once healed the person with a rotationplasty can eventually be fitted with a “below knee” prosthetic leg where the foot rests inside a custom socket and the rotated ankle is protected with metal joints and a thigh cuff.   The ankle then controls the prosthesis much like a knee but with slightly less overall range of motion.  

Share Your Story: Chief Growing Officer

Share Your Story: Chief Growing Officer

by | Apr 13, 2023 | Prosthetics & Orthotics

It’s Limb Loss and Limb Difference Awareness Month, and we want to highlight our patient Isa, who also happens to be the 2022 Gerber baby! Learn more about her journey below.

Blog written by Isa’a parents, John and Meredith. 

What prompted seeking medical attention?
During our 20-week ultrasound, we learned that Isa would be born with a limb difference. We began educating ourselves on the resources available, and when she was born, we met with our local children’s hospital to discuss initial treatment options. We were fortunate to be able to seek out further treatment recommendations from experts in lower limb differences.

How did you learn about the Scottish Rite for Children?
During our initial consultation at our local children’s hospital, they directed us to Scottish Rite and assured us that the providers who would care for her are truly experts in their field. After looking online and reading about treatment options available and testimonials from children and families, we asked to schedule an initial appointment. 

Can you describe Isa’s treatment journey?
We first met Dr. Tony Herring and Dr. David Podeszwa on May 24, 2022. This was an incredible visit and ultimately what helped us to decide that Scottish Rite was where we wanted Isa to get her care. 

Both Dr. Podeszwa’s and Dr. Herring’s teams met with us together. They noted that this doesn’t typically happen, but they wanted us to be able to meet with both teams on the same day. Everyone present was so kind. Dr. Podeszwa started by reviewing Isa’s images (previous MRI from another facility) and discussing treatment options as she got older. Dr. Herring followed and discussed the amputation process for her right foot. He showed videos of children with similar limb differences doing things like walking, running and even slam-dunking a basketball! Seeing these videos and hearing about the successes of other children with similar conditions helped us to feel more confident in the treatment plan for her.

One of the unique opportunities that Scottish Rite provides is peer support. We were matched with another child and family who had a similar limb difference and had been through the amputation and prosthetic journey. Being able to speak with another child and family, again, helped us to feel confident in the treatment plan and hopeful for all the things Isa will be able to do in the future.

After that, we had an additional follow-up visit with Dr. Herring, and then on January 19, 2023 Isa had a Syme amputation of her right foot. The hospital stay helped to prepare us for taking care of her and setting her up for a successful recovery. We cannot thank our nurses, physical therapists, child life and other support staff enough during our time in the hospital! Isa was so loved by everyone, and we felt the support from everyone around us. The hospital stay was short, and on January 21, we started our journey back to Oklahoma.

After the surgery, we had several contacts with Martha, the nurse who works with Dr. Herring, and with Rosie in Child Life. They were instrumental in helping us with questions that arose post-surgery. It was only a few short weeks and then we were back at Scottish Rite following up with Dr. Herring!

At her appointment on February 13, she was cleared to meet with prosthetics to get the first casting for her prosthetic leg. We met with Director of Prosthetics Don Cummings two separate times before we returned on March 21 for her final fitting and physical therapy. Though the initial sessions of physical therapy were challenging, by the third day, Isa was standing and taking supported steps with her new prosthesis! Brenda H. and her team were amazing at making Isa feel comfortable, so she could take those amazing first steps. Child Life specialist Rosie, also visited with us and gifted Isa a stuffed cat, who has an amputation like hers. We spent three days with Don and Brenda who worked to adjust Isa’s prosthetic to the perfect fit. We are so grateful for the education and guidance they provided us. We even had time for a call to our oldest daughter, Tempe, who told us what color she felt Isa would like for the outside of her prosthesis: purple with sparkles. Don said he would work to make Tempe’s vision come true.

We will be forever grateful for the experiences we have had with the teams at Scottish Rite. This has been and will continue to be an amazing journey. 

How would you describe your overall experience at Scottish Rite?
The experience has been amazing. From our first contact to schedule the appointment with Dr. Herring and Dr. Podeszwa to our most recent visit with Don Cummings and Brenda H., we have always felt that everyone at Scottish Rite is there because they love the work they do each day. Each person you meet greets you with a smile and engages you in conversation. Everyone is helpful and always works to provide resources or direct you to the correct person for your needs. The facility is unlike anything else that we have ever experienced and truly works to give children back their childhood.

What are some things Isa likes to do?
Isa loves ANYTHING that her big sister does. She follows her around and always wants to play. Isa loves to play with Duplos and Fisher-Price® Little People. She loves Sesame Street®, especially Elmo® and Cookie Monster®. She loves being outdoors and going for walks. Isa loves being helpful. She will bring you your shoes if it is time to leave. 

She wants to help brush her teeth, and she puts away her toys when it is time to clean up. She loves to talk to others and show them things. Isa has a large vocabulary already and gains new words every day! Also, she loves to crawl and climb. Once she gets comfortable with her prosthesis, it is going to be hard keeping up with her!

 

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