Frequently Asked Questions

I am an active above the knee amputee and would like to know how I can get my insurance company to pay for a C-Leg that all the military veterans are receiving from the V-A?

There are a couple of different types of micro-processor knee units available and it is becoming more of the "norm." These prosthetic knee systems have proven to give the patient more control and greater stability no matter what age the patient is. Medicare does recognize the benefits of the micro-processor knee and has set fee screens for it. You need to check with your specific insurance carrier to see if they will cover it. We have had good results in presenting the proper information to the insurance carrier and eventually, having them accept it. If you need assistance with this or any other insurance issue call my office at 800-980-3000.

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My leg brace is so heavy. Is there anything lighter?

Leg braces can feel heavy for many reasons. Broken springs or stirrups, and too much play in the mechanical joints can make the orthosis seem heavy. Physical changes, like muscle contractures and muscle weakening also affect how heavy the brace feels while wearing it. There are several options now using lighter materials like titanium and carbon, as well as new technology that allow knee joints, for instance, to lock and unlock safely while walking. This allows a more normal stride as opposed to a “stiff knee gait,” which is very hard on the entire body.

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I am 37 years old and was in an auto accident 4 years ago that left my left ankle crushed. I have had multiple surgeries and am living in constant pain. My doctor gave me a choice of either having an amputation or live the rest of my life on pain medication. If I chose the amputation, would I still be able to work and have a normal life?

I have consulted with many patients who had to make a decision such as yours. It is not an easy decision, I know, but to help make you more comfortable with the decision you need to know what wearing a prosthesis entails. During the consultation I give the patient information detailing the prosthetic treatment plan and an approximate time frame for the different segments. Also, I have them talk with other amputees who have been through similar situations. Your understanding of what takes place will have a positive impact on your rehabilitation. In most cases, after the rehabilitation period, I would expect you to return to an active lifestyle.

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My seven year-old child was in an accident that left him without his right leg just below the knee. I was told that he will need several prosthesis before he becomes an adult. Is this accurate? And does insurance pay for these?

As your child grows it will be necessary to adjust the prosthesis to achieve the proper fit. Just as their feet grow and need to change sizes in shoes, so does the residual leg. Once adjustments can no longer be made to accommodate the growth change then either a portion or the entire prosthesis will need to be re-made. Depending on growth spurts, it’s not uncommon to have to remake a prosthesis in the same year. In most instances, insurance will pay for the components that they previously covered. Your prosthetist should have accurate records to document changes to make things go smoothly.

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My father is retired and has Medicare Advantage, how is his prosthetic care going to be covered?

He can go to any Medicare participating provider and receive his prosthetic care. If you need to know more specifics of what your Medicare Advantage policy covers, contact Linda at 1-800-980-3000.

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How do you decide which brace a person should receive?

We work from a physician’s prescription. Sometimes the choice for the ideal orthosis for each patient is obvious. However, for most custom orthoses, a complete consultation is necessary. This typically involves the following: a physical evaluation of involved extremities, muscle testing, gait analysis, related medical history, and a potential conference with a physical or occupational therapist. The physician is often contacted for insight as well. Finally, each orthosis is fabricated based on the important activities the patient performs on a regular basis.

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I have noticed more high school, college, and professional athletes (primarily basketball players) wearing clear plastic, face masks during the game. Why is this?

Facial trauma is common in contact sports. Fractures to the face generally stem from direct blows. Athletes are anxious to return to practice and competition as soon as possible, thus requiring a plastic face mask for protection. We custom fabricate these masks in our lab from an impression of the patient’s face, which is generally taken with dental alginate and plaster. The function of the mask is to distribute forces across a large surface area, thus preventing further injury. Athletes report excellent success in preventing significant injury by using the mask. We have also custom fabricated shin guards for soccer players and elbow wrist orthosis for gymnasts.

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My five year old child was diagnosed with cerebral palsy and wears AFO’s (Ankle Foot Orthoses) to improve her walking. The problem is, she does not like to wear them. Any suggestions?

Maybe she feels self-conscious about being different than the rest of her peers. The parent can help reassure their child by making the AFO’s a normal part of her daily routine. Encourage her to take part in recreational activities to get the functional benefit of the orthosis. We also have a variety of transfer patterns and decals for kids to choose from, to personalize their AFO’s. If your daughter feels good about her orthoses, she is more likely to wear them. Also, as your child grows, the AFO’s could cause discomfort by not fitting properly. This can be adjusted by the orthotist to accommodate pressure areas. Depending on growth spurts, it’s not uncommon to have to remake an orthosis in the same year. In most instances, insurance will pay for the same material and components that they previously covered. Your orthotist should have accurate records to document changes to make things go smoothly.

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I am a 52 year-old male with degenerative arthritis in my knee. Is there an alternative to a knee replacement?

There are many different knee orthoses that unload the affected compartment. We offload the knee by a few degrees and prevent any friction between bones, most commonly, in the medial compartment. It is not a permanent fix, but it can prolong surgery for a couple years. These orthoses are designed to reduce symptoms and stabilize the knee to help delay the degeneration of bone and cartilage.

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I am an amputee and a working mother. I need to dress up for my job and would like to wear different heel height shoes. The only other woman I know that wears a prosthesis has to change the prosthetic foot to match the heel height of the shoes. Is there anything else available?

There are at least three types of prosthetic feet that will adjust from a sandal height to a 2” heel. Improvements have been made to these feet recently and with a touch of a button, are much more “user friendly.” There are some limitations to using these feet, however. Consult your prosthetist on your particular situation to see if this would be an option.

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My 87 year old mother recently had an amputation surgery. At her age, will she be able to walk with a prosthetic leg?

Many people are able to return to walking at or near pre- surgical levels. No matter what age limb loss occurs. Age is a factor but less important than other issues. What is your mother’s general medical condition? Was she walking before her surgery? Is she mentally alert? Strength, attitude, family support etc. are all factors to consider. A prosthesis is not a solution by itself. Rehabilitation is needed to oversee the recovery process to achieve the return to normal activities.

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If my insurance does not cover orthotic or prosthetic devices that I need, do I have any payment plan options?

We do realize that there are many health care policies that may have a rather large deductible and/or co-pay. Many employers are also downsizing the health care coverage that they are offering their employees. This facility works with financial institutions and credit companies on a regular basis. There are “no interest” loans to cover medical expenses that are not covered by your insurance policy. We have a list of several non-profit organizations that will assist with medical expenses if certain criteria are met. Linda, our business manager, can help assist you, call 800-980-3000.

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My son was born with a symmetrical head shape, however when he was about two months old, I noticed one side of his head being flat. What caused this and can it be fixed?

Your son is presenting with a cranial deformity termed, plagiocephaly. Several factors often play a role in causing this deformity. Due to SIDS (Sudden Infant Death Syndrome), parents are putting their babies to sleep on their backs. Also, since car seats can be removed and attached to a stroller, babies are spending most of their time on their backs and not encouraged to be on their tummies or sitting up. Finally, the majority of these kids are often bottle-fed. Alternating the arm that holds and feeds the baby is often overlooked, whereas with breast-fed children, it’s a necessity. This deformity can be treated conservatively with a cranial remolding helmet, as long as it is used within the ages of 3 – 12 months. This orthosis is custom molded and is worn 23 hours per day. Better results are achieved when treatment starts sooner. Check with your pediatrician or family physician to see if there is a need for treatment.

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I had a stroke several years ago and was prescribed an AFO for foot drop in the hospital. Recently, I’ve noticed the AFO rubbing my ankle raw. What should I do, so that I can wear this orthosis again and ensure that I don’t trip and fall?

We can perform adjustments on this AFO to relieve pressure at the ankle. You can call our office and schedule an appointment to have an orthotist look at the fit of the AFO and evaluate your gait. Adjustments can be made to the orthosis to relieve the pressure and optimize the function. Also, new components and styles of these AFO’s continue to change. If the structural integrity of your current AFO is compromised, or you are interested in seeing other types of AFO’s, just ask your orthotist. Maybe there is a type of AFO available that will better suit your needs.

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I am 41 and just learned that I am a type 2 diabetic. My brother has been a diabetic for 10 years and had to have an amputation and now wears a prosthesis. Is there anything you would recommend I do to prevent further complications?

Diabetes affects the vascular system, primarily, in the lower extremities. Blood flow is restricted and the feeling sensation in the feet and legs is reduced. It is very important to have the proper fit and style of shoes to prevent the development of any sores on the feet. It is recommended that you see a podiatrist for foot care such as nail trimming. As one physician once told me “all sores or cuts to the foot or leg do not end up in amputation surgery but all amputations are the result of a sore or cut to the foot in the diabetic patient.” Preventative measures are you best bet.

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What is the difference in a knee brace if I purchase one at the sporting goods store or at your office?

A knee orthosis does not fix your problems totally, but provides structural support to relieve pain, allow stability or improve alignment. These functions are often overlooked in knee orthoses offered through sporting goods stores. At our office, a certified orthotist will measure and take an impression of your knee, if necessary, to assure proper fit of the orthosis. Knee orthoses can often be adjusted to relieve certain compartments and allow so many degrees of flexion and extension. This is also true for other joints (such as the elbow, wrist, ankle, etc.). If your doctor recommends a knee orthosis, an orthotist will address the specific problems to insure the proper orthosis is fit.

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I am on Medicare and am a diabetic. I heard that Medicare will pay for a pair of shoes for me, is this true?

Medicare will pay for one pair of shoes and inserts for those who meet certain criteria:

  1. You must have Medicare Part B;

  2. you must be a diabetic with a doctor monitoring your diabetic condition

  3. you must meet certain physiological conditions determined by your physician.

Contact your doctor about writing a prescription for diabetic shoes and inserts. Once we see you, we will send a medical necessity form for the doctor to fill out. We have a foot clinic every Thursday with a certified Pedorthist evaluating each case.

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My father is a diabetic and just had an amputation below the knee. He is retired and prior to the surgery, was very active around the community. He has been laid up for 6 months and has lost a lot of strength, energy, and motivation. What benefit will there be to get a prosthesis if he is depressed?

It is not uncommon to feel depressed after having an amputation. There is a grieving process that most people experience because of the loss of a limb. First, I would talk with the physician to see if your father was able to have physical therapy to regain some of his strength. Once that is achieved he will be ready to be fit to a prosthesis. There needs to be strong family support to encourage him through the process. Fitting a prosthesis is a process that involves a “team” approach, including the physician, physical therapist, family, and the prosthetist. When everyone works together, it will all fall into place.

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I am 52 years old with type 2 diabetes. Two months ago I developed an ulcer on the bottom of my foot because of poor fitting shoes. I bought new shoes and tried various treatments but the ulcer has not healed. I am still working and need to be on my feet to perform my job. Is there any orthotic device that can help me?

Yes. A custom made Healing Boot, also known as a C.R.O.W. or Clamshell Walker, can promote healing while you keep walking. The Healing Boot is designed, specifically, to take weight off of the ulcerated areas while evenly loading the remaining plantar surface of the foot. The ankle is held in a neutral position which prevents movement of the foot. A rocker bottom sole is applied to allow a natural rollover, when walking, while keeping the ankle in a fixed position. We have had good results healing diabetic ulcers and stabilizing Charco ankle deformities. If you are interested consult your physician and call my office for a free evaluation.

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