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Category: Means of orthopedic/technical support other than prosth

Freebasing 3D shapes: wine glass holder [way to go]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Freebasing 3D shapes: wine glass holder [way to go]; published November 29, 2016, 06:09; URL: https://www.swisswuff.ch/tech/?p=6926.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Freebasing 3D shapes: wine glass holder [way to go]}}, month = {November},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6926}}


While the "bionic" hands are the current darlings of the hypsters, the hooks are the darlings of real people, i.e., those that actually work [definitions here / tongue in cheek / GOH DTE type stuff].

And with that, the real avenue for home improvement are the hooks.

That is where it's at, that is where the future lies, that is where the bear steps (hier steppt der Bär), that is where the pope boxes wearing a chain armour (da boxt der Papst im Kettenhemd).

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Bag or backpack design and convenience for right below elbow amputee [convenience demonstration]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Bag or backpack design and convenience for right below elbow amputee [convenience demonstration]; published November 28, 2016, 19:25; URL: https://www.swisswuff.ch/tech/?p=6917.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Bag or backpack design and convenience for right below elbow amputee [convenience demonstration]}}, month = {November},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6917}}


The question was posed as to whether a particular bag design works well, or what should be improved, for arm amputees. As we know, this blog is a technical right below elbow amputee issues blog and that is what I can offer.

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Stump after wearing myoelectric "bionic" prosthesis for 10 hours [graphic #voightkampff]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Stump after wearing myoelectric "bionic" prosthesis for 10 hours [graphic #voightkampff]; published May 5, 2014, 17:43; URL: https://www.swisswuff.ch/tech/?p=2979.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Stump after wearing myoelectric "bionic" prosthesis for 10 hours [graphic #voightkampff]}}, month = {May},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=2979}}


2 Comments

Any self respecting medical doctor, orthopedic surgeon, prosthetist, and "bionic" researcher will ask you - in a concerned professional way - "and, do you wear your prosthetic arm often, hopefully even daily?".

We also must accept that wearing "bionic" arms is nowadays assumed to constitute "human enhancement". This obviously is something I will directly and confrontatively label as bitter, ignorant, harsh and degrading cynicism.

If I do wear my prosthetic arm daily, in their view, that makes me a better human or even more human at the same time as I am, in their view, maybe not so much a better human but a "good doggy". Really and in fact, we have a reality split in that - at the same time and at once - my realities are two fold and split:

(1) Outside: On one hand, me trying to wear a prosthetic "super" hand - such as a "bionic" hand - makes my shape outline appear more like the shape outline of other people and so there is this aspect of possibly becoming a better, a deeper human. Conversely, the disfigurement of an arm stump thus makes me less of a human - and that is also what the face of many shee shee froo froo people, many so-called superficial people, will tell me when (or if) I look at them. Clearly, my amputated arm can make other people feel that I am less human. And it clearly does so on any given occasion. This is to a very small part remedied by me wearing this "bionic" apparatus - a machine for symbolism and "hope" far more than a machine for grasping, working, getting stuff done or feeling well.

(2) Inside: On the other hand, wearing a myoelectric arm is a really uncomfortable and skin damaging ordeal that is cumbersome and even in the best of all worlds painful. It feels bad to a degree, where I cannot possibly be totally human any more - as I have to push all normal human reactions such as pain, self respect, worry about the skin on my stump, fear of what all that pain does to me, etc. aside. There is a truly heartfelt authentic element in praising my stubborn wearing of a myoelectric "bionic" arm using the words "good doggy".

So, wearing a "bionic" myoelectric arm on the outside is an act of extreme humane-ness, it approximates the un-disfigured appearance like nothing else. As long as it does not approximate anything, it represents an 80'000 USD promise - and that is extreme in terms of symbolism.

At the very same time, what goes on inside the socket is beyond comprehension to many people - as it is not just not human, but worse, it has truly inhuman aspects. It lowers one, soul wise and as an individuum, in my view.

Here is how my stump looks like after a duration of 10 hours of wearing my iLimb Ultra Revolution at the office, typing and carrying light weight files, possibly holding a cup while rinsing it with water, photographed 1/2 and 7 hours after removing the prosthetic arm. To get the battery to last that long, I had switched the hand off for extended periods of time. Like, when I was typing. Never did my arm look like that after even hard work with the body powered arm such as jobs like hedge cutting [link], scrubbing [link] serious furniture moving [link] and so on. Yesterday I cut the hedges again, got rid of major amounts of stuff and moved a few hundred liters of green waste to the disposal with the body powered arm and really, the skin of my arm is not at all like what we see below - all is smooth and no problem. It is not the prosthesis as such that is a problem generally. It is the difficulty to achieve electrode fit and socket fit at once that really constitutes the "bionic" dilemma here, combined with hard lift and pull forces. Leg amputees can not understand from their own sockets, they experience different problems, not these. If it just was some simple body powered arms, or passive arms, we'd all be cool. Look, I am not saying "eeks, bad". I am saying, why the pansy boy type of immature excitement over what really is still problematic and massively overpriced technology when it comes to "bionic" arms? And here: can you reflect on the deeper meaning of what "bionic" arm wearing may entail?

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Plastic --- heals [new material]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Plastic --- heals [new material]; published July 11, 2013, 11:35; URL: https://www.swisswuff.ch/tech/?p=1766.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Plastic --- heals [new material]}}, month = {July},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=1766}}


Prosthetic arms and hands have three problems:

- comfort and fit

- function and weight

- decay

Even a bare stump is better in terms of comfort, fit and decay - mostly. Skin heals, often all one has to do is wait a little.

But now, self healing polymers are out.

From Sciencemag:

Chemists, meanwhile, have become increasingly interested in "self-healing" polymers. This sounds like science fiction, but several research groups have produced plastics that can join their cut edges together when scientists heat them, shine a light on them, or even just hold the cut edges together. In 2008, researchers at ESPCI ParisTech showed that a specially designed rubber compound could recover its mechanical properties after being broken and healed repeatedly. Chemical engineer Zhenan Bao of Stanford University in Palo Alto, California, and her team combined these two concepts and explored the potential of self-healing polymers in epidermal electronics. However, all the self-healing polymers demonstrated to date had had very low bulk electrical conductivities and would have been little use in electrical sensors. Writing in Nature Nanotechnology, the researchers detail how they increased the conductivity of a self-healing polymer by incorporating nickel atoms, allowing electrons to "jump" between the metal atoms. The polymer is sensitive to applied forces like pressure and torsion (twisting) because such forces alter the distance between the nickel atoms, affecting the difficulty the electrons have jumping from one to the other and changing the electrical resistance of the polymer. To demonstrate that both the mechanical and the electrical properties of the material could be repeatedly restored to their original values after the material had been damaged and healed, the researchers cut the polymer completely through with a scalpel. After pressing the cut edges together gently for 15 seconds, the researchers found the sample went on to regain 98% of its original conductivity. And crucially, just like the ESPCI group's rubber compound, the Stanford team's polymer could be cut and healed over and over again. "I think it's kind of a breakthrough," says John J. Boland, a chemist at the CRANN nanoscience institute at Trinity College Dublin. "It's the first time that we've seen this combination of both mechanical and electrical self-healing." He is, however, skeptical about one point: "With a scalpel, you can very precisely cut the material without inducing significant local mechanical deformation around the wound." Failure due to mechanical tension, however, could stretch the material, producing significant scarring and preventing complete self-healing, he suspects. Now, Bao and her fellow researchers are working to make the polymer more like human skin. "I think it will be very interesting if we can make the self-healing skin elastic," she says, "because, while it's currently flexible, it's still not stretchable. That's definitely something we're moving towards for our next-generation self-healing skin."

Links:

"MYO" - reasonably complex myoelectric control consumer electronics apparently widely available soon [PRODUCT ANNOUNCEMENT]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - "MYO" - reasonably complex myoelectric control consumer electronics apparently widely available soon [PRODUCT ANNOUNCEMENT]; published March 30, 2013, 11:05; URL: https://www.swisswuff.ch/tech/?p=1531.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - "MYO" - reasonably complex myoelectric control consumer electronics apparently widely available soon [PRODUCT ANNOUNCEMENT]}}, month = {March},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=1531}}


The "toy class" is under way.

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Is our society slightly off? Prosthetic aids pre-built-in? [weird thing]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Is our society slightly off? Prosthetic aids pre-built-in? [weird thing]; published March 17, 2013, 18:17; URL: https://www.swisswuff.ch/tech/?p=1513.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Is our society slightly off? Prosthetic aids pre-built-in? [weird thing]}}, month = {March},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=1513}}


Our society in general tends to maintain a public space that is minimally accessible to "everyone". Much rather, it is minimally accessible to most people, statistically speaking.

That means, people that have difficulty reading small stuff, people with manual handicaps, people that are hard of hearing, wheelchair users and others are meant to have a hard time. By design, so to say.

So I was extremely surprised to realize that around 3-4 years ago, Hero marmalade glasses started to become a lot easier to open. Then I was very surprised to see how cash register clerks in supermarkets started to be increasingly helpful when one tries to lug stuff with just one hand and half arm or so. And then.... this? Supermarket carts with magnifying glasses?

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Alternative to key lanyard: cable tie [tech tip]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Alternative to key lanyard: cable tie [tech tip]; published November 7, 2011, 14:09; URL: https://www.swisswuff.ch/tech/?p=504.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Alternative to key lanyard: cable tie [tech tip]}}, month = {November},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=504}}


I always seem to have problems with keys. Mostly that is because I need my (left) hand to handle car door, luggage, door handles and other stuff. So the prosthetic needs to be able to hold on to and handle keys.

Recently I found that cable ties are great because they are dirt cheap, widely available and super useful.

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Stump warmers - for my arm I can mail order baby leg warmers [product info]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Stump warmers - for my arm I can mail order baby leg warmers [product info]; published October 9, 2011, 12:07; URL: https://www.swisswuff.ch/tech/?p=492.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Stump warmers - for my arm I can mail order baby leg warmers [product info]}}, month = {October},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=492}}


While knitting one's own tube socks can be an affordable and convenient thing, ordering them online is a real option as it turns out more people like to sew and knit stuff than meets the eye. So, why not take advantage of that.

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Stump warmers - sewing tubes [product info]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Stump warmers - sewing tubes [product info]; published October 9, 2011, 11:09; URL: https://www.swisswuff.ch/tech/?p=491.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Stump warmers - sewing tubes [product info]}}, month = {October},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=491}}


1 Comment

My god child and her family have one toy that is a tube knitting machine. It is made from plastic and as that it is prone to break. In fact, one part broke but her mother succeeded replacing it herself even though it was rather hard to get that done. But all in all most of us are rather crafty ; )

To keep my blue cold freezing under-circulated stump warm, as that reduces stump pain and phantom pain, a tube knitting option isn't necessarily bad to have so I figured y'all might want to have a look.

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Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]; published September 25, 2011, 16:33; URL: https://www.swisswuff.ch/tech/?p=487.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]}}, month = {September},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=487}}


CNN posts an article with a letter of Sheila Advento where she appears to wholly embrace her transplanted hands1. Also, there is a video on Youtube to watch [link]:

Obviously she is a lot better in terms of progress as other transplant recipients some of which have almost no perceptible progress of function, and also, we have not seen the end of her story - - but come what may we wish everyone all the best all the time for anything they would wish for. Obviously.

But this is a right below elbow amputee blog and I am more interested in Waldorf & Statler type comments and so let's have a look at what else.

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Comparison of various aspects of below elbow amputation options [prostheses, no prosthesis, surgery]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Comparison of various aspects of below elbow amputation options [prostheses, no prosthesis, surgery]; published July 6, 2011, 23:20; URL: https://www.swisswuff.ch/tech/?p=452.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Comparison of various aspects of below elbow amputation options [prostheses, no prosthesis, surgery]}}, month = {July},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=452}}


Comparing various means for rehabilitation one will invariably have to weigh one issue against the other. And mind you - a lot of the problems are not apparent at the desk, or in theory. A lot of the nasty and sometimes long term problems manifest themselves only in blood, flesh, juice and when putting things to action.

The following overview and table (below) give an overview over my current rating of various aspects. These relate to options regarding what to do with the damaged arm.

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Robotic Arm Kit [tinkerers' corner]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Robotic Arm Kit [tinkerers' corner]; published May 28, 2011, 11:04; URL: https://www.swisswuff.ch/tech/?p=419.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Robotic Arm Kit [tinkerers' corner]}}, month = {May},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=419}}


There is a Robotic Arm Kit you can buy for less than 60 USD. This should get your attention...

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Electric heating for my prosthetic arm [tech build / instructions]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Electric heating for my prosthetic arm [tech build / instructions]; published December 27, 2010, 01:43; URL: https://www.swisswuff.ch/tech/?p=378.

BibTeX: @MISC{schweitzer_wolf_1573557991, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Electric heating for my prosthetic arm [tech build / instructions]}}, month = {December},year = {2010}, url = {https://www.swisswuff.ch/tech/?p=378}}


2 Comments

I am suffering from the combination of cold and bad circulation in my stump. It causes a blend of stump pain, an increase in phantom sensation and ultimately phantom limb pain [6].

To specialists, this is a well known issue and not a rare problem; particularly, venous drainage problems have been documented to correlate with stump and phantom pains [1]. Vascular return is particularly a problem with longer forearm stumps [2,3], and in my instance, that issue was known and declared to me even before the amputation by the surgeon, however, having a long stump has a lot of advantages as well. Compressing the stump helps to decrease the cross section of my arm veins as all cutaneous veins are compressed and thus pressure is higher in the deeper veins - a well established observation also for legs, where a certain well balanced venous compression (but not too much of it) has been documented to increase flow [4,5 - see text cited with these references below for details about pressure]. What treats the congestion well is a relatively tight fit of a prosthetic socket, or a tight compression sock, or a tight bandage. I wouldn't just say snug, I'd really need it tight - but not too tight [6].

To make things worse, a vicious cycle seems to occur at the moment my poorly circulated stump is cooled down significantly. Then, circulation gets minimal rather quickly and pains of stump and phantom hand get severe and hard to bear. Normally, phantom sensations and pains as they occur daily are no big issue - one does get used to these. But that type of extreme pain is a warning signal. So I decided to take that signal serious and after getting what they call 'minor frostbite' on my stump from a skiing weekend, I went forward to research the issue of heating the prosthetic arm externally and to build such a heating from available parts. For my condition - bad venous drainage, bad vascular return, cold vicious cycle - a moderate but steady heating that would fit inside the prosthetic arm and that would last for a steady few hours and not peak over only minutes was what I needed.

Now seeing as if that is a really medical application, why not say one word about that. My arm stump has a reduced ability to sense temperature. That means if the darned thing gets too hot, there is a really good chance I will only know once it is too late. Logically I will opt for a less aggressive heating, and exclude heat pads (see below). As I am doing this completely cross label, using parts that were not designed for this application, I am doing this the usual test pilot way - test extensively, check extensively, but take a certain risk as well. If anyone was to sell such pads for prostheses you will have to get really good insurance, as stumps and prostheses in winter are a really complicated subject you may just not want to get into. This is for people that are in the position to try it out themselves and take any consequences necessary at any given point in time.

So, here we go.

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