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So You're a Legsmith: Richard Myers

Fitting challenging patients with lower-extremity prostheses

The Trade: The Irvine company Myers founded four years ago outfits about 200 amputees a year with lower-extremity, hard-to-fit prostheses. He welcomes the challenge every patient brings, from their first fitting to their last, a process that can take two weeks to three months.

A chance meeting at a trade show changed the lives of an amputee who tried on a new prosthetic—as well as the man working for the company that developed it. “I decided I wanted to help people rather than develop products,” says Myers, who was moved by what he saw that day. After nearly two decades of engineering medical devices and working for a prosthetics company, Myers struck out on his own with Southern California Prosthetics. He spends hours on his knees, studying a patient’s gait and making adjustments. “I’m a 53-year-old man doing a 25-year-old man’s job. But I absolutely love it.” In Myers' own words:

How’d this become your profession?
I was at a San Diego trade show some years ago, when the Renegade brand foot was introduced. A man who came by had the same foot size as the sample and asked to try it on. I fit him there in the booth, and watched as he walked up and down the hall. He started to move faster, and then broke into a run. When he came back to the booth, he told me with tears in his eyes that in 15 years since his amputation, he’d never been able to run until that moment.

Your background?
From 1987 to ’97, I made medical devices such as dental implants, cardiovascular products, and then started making prostheses. I was a vice president at Ossur, the largest company in the industry. I enjoyed solving challenging engineering problems, but I switched to a more hands-on approach, to do something more meaningful.

Who are most of your clients?
Amputees 55 and older with vascular disease constitute 70 percent of the market, and they are predominantly sedentary. But we specialize in patients who want to be active on a daily basis. For example, we have a patient in his 70s who is a triathlete, and one in her 80s who swims and plays various sports. Every amputee is unique; no amputation is the same.

How do you fit a prosthesis to the body?
The ideal amputation is about halfway up through the tibia, or shinbone, for a below-the-knee prosthesis. For one above the knee, the ideal fit is as low as possible on the femur. We also occasionally fit hip disarticulations in which the entire leg is gone, but that’s also fairly rare.

What are we talking, moneywise?
For an above-the-knee prosthesis, from $22,000 to $45,000; below-the-knee, from $6,000 to $15,000. An above-the-knee is higher because it has the joint with all its components, and it takes more time to fit. And microprocessor-controlled knees are extremely expensive—up to $100,000.

Microprocessors?
Microprocessor-controlled feet and knees have computers in them that sense what the amputee is doing at a given moment. The computer decides whether to increase or decrease resistance in the foot or ankle to enable a natural gait.

Can we assume prostheses are covered by insurance?
Most insurance companies do help pay for our custom-fit prostheses, and PPO plans cover services by out-of-network providers like us. Medicare patients usually are covered, but HMO patients aren’t. Insurance companies haven’t been accepting new participating providers for their HMO plans because they have providers that make prosthetics cheaply. It wouldn’t be possible for us to fit patients at those costs, because we often see a patient 10 to 15 times to make sure we get the correct fit, versus three to five times.

What makes your company different?
Most others are closed environments, where patients never see other amputees they can share their stories or experiences with. I didn’t want my facility to feel so medical, or like a shoemaker’s shop where you’re fitted once and never return. In most cases, our diagnostic socket would be their finished product. The socket is the most crucial element for a great prosthesis ... and as I say: “If the prosthesis doesn’t fit, the amputee will sit.”

But once it’s done, you’re done, right?
Prostheses last about three to five years. Like any mechanical part, they wear out. Amputees also have to keep their weight steady, or else they’ll need a new socket.

Let’s talk style.
We can put any kind of material or design on a patient’s socket. We have one patient who plays a pirate at Disneyland and we attached a wood-grain fabric to his prosthesis as well as a lower component that looks like a peg leg.

Any favorite patient stories?
When he was just 18 and stationed in Vietnam, Don Jackson, an Orange County resident, stepped on a tank mine that blew him 50 feet into the air. When I met him, he was in a wheelchair and wearing pants he’d cut off at the end of his residual limbs. After we fit him with prostheses, he walked for the first time in 45 years. He and his wife, Scheryl, met after he’d become an amputee, so they’d never danced. So we turned down the lights in our gym, set a boom box to the tune of their Lionel Richie wedding song, and they had their first dance.

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